KAILUA-KONA — Some Ironman athletes are already fatigued, and the race won’t even begin for another two days. ADVERTISING KAILUA-KONA — Some Ironman athletes are already fatigued, and the race won’t even begin for another two days. The source of
KAILUA-KONA — Some Ironman athletes are already fatigued, and the race won’t even begin for another two days.
The source of their weariness has nothing to do with physical exertion and everything to do with an inundation of medical alerts involving international travel, as several triathletes compete in events all over the world.
It was a dengue fever outbreak that most recently gripped Hawaii Island, with more than 250 confirmed cases occurring between September 2015 and March 2016.
But as Ironman approaches, bringing with it more than 2,300 participants from 64 countries and territories across the globe, the disease du jour is Zika — a mosquito-borne illness that medical experts believe poses the greatest threat to pregnant women, in particular the fetuses they carry.
According to the Centers for Disease Control, there have been confirmed outbreaks of Zika in nearly 60 countries worldwide including the United States. Still, several Ironman competitors approached the topic Wednesday either tiresomely or with an air of nonchalance.
“I know I’m supposed to be concerned, but there are so many things to be worried about, so I just try to skip everything and if it happens, it happens,” said Mikael Nelker, a 38-year-old stockbroker from Sweden. “If it happens, then maybe you register something, but otherwise, it’s just everybody crying wolf.”
Nelker isn’t without a point.
According to the DOH, as of Oct. 3, there have been 10 confirmed cases of Zika throughout the state, although all of the afflicted were Hawaii residents who contracted the disease abroad. There have been no confirmed cases of anyone contracting Zika while in the state.
But all it takes is one.
Statewide coalition
Department of Health spokeswoman Anna Koethe said the DOH has partnered with the Department of Transportation (DOT), the Hawaii Tourism Authority (HTA) and Ironman in a proactive approach to build the strongest possible first line of defense.
The foundation of that defense is public education, said Eric Honda, environmental health branch chief for the Hawaii District Health Office. Efforts surrounding the Fight the Bite Campaign, for instance, had a leg up heading into Ironman as they were initially coordinated back when dengue took hold.
“Talking specifically about Zika, only one in five people are symptomatic, and even those that are symptomatic, the symptoms are so mild as compared to dengue that they might not go to the doctor and get tested,” Honda explained. “(People need to be aware) and take precautions not to get bit. Upon coming home, even if they feel slightly ill, they should go to the doctor and get tested.”
A large part of the state’s effort to spread awareness about the often clandestine danger Zika poses and the necessary precautions has centered around signage throughout Hawaii’s airports and harbors.
Tim Sakahara, DOT spokesman, said overt signs and banners with informational tips can be seen at exits and baggage claims across the state.
The department has also worked to set up digital warnings to flash on baggage claim monitors. Insect repellent stations, too, have been erected at points of entry throughout Hawaii.
Messaging doesn’t always hit home
Unfortunately, however, the warnings don’t always produce the desired effect. Kayla Kielar, 33, of Redwood City, California, said she didn’t notice any signs about Zika at the airport.
“I knew it was happening in Florida because when I went there, they made a big deal when I travelled,” said Kielar, adding that the airline may have even made an announcement. “They just warned you about it that Zika was there.”
Filipe Aragao — a 31-year-old who travelled to Kailua-Kona from Brazil, where the threat of Zika was widely publicized during this summer’s Olympics — also said he didn’t receive any information, either at the airport or through race communications.
He mentioned overhearing some concerned travellers mention the disease while en route to Hawaii, but that it hasn’t been a topic of conversation among athletes since his arrival.
Both Aragao and Kielar said applying insect repellent won’t be part of their pre-race routines.
“In some specific points in the country you have it, but in my city, it was simple. It was not near for me,” he said. “And to be fair, I’m not thinking about Zika or mosquitoes.”
None of the athletes said they’d received email notifications about the threat of Zika. But Diana Bertsch, Ironman race director, said the organization worked with the DOH on crafting a message and disseminated it as widely as possible.
“We have done everything we can as far as our social media avenues and our direct email avenue to get the message to the athletes,” said Bertsch, adding that media members were also contacted.
Still, some Ironman athletes weren’t particularly fearful Wednesday, and Kielar said she hadn’t even considered the prospect of Zika as a problem whatsoever.
George Szigeti, president and CEO of the HTA, said fear isn’t the goal. The messaging HTA helped coordinate was crafted specifically so that it wouldn’t read as fear mongering — the same strategy that was employed during the dengue outbreak, which had no measurable affect on tourism numbers.
“Our message isn’t one of fear, it really is one of education,” Szigeti said. “I think the people see Hawaii as a safe, clean, welcoming destination. That’s why this summer will close as the best summer ever with visitor arrivals coming to Hawaii.”
Alternate approaches
While spreading the word has been the primary objective in combating the potential of Zika taking hold in Hawaii, other measures have also been employed.
One such method is approaching the problem from a vector standpoint rather than focusing only on the human component. Honda said vector control teams have been working continuously in the field, conducting surveys and applying control measures where necessary at resorts up and down the Kohala Coast, from Mauna Kea Beach all the way to Keauhou Bay.
There has been discussion in the past of screening incoming visitors to Hawaii for diseases like Zika, and pilot programs were even tested in previous years following concerns about pandemic flu.
But Dr. Sarah Park, Hawaii state epidemiologist, said the process proved unfeasible because of incubation periods and false positives.
“It ends up being a lot of effort for very little gain,” she said. “Were able to do it, but it took so many months of effort and a lot of coordination just to screen a couple of flights. We didn’t detect any ill people at the time and we don’t know if any one of them could have been ill at any point later on.”
Park added that one element of Zika often overlooked and which residents and visitors alike must take into account is that the disease is sexually transmitted. She said taking standard precautions to protect against typical STDs should prove equally as effective in curbing the spread of Zika.
