Two possible cases of dengue fever on the Big Island

State health officials are investigating two possible cases of dengue fever on the Big Island.

Deputy State Epidemiologist Melissa Viray would not identify who the patients are or where they live, saying only that they are from the Big Island. She also chose not to say whether they are related or whether they are from the same part of the island, citing privacy concerns.

The illnesses were reported to the state Department of Health last week, Viray said.

Blood samples have been sent to experts at the Centers for Disease Control and Prevention in Ft. Collins, Colo. They will perform tests following a preliminary analysis conducted by the Hawaii DOH. Depending on delivery times, the follow-up testing results could be available next week.

“There are two cases on the Big Island where dengue fever is one of the possibilities we’re considering,” Viray said of the diagnosis process. “Right now, we’re still in the middle of our investigation, and we’re still awaiting confirmatory testing from the CDC. … It’s a little too early yet to know whether it’s dengue or another infection.”

Viray would not say what kind of symptoms had been observed in the patients, only that they resembled those of dengue and other mosquito-borne illnesses, like the Chikungunya virus.

There have been limited outbreaks of dengue in Hawaii in the past, she said, including Pearl City in 2011 and on Maui in 2001. Both times, however, “we squashed it,” she said.

Over the last week, Health Department workers have “done assessments of the environmental area around the homes and workplaces,” of the affected individuals, she said. “We haven’t seen any evidence of the mosquito.”

There are several types of mosquitoes in the Hawaiian Islands, but only a couple that could carry a disease like dengue, Viray said.

“We do have the Aedes (aegypti) species of mosquitoes, and the (Aedes) albopictus, which are very prevalent on all the islands in the state. We worry about it, because it can transmit some of the mosquito-borne illnesses we see elsewhere in the world,” she said.

The principal symptoms of dengue fever include high fever and at least two of the following: severe headache, severe eye pain (behind eyes), joint pain, muscle and/or bone pain, rash, mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising), and low white cell count.

The CDC advises members of the public go immediately to an emergency room or the closest health care provider if any of the following warning signs appear: severe abdominal pain or persistent vomiting; red spots or patches on the skin; bleeding from nose or gums; vomiting blood; black, tarry stools (feces, excrement); drowsiness or irritability; pale, cold or clammy skin; or difficulty breathing.

Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.