Dengue is a serious disease caused by a bite from an infected mosquito. With many popular surf spots in overseas endemic Dengue areas, we generally have a few cases brought back every year. On Maui aggressive steps, under Public Health officer Dr. Lorrin Pang, to prevent Dengue from taking hold in our local mosquitoes has isolated these cases and prevented a recurrence of the 2001 situation where East Maui mosquitoes became infected with Dengue.
Prior to that, the last known Autochthonous (caused by our mosquitoes rather than contracted overseas) dengue infections in Hawaii were in 1944. Allowing dengue to get a toe hold in our home-grown mosquitoes, would be a disaster. For instance the island of Bali has yearly outbreaks which fill their hospitals to 100% occupancy.
But now dengue has taken hold on Big Island.
The Maui outbreak was stopped and eradicated by a major public information campaign including flyers and free mosquito repellent placed along the Road to Hana, public service announcements on TV and radio, community meetings and close monitoring of possible cases. The Public Health department on Maui still insures that dengue doesn’t take hold by eradicating mosquitoes around a suspected case home and going door to door to warn neighbors to eradicate mosquitoes, take precautions not to be bit and be aware of symptoms.
But what is Big Island doing? According to residents, not much.
Oahu office is overseeing the crisis but it is not clear that they are responding to the outbreak with the quick action that is required to prevent dengue from becoming entrenched on Big Island (and as we’ve seen with the coqui frogs and Little Fire Ants, spreading to the rest of the Hawaiian islands).
- They have not identified the infected areas. Kona-Kailua, Kaloli Point, and Volcano have been mentioned in social media as sites with dengue cases but DoH is mum.
- They have not done education outreach
- It is unclear as to whether they are even eradicating mosquitoes around infected patients and warning neighbors.
Since the Health Department is letting us down on this threat, it is up to the residents to do their job for them. Make sure this information gets out.
- Clean up all old tires and containers which could hold water for mosquitoes to breed in. Plants which hold water at the base of their leaves like Bromeliads should be taken out or squirted daily with soapy water.
- Wear mosquito repellent. Consider a mosquito net for your bed.
- If you experience fever, bad headache, bone aches and fatigue, suspect dengue and report it to Oahu Dept of Health at 808 586-8362. Rash is also a symptom in some cases.
- If you suspect you have dengue, your biggest danger will be dehydration. Dengue attacks the platelets in blood. These are the clotting factors and with low platelets you may have many small hemorrhages which appear as red dots (especially on the feet) and dark dots obscuring your vision. Don’t worry, all this will go away a few months after you recover. Your immediate danger is shock due to loss of fluids.
- Have someone take care of you and insure you have plenty of fluids and are fed.
- Tell your doctor you suspect Dengue and that they should take a platelet count. Your platelets don’t start dropping until a few days after the other symptoms appear. If they drop below 80,000 you might need to be hospitalized for supportive care like IV fluids. There isn’t much else that you can do.
- Stay in bed and rest.
- Notify your neighbors and give them this information
- Allow Dept of Health to spray around your house to kill the infected mosquitoes. I know many people don’t like pesticides (with good reason) but this is one of the few circumstances where they are life savers and worth the side effects.
- Organize community information sessions and make sure the Dept of Health shows up to educate and inform residents and visitors.
- Visitor accomodations should inform visitors about wearing mosquito repellent.
If the Big Island Department of Health won’t get on the ball and treat this as the emergency it is, we will have to pick up the slack. Here are some informational handouts: