Hawaii reports outbreak of dengue fever

Local health officials are working to control the spread of first endemic transmission of the tropical disease since World War II.

By Victoria Stagg Elliott, AMNews staff. Oct. 15, 2001.

The Hawaii Dept. of Health is struggling to control an outbreak of dengue fever in a rural area of east Maui, according to the state agency.

Since the middle of September, 18 cases have been confirmed. None of those with the infection had a history of travel to dengue fever areas. The outbreak is being considered the first endemic transmission on the island in more than 50 years.

"We'd never seen folks who hadn't traveled become infected," said Paul Effler, MD, MPH, a state epidemiologist in Hawaii. "It's puzzling to us. Why this time? Why this location?"

The new situation is being watched closely by public health officials around the country, including Texas. Although there have been no reported cases in the state, this year or last, recent outbreaks south of the border have the health department there braced for possible impending trouble.

"We're hearing a lot of reports now about dengue fever in South and Central America, so it's just a matter of time before we have another outbreak," said Julie Rawlings, MPH, an epidemiologist with the Texas Dept. of Health.

Dengue fever has no cure, although a vaccine is currently in clinical trials. The only ways to combat it are vigilant surveillance and controlling the mosquitoes that spread the virus.

These steps, however, are hampered by problems with diagnosis. The mild form of the disease is characterized by symptoms that can be easily confused with the flu. The disease is also just not seen that often in the United States.

"It's important to get the right diagnosis if there are mosquitoes in the area that can transmit it," said Dr. Effler. "You also don't want to treat them inappropriately for other things." [...]