Dengue Fever outbreak worsens in Hawaii as 139 people sick

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dengue.jpgThe number of cases of dengue fever in Hawaii has risen to 139, prompting health authorities this week to warn residents and travelers to the popular winter vacation destination to take precautions to avoid contracting the virus.

The Department of Health said in its latest statement on the outbreak that 122 residents and 17 visitors on Hawaii Island, the largest of the state's eight main islands, have been confirmed to have dengue fever.

The first cases in the current outbreak were traced back to September, and over time they developed into what is now being treated as a cluster of 108 adults and 31 children. The cluster has now grown to rival the last major dengue outbreak, which took place in 2001 and lasted about 10 months with 92 cases on Maui, 26 on Oahu and four on Kauai.

The outbreak is taking place at the start of the island's peak tourism season, which usually begins around mid-December and lasts until March or mid-April. The Hawaii Tourism Authority published an alert last month instructing tourists to take precautions against the illness.

"Of the confirmed cases, 122 are Hawaii Island residents and 17 are visitors," the state department of health said in an update released Monday.

But there's not much they can do, an expert at the Centers for Disease Control and Prevention said.

"Dengue control is extremely difficult. We don't have a very good way of stopping dengue outbreaks," said Dr. Lyle Petersen, an expert on mosquito-borne infections at CDC who's just back from Hawaii.

"Maybe you can slow it down somewhat but there's no way to stop it."

That's in part because dengue usually causes a very mild illness, so people are still apt to go outside, where they are likely to be bitten by mosquitoes - which in turn will spread the virus to others.

Petersen says there are "clearly" more than 139 cases now on Hawaii. "You can't count them all. You are counting people going to the doctor and seeking medical help and getting tested. But people with more mild illness may not go to the doctor," he said.

Dengue is carried by mosquitoes - especially the Aedes aegypti mosquito that thrives in tropical zones. There's no treatment for dengue and no vaccine.

It can cause a very severe form called dengue hemorrhagic fever, which kills 20 percent of victims, although good medical care can lower death rates dramatically.

The last real dengue outbreak in Hawaii was in 2001 and 2002, and lasted nine months. This outbreak may have been driven by a lot of recent rain, Petersen said.

Dengue has been moving into the continental United States, especially in Florida and south Texas.

The CDC's keeping an eye on two other mosquito-borne viruses - Chikungunya and Zika. "Chikungunya and Zika are spread by the same mosquito," Petersen said. "We are definitely worried about one of those viruses being introduced on Hawaii."