Department of Health ramps up dengue testing in Hawaiʻi

A sharp rise in dengue around the world and in Hawaiʻi has prompted the Hawaiʻi Department of Health to update dengue testing criteria to strengthen the department’s detection and rapid response capabilities.

So far this year, there have been seven confirmed dengue cases in Hawaiʻi, all travel-related, putting the state on track to surpass the 16 travel-related cases in 2024. In previous years, there were only about four cases annually. Several of this year’s dengue cases came from exposure during travel to other Pacific Islands currently experiencing outbreaks.

The increase in travel-related cases increases the risk of locally acquired infections possibly leading to an outbreak. In Hawaiʻi, there have been three local dengue outbreaks since 1946:

• On Maui, Oʻahu and Kauaʻi in 2001-02.
• On Oʻahu in 2011.
• On Hawaiʻi Island in 2015-2016. This outbreak had 264 confirmed cases, 238 of them Hawaiʻi Island residents.

Dengue is transmitted from an infected person to a mosquito, and then to another person. Identifying cases as they arise and responding immediately with mosquito-control measures is essential to prevent the spread of dengue locally. 

To that end, the Health Department has issued a medical advisory to healthcare providers, urging them to test for dengue in all persons with highly clinically compatible illness, and to consider the possibility of locally acquired dengue, regardless of travel history. Also, providers are urged to report suspected dengue cases immediately to the the department’s Disease Investigation Branch.

Facts about dengue

Vectors: The bite of an infected Aedes aegypti or Aedes albopictus mosquito. Aegypti is found on Hawaiʻi Island, while albopictus is widespread throughout the state.

Symptoms: Symptoms usually appear five to seven days after a bite. They include a sudden onset of fever, severe headaches, eye pain, joint and muscle pain, and rash. Symptoms typically last two to seven days. While severe illness can occur, most people recover within a week. Some people with dengue have blood clotting problems, a serious illness known as dengue hemorrhagic fever. Contact your healthcare provider if you develop symptoms after a mosquito bite.

Geographic areas of origin: Some countries are reporting increased dengue cases, including Fiji, French Polynesia, Tonga, Philippines, Brazil, Colombia and Mexico. Travelers should review up-to-date country-specific travel information for guidance on dengue risk and prevention measures at least four to six weeks before traveling.

Protect yourself: Wear protective clothing, use insect repellent and bed nets and sleep in air-conditioned rooms when traveling to areas with dengue risk. After returning home, avoid mosquito bites for three weeks.

Fight the bite: Eliminate standing water around your home where mosquitoes can breed. Fix holes in windows and screens.

If you get dengue: Bed rest and acetaminophen (NOT aspirin or ibuprofen) to treat fever are recommended. There is no specific treatment for dengue. Stay indoors and avoid mosquito bites during the first week after your symptoms started, or until your fever resolves (no fever for 24 hours without use of fever-reducing medications), whichever is later.