The Hawaii Department of Health (HDOH) has reported four additional dengue fever cases Friday on the Big Island  bringing the total in the outbreak of locally acquired cases to 38.

Potential sources of dengue in Hawaii/HDOH
Potential sources of dengue in Hawaii/HDOH

A breakdown of the outbreak is as follows: Of the confirmed cases, 30 are Hawaii residents and 8 are visitors. 32 cases have been adults; six have been children (<18 years of age). The current 2015 Hawaii Island outbreak involves DENV 1 serotype virus.

Current investigations have identified South Kona (in particular Hookena and Honaunau) as an area of particular concern, but the entire island is considered to be at risk.

HDOH staff are conducting assessments of areas of concern for the presence of mosquitoes and may as a precaution spray areas specifically related to our ongoing investigation.

In addition, health officials have been hosting community meetings throughout the area.

Dengue fever is a viral illness spread by mosquitoes. There are four closely related dengue viruses (DENV 1, DENV 2, DENV 3, and DENV 4). These viruses are transmitted to humans by the bite of an infected mosquito. The disease occurs mainly in tropical Asia, Africa, the Caribbean and the South Pacific. It is most common during the rainy season in areas infested with infected mosquitoes. Sometimes, persons arriving from other countries may enter the United States with dengue fever and infect local mosquitoes, as happened in Hawaii in 2001 and 2011.

The symptoms of dengue fever include sudden onset of fever, severe headaches, eye, joint, and muscle pain, and rash. The rash typically appears on the hands, arms, legs and feet 3 to 4 days after the fever begins. Minor bleeding problems can also occur. The symptoms usually go away completely within 1 to 2 weeks. Sometimes, people with dengue fever have blood clotting problems. When this happens, the illness is called severe dengue. Severe dengue is a very serious illness with abnormal bleeding and very low blood pressure (shock).

There is no specific treatment for dengue fever. Bed rest and acetaminophen (Tylenol) to treat fever and pain are recommended. Aspirin and NSAIDS (ibuprofen, naproxen) are not recommended as they can make bleeding problems worse. There is currently no vaccine for dengue fever.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today and the Executive Editor of The Global Dispatch

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