The Hawaii State Department of Health (HDOH) reported Wednesday four additional dengue fever cases on Big Island, bringing the total cases to 157. Health officials report of the 157, seven are still potentially infectious.


The cases further breakdown as follows: 140 are Hawaii Island residents and 17 are visitors. 123 cases have been adults; 34 have been children.

On Tuesday, the HDOH released the Interim Assessment of the Response to the Dengue Outbreak on the Island of Hawaii provided to the State and County of Hawaii by Dr. Lyle R. Petersen, MD, MPH, director of the Division of Vector-Borne Diseases for the U.S. Centers for Disease Control and Prevention (CDC).

According to the 10-page report, the response by DOH to the ongoing outbreak has been timely, well considered, and appropriate. Coordination between State and County is excellent, and operations within Hawaii County are proceeding under an effective incident command structure at the Hawaii County Civil Defense Agency. All facets of a public health response to a dengue outbreak have been addressed adequately: community outreach, surveillance, diagnostic testing, medical care, and vector control.

The report identifies two critical deficiencies that should be urgently addressed: communications and medical entomologic (entomology is the study of insects) capabilities. “Communications capacity at the State Department of Health is inadequate,” notes Petersen.

He adds that the dengue outbreak overwhelmed the one full-time communications professional at DOH. A public relations firm was hired and CDC communications experts were brought in to assist with the ongoing outbreak. Longer-term, hiring additional communications personnel is recommended.

Regarding entomologic capabilities the report states that the response to the outbreak has been hampered by a “lack of technical and general staffing capacity at the Department of Health”. The report cautions that introductions of other mosquito-borne diseases such as Zika and chikungunya are likely and will require entomologic expertise that does not currently exist in DOH. The report recommends restoring entomologic capacity lost in the DOH.

Laboratory capabilities and epidemiological response received positive responses in the report. Strong state lab capacity and stating the current laboratory testing protocols are state of the art and turn-around of results rapid and epidemiological response was timely and well considered were noted.