Dengue usually occurs in tropical Asia, Africa, the Caribbean and the South Pacific. The virus is not endemic in Hawaii but is sometimes brought in by infected travelers. State officials believe this is how the current outbreak started. These are the first locally acquired cases since 2011 on Oahu.
Dengue Fever is transmitted to humans when they are bitten by infected mosquitos. The Aedes aegypti mosquito is the most efficient carrier of Dengue and is found in Hawaii.
Symptoms of Dengue usually start 2-5 days after the mosquito bite with high fever, muscle and joint pain, nausea, vomiting, generalized weakness and a rash during the febrile phase. In the tropics this disease is known as “breakbone fever” because of the severity of the muscle and joint pains.
Dengue usually gets better on its own and lasts about six days. Some people will experience very mild symptoms and some more severe. In rare cases a hemorrhagic form of the disease may occur with leakage of blood vessels throughout the body leading to shock and possibly death.
Since Dengue is caused by a virus there is no specific treatment. Mild symptoms can be treated at home but in some cases admission to hospital may be necessary for IV fluids and other supportive measures.
There is no vaccine for Dengue and no medication. The only means of preventing Dengue is avoiding mosquito bites.
Dengue bearing mosquitos fly in daytime hours so protection with clothing and mosquito repellents is extremely important. Dengue bearing mosquitos tend to breed in small pools of water found in patio pots and tires. Hence travellers are at highest risk in urban and residential areas.
Current recommendations for insect protection are as follows:
- Wear clothing that exposes as little skin as possible
- Apply a repellent containing DEET (30-35%) or Picaridin to exposed skin areas following the product directions. In Canada the highest DEET concentration allowable is 30%
- When using both repellent and sunscreen, apply the sunscreen first (SPF 30-35) and the repellent on top. Repellents can reduce the SPF effectiveness of sunscreens so they may need to be applied more frequently.
If severe flu like symptoms occur while travelling in Dengue risk areas be sure to seek medical attention.