While so far only two unconfirmed cases of the painful tropical disease dengue fever had been reported in Keanae as of Thursday, nonprofit, state and county officials said they were preparing an all-out war on mosquitoes to stop another outbreak from occurring.
No one wanted to see the mosquito-spread disease revisit Maui where more than 100 suspected cases were reported in East Maui, from late 2001 to the spring of 2002.
"Hana might be teeming with mosquitoes, but we've been through this before, and we know what to do, and the fear shouldn't be as great once you've faced anything like this before," said County Council Member Bob Carroll, who holds the East Maui residency seat. "This time, hopefully, we'll nip it in the bud and it won't go anywhere."
Carroll said he was working with state health officials to organize the East Maui community to eradicate mosquitoes.
Plans included bringing in the trained staff of the Maui Invasive Species Committee to help eliminate mosquito-breeding areas, the council member said.
However, East Maui's tightknit communities already had sprung into action, said Dawn Lono of Carroll's staff in Hana.
That includes residents checking on their friends, family and neighbors and doing what they can to eliminate mosquito-breeding grounds, particularly at the homes of elderly and disabled people, Carroll said.
"We're really good in Hana about taking care of each other," he said.
Gary Gill, deputy director of the state Department of Health in charge of environmental health administration, said two members of the state's vector control staff, who are already stationed on Maui, would be involved in the efforts.
And Maui County spokesman Rod Antone said other ideas were in the works to set up stations along Hana Highway to distribute mosquito repellent to residents and visitors at concession stands and craft shops.
"We'd like someone to donate the repellent, but if that doesn't happen fast, I'm headed down to Costco and buying up every bottle they've got," Antone said.
Perhaps most importantly, three informational community meetings are set for East Maui residents with world-renowned - and Maui's own - dengue fever expert Dr. Lorrin Pang, of the state Department of Health. Two meetings are set for Saturday, Carroll said. The first is at 1 p.m. at Nahiku Hawaiian Church. The second is at 3 p.m. that same day at the Keanae Congregational Church. The next informational meeting is 6 p.m. Thursday at Helene Hall in Hana.
Pang said he had been traveling along Hana Highway to meet with as many people as possible to make sure they are doing everything they can to prevent the spread of the disease.
Dengue fever is sometimes referred to as "break-bone fever" or "bone-crushing fever" because of the severity of its symptoms. Dengue hemorrhagic fever, a more advanced stage of the disease, can be life-threatening.
The thing to remember about dengue fever is that while there may or may not be just two cases in East Maui, that does not mean it couldn't have traveled across the island already in a host, said Marc Nishimoto, a Health Department public health emergency preparedness planner.
That infected person could in turn be bitten by a mosquito, the carrier of the virus for which there is no cure or immunization shot.
As of Thursday, there were only four cases, all on Oahu, of dengue fever confirmed by the Health Department and U.S. Centers for Disease Control and Prevention, which is conducting blood tests in the CDC's dengue fever lab in Puerto Rico. It could be a week to 10 days before the results come back for the suspected cases from East Maui, said state epidemiologist Dr. Sarah Park on Thursday.
She added that health officials should not wait for the results of those tests and should treat patients with any symptoms immediately as though they have the disease.
In the meantime, the community should be working together in earnest and as soon as possible, officials said, to cut brush at least 20 yards away from homes and fill in or dump out larva breeding grounds, such as ditches and empty tires. Fogging with a cloud of insecticide aimed at killing mosquitoes may be effective as well.
The disease - if treated properly - is quite survivable, Pang said. He implored people with any symptoms to call a health professional immediately.
Hundreds of people worldwide die annually of the disease. Deaths usually occur in developing countries where people live in squalid conditions, experts said.
Pang said he was well aware that many East Maui residents are often cynical about the government and doctors, but he warned people not to ignore this issue and risk the spread of the disease.
During the outbreak that occurred in East Maui about a decade ago, no one died, but more than 100 suspected cases were reported - and perhaps hundreds more weren't, health officials said. Now, those survivors, including state Sen. J. Kalani English, have to be extra careful since they are susceptible to dengue hemorrhagic fever, Pang said.
Carroll said he was serving on the County Council during the last outbreak on Maui.
"I was working closely with Dr. Pang and Kalani to help organize the eradication efforts," he said. "It was pretty scary. Some people thought it was just the flu, and some thought they were going to die. A few of those people have never been the same since."
The disease was reported this time around in Hawaii on March 24 in Oahu's Pearl City area. The state confirmed four dengue fever cases there, and all four adults from the same family survived and are no longer ill, said Health Department spokeswoman Janice Okubo on Thursday from Honolulu.
It also should be noted, she said, that dengue fever cannot be transmitted from person to person.
* Chris Hamilton can be reached at chamilton@mauinews.com.
