WAILUKU - East Maui residents should do everything they can to eliminate mosquitoes in their community to prevent two suspected cases of dengue fever from turning into an epidemic, said dengue expert and Maui District Health Officer Dr. Lorrin Pang.
Pang met with about 40 Keanae and Nahiku residents Saturday to answer questions and share information about the "bone-crushing" tropical disease.
"I told them, irrespective if cases are confirmed, we are being bombarded by people who are traveling right now, and they could be carrying it. It's dengue fever time across the globe.
"They said, 'We did eradicate it before, and we're willing to do it again.' "
Pang said that means cutting back brush at least 20 yards from homes, and eliminating potential mosquito breeding grounds in yards, such as empty flowerpots and old tires. He also said he hoped that East Maui Irrigation could be convinced to increase flows at Makapipi Stream, and maybe other waterways, so that faster-moving water could flush out mosquito larvae.
County Communications Director Rod Antone said the Public Works Department might support the prevention effort by cleaning up public property.
Pang said nonprofits, community groups and government agencies have already started working on mosquito eradication and dengue prevention. One effort will involve setting up five stations along Hana Highway near popular tourist destinations to distribute mosquito repellent, which he hopes to purchase with state funds.
The remote East Maui communities have welcomed the help of Pang and his colleagues - in stark contrast to the suspicious reception public health officials received when the area last saw a dengue fever outbreak 10 years ago.
"They were hostile back then, and now it's night and day," he said. "I think it's because we had a great result a decade ago. People already know what to do."
Pang said he reviewed basic information about dengue fever for newcomers at the meetings, and also explained how the disease can quickly become more dangerous if it's contracted for a second time.
While a first infection can be painful, with a second contraction of dengue, the victim can feel just fine after their fever breaks, then start hemorrhaging and go into shock.
He advised anyone with feverish symptoms to contact a health professional.
Symptoms of dengue include severe headaches, fever and incredible muscle aches. The disease is treated with acetaminophen - not blood thinners such as ibuprofen - and patients should be closely watched, drink plenty of fluids and be cooled with damp sponges.
About one in a thousand people will have serious complications in a first infection of dengue fever. Between 15 and 85 percent will experience at least some symptoms.
While a prior dengue infection will give the victim immunity to that strain, if they contract a different strain of the disease, they will experience much more severe symptoms and have a much higher risk of dying, Pang said.
He said it has not yet been determined if the current outbreak is the same strain of the disease that sickened as many as 100 East Maui residents in 2001 and 2002.
State Sen. J. Kalani English, who was among the Hana residents who contracted dengue 10 years ago, and state Rep. Mele Carroll, have said they are working at the Legislature to restart an environmental response team to address the issue.
And County Council Member Bob Carroll, who holds the Hana residency seat, said he plans to request aid again from the Maui Invasive Species Committee in helping East Maui residents, especially the elderly, in cleaning up potential mosquito breeding grounds in their yards.
Carroll attended the meetings in Nahiku and Keanae on Saturday. A third meeting is scheduled for 6 p.m. Tuesday at Helene Hall in Hana.
"We're hopeful to get on it right away," Carroll said. "We think we can at least keep it to a minimum and have no outbreak . . . I think we can handle it."
Pang said he expects the U.S. Centers for Disease Control and Prevention to have the results of the blood tests on the two suspected Keanae cases in the next five days. Four cases were already confirmed late last month from a family in Pearl City on Oahu.
"Help out your neighbor," Pang said. "I don't want you to think you are ratting them out, but try to remember that you are helping them out. That's why we are running a lot of our information through the community associations. It should be easier to talk to them."
Hana resident Jean Mardfin was a bit skeptical about how successful total eradication efforts in East Maui could be. After all, the region has regular heavy rainfall and thousands of acres of undeveloped land and a number of unkept yards.
"I am very well aware of dengue," her husband, Ward Mardfin, of the Maui Planning Commission, said. "When I lived in Fiji (years ago), people died from it all the time. I think I might have had it in Vietnam. And I was here in Hana the last time we went through it. It does a nasty piece of work to you. You do not want to mess around with it.
"We will have to do whatever we can to stop it," he said.
* Chris Hamilton can be reached at chamilton@mauinews.com.
