HANA - Three new cases of dengue fever are suspected in Hana, along with a possible case in Haliimaile and an additional two or three Upcountry, according to health officials.
In a meeting with Hana residents Tuesday night, Maui District Health Officer Dr. Lorrin Pang said at least one of two cases previously suspected in Keanae had been tentatively confirmed by a laboratory in Hawaii, although he was still waiting for official verification from a Centers for Disease Control and Prevention lab in Puerto Rico.
But he said residents should take steps now to protect themselves and fight back against disease-spreading mosquitoes - not wait the 15 days or longer it could take to get the final test results.
"We're gonna move on this," he said. "The world is so hot with dengue right now. If we didn't get it now, we'd get it next week, so let's just clean this thing up."
He reiterated the message that residents should clear their yards of standing water where mosquitoes breed, use insect repellant when going outside, and take extra steps to prevent the sick from being bitten by mosquitoes and spreading the disease to more carriers.
He also said people with symptoms of dengue - fever, headache, sunburnlike rash, and aching joints and muscles - should go to a health care professional to be tested for the disease. Tracking the location of new dengue cases will help public health workers target their efforts to control the spread of the illness, he said.
About two dozen Hana residents attended the meeting at Helene Hall, where they also heard from the community's public health nurse and Maui County Council Member Bob Carroll.
Ten years after they staged a massive cleanup and a public health campaign to successfully stop a dengue outbreak, Hana residents were hopeful Tuesday that they could do it again.
But many also said they were concerned about the community's latest bout with the tropical disease - and were especially worried that people who caught dengue a decade ago would be at a higher risk for serious complications now if they were infected again.
Sam Akoi, the retired Hana area manager for the Maui Invasive Species Committee, remembers being constantly exposed to mosquitoes while working in wet, mountainous areas. Ten years ago, he got sick.
"I was at work, and I felt weak. My body was weak, and the boys started joking with me, saying you better get a checkup, maybe you get the dengue," he recalled. "When the results came in, definitely I did have dengue."
Akoi was sick for three days with weakness, pain in his joints and nausea - but he knows that if he got sick a second time, the results could be much more serious.
"By working in the mountains a lot and being around a lot of mosquitoes, ho, I get paranoid," he said. "That mosquito spray - I spray my whole body with that."
Hana High and Elementary School health staffer Mavis Oliveira Medeiros said she noticed in 2001 when a group of students returned from a cultural trip to Tahiti that they soon began showing signs of dengue fever.
"That's when it started," she said. "They were all getting sick."
Now, Medeiros said she is diligent about applying mosquito repellent when she leaves the house, and makes sure her children do the same. She said she wanted to see the Hana community get serious about the latest outbreak.
"The concern is that people don't know it's here, and everybody's being careless about it," she said. "It hasn't been confirmed yet. I just hope everybody exercises the precautions and checks their yards and plants."
Department of Water Supply employee Sherman Baisa said he was nervous about working in the damp environment of East Maui.
"I'm from outside, and I'm here doing a job," he said. "I'm just worried about it 'cause I'm working in Nahiku a lot."
But he was hopeful the mosquitoes might overlook him.
"They don't bite me, thank God," he said. "They don't like me, I guess."
Several residents also expressed concern about the economic impacts of dengue on the remote East Maui community. Dawn Lono, who works as an aide to Carroll in Hana, said she didn't want visitors to be scared away by the outbreak.
"How do we not blow this out of proportion?" she asked. "We are so dependent, in Hana, on our tourism industry."
Pang said the best response was to "play it straight," and provide clear and honest information about dengue and how people could protect themselves.
"Some tourists do get scared away," he said. "But if you don't tell people about it, there's another bunch of tourists that are mad as heck" that they weren't informed.
Pang said the prevalence of dengue has increased 15- to 20-fold worldwide since 1980, after a vaccine was discovered for yellow fever, leading communities to stop spraying DDT to control mosquitoes.
In Hawaii, surfers, paddlers and others who travel to far-flung, tropical areas are especially at risk for contracting the disease - and bringing it back to the state, he said.
Tourists are also potential carriers - and that's one reason the state is restarting an effort to distribute mosquito repellent to visitors at key points along Hana Highway.
While there's no vaccine to cure or prevent dengue, Pang said there were some indications that Vitamin A - found in yellow fruits and vegetables like carrots, squash and mango - could lessen the symptoms.
"You'll get sick, but not quite as sick," he said.
To prevent the disease from spreading, Pang said people should concentrate on clearing mosquito-breeding areas closest to their homes - not worry about mosquitoes in the jungle far from people.
"The best thing you can do is clear around your house," he said. "That's where the action is. The closer to your house, the more you clean."
State and county officials are working to get more funding for teams of workers to help with community cleanup efforts, he said.
Retired nurse Sue Cuffe said she hoped officials could bring back the action teams that responded to the crisis 10 years ago - and at the time provided short-term jobs for residents who were then out of work.
"I thought Hana's response 10 years ago was fantastic," she said. "We jumped right on it and managed to stop it. Hopefully we'll be able to do it again."
* Ilima Loomis can be reached at iloomis@mauinews.com.
