The Hawaii Department of Health confirmed four new cases of dengue fever on the Big Island on Friday, bringing the number of locally acquired cases to 23 since late last month.
Dengue fever, a viral illness spread by mosquitoes, is not endemic to Hawaii, but the state does have the mosquito species capable of transmitting the disease, said Dr. Sarah Park, an epidemiologist with the state's health department.
The current outbreak is a "big concern" because of the potential for the disease to be established in the local mosquito population, which would increase the chances of an epidemic, Park told The Huffington Post.
"It’s likely an infected traveler infected the local mosquito population, which led to this cluster, so we want the public to be aware of this mosquito-borne disease and the steps they can take to prevent infection," she said in a statement last week.
Symptoms of dengue fever typically begin within a week of being bitten by an infected mosquito and can include fever, rash, joint or muscle pains, headaches or pain behind the eyes, according to Hawaii's health department.
Symptoms usually last between two and seven days, but are known to be pretty brutal.
There is currently no vaccine or specific treatment for dengue fever, but early detection can keep the disease from being fatal. Hawaii's health department recommends bed rest and taking acetaminophen -- like Tylenol -- to treat fever and pain. (However, it cautions against aspirin and NSAIDS, like ibuprofen and naproxen, which can worsen bleeding problems.)
The latest outbreak has so far affected 15 residents and eight visitors. It marks the first locally acquired cluster in Hawaii since four people contracted dengue fever on Oahu in 2011, and is the largest one since 2001, when 122 cases were confirmed after an outbreak started on Maui.
Health officials are encouraging people to use mosquito repellents and wear long sleeves and pants to limit exposure to the insects and help stop the spread of the disease.
"The good thing is we’re entering into a dry, hot period on the Big Island, and the rest of the state, and that’s going to help a lot, but it’s not going to be the solution if there are infected mosquitos," Park said.
The biggest frustration, she added, is that the Department of Health received late notice about the outbreak. The fever may have hit the Big Island as early as mid-September, but officials didn't begin investigating until late October and don't know yet how active the disease transmission is.
"Unfortunately, we’re kind of playing catch up, and unfortunately that’s not all that unusual in public health," Park told HuffPost. "I really understand where the public is frustrated. We're equally as frustrated."
While it is not uncommon for dengue to pop up in Hawaii, cases are typically diagnosed in travelers who got the virus elsewhere. For example, LiveScience reports that health officials diagnosed 13 cases of dengue in Hawaii earlier this year, but the disease was contracted elsewhere. Dengue fever most commonly occurs in tropical Asia, Africa, the Caribbean and the South Pacific.
Health officials confirmed one case of dengue on Oahu on Wednesday, Park told HuffPost, adding that it is completely separate from the Big Island outbreak.
"This is just a reminder that we're always at risk of having an infected traveler come in," she said.
On Wednesday, officials with the County of Hawaii closed Hookena Beach Park, on the west side of the Big Island, in an effort to curb the spread of dengue fever.
As many as 400 million people are infected by dengue yearly, according to the Centers for Disease Control and Prevention.
Allie Wesenberg, a star of the web series "Internet Killed Television," was among those who reportedly fell victim to the latest outbreak. She was hospitalized after returning to Florida from a Hawaiian vacation.
"I'll be really honest with you, like, I ... I seriously thought I was going to die. I'm not kidding you when I say that, because they couldn't figure out what was wrong with me," she said in a video posted to YouTube.
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