DOH fine-tunes dengue testing process

The state Department of Health says it addressed issues which, in some cases, slowed the delivery of results from dengue fever blood tests to Hawaii Island residents.

Internal communication problems within the DOH and communication with laboratories on the Big Island, as well as issues with courier services transporting blood samples to the state lab in Pearl City, Oahu, were identified as the primary factors slowing the process, said a department spokeswoman.

“We think there was some type of break in communication, with the results moving forward going outside of their lab,” said Communications Director Janice Okubo. “We are also looking at transport time.”

At the beginning of the outbreak, which was reported Oct. 27, health officials had to send blood samples to a Centers for Disease Control and Prevention lab in Colorado because its specialized equipment was capable of making more precise determinations, explained State Epidemiologist Dr. Sarah Park.

But after multiple cases were verified on the Big Island, the DOH laboratories took over Nov. 2 the task of confirming the presence of the dengue virus in patients exhibiting symptoms of the mosquito-borne disease.

The state labs are capable of routinely handling between 50 and 60 dengue tests a day, according to DOH Director Virginia Pressler, and the department has the ability to ramp up in the event of a surge, should the dengue outbreak continue to expand.

Since the lab began performing the tests, it consistently has put out results no more than three days after receiving them, Okubo said. So, when the DOH received complaints from some people claiming their results took up to two weeks to be returned, health officials began to look into the problem.

Craig Allind, who works on a small coffee farm in Honaunau, said Wednesday he was one of those people who raised a red flag about the testing delays.

On Sept. 11, he was admitted to the hospital, exhibiting many of the symptoms associated with dengue, but the outbreak had not yet been discovered, and doctors had a hard time figuring out what was causing his illness.

“It wasn’t until weeks later, this dengue thing came up, and retrospectively they tested me,” he said.

Despite receiving the results eight days later, and those results coming up negative for dengue, Allind said he was bothered by how long it took to get results.

“Only the state can do dengue. The labs on the Big Island can’t handle it, so they have to courier your blood to Oahu. … It just seems like we’re a Third World nation or something,” he said.

In an attempt to speed up the process, DOH workers now have in place a system for sending results to a central location within the department. From there, all results will be sent out to various labs to then be disseminated to physicians, who can then tell their patients, Okubo said. The DOH also is looking into ways to speed up delivery of blood samples to the Pearl City labs.

“People should be receiving their results in about a week,” she said. “It’ll take about that time to transport the sample, conducting the test and getting results back through the lab. … If (patients) don’t hear back, they should contact their physician. … And we’d like to know about that, too. They can provide that feedback through (telephone number) 211 or our district health offices.”

The Hilo district office can be reached at 974-6010. The Kona office is at 322-1513.

As of Wednesday afternoon, the DOH had identified 72 confirmed cases of dengue, including 62 Hawaii residents and 10 visitors. Fifty-three of the cases are adults and 19 children, with the latest onset of symptoms now at Nov. 12.

“As of today, a total of 103 reported potential cases have been excluded based on test results and/or not meeting case criteria,” according to an update on the DOH website, at health.hawaii.gov/docd/dengue-outbreak-2015/.

Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.