Two West Hawaii lawmakers are calling for the Centers for Disease Control and Prevention and the World Health Organization to send medical experts to help quell dengue fever on the Big Island before it becomes endemic.
A joint intersession meeting of the state House and Senate about the outbreak is scheduled Friday, and control efforts are swinging now to schools.
Kona Sen. Josh Green and Naalehu Rep. Richard Creagan say a well-meaning but understaffed and overwhelmed state Department of Health is out of its depth in the dengue battle.
“We can no longer convey the illusion that we in Hawaii currently have the expertise or resources in place to assess or control this outbreak effectively,” the lawmakers wrote in a letter Wednesday afternoon to Gov. David Ige and DOH director Virginia Pressler.
Asked if he requested a change in the state approach to the dengue outbreak as the cases escalate, Green supplied the letter with detailed recommendations he and Creagan are making.
“We ask that senior CDC and WHO professionals be engaged to come to Hawaii immediately to give an extensive opinion and assessment of the current dengue outbreak,” the lawmakers wrote. “Resources must be made available to communicate effectively with migrant worker communities. … They must have mosquito repellent and free additional work gear. We should also pursue support for the farming community and these workers for lost wages and lost productivity.”
Green and Creagan called for more opportunities to get tested locally. Many people lack the resources to go to doctors or do not want to call attention to themselves, and will suffer the disease in silence and risk spreading it, the lawmakers said.
“Once dengue fever penetrates Puna and Hilo, it will not be eradicated for a generation,” they said. “This will occur if we don’t take drastic action.”
State epidemiologist Sarah Park defended the DOH response to the outbreak, saying she already is in close contact with the CDC, that she and her deputy trained with the organization, and the CDC adamantly is in agreement the only way to control the outbreak is through mosquito bite prevention and initiatives such as the state’s “Fight the Bite” campaign.
“From Day 1, I have been in close conversation with the CDC,” Park said. “I never work in a vacuum during a disease outbreak.”
Park said the outbreak highlights a lack of access to health care, but people might be mistaken about what the CDC can offer.
“They are not ‘boots on the ground’ people,” she said. “They are epidemiologists and entomologists. If we need technical assistance, they provide that.”
The agency is sending mosquito traps and has been providing lab support as well as studying the origin of the strain now infecting people on the island, said Park, who described email and data exchanges with the agency.
“The WHO doesn’t come into a country unless it’s invited to go into that country,” Park said. “I don’t think President Obama is going to ask the WHO to come to Hawaii.”
Park said the recent uptick in cases is not a cause for alarm.
“On the scale of dengue outbreaks, it’s a not a huge one,” she said. “Would I like to see it slow down? Sure. As it becomes more commonplace for people to protect themselves from mosquito bites, I think that will peter off. Until protective measures become formally established, there is an upswing in cases and then it declines. I’m hoping that is what will happen here.”
A DOH field investigations supervisor now is training Hawaii County EMS personnel to recognize and respond to dengue and is sharing exposure data with the county to help it fight the disease, Park said.
The Senate Committee on Commerce, Consumer Protection and Health and the House Committee on Health will be briefed Friday on containment efforts from DOH officials. The meeting is at 9 a.m. at the State Capitol.
Puna Sen. Russell Ruderman is on the Senate committee and Creagan is vice chairman of the House committee. The meeting will be broadcast on the Big Island on Na Leo O Hawaii community television and online at www.olelo.org/olelo55/
“We’re asking for a bigger team that deals with this all the time, that isn’t embedded in departmental stuff, to come in,” Creagan said. “This is really becoming a disaster. If we lose the fight here and it becomes endemic, we’ll always be looking over our shoulder.”
Puna Sen. Russell Ruderman said the state’s response to the dengue problem on the Big Island has been weak and slow to gain momentum. While Puna is not at the center of an outbreak, high moisture levels and big mosquito populations put the area at risk if the disease spreads, he said.
“It’s a huge concern for us over here in the long term,” he said.
The tepid response has been similar to the way the state has dealt with rat lung worm, a debilitating disease that attacks the nervous system and can leave patients with years of crippling pain, Ruderman said.
“Too often, the state ignores Big Island problems, but it’s a foolish approach,” he said. “Because once they are well established, they will spread to the other islands. Someone infected is going to get on a plane.”
Email Bret Yager at byager@westhawaiitoday.com.
