“Considering the flight range of vector mosquitoes, a neighborhood wide approach to adulticiding will likely best reduce adult mosquito populations. However, the large distances between houses, dense vegetation, homeowner reluctance (many organic farms in the area and general opposition to chemicals), homeowner not at home, unoccupied homes, and large staffing and equipment requirements likely present unsurmountable obstacles to this approach.” – Hawaii Assessment pg 4, US Center for Disease Control

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DEPARTMENT OF HEALTH RELEASES INTERIM ASSESSMENT OF RESPONSE TO DENGUE OUTBREAK ON ISLAND OF HAWAII

News Release from Hawaii DoH, December 16, 2015

HONOLULU – The Hawaii State Department of Health (DOH) is releasing the Interim Assessment of the Response to the Dengue Outbreak on the Island of Hawaii provided to the State and County of Hawaii by Dr. Lyle R. Petersen, MD, MPH, director of the Division of Vector-Borne Diseases for the U.S. Centers for Disease Control and Prevention (CDC). Dr. Petersen’s assessment of current response efforts was conducted at the request of the State and County. The assessment is posted at www.health.hawaii.gov/docd/dengue-outbreak-2015/

“We thank Dr. Petersen and the CDC team that have been working with us on this dengue outbreak and their work on the interim assessment,” said Health Director Virginia Pressler, M.D. “The assessment moves us forward, providing a frank evaluation and recommendations. Clearly this outbreak is about more than the state health department, the county, or CDC – it’s about all of us. We must all fight the bite if we are to break the cycle of infection and protect ourselves.”

According to the 10-page report, the response by DOH to the ongoing outbreak has been timely, well considered, and appropriate. Coordination between State and County is excellent, and operations within Hawaii County are proceeding under an effective incident command structure at the Hawaii County Civil Defense Agency. All facets of a public health response to a dengue outbreak have been addressed adequately: community outreach, surveillance, diagnostic testing, medical care, and vector control. The report identifies two critical deficiencies that should be urgently addressed: communications and medical entomologic (entomology is the study of insects) capabilities.

“Communications capacity at the State Department of Health is inadequate,” notes Petersen.  He adds that the dengue outbreak overwhelmed the one full-time communications professional at DOH. A public relations firm was hired and CDC communications experts were brought in to assist with the ongoing outbreak. Longer-term, hiring additional communications personnel is recommended.

Regarding entomologic capabilities the report states that the response to the outbreak has been hampered by a “lack of technical and general staffing capacity at the Department of Health”. The report cautions that introductions of other mosquito-borne diseases such as Zika and chikungunya are likely and will require entomologic expertise that does not currently exist in DOH. The report recommends restoring entomologic capacity lost in the DOH.

The report addresses both laboratory testing and the epidemiology capacities, highlighting a strong state lab capacity and stating the current laboratory testing protocols are state of the art and turn-around of results rapid. The report determined that the epidemiological response was timely and well considered but warns that current resources are taxed, and there is little surge capacity if another significant health event arises in the state.

The report concludes that the coordination of response efforts between DOH and county offices of Civil Defense, Fire, Parks & Recreation, and Public Works has been extremely well organized and serves as a model for others.

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