Words and (in)actions; Residents see failings in state response to dengue fever

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The state is telling people to “Fight the Bite” to prevent the spread of dengue fever, but some residents see gaps in how the state is handling reported cases.

The state is telling people to “Fight the Bite” to prevent the spread of dengue fever, but some residents see gaps in how the state is handling reported cases.

One of those residents is Melissa Fletcher of Volcano, who was suffering classic symptoms and said she could not get tested without extensive efforts.

She probably was exposed Oct. 26, she said, while making a site visit in Honaunau and another in Hookena for her business.

“Both places, I got eaten alive” by mosquitoes, she said.

Fortunately, her husband was staying in their vehicle with their sleeping 3-year-old daughter, she said, or they would have been bitten, too.

On Oct. 30, she had a 102-degree fever, was vomiting and had intense lower back pain. At the time, she didn’t realize these were symptoms of the disease, as was the rash she developed the next day. It wasn’t until Nov. 2 she made the connection between dengue fever and her symptoms. She said that largely was because of the slow dissemination of information about the disease.

The state Department of Health reported the first confirmation Oct. 29.

Fletcher then called her primary care provider, as instructed by public health officials. After explaining her concerns, she said the scheduler told her there were no appointments available for three to five weeks. She was told she could visit as a walk-in, but there was a good chance she would not see a doctor.

After making calls to the DOH and Centers for Disease Control and Prevention, she returned to the provider and managed to talk to someone who arranged for an appointment.

But that was a disappointment, too, she said.

“I knew more about dengue (than the doctor) because I’ve been studying intently,” Fletcher said.

Ultimately, the person called the DOH to determine which tests were needed. Despite a promise of a callback in five minutes, they never received a reply before the clinic closed.

Fletcher went to get the tests the doctor directed, only to receive a call later that they hadn’t drawn samples for all the necessary tests.

The DOH and CDC have not returned her calls, she said.

A message left with the DOH was not returned Wednesday, which was a federal holiday.

Fletcher said she’s concerned there might be other people who have the disease who haven’t made reports.

“I don’t think most people are that tenacious,” she said.

The concerns extend to island visitors, eight of whom are confirmed to have the disease.

One Big Isle resident who’s been following news of the outbreak said he’s concerned visitors are unaware of the situation, leaving them vulnerable.

They aren’t getting warned, which means they won’t know to take the protective actions directed, said Mountain View resident Ron Baptista. His friends flew in from Alaska, checked in at their hotel and spent their first day visiting Kailua-Kona and South Kona. It wasn’t until they spoke to him that they knew dengue was present.

“I advised them because this was in the papers the last couple weeks,” Baptista said.

Visitors lack that level of information, he said, adding that makes it important to tell them early, either during their flights or at their hotels.

“It’s easy enough for them to get bit,” Baptista said, and not realize the risk.

The number of confirmed cases islandwide remained at 33 people, who were infected between Sept. 11 and Nov. 2, the DOH said Wednesday on its website.

The cases include 29 adults and four children.

It is still unclear where the virus came from, as dengue is endemic to many tropical regions. The CDC lab received a sample Monday and has begun testing, according to state epidemiologist Dr. Sarah Park.

The disease currently on the island is called DENV-1. There are three other related dengue types.

A person who becomes infected with any particular dengue type is fairly safe, said Dr. Richard Creagan, now the member of the state House for North and South Kona and west Ka‘u. He formerly worked as an epidemiologist.

So long as people who were infected are only reinfected with DENV-1, they will have the normal antibody response that will rapidly control the virus, he said. It is when they become infected with a different virus they become at risk for the potentially deadly shock and bleeding fever.

As a viral infection, the only effective treatment is replacing fluids lost from the blood vessels. Pain medications also are used, although Park stressed not using aspirin or ibuprofen. Both can contribute to bleeding problems.

As far as Fletcher, she expects to know if she had the disease in about four days.

Anyone who suspects they could be infected with dengue fever should report it by calling 586-4586.

Email Graham Milldrum at gmilldrum@westhawaiitoday.com.