HONAUNAU — Residents in the heart of dengue territory in South Kona are nervous about the disease, and still want more done to address an outbreak that has dragged on for four months now.
Some 60 people attended a meeting Thursday night with Hawai County Civil Defense, the state Department of Health and the Centers for Disease Control and Prevention, hosted by Puuhonua o Honaunau National Historical Park as confirmed cases crept up to 249 total since the outbreak began in September.
Some residents called on Civil Defense Chief Darryl Oliveira to quickly ask for an emergency declaration — one which Oliveira said will be on the way shortly. The call for the declaration would put federal resources into the dengue fight and was first sounded last fall by Kona Sen. Josh Green and Naalehu Rep. Richard Creagan, and echoed last week by Congresswoman Tulsi Gabbard.
A petition on MoveOn.org urging an emergency declaration and a permanent mosquito control program had gathered 898 signatures on Wednesday. Island residents have also launched a Facebook public group called Hawaii Dengue Fever Awareness, with 1,300 members.
Krista Johnson, one of the founding members of the group, made an emotional appeal to Oliveira to seek whatever resources he could through the declaration.
“If you don’t utilize all the resources available to you, Zika will be next,” she said.
A January report on a trip to the Big Island by the CDC commended the efforts of the county and a severely overtaxed state Vector Control Division, but also called into question the effectiveness of current strategy. Field reports suggest that only 25 percent of the homes within a 200-yard radius of an infected site have been surveyed, due to the homeowner not being present or refusing entry to survey crews. That number should be close to 90 percent for mosquito management to be effective, the report says.
New dengue cases also tend to crop up in the neighborhood of a home that has been targeted for treatment, suggesting the current 25-yard treatment area should be expanded to 200 yards, according to the CDC. An entomologist should be stationed on the island permanently to develop ongoing mosquito surveillance and Vector Control staff should be beefed up significantly to respond to this outbreak and future ones, the report recommends.
Naalehu Rep. Richard Creagan, in a phone interview, said the next step needs to be a permanent and “serious eradication program for the aedes aegypti mosquito.”
“Because if the Zika virus hits and we don’t have our ducks in a row, it’s going to be much worse than dengue,” he said.
Others attending the meeting Thursday night called for a stronger attack on mosquitoes as well.
“We’re not hearing proactive, we’re hearing reactive,” said one resident, who called for systematic elimination of mosquitoes in populated areas at least.
CDC entomologist Ryan Hemme and Oliveira said it would take massive resources to tackle mosquito populations in general and that targeting infected populations is much more effective.
Oliveira said the county Department of Environmental Management has taken in 7,000 tires in an effort to reduce breeding sites. Workers continue to assess and spray infected areas, and anyone who calls 911 or goes to a fire station lacking access to health care can have their blood drawn by a paramedic and tested for dengue, he said.
Christine Kern, who lives above Kealakekua Bay, said dengue gives her one more thing to worry about as she battles cancer. She also wants to see more boots on the ground.
“It makes me very nervous just to live here right now,” she said.
Bruce Anderson, who was the director of the DOH during the Maui outbreak of 2001, said the current response has many of the same elements as the one on Maui, but he also recommended more focus on eliminating breeding sites rather than trying to knock down adult mosquitoes.
“Spraying is a temporary solution at best,” he said.
Anderson said that free screening sites were set up around the island and that 2,000 workers were helping spread the word to eliminate breeding sites on Maui in 2001.
“I had 84 vector control workers under me on that island and lots of entomologists,” Anderson said.
The upshot of the outbreak, he said, was that “we really cleaned up that island.”