Dengue virus is carried by the Aedes aegypti mosquito, the same type that can spread Zika virus. A bite from a mosquito harboring the virus can result in headaches, rashes and severe joint pains. In serious cases, it can cause internal bleeding and death.
Dengue virus is carried by the Aedes aegypti mosquito, the same type that can spread Zika virus. A bite from a mosquito harboring the virus can result in headaches, rashes and severe joint pains. In serious cases, it can cause internal bleeding and death.
James Gathany/CDC
There is no drug for dengue. Patients must be monitored carefully for the onset of the severe form of dengue. Pictured, a nurse looks after a patient with dengue at a hospital in Manila, Philippines.
There is no drug for dengue. Patients must be monitored carefully for the onset of the severe form of dengue. Pictured, a nurse looks after a patient with dengue at a hospital in Manila, Philippines.
NICOLAS ASFOURI/AFP/GettyImages
The main control measures for dengue to date have been to reduce the numbers of mosquitoes by large-scale spraying of insecticides. The chemicals have been deployed in both residential and public spaces in a mass culling of the insects spreading the disease.
The main control measures for dengue to date have been to reduce the numbers of mosquitoes by large-scale spraying of insecticides. The chemicals have been deployed in both residential and public spaces in a mass culling of the insects spreading the disease.
Inti Ocon/AFP/Getty Images
Urbanization has aided the spread of dengue, with more than 100 countries now endemic for the disease. Pictured, containers, bottles and tires are perfect breeding sites for Aedes aegypti mosquitoes that transmit the dengue virus. The versatile mosquitoes can lay eggs on any shallow surface of water.
Urbanization has aided the spread of dengue, with more than 100 countries now endemic for the disease. Pictured, containers, bottles and tires are perfect breeding sites for Aedes aegypti mosquitoes that transmit the dengue virus. The versatile mosquitoes can lay eggs on any shallow surface of water.
JOHAN ORDONEZ/AFP/Getty Images
Public spraying of insecticides is based on seasonal changes, with more cases expected during rainy seasons in the tropics. But the measures haven't proven to curb the spread of disease adequately.
Public spraying of insecticides is based on seasonal changes, with more cases expected during rainy seasons in the tropics. But the measures haven't proven to curb the spread of disease adequately.
ORLANDO SIERRA/AFP/Getty Images
Experts believe a vaccine is needed to truly control the disease. A dengue vaccine, called Dengvaxia, recently became available in Mexico, Brazil, the Philippines and El Salvador.
Experts believe a vaccine is needed to truly control the disease. A dengue vaccine, called Dengvaxia, recently became available in Mexico, Brazil, the Philippines and El Salvador.
PHILIPPE DESMAZES/AFP/Getty Images
Dengue fever: How a mosquito infected millions, and not with malaria

Story highlights

Number of dengue fever cases on Hawaii Island now 136

Daily increase in cases of illness should be expected

CDC: "We don't have tools yet to minimize outbreaks [of dengue] rapidly"

CNN  — 

Since September, there have been 136 confirmed cases of dengue fever on Hawaii’s Big Island, according to the Hawaii Department of Health.

This is six more cases than the number reported Thursday, when Dr. Virginia Pressler, director of the Hawaii Department of Health, said there has been a “slow trickle” of new cases every day.

“The community needs to understand that we expect to see new cases identified on a daily basis,” Pressler said during a news conference Thursday.

This is the first locally transmitted outbreak of the viral illness on the Big Island and the first outbreak in the state since five people were infected on the island of Oahu in 2011. However, this outbreak is being likened to the last widespread outbreak, which was on Maui in 2001. It lasted for 10 months and more than 120 people became ill.

“This could go on for a number of months to come,” said Dr. Lyle Petersen, director of vector-borne diseases at the Centers for Disease Control and Prevention. He said it’s not possible to predict how many cases will occur.

During the Maui outbreak it took eight months to reach a similar number of cases that the current outbreak has reached in two months, which Peterson said is concerning. But he made the distinction that there are more people in the outbreak area this time.

The key to ending the outbreak is controlling mosquitoes, which transmit the virus, and that takes time. “If [this outbreak] continues for a number of months it’s not a failure of the system. We don’t have tools yet to minimize outbreaks rapidly,” Petersen said.

The CDC has been offering technical and laboratory assistance as well as advice. Peterson and an entomologist and a technician from his team have been working with local and state officials on the Big Island since Wednesday.

There are two types of mosquitoes – Aedes aegypti and Aedes albopictus – that can transmit the virus, and both types are found in Hawaii. They are particularly hard to control because they breed in even the smallest pockets of water. Darryl Oliveira, with the Hawaii county civil defense agency, said it’s impossible to eliminate them.

“The public can help by using repellant, minimizing mosquitoes on property and getting medical attention without delay,” Petersen said.

Most people with dengue fever do not have symptoms. Those who do get sick develop a high fever and severe joint and muscle pain, which is why the illness is nicknamed “bone fever.” People who have had it describe it as the worst fever and body aches they’ve ever had. Symptoms begin about five to seven days after exposure. Some individuals develop a rash on their hands, arms, feet and legs three to four days after the fever begins.

When diagnosed properly, dengue is successfully treated and the death rate is 1%. Acetaminophen is given to relieve symptoms, which usually last for one to two weeks.

Peterson said the number of cases in Hawaii is small compared to the 100 million clinical cases of dengue fever that occur each year in areas where it is endemic, or regularly found. He believes the likelihood of the disease becoming endemic to Hawaii is low.