HAWAII ISLAND – As the number of confirmed cases of dengue fever rises on Hawaii Island, two doctors-turned-lawmakers are challenging state officials – in writing and on video – to step up the response to the outbreak.

In a letter to state administration officials, State Senator Josh Green and State Representative Richard Creagan – both of whom represent parts of South Kona and both of whom are physicians – warned that the “Dengue fever outbreak on the Big Island is at a point where it may likely take a very significant turn for the worse.” The letter urges the state to address the “huge groups of migrant workers that can and likely will move dengue throughout the Big Island if immediate action isn’t taken.”

The lawmakers are also asking that senior Centers For Disease Control and Prevention and World Health Organization professionals “be engaged to come to Hawaii immediately to give an extensive opinion and assessment of the current Dengue outbreak.”

“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 letter states. You can read the entire letter below.

In addition to the letter, Sen. Green also recorded an interview on Think Tech Hawaii with State Epidemiologist Dr. Sarah Park, who is also Chief of the Disease Outbreak Control Division. Rep. Creagan joined in the discussion. So did Lynn Nakasone with the health department’s Environmental Health Services Division. The long and informative discussion was peppered with one or two moments of tense back and forth concerning the response to the outbreak. Video courtesy Think Tech Hawaii is included below, as well.

The Hawaii State Department of Health will host a press conference on Oahu regarding the current dengue fever situation tomorrow (Thursday, Nov. 19).

There are 72 confirmed cases of locally acquired dengue fever on Hawaii Island, according to the most recent numbers from the state.

November 18th, 2015

Dear Director Pressler and Governor Ige,

The Dengue fever outbreak on the Big Island is at a point where it may likely take a very significant turn for the worse.

There are huge groups of migrant workers that can and likely will move dengue throughout the Big Island if immediate action isn’t taken.

Dr. Pang witnessed a similar crisis in Honduras and between the cities in Brazil. As you know once dengue is introduced and becomes endemic the whole way of life for a society changes. Citizens on Big Island and the tourism industry will be gravely and negatively affected indefinitely if we allow this to happen.

OUR SPECIFIC CONCERNS

The large migrant groups on Big Island must be engaged, assessed and supported immediately. It is our opinion that we are facing a potential disaster if the strategy for them isn’t REVISITED with additional support. By the time the current leadership team recognizes this as a crisis, it will be too late for an effective intervention.

WE HAVE SPECIFIC REQUESTS

1. 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. They must be provided space and resources to independently assess the current outbreak and then share their findings with our respected but under-resourced team.

2. Resources must be made available to communicate effectively with the migrant worker communities, especially the Micronesian and Hispanic workers, that will imminently be deploying to Ka’u and Puna to do seasonal work. They must have free 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, if they cannot work for a period of time and therefore agriculture cannot proceed normally, as we work to end the outbreak.

3. More local testing capacity and access to healthcare should be immediately provided in certain targeted Big Island areas, per the collaborative recommendations of our local healthcare personnel, the DOH team and CDC/WHO recommendations.

A VERY MODEST INVESTMENT NOW WILL PAY DIVIDENDS LONGTERM

If these actions require an emergency declaration, please proceed immediately with one. Of course nothing is certain at this stage but the potential for a disaster makes us insist we move quickly and aggressively.

Once Dengue fever penetrates Puna and Hilo it will not be eradicated for a generation. This will occur if we don’t take the drastic action as described above.

The current DOH response requires more support and it needs a fresh and objective eye on the problem. We understand the incredible stress that this has placed the department under, especially Dr. Park. This is borne out by the innumerable concerns people have shared with us, the elected representatives of the region, describing the response they have received from DOH as demeaning, dismissive or not in tune with the culture and expectations of the Big Island. This is not what we expect to hear from the community and we know it is not what the department leadership means to convey. However it is a reality.

Many areas of the world with more experienced people on this specific problem, with more resources at their disposal, with stricter quarantine laws and even the use of experimental products have attempted to control dengue yet have still failed miserably.

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.

During the Maui epidemic experts felt matters were hopeless. But by engaging the full complement of global support it was not so. We must act again by augmenting our team to have a similar success. Undoubtedly this call to action will meet with resistance from our local team, who we acknowledge is working extremely hard, but will feel this diminishes their hard work to date. It should not be perceived that way. They are, in our professional opinion, simply too under-resourced to do what is necessary to tackle the entirety of this challenge, and if we may be blunt, are too close to the problem to accept input from the many community leaders, health professionals and concerned citizens that have asked us to compel a larger international response to this public health crisis.

Please act today to save tomorrow.

Sincerely,

State Sen. Josh Green and State Rep. Richard Creagan

FULL VIDEO: Think Tech Hawaii

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