State officials celebrated a big milestone on Wednesday in the fight against dengue fever, but said it’s too soon to declare victory in the outbreak — and warned that Hawaii’s real battle may just be beginning.

“It’s critical for everyone to understand this is not the end,” Department of Health Director Virginia Pressler said. “This is just the beginning of a new phase where we need to be prepared every day for a new mosquito-borne disease outbreak.”

As of Wednesday, Hawaii Island had gone 30 days since the “end of the infectious period” of the last locally acquired case of dengue fever, Gov. David Ige said.

Dr. Virginia Pressler speaks to media during press conference updating efforts against Zika and other viruses on Hawaii island. 27 april 2016
The state is working on a plan for combating future mosquito-borne outbreaks, Department of Health Director Virginia Pressler said at a press conference with Gov. David Ige Wednesday. Cory Lum/Civil Beat

The dengue virus has a maximum 10-day incubation period for humans, so 30 days represents three cycles of incubation.

There is no standard amount of time for when an outbreak can be declared over, Pressler said.

The state’s emergency proclamation over dengue and Zika remains in effect, and state efforts in combating mosquito populations will not wane, Ige pledged.

With the ease of international travel and the increased spread of vector-borne diseases around the world, an outbreak of dengue or Zika could be just a mosquito bite away.

Since the start of 2016, the state has confirmed four imported cases of Zika, one case of chikungunya, and six cases of dengue.

“We are always vulnerable to these types of threats,” said Darryl Oliveira, administrator of Hawaii County’s Civil Defense Agency, adding that the state needs to maintain vigilance moving forward.

Ige offered liberal praise on Wednesday for county and state efforts in combating the largest dengue outbreak since the 1940s. More than 1,600 individuals have been examined for possible dengue infections, and officials have visited more than 500 private properties and 300 public spaces looking for mosquito breeding areas, Ige said.

Since the start of the outbreak there have been 264 confirmed cases of dengue on Hawaii Island.

The dengue outbreak has also helped the state restore vital services, Ige said.

“This incident has truly helped the state of Hawaii be better prepared moving forward,” Ige said.

The Centers for Disease Control and Prevention warned in December that Hawaii’s Department of Health had “critical deficiencies” in staffing that could hamper future efforts should another outbreak occur.

Governor Ige Zika virus update presser held at the Gov’s office. 27 April 2016
Governor Ige briefs media and some lawmakers in the gallery, updating efforts to combat Dengue and other potential viruses. Cory Lum/Civil Beat

The state’s vector control team was gutted by budget cuts in 2009 — along with efforts to monitor the arrival of new mosquitos and track the population on Hawaii Island.

The state has restored a number of the vector control positions since the start of the outbreak, and re-hired the entomologist who was conducting the mosquito study on Hawaii Island before getting laid off.

Conducting surveillance to identify mosquito populations throughout the state will be an important part of future efforts, Pressler said,

Last week lawmakers agreed to fund 20 new positions and allocate $1.27 million for the state Department of Health’s fight against dengue fever and other vector-borne diseases. The governor had requested 33 positions and $2.34 million in funding.

The National Guard is also helping to clean up mosquito-breeding areas on the Big Island, and will continue to do so for several weeks.

Although state officials are vowing that efforts against mosquito-borne diseases will not diminish when the outbreak ends, historically such promises have proved hard to keep.

After the Maui dengue outbreak in 2001, lawmakers had a slew of plans for keeping mosquito populations under control. Within a decade, most efforts had been abandoned and staff tasked with tracking mosquitos was largely laid off.

Mosquito control is “the easiest thing for politicians to cut,” David Morens, a senior scientific adviser at the National Institute of Allergy and Infectious Diseases, told Civil Beat in February.

“I am not confident at all that efforts will be sustained,” said Karen Anderson, a Hawaii Island resident who has been raising awareness about dengue through a Facebook page that now has more that 1,400 members across the islands.

“I think the Department of Health needs to honestly assess what their response has been to the dengue outbreak here, and really evaluate how they can improve things moving forward,” Anderson said.

Anderson and her neighbors are continuing their efforts in south Kona to create trapping programs, increase public education about mosquito abatement, and train residents on how to identify the mosquitos most responsible for spreading the disease.

“We are continuing to work as a community,” Anderson said. “We are not letting down our guard.”

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