Good morning, my name is Lauren Pang, I'm the physician who lives on Maui.
I am the district health officer for Maui County for the State Department of Health.
So the Department of Health, my office, and the Maui County Civil Defense, we've partnered
together and we've decided that we would like to present to Maui County monthly video series on
updates where we stand with certain diseases, mosquito-borne diseases, that are affecting the
rest of the world and coming into Maui. So these mosquito-borne diseases are dengue, zika,
and chikungunya. You can call it chikungunya chick for short, okay? So where do we stand now?
And a little bit basic background since this is the first time I'm presenting to you. We are
having about several imported suspected cases of these three diseases per month. Now before this
last year, we were looking at maybe several imported cases coming outside from Hawaii,
several cases per year, but now we're having several per month and it's all mixed up. Some chick,
some zika, and some dengue, okay? Imported means that people, either residents, go somewhere where
they get the disease, say Mexico or Philippines and they bring it back. And so all of our stuff
that we've been looking at, but it's really picked up, is imported and sometimes visitors might bring
it in, okay? So then they get sick here and we have to investigate, okay? Now once again,
there is no local transmission. That means these people have brought this stuff back. They might
have spread it to our mosquitoes and the mosquitoes might give it to a local residents. We haven't
seen the second half yet. We haven't seen our local residents. So all of the people, cases we
look at or suspect, they have travel history and then we usually pick them up because they're sick,
okay? So we're looking at imported cases, no outbreak yet. Now of course in Florida,
they've imported so many that they have an outbreak, but that's not us yet, okay? Now where are these
things coming in? I can tell you, when you get several a month, they're occurring all over Maui,
okay? It's not one particular spot. In fact, we had one on Lanai, etc., etc. A lot of times these
suspected cases, travel history symptoms, they turn out when we check them by the laboratory,
not to be the disease at all. They're not confirmed. Well, why don't we just do the laboratory first?
Because the laboratory takes time to actually confirm some of these. Most of these tests are
sent to Honolulu. Sometimes they've got to be sent farther to the CDC on the mainland. Sometimes
the timing is wrong. You drew the test too early. So different tests become positive at different
times. Nonetheless, based on just the symptoms in travel history, we will start to look at these
places. And two-thirds of the time, which is par for the course, it does turn out to be negative.
And then we think, well, you did all that work for nothing. Not quite. When we go out, even if it's
negative, and even if we're extra cautious, it makes the communities very aware that we're under
the threat, or because the rest of the world is having these issues. And it's kind of a general
message, but we focus it where the case was. So what do we do? We go out to these homes. And right
now, we're looking at a couple, in fact, today, a couple imported, suspected cases in Honokowai and
Kihei. And I told you in the past, it's been all over. We had them in Hana, Makawao, Lanai,
et cetera, et cetera. And we tell people, help them control the mosquitoes. Don't get bitten. Long
pants, long sleeve shirt, use repellent, use mosquito coils. Fix the screens on your house. Don't
get bitten. Next, go around your house and destroy the breeding sites, those water pockets that
have the larva in it. If you can't empty it out, say you have bromeliads, spray it once a week with
the soapy water solution. Just use dishwasher soap. It's on our website. What's the dilution? So
that's what we tell people. And we're focusing on the areas that we have suspected imported cases.
What else do we tell the people? Well, if a case has come in, imported, and the mosquitoes bit
him, then our mosquitoes have these diseases. And they might transmit it to our residents who
never travel. So we have to go inform all the residents around this area. And by that, I mean,
200 yards, it's a daybiter. So where they live, where they work and where they eat lunch, to look
for symptoms. And if they have symptoms of these diseases, headache, fever, body ache, joint ache,
sometimes a rash, Zika is red eyes. But you notice I didn't say cough or vomiting or diarrhea. So
we're looking for kind of febrile illnesses with general body ache and general, maybe a rash. If
they have these, that means they might have got it from the mosquitoes that bit the imported cases.
Then they should call their doctor and he'll run a test. We work very closely with the doctors. And
they will notify us to watch for secondary cases. When you have secondary cases, that means you
have an outbreak, kind of like Florida or like many other countries, the rest of the world. So we
can't go so many places all the time, so often now. So the reporting of secondary cases or the
suspicion, we are going with this public service announcement, because we can't visit all the
homes all the time. A lot of you aren't home when we go visit. And then we leave flowers on your
door. So if you have these symptoms, even if you didn't travel, please tell your doctor what's
going on. I'll call that and he'll call us or call the Department of Health. And we will talk
about this. Now, where are these cases? If you go to this website, it's one word Maui Ready,
that's one word, dot org slash mosquito. Or you could go to CO, I think that's the answer, County,
dot Maui, dot HI, dot US. We've decided to vaguely kind of map where these imported cases are coming.
But the more we have, people might just throw in the towel and say, look, everybody on Maui
everywhere all the time, control those mosquitoes, watch for secondary cases. Well, we're trying to
be a little more focal now. So if you go onto the website, you can see where we are looking. Now,
if an imported case comes and he doesn't spread it to the other neighbors and we watch and we
don't see anything for maybe two months, well, it burned out. It's not going to go anywhere. So then
we try to track and pay attention to kind of an active, suspected imported cases. If it comes back,
he's lab negative, then okay, let it go. It looks like we don't say we overreacted. I think this is
quite precautionary. If you go out and only find positive lab confirmed cases, well, I don't think
you're doing enough. You're not being precautious enough. So that's the situation. I will try to
give you us or the county people will come in and we'll give you monthly updates on what's going on.
