Confirmed cases of dengue fever on Hawaii island today climbed to 93, increasing by a single case since Monday. 

The state Department of Health reported today that 23 children and 70 adults — including 13 visitors — have fallen ill in an outbreak that could continue for months and spread into new areas. 

The disease is transmitted by mosquitoes, and symptoms include fever, severe headaches, pain behind the eyes, joint and/or muscle pain and rash. 

To contain the outbreak, the health department has been conducting assessments for mosquito activity and sprayed pesticide.