A few months ago, while weed-whacking, mowing, weeding and pruning at her family’s South Kona fruit farm, Bree DuPertuis paid little attention to the pesky buzz of mosquitoes.
Typically, 50 to 100 mosquito bites by the end of a workday were no big deal.
“I get bit every day. It’s our life out here. After 10 years of being a farmer, there’s no effort to not get bit. It’s just a way of life,” said the 37-year-old Honaunau resident.
That was her take on mosquitoes before a bite infected her with dengue fever in November. She is still recovering.
On Friday the state Department of Health reported that confirmed cases in the ongoing outbreak on the Big Island number 202, with 189 cases no longer infectious and 13 potentially infectious.
South Kona and Milolii are pinpointed as two high-risk areas for dengue fever. Of the confirmed cases, 182 are Big Island residents and 20 are visitors.
While dengue is not endemic to Hawaii, it is intermittently imported from endemic areas by infected travelers.
The recent cases mark the first cluster of locally acquired dengue fever since the 2011 outbreak on Oahu, when four cases were confirmed.
Health Department officials were notified of the first locally acquired case on Oct. 21 but took a week to verify and notify laboratory networks. After the presence of dengue fever was confirmed, Hookena Beach Park, a popular recreation area, was shut down and has remained closed. Officials later closed Milolii Beach Park.
DuPertuis said she was unaware of the emerging dengue threat when she contracted the illness, perhaps on her farm or at her second job with a cleaning crew.
Her symptoms appeared Nov. 8, with a fever approaching 104 degrees and a feeling of delirium. A friend took her to Kona Community Hospital and wheeled her into the facility because DuPertuis felt too ill to walk.
After a day in the hospital, she went home and attempted to set up a mosquito-free room. Dengue is a viral infection spread via mosquitoes that bite an infected person and then carry the virus to the next person.
“I wanted to ensure that I didn’t get bit when I got sick,” DuPertuis said, pointing out that because her residence is not entirely walled in, she had to close up some breezy areas. Her mother cared for her at her home for a week, and her family sprayed the yard.
“The first five nights were pretty traumatic,” DuPertuis said, with the “fever spiking, not sleeping and delirium” and a continuous headache.
“The headache was the worst of it,” she said.
About a week after her hospital stay, DuPertuis said she began to feel the illness in her bones.
“It felt like a thorn in every joint,” she recalled. “It traveled from my joints into my bones. I really did feel … like twisting my bones out of place.” In addition, DuPertuis said her blood pressure plummeted and her hands and feet became “comically swollen.”
She added, “After 2-1/2 to three weeks, I was able to finally go to the store, feed myself properly, actually barely start to function.”
Anecdotally, she recognizes her case as especially severe.
“I was much sicker than everyone else I know,” she said.
DuPertuis, who was also part of a housecleaning crew, suspects that the rest of the crew unknowingly contracted dengue fever before she did.
On Nov. 1 the four-person crew was scheduled to clean out a vacation rental house in Hookena, South Kona — now considered ground zero for the outbreak. Three crew members were too sick to work.
“They had contracted it a week before,” DuPertuis said. “I hadn’t gotten it at that point, and worked that day. A few days later they shut down the beach.”
The vacation rental that DuPertuis cleaned is like a lot of places in Kona, where there is “a lot of cabana living,” she said. “It’s common to have very rustic living spaces. The attraction is you’re not completely walled in.”
DuPertuis said she’s still experiencing some residual symptoms, including weakness, which has slowed the progress in her new employment pursuit. At the time she contracted dengue fever, DuPertuis was getting licensed to work as a massage therapist.
She is actively telling others that she contracted dengue — even if that leaves her feeling a bit sheepish.
“It’s important to tell all your neighbors so they can be on high alert,” DuPertuis said. “It’s embarrassing. I was working all around the community before my fever spiked. I don’t know if I could have been passing it on to them.”
The disease is not often fatal, but can be in severe cases known as dengue hemorrhaghic fever.
The Centers for Disease Control and Prevention advises, “When infected, early recognition and supportive treatment can substantially lower the risk of medical complications and death.”
As the new year gets underway, DuPertuis said she now reaches for bug spray and wears long sleeves to avoid everyday mosquito bites.
Health officials encourage anyone with symptoms of dengue to seek medical care and to get tested.
The CDC lists the principal symptoms as high fever and at least two of the following: severe headache, severe pain behind the eyes, joint pain, muscle and/or bone pain, rash and bleeding from the nose or gums. Other symptoms include severe abdominal pain or persistent vomiting, red spots or patches on the skin, vomiting blood, black stools, drowsiness or irritability, difficulty breathing and pale, clammy skin.
In cases of dengue hemorrhagic fever, blood vessels can become leaky and touch off circulatory failure and shock. If diagnosis is made early, a health care provider can treat the illness with fluid replacement therapy.
