The Hawaii Department of Health has confirmed two more travel-related cases of dengue in the state — this time on Kauai and Maui.

This is the first dengue case for Kauai, and the second for Maui, so far this year. The total number, including the case reported last week on Oahu, has grown to eight so far this year.

“Exposure for these cases originated among various locations worldwide,” said DOH in a news release. “Multiple regions around the world are currently experiencing higher-than-normal dengue activity.”

DOH said the two newest cases involved individuals who traveled to a region where dengue is known to be spread but did not specify where, and that teams were deployed for inspection and mosquito control in affected areas.

Dengue outbreaks occur in parts of Central and South America; parts of Asia, including the Philippines; the Middle East; Africa; and some Pacific Islands, including American Samoa, the Federated States of Micronesia, the Marshall Islands, Palau; and parts of the Caribbean including Puerto Rico.

Dengue virus is spread from infected person to mosquito to person, according to DOH. While Hawaii is home to the type of mosquitoes that can carry dengue, the disease is not established here.

Symptoms include the sudden onset of fever, nausea, vomiting, rash and body aches, which typically last two to seven days. Although life-threatening illnesses can occur, most people recover after about a week.

The Centers for Disease Control and Prevention has also issued an alert notifying health care providers and public health authorities of the increased risk of dengue infections in the U.S. this year.

According to the CDC, the global incidence of dengue this year “has been the highest on record” for this calendar year, and many countries, including those in the Americas, are reporting higher-than-usual dengue case numbers.

Anyone who plans to travel or has traveled to an area with dengue is at risk for infection, said DOH.

Four to six weeks before travel, Hawaii residents should review country-specific travel information for the most up-to-date guidance on dengue risk and prevention measures for that country.

Residents returning from an area with a risk of dengue should take steps to prevent mosquito bites for three weeks. If symptoms develop within two weeks upon return, they should seek medical evaluation.

Health officials also recommend eliminating mosquito-breeding sites in and around homes by pouring out containers of standing water.