A young woman, eight months pregnant, arrived at Hilo Medical Center feeling ill this month. She was diagnosed with a urinary tract infection and sent home with antibiotics, according to her father, who asked not to be identified.

That same day, her mother was admitted to the Hilo hospital with a high fever, dehydration and a low platelet count. She eventually was diagnosed with a severe case of dengue fever, but it took days to get the test results back.

It turned out her daughter had also contracted dengue fever, but medical personnel failed to catch it.

"That is partially Hilo hospital’s bad," the woman’s father said. "But my feeling was that the Department of Health really didn’t educate the doctors well enough."

The incidents were recounted by state Sen. Russell Ruderman (D-Puna) on Friday during a legislative briefing on dengue fever hosted by the House Health Committee and the Senate Commerce, Consumer Protection and Health Committee.

Hawaii island has been battling an outbreak of dengue fever since mid-September. Concerned about the continued spread of the illness, lawmakers called on state health officials and Hawaii County defense administrators to brief them on their efforts.

The hearing was attended by Virginia Pressler, director of the Hawaii Department of Health, and Sarah Park, the state’s epidemiologist. Darryl Oliveira, the County of Hawaii’s civil defense administrator, spoke to the lawmakers by phone from the Big Island.

Park said that despite the incident at Hilo Medical Center, the Health Department was doing everything it could to educate health providers.

"Unfortunately, I can’t be responsible for every medical provider out there," she told lawmakers. "I can only try to educate them as much as possible"

To that end, she said, "We’re sending out medical advisories, we are engaging our partners, we have a clinician resource page."

There have now been 88 confirmed cases of the virus; 75 are Hawaii residents and 13 are visitors. Twenty-one of the cases have been in children under the age of 18.

North and South Kona, as well as Kau, have been most heavily affected, but Health Department maps indicate areas of risk throughout the island, including Hilo, Waimea, Pahoa and Volcano.

Most people who contract the mosquito-borne illness, also known as break-bone fever, don’t show any symptoms, according to the Centers for Disease Control and Prevention. But those who do can run high fevers and experience painful joint and muscle pain, severe headaches, rashes and pain behind the eyes. In severe cases there may also be vomiting, bleeding and liver, heart and lung complications.

"We are all taking this very seriously," Oliveira said. "The mayor, the governor and all of us are committed to putting a very aggressive attack forward and committing as much resources as we can to this effort."

Oliveira said that the county has been working to get out information about dengue fever through radio spots, its Web page, social media and, increasingly, community meetings. Officials are also targeting the homeless and migrant agricultural workers, who are considered at elevated risk for contracting and spreading the disease.

He said that the county had been working with resorts and the Hawaii Tourism Authority to alert visitors.

The county is also spraying pesticides at schools, prioritizing those where someone in the vicinity of the property has contracted the illness.

"There has been no evidence to suggest that schools are a source of the outbreak or hot spot," said Oliveira. "Treating areas around the schools is pre-emptive."

Oliviera said that the county hopes to expand spraying to charter and private schools.

Some lawmakers, however, expressed frustration that the officials weren’t employing a more aggressive spraying schedule.

"We understand that you are saying that spraying alone is not the answer and that the spraying is being done where there are confirmed cases, and we hear that," said state Rep. Nicole Lowen (D, Holualoa-Kailua-Kona-Honokohau). "And I hope that you are hearing us say that we believe it is not the only solution, but it is still part of the solution."

A CDC report on a previous dengue fever outbreak in Hawaii concluded that spraying around schools "had questionable utility in combating the outbreak."

Both Park and Pressler said that the best way to control the virus is to minimize mosquito bites by getting people to wear mosquito repellent and discard standing water.

"The life cycle of the dengue virus absolutely requires a human. We are part of the life cycle of the virus — it’s mosquito, human, mosquito and ongoing," said Park. "So the goal is to really cut that life cycle — and cutting that life cycle means separating the human from the mosquito. There is no way we are going to get rid of all of our mosquitoes at this point, and as long as the mosquitoes are there, the threat will always be there."

Some lawmakers said that they thought the Health Department could do more. Samples have to be flown to Oahu to be tested for dengue fever, and the processing takes a week, making it more difficult to control the virus in affected areas.

However, Park said it wasn’t feasible to set up a lab on the Big Island. She said Hawaii is one of the few states that can do its own testing. In 2001, when the state had an outbreak of 122 cases, samples had to be sent to the mainland.

Health officials were also criticized for not getting out information fast enough to health providers. The Health Department recently partnered with Toby Claremont, director of the Health Care Association of Hawaii, to help communicate with health providers about the dengue fever outbreak. Claremont said that he expects to have contacted all providers by the end of the month.

Park stressed that this is just a continuation of the state’s outreach efforts.

But Ruderman wasn’t persuaded, noting the problems at the Hilo hospital.

"I find it shocking that they don’t have a database to immediately reach all health care providers on any given island," he said. "I also find it outrageous that it is still taking a week to get blood tests back. I see no reason why they can’t establish an emergency lab on the Big Island so that we can respond in a day or two instead of a week or more."