Hawaii - Jeff Campbell [491]
Covering all the islands, the Hawaii Health Guide (www.hawaiihealthguide.com) is the most comprehensive central resource for finding local hospitals, health services and practitioners.
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INFECTIOUS DISEASES
In addition to more common ailments, several infectious diseases are present in Hawaii. Most of these diseases are acquired by mosquito or tick bites, or through environmental exposure.
Dengue Fever
Dengue is transmitted by aedes mosquitoes, which bite preferentially during the daytime. Since they breed primarily in artificial water containers (like barrels, plastic containers and discarded tires), dengue is especially common in densely populated, urban environments. In Hawaii the last outbreak was in 2002. For updates, consult the Hawaii State Department of Health website (www.state.hi.us/doh).
Dengue usually causes flulike symptoms, including fever, muscle aches, joint pains, headaches, nausea and vomiting, often followed by a rash. There is no treatment for dengue fever except to take analgesics such as acetaminophen/paracetamol (eg Tylenol) – do not take aspirin, as it increases the likelihood of hemorrhaging – and drink plenty of fluids. See a doctor to be diagnosed and monitored. Severe cases may require hospitalization for supportive care. There is no vaccine. The cornerstone of prevention is insect-protection measures.
Giardiasis
This parasitic infection of the small intestine occurs all over the world. Symptoms include nausea, bloating, cramps and diarrhea, and may last for weeks. To protect yourself, don’t drink from waterfalls, ponds, streams and rivers, which may be contaminated by animal or human feces. The infection can also be transmitted from person to person if proper hand-washing is not done. Giardiasis is easily diagnosed by a stool test and readily treated with antibiotics.
Leptospirosis
Leptospirosis is acquired by exposure to water contaminated by the urine of infected animals, such as rats and feral pigs. Outbreaks often occur at times of flooding, when sudden overflow may contaminate water sources downstream from animal habitats. Even an idyllic waterfall may, in fact, be infected with leptospirosis. The initial symptoms, which resemble a mild flu, usually subside uneventfully in a few days, but a minority of cases are complicated by jaundice or meningitis. It can also cause hepatitis and renal failure, which might be fatal. Diagnosis is through blood tests and the disease is easily treated with doxycycline. There is no vaccine. You can minimize your risk by staying out of bodies of freshwater (eg pools, streams) that may be contaminated; avoid these entirely if you have open cuts or sores. Take trailhead warning signs about leptospirosis seriously. If you’re camping, water purification is essential.
West Nile Virus
Hawaii has no known cases of West Nile virus in humans, but infections have occurred across the mainland US and the rising number of reported cases in California is cause for concern. The virus is transmitted by culex mosquitoes, which are active in late summer and early fall and generally bite after dusk (see also Mosquito Bites, Click here). Most infections are mild or asymptomatic, but the virus may infect the central nervous system, leading to fever, headache, confusion, lethargy, coma and sometimes death. There is no treatment for West Nile virus.
For the latest update on the areas affected by West Nile, go to the US Geological Survey website (http://disease maps.usgs.gov).
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ENVIRONMENTAL HAZARDS
Vog, a visible haze or volcanic smog from active volcanoes, is usually dispersed by trade winds. Short-term exposure is not generally hazardous, however, heavy vog can create breathing problems for some. For more, Click here.
p79 for advice on ocean safety.
Altitude Sickness
Acute Mountain Sickness (AMS), aka altitude sickness, may develop in those