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Orchid Club Hosts Rat Lungworm Disease Presentation

Rat lungworm disease is carried by slugs and snails. Hawai‘i Department of Health photo.

Prevention and control of Rat Lungworm Disease is the topic of a presentation by Jason Dela Cruz of the Hawai‘i State Department of Health at the Wednesday, March 14, 2018, meeting of the Kona Daifukuji Orchid Club (KDOC).

The meeting begins at 7 p.m. A potluck starts off the meeting and guests are invited to participate at the Daifukuji Soto Mission Hall.

“Since a lot of our orchids are outside in the environment, we should be diligent in controlling conditions promoting the spread of the disease,” said Joyce Hancock, KDOC program chair.

The Kona Daifukuji Orchid Club is West Hawai‘i’s oldest orchidaceae organization, with a mission to learn and foster orchid culture and promote fellowship among orchid collectors. The club meets the second Wednesday of every month at the Daifukuji Soto Mission Hall on Highway 11 at Mile Marker 114, just north of Kainaliu.

For information, visit online or phone (808) 328-8375.

DOH Cites Water Company for HI-5 Violations

Screen shot of website

The Hawai‘i State Department of Health (DOH) has cited Hawaiian Isles Water Company for delinquent reports and payments to the Deposit Beverage Container (DBC) program from August through November 2017. The company has complied with the department’s enforcement order and paid a $14,400 administrative penalty fee and the monthly amounts owed to the state.

Hawai‘i Revised Statutes §342G-105 requires beverage distributors to submit monthly distributor reports and payments to the DOH no later than the 15th calendar day of the month following the end of the payment period. Hawaiian Isles Water Company received multiple written notices reminding them of reporting and payment requirements prior to being assessed a penalty.

“Distributors can avoid serious penalties by responding to reminders from the state and submitting their payments and reports on time,” said DBC Program Manager Darren Park. “Late distributor payments and reports affect program funds and our ability to reimburse recycling companies for containers redeemed and recycled each year.”

Hawai‘i’s DBC program funds are used to recycle more than 600 million containers redeemed in the state each year. Through recycling, consumers are helping to remove beverage containers from the waste stream and reduce litter in the community. The program certifies independent recycling companies to operate Certified Redemption Centers (CRCs) statewide. CRCs provide Hawai‘i consumers with refunds of the five-cent deposit fee that is paid for eligible containers. Beverage distributors submit payments and reports to the program for all HI-5 containers sold within the state.

Sheraton Kona Fined for Operating Without Permit

A Notice of Violation and Order against Kona Surf Partners LLC (dba Sheraton Kona Resort & Spa at Keauhou Bay) was issued by the Hawaiʻi State Department of Health for operating their “Da Dog House” food establishment without a valid DOH permit. A penalty fine of $20,000 was issued.

The company has 20 days to request a hearing to contest the notice.

On Jan. 12, 2018, a DOH health inspector observed the Sheraton Kona Resort & Spa selling prepared food at their “Da Dog House” food establishment. At the time, “Da Dog House” did not possess a valid food establishment permit issued by the DOH as required by state law.

In addition, the Sheraton Kona Resort & Spa at Keauhou Bay posted a copy of their Convention Center food establishment permit at the “Da Dog House” site. It was determined the establishment had been operating illegally since Dec. 24, 2017.

“One of the most serious violations of the food safety code is operating without a valid permit,” said Peter Oshiro, environmental health program manager. “The permit process initiates the regular review and inspection of a food establishment to ensure compliance with basic health and safety requirements that provide standard protection against food illness.”

“In this case, the facility in question was operating without the requisite infrastructure needed to safely serve food which includes basic plumbing to allow employees to wash their hands,” Oshiro added. “The permit and inspection process ensures this and other basic food safety measures are in place.”

Sheraton Kona Resort & Spa at Keauhou Bay is located at 78-128 Ehukai Street, Kailua-Kona.

For more information on the department’s food safety program, click here.

Hawai‘i Mumps Outbreak: 770 Confirmed Cases

The total number of confirmed mumps cases in Hawai‘i as of Thursday, Jan. 4, 2018, stands at 770, with 108 on Hawai‘i Island, 610 on O‘ahu, 49 on Kaua‘i and three on Maui.

The ongoing mumps outbreak is by far the worst in several decades for Hawai‘i, which typically has fewer than 10 cases a year.

State Epidemiologist and Chief of the Disease Outbreak Control Division Dr. Sarah Park noted that in previous years, mumps cases were imported, but recently outbreak cases have been acquired locally. What began in March 2017 as two clusters of cases involving nine individuals on O‘ahu, increased to 500, with confirmed cases in all counties by late October 2017.

Commonly considered a disease that affects only young children, mumps, is affecting primarily adults and adolescents in Hawai‘i. Adults between the ages of 20 and early 40s, and adolescents 10 years old and above make up the majority of Hawai‘i’s recent mumps cases, according to the Hawai‘i Department of Health (DOH).

However, the DOH offers practical ways to avoid getting the disease.

“We strongly recommend getting an outbreak dose of the MMR (measles, mumps and rubella) vaccine, especially for those who live, work or socialize regularly in crowded settings,” said Dr. Park. “It’s also important to stay home when sick and even consider methods of social distancing, which includes avoiding crowded settings and gatherings, and not hugging or kissing when greeting others.”

“Based on the cases that we have been able to track, the common denomination has been exposure to some type of gathering, whether school, work, church, family gathering or other social event,” she said.

Hawai‘i is not the only state that has experienced a mumps epidemic. According to the Centers for Disease Control and Prevention (CDC), from Sunday, Jan. 1, through Saturday, Dec. 2, 2017, 48 states and the District of Columbia, reported mumps infections. In addition to Hawai‘i, Washington, Texas, Arkansas, Missouri and New York each reported more than 300 cases in 2017.

The MMR vaccine prevents most cases of mumps and complications caused by the disease. Individuals who have been appropriately vaccinated with a routine two-dose series can still get mumps, especially if they have prolonged, close contact with someone who has the disease, but those who are vaccinated and get the mumps will likely have less severe illness than unvaccinated individuals.

“If it were not for our highly vaccinated population, we would expect to see many more cases in individuals exposed to the mumps virus, more severe illness in those who have been sick, and more complications from the disease,” Dr. Park said.

The most common symptoms of mumps include swollen glands in front of ears or jaw on one or both sides, fever, muscle aches, headache, loss of appetite, and tiredness. Persons with symptoms of mumps should contact their healthcare provider for testing.

Complications from mumps include orchitis (swelling of the testicles), oophoritis (swelling of the ovaries), meningitis (infection of the covering of the brain and spinal cord), encephalitis (swelling of the brain), and temporary or permanent hearing loss. In rare cases, death may also occur.

The MMR vaccine is available at local pharmacies. To locate a vaccinating pharmacy nearest you, go online or call the Aloha United Way information and referral line at 2-1-1.

Additional information about mumps can be found on the DOH website.

DOH Places 7 Hospital Employees on Off-duty Status Without Pay

The Hawaii State Department of Health (DOH) is placing seven Hawaii State Hospital employees on off-duty status without pay pending the investigation of the escape of a patient on Nov. 12. The hospital employees are being notified and will be relieved of their duties for 30 days as the internal investigation continues. As the investigation progresses, more employees may be identified and placed on off-duty status.

The department is committed to a thorough investigation, evaluation and correction of our hospital protocols and procedures to prevent this type of incident from reoccurring. In addition to placing employees on off-duty status, all unescorted on-campus and off-campus privileges have been stopped, visits to Kaneohe Clubhouse have been suspended, all staff have been retrained on the accountability process, security staff have been reassigned, all levels of patient privilege and visitation policies are being reviewed, additional unannounced patient area searches are being conducted, and procurement of additional security fencing is being expedited.

Hawaii Department of Health Receives $3.04 Million Federal Grant for Treatment of Adolescent Substance Abuse and Mental Health Disorders

The Hawaii State Department of Health’s Alcohol and Drug Abuse Division (ADAD) has received a $3.04 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, to provide funding over four years for the treatment of adolescents and transitional aged youth with co-occurring substance abuse and mental health disorders.

The grant is designed to bring together stakeholders who serve Hawaii’s adolescents, enhance and expand treatment services and implement financial mechanisms and other reforms that improve the efficiency of substance use disorder (SUD) treatment efforts.

“We are moving towards our goal of a drug free Hawaii,” said Edward Mersereau, ADAD chief. “This grant will allow us to expand the Hawai‘i Adolescent and Transitional Aged Youth Treatment Implementation project (YT-I) to increase rates of abstinence, enrollment in education, vocational training, employment and social connectedness—along with decreasing criminal and juvenile justice involvement among our youth.”

ADAD’s treatment services are designed to promote a statewide culturally appropriate, comprehensive system of services to meet the treatment and recovery needs of individuals and families. Throughout this project, ADAD will have a coordinated SUD treatment services program with the department’s Child and Adolescent Mental Health Division, Family Guidance Centers, and four drug and alcohol treatment providers.

According to a 2014 DOH report on alcohol and drug abuse treatment services in Hawaii, adolescents comprised more than half (53 percent) of the nearly 4,000 clients who received treatment by ADAD in 2014. At a six-month follow-up that same year, almost all adolescents (99 percent) who received services were attending school and the majority (61 percent) reported not abusing any substances in the 30 days prior to follow up. The vast majority of those adolescents continued to have no arrests, no hospitalizations, and no emergency room visits since discharge.

“The result of this project will be higher cross-professional training in SUD treatment practices, a more proactive approach to preventative healthcare, a concrete referral system that leaves little room for patients to fall through the cracks, and expanded use of health information technology for better informed decision-making at the point of care,” Mersereau said. “Our goal is a statewide system of treatment that is substantially more effective in utilizing existing resources and treatment methods far beyond the life of the YT-I project.”

The Department of Health’s Alcohol and Drug Abuse Division is the primary and often sole source of public funds for substance abuse treatment in Hawaii. ADAD’s treatment efforts are designed to promote a statewide culturally appropriate, comprehensive system of services to meet the treatment and recovery needs of individuals and families. Treatment services have, as a requirement, priority admission for pregnant women and injection drug users. For more information about the division go to: http://health.hawaii.gov/substance-abuse/.

Hawaii Mumps Outbreak Explodes – 16 Additional Oahu Cases

The Hawaii State Department of Health (DOH) has confirmed 16 additional cases of Oahu residents with mumps bringing the total number of cases in 2017 to 81. The recently confirmed cases include children and adults. Most of the cases are linked to previously confirmed illnesses. None of the individuals required hospitalization and all have recovered or are recovering.

The number of cases continues to steadily increase as today’s number represents test results received over the extended holiday weekend. The department expects to see more cases of mumps in Hawaii as the viral disease is highly contagious and circulating on Oahu. Information on case numbers is updated regularly at http://health.hawaii.gov/…/department-of-health-investigat…/.

The DOH is recommending all adults born in or after 1957, without evidence of immunity to mumps, who cannot verify previous MMR vaccination, should receive at least one MMR vaccine dose. Individuals with only one documented MMR dose, are strongly encouraged to consider receiving a second MMR vaccine dose.

MMR vaccine is available at local pharmacies across the state. To locate a vaccinating pharmacy in your community, visit http://health.hawaii.gov/…/vaccines-immun…/vaccine-locators/ or call the Aloha United Way information and referral line at 2-1-1.

Mumps is spread when an infected person coughs or sneezes. The virus is also spread by sharing items such as cups or eating utensils, or by touching contaminated objects or surfaces and then touching the eyes, nose, or mouth.

Prevent the spread of mumps in our community by:

  • Ensuring your family is fully vaccinated with the MMR vaccine. High vaccination coverage helps to limit the spread of mumps. Two doses of the vaccine are 88 percent effective at protecting against mumps and one dose is 78 percent effective. Being fully vaccinated can help protect loved ones, family members, friends, classmates and coworkers.
  • Patients suspected or diagnosed with mumps should self-isolate and avoid going out and exposing others for nine (9) days after onset of parotitis (tender, swollen jaw).
  • People who have been exposed to mumps and are not vaccinated should not attend school, work or travel from day 12 through day 25 after exposure.

Additional information about mumps and the ongoing investigation can be found on the DOH website at http://health.hawaii.gov/…/department-of-health-investigat…/.

Hawaii Department of Health Orders Meadow Gold Dairies to Stop Distribution and Sale of 2% Reduced Fat Milk

The Hawaii State Department of Health (DOH) has ordered Meadow Gold Dairies to stop its distribution and sale of two-percent reduced fat milk. DOH issued a Cease and Desist Order to the company today after laboratory results from routine milk samples exceeded standard limits for Coliform bacteria.

“Milk production is regulated with routine testing both at the farm and after packaging to ensure a safe product,” said Peter Oshiro, program manager of the DOH Sanitation Branch. “Department of Health inspectors will work with Meadow Gold Dairies to investigate the possible source of contamination, approve a plan of correction, and conduct further testing to confirm the company meets the standards to resume two-percent reduced fat milk distribution and sale.”

Samples of two-percent reduced fat milk taken from Meadow Gold Dairies on Jan. 19, Feb. 6 and 22, 2017, revealed excessive Coliform counts of more than 150/ml, 130/ml and more than 150/ml respectively. The maximum allowed Coliform limit for pasteurized milk is 10/ml. Coliform is used an indicator of post-pasteurization contamination.

DOH conducts monthly testing of samples of all Grade A raw and pasteurized milk produced at dairy farms and milk plants in Hawaii. State and Federal regulations require that samples be taken a minimum of four out of every six months, though most jurisdictions in the nation, like Hawaii, conduct sampling every month. DOH may also accelerate routine sampling of a specific product whenever product samples do not meet required standards.

Hawaii Administrative Rules Title 11 Chapter15 states that the DOH may suspend the distribution and sale of a particular milk product produced by a milk plant, whenever the product is in violation three times out of the last five consecutive samples for the first three Critical Control Point (CCP) standards listed below.

Critical Control Point/Critical Limits:

  • Temperature – 45°F or less
  • Bacterial Limits -1 0,000/ml or less
  • Coliform – 10/ml or less
  • Phosphatase – 1mcg/ml or less
  • Antibiotics – No Positive results on drug residue detection

To resume distribution and sale of two-percent reduced fat milk, Meadow Gold Dairies must pass health inspections and undergo additional testing of product samples. All other milk products from Meadow Gold Dairies meet state and federal standards required for distribution and sale.

Hawaii DOH Cautions Travelers Headed to 2016 Summer Olympic Games About Zika Virus

With the 2016 Summer Olympic Games set to begin at the end of this week in Rio de Janeiro, Brazil, the Hawaii State Department of Health (DOH) is cautioning all travelers, especially Hawaii residents, to take preventive measures against being bitten by mosquitoes while there, because of the ongoing Zika outbreak in that country.

2016 OlympicsThe U.S. Centers for Disease Control and Prevention (CDC) currently has posted a Level 2 Travel Alert, advising travelers to the Olympic Games to practice enhanced precautions while in Brazil. CDC is also recommending that women who are pregnant not attend the Olympics because of the risk Zika poses to a developing fetus. Zika has been linked to cases of microcephaly, a serious birth defect that causes a baby to be born with a smaller than normal sized head because of abnormal brain development, which can result in medical problems and impaired development.

“We wish Hawaii residents going to Brazil for the Olympic Games safe travels, and urge them to heed travel warnings by preparing carefully and doing what they can to prevent mosquito bites,” said Health Director Dr. Virginia Pressler. “If people avoid being bitten by mosquitoes, they will substantially reduce their risks of contracting Zika virus and bringing it back to Hawaii. We don’t have locally transmitted Zika here, and we must do whatever we can to keep it that way.”

Travelers returning to Hawaii from areas affected by Zika and other mosquito-borne viruses are advised that if they become ill within two weeks of returning home, they should consult and be assessed by their healthcare provider.

While there have been no cases among persons who have been infected by mosquitoes in Hawaii, our state has been identified as a high risk area for experiencing local Zika spread because of our year-round warm temperatures and consistently high travel rates, both into and out of the state. Florida is also identified as a high-risk state for local Zika transmission, and recently confirmed its first cases of locally-acquired Zika. These cases are the first instances of locally transmitted Zika in the United States.

Local mosquitoes can become infected when they bite an infected human. Active local transmission begins when infected local mosquitoes infect the humans they bite. Zika can also be spread from an infected pregnant woman to her unborn child before or during birth and from an infected person to their sexual partners.

To protect against contracting Zika, especially during travel to Brazil for the Olympics, or other locations with local mosquito-borne transmission, DOH recommends the following precautions:

  • Apply EPA-registered insect repellent containing 20-30 percent DEET, especially if outdoors.
  • Wear protective clothing, such as light-colored long-sleeved shirts, long pants, socks and shoes.
  • Avoid activities outdoors at sunrise and sunset when mosquitoes are most active.
  • Avoid areas with mosquitoes, such as shady, damp locations or standing water.

For travel notices and information related to Zika, visit the CDC’s Zika Travel Information page at http://wwwnc.cdc.gov/travel/page/zika-travel-information. For more information about Zika virus, visit DOH’s Disease Outbreak and Control Division’s website at http://health.hawaii.gov/docd/dib/disease/zika_virus/. Additional resources about DOH’s efforts to raise awareness about mosquito-borne disease prevention in Hawaii can be located at FightTheBiteHawaii.com.

Hawaii Department of Health Awarded $3.7 Million to Support Epidemiological and Laboratory Activities

The Hawaii State Department of Health (DOH) has been awarded $3.7 million from the U.S. Centers for Disease Control and Prevention (CDC) to support infectious diseases epidemiological and laboratory activities in the state. The funding is being provided through the CDC’s Epidemiology and Laboratory Capacity for Infectious Disease Cooperative Agreement (ELC).

Mosquito Bite

In addition to funding vital ongoing infectious disease surveillance and investigation for areas such as foodborne disease, flu, and healthcare-associated infections, the ELC award will provide increased support in the area of arboviral disease (e.g., dengue, Zika, chikungunya) and critical new resources to address growing concerns presented by general antimicrobial resistance and specifically, antibiotic-resistant gonorrhea and chlamydia.

“These new funds will help in many critical areas of disease investigation, including providing support for our current Hepatitis A outbreak,” said Health Director Dr. Virginia Pressler. “We’re grateful for this recognition and generous grant from CDC, and will work to ensure that these new funds translate to sustainable efforts to protect our residents and visitors in Hawaii.”

Of the approximately $3.7 million awarded, ELC funding will focus on areas including:

  • $1,062,000 to support Hawaii’s efforts to protect the state from Zika and other arbovirus diseases such as chikungunya and dengue. ELC funds will be used to augment epidemiologic surveillance and investigation, enhance mosquito monitoring, and provide supplies and support to the State Laboratories Division for arbovirus testing.
  • $2,711,149 to support other ELC efforts, including: building capacity to address antimicrobial resistant gonorrhea and chlamydia concerns, increasing laboratory capacity for antimicrobial resistance detection and response infrastructure, strengthening flu surveillance and foodborne surveillance and response capacity, increasing health information systems capacity, and other ELC activities.

“The funding of this award will greatly boost our efforts to protect our community against the potential introduction of Zika virus and many other infectious diseases,” said State Epidemiologist Dr. Sarah Park. “By building our capacity to find and stop disease outbreaks we increase our ability to help save lives.”

Dr. Chris Whelen, State Laboratories Division administrator added, “We are grateful to the CDC ELC program, and very excited about expanding the role of the State Laboratories in combating drug resistant infectious diseases.”

The Department of Health’s Disease Outbreak Control, Environmental Health Services, Family Health Services, Communicable Diseases and Public Health Nursing, and State Laboratories Divisions are working jointly across the department and with partners throughout the state to assure a comprehensive Zika prevention strategy and response plan. The ELC funding in addition to grants through the Public Health Emergency Preparedness Cooperative Agreement and the Hawaii Birth Defects Surveillance, Intervention, and Follow-up for Zika Virus Grant will further support these efforts to protect public health.

Information on Zika virus can be found at the Department of Health’s Zika webpage at http://health.hawaii.gov/docd/dib/disease/zika_virus/.

For more information on the ELC program, go to http://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html.

Statewide Campaign on Mosquito-Borne Diseases and Threats to Hawaii to be Announced

Governor Ige and the Mayors of Honolulu, Maui, Kauai, and Hawaii Counties will announce a new statewide public education campaign to build awareness of mosquito-borne diseases and their threat to Hawaii.

Mosquito Bite

The state and counties will also announce the state’s planning efforts to prevent, prepare, and protect Hawaii from mosquito-borne disease outbreaks this summer and throughout the year. State departments will mention special efforts underway to reach visitors, traveling residents and students with guidance on preventing the spread of Zika.

Why: As a favorite travel destination, Hawaii is identified as one of the nation’s higher risk areas for the potential spread of Zika virus. With the Aedes Aegypti mosquito present in our state, year-long warm climate, and past experience with dengue outbreaks, mosquitos pose a serious threat to our residents and visitors.

When:  Thursday, June 30, 2016 at 1:00 p.m.

Where: Governor’s Ceremonial Chambers, State Capitol 5th floor

Who:

  • Governor David Y. Ige
  • Mayor Kirk Caldwell, City & County of Honolulu
  • Mayor Alan Arakawa, County of Maui
  • Mayor Bernard Carvalho, County of Kauai
  • Mayor Billy Kenoi, County of Hawaii
  • Dr. Virginia Pressler, Director, Hawaii Department of Health
    Major General Arthur J. Logan, Adjutant General, Department of Defense
  • George Szigeti, Director, Hawaii Tourism Authority
  • Ross Higashi, Airports Division Deputy Director, Department of Transportation
  • Steven Schatz, Deputy Superintendent, Department of Education

Hawaii Department of Health Delays Announcement of Medical Marijuana Dispensary Licensees to April 29

The Hawaii State Department of Health is reviewing the criminal history records of applicants for the Medical Marijuana Dispensary licenses after announcing last week that applicants were given notice to provide consents and submit fingerprints.

Medical Marijuana“The applicants have been very responsive and a majority of applicants were able to submit their fingerprints and consents by Tuesday,” according to Peggy Leong, Supervisor for the Medical Marijuana Dispensary Licensing Program. “A small number of applicants are traveling abroad and unable to respond as quickly as we had hoped. In addition, it also came to our attention that many business entities, such as limited liability corporations, corporations and trusts failed to submit the consents and fingerprints of the individuals involved in the entities. The department sent an email to all applicants clarifying the requirements of who is subject to a background check.”

“Given the situation, and in order to provide all applicants a fair opportunity to comply with the statutory requirements, we may not be able to obtain and review the remaining information until the last week of April,” Leong added.

Director of Health Dr. Virginia Pressler said, “We have requested that applicants submit the remaining consents and fingerprints no later than April 25 and we will be pushing hard to complete our review and announce the licensees by Friday, April 29. While we regret the delay, we believe the priority is to do this the right way, and that includes being fair to the applicants by providing this additional time.”

Leong said the applicants have all been very cooperative and understanding, despite the challenges of establishing a brand new and complex program, “We really appreciate their patience and willingness to work through this with us.”

More information about the Medical Marijuana Dispensary Program can be found on the website: https://health.hawaii.gov/medicalmarijuanadispensary

Hawaii Department of Health Statement on First Case of Zika This Year

The Hawaii State Department of Health has confirmed the first imported case of Zika in Hawaii this year. The individual had a history of travel in the Pacific and has since recovered and is no longer infectious. The case was confirmed this week by the department’s State Laboratories Division.

Mosquito sucking blood on a human hand

Mosquito sucking blood on a human hand

The department conducted an investigation of the case and has determined there is no health risk to the public.

To protect the privacy of the individual, no other information will be made available about the case.“Because people frequently travel to areas abroad where Zika virus is present, we can expect that we may see more imported cases in the coming months,” said Health Director Dr. Virginia Pressler. “With Zika, and our current dengue outbreak, it’s important for everyone in the state to reduce mosquito breeding areas by getting rid of standing water, and use repellant or protective clothing to prevent mosquito bites.”

The department sent an advisory to healthcare providers statewide on Feb. 17, 2016 updating them on clinical guidance for Zika virus and urging them to be aware of areas abroad where Zika virus is circulating.

In 2015, the Department of Health reported four imported cases of Zika virus in the state.

For travel guidance go to http://wwwnc.cdc.gov/travel/page/zika-travel-information For information on symptoms, diagnosis and treatment go to: http://www.cdc.gov/zika/symptoms/index.html For information on Zika and pregnancy go to: http://www.cdc.gov/zika/pregnancy/index.html

Hawaii Department of Health Takes Critical Role in National Efforts to Control Zika Virus

The Hawaii State Department of Health (DOH) State Laboratories Division is taking an active role in national efforts to control the spread of Zika Virus. Hawaii’s State Laboratories recently provided confirmatory testing for samples from American Samoa and the Marshall Islands to support these U. S. Affiliated Pacific Island Jurisdictions in verifying disease outbreak activity.

A mosquito laying eggs

A mosquito laying eggs

“Hawaii is fortunate to have an experienced and capable public health laboratory that can serve our state with timely and quality testing under emergency conditions,” said Health Director Dr. Virginia Pressler. “That same capability is not available in many other areas of the Pacific, and providing lab support to these areas, when we can, is critical to controlling the spread of diseases and reducing the risk of introduction to Hawaii.”

“With Zika emerging in U.S. island territories of American Samoa, Puerto Rico, and the Virgin Islands, the nation is on alert,” said Dr. Thane Hancock, team leader for the U.S. Centers for Disease Control and Prevention (CDC) American Samoa Zika Response.

The timely response by the Hawaii Department of Health’s State Laboratories staff provided critical support for local disease investigations and for monitoring potentially exposed pregnant women.”

This month, DOH began using the CDC developed real-time reverse transcriptase (rRT) polymerase chain reaction (PCR) test for Zika virus. With this recently developed capability, DOH provided officials in American Samoa and the Republic of the Marshall Islands (Majuro), the first laboratory evidence of Zika transmission in these two U.S. affiliated jurisdictions.

“It’s always a balance to ensure our state needs are met first, but the staff here is more than willing to step up to support national efforts,” said State Laboratories Director Dr. Christian Whelen. “This work helps to better prepare us for potential issues that could arise in our state, and identifying and controlling outbreaks in the Pacific benefits all of us.”

While PCR is the best test during early onset of symptoms, testing for antibody to the viruses is preferred after about a week of illness. CDC is shipping antibody test materials to Hawaii so that the department’s State Laboratories Division can establish these capabilities over the next few weeks.

“The testing is very similar to the methodology our labs use for other RNA viruses such as Chikungunya, dengue, influenza, and measles,” added Whelen. “Our laboratory staff have been thoroughly trained to safely work with high risk specimens.”

DOH continues to work with the healthcare community, state, county, and federal officials to prepare for infectious diseases that threaten Hawaii and the Pacific. The State Laboratories Division administers a statewide laboratories program which conducts and regulates scientific analysis in support of environmental quality, health and safety, and infectious disease monitoring and control activities.

Hawaii Department of Health Meets EPA Interim Targets Ahead of Jan. 29 Deadline – More Funding for Water Quality Projects

The Hawaii State Department of Health Drinking Water State Revolving Fund Program disbursed more than $10.36 million in federal funds in the last half of 2015 to support infrastructure improvements in the public water systems for all four counties. This exceeded the interim target of $7.67 million in disbursements.

Clean Water Act

In addition, as of Jan. 4, the Department of Health made commitments to provide funding totaling over $32.7 million, exceeding the $28.28 million interim target. The commitments for the four Hawaii County Department of Water Supply water system improvement projects include:

  • Over $4.1 million for the Laupahoehoe Reservoir;
  • Almost $12.9 million for the Waimea Water Treatment Plant microfiltration project
  • $823,420 for phase one of the Halaula well development project;
  • $3.2 million for the Ahualoa-Honokaa transmission waterline.

The Honolulu Board of Water Supply commitment involves $11.65 million for multiple water system improvements.

Each year, Congress appropriates funds that are administered by the EPA to provide grants to states to capitalize low-interest loan programs for public water system infrastructure improvements. The funds come with stipulations.

This year, Hawaii had to meet two interim requirements by Jan.29, 2016, and these were met well ahead of schedule by Jan. 4, 2016.

“We must continually demonstrate our stewardship of the federal funds and account for how the funds are being used before we can receive additional funds,” said Joanna Seto, Safe Drinking Water Branch chief. “Our SRF team and County customers were all aware of the pending deadline and what was at stake. There was great teamwork and collaboration to meet the deadline.”

The EPA awarded the Hawaii Department of Health $688,000 on Sept. 28, 2015, and withheld a little over $8 million in federal funds, pending the Department of Health’s ability to meet specific targets by Jan. 29, 2016.

Since it began in 1997, the Drinking Water State Revolving Fund has disbursed more than $201.5 million in low interest loans.

Background

There are two funds for water system infrastructure improvement projects: the Clean Water State Revolving Fund infrastructure loan program, established by the Clean Water Act of 1987, and the Drinking Water State Revolving Fund infrastructure loan program, established by the Safe Drinking Water Act Amendments of 1996.

The Clean Water State Revolving Fund, which is also referred to as Hawaii’s Water Pollution Control Revolving Fund, provides low-interest loans to Hawaii’s four counties to construct high-priority wastewater, storm water, and non-point source water pollution projects.

Since it began in 1991, the Clean Water State Revolving Fund has disbursed more than 705.8 million in low-interest loans, providing significant savings in interest costs to the counties.

Department of Health Issuing Recall on Oysters Imported from Korea

The Hawaii State Department of Health (DOH) is issuing a recall notice for frozen, raw oysters imported from Korea and sold in bulk to distributors and food establishments in Hawaii. The individually quick frozen (IQF) raw oysters on the half shell are packaged under the Dai One Food Company label.

Department of Health

The shellfish harvest dates are Feb. 10, 11, 12, and 13, 2015 and are listed on the required shellfish identification tags for all bulk shellfish cases. “The department has already conducted product trace-backs and embargoed all of the suspect product on Nov. 24 at various local shellfish distributors and restaurants,” said Peter Oshiro, “Although this product is not sold directly to the public, a recall has been issued as an additional safeguard to further notify anyone who may possess the product that it is unsafe and should be destroyed.”

A product embargo prohibits businesses from using a product suspected of causing illness until a determination is made on the safety of the product. The department received reports of sporadic illnesses (11 total) in September, October, and November of this year that appeared to be linked to the consumption of raw oysters.

Samples of the suspect oysters were sent to U.S. Food and Drug Administration Gulf Coast Seafood Laboratory in Alabama for testing, and the samples tested positive for Norovirus. With the positive lab results, DOH has ordered all of the embargoed product held by distributors and restaurants to be destroyed.

Norovirus symptoms include nausea, vomiting, abdominal cramps, diarrhea, fever, and headaches with onset usually within 12-48 hrs after consuming contaminated food. Anyone experiencing these symptoms should consult a physician and if foodborne illness is suspected, report it to the DOH Disease Investigation Branch at (808) 586-4586.

Department of Health food rules effective February 2014 require a consumer advisory at the point of sale for any restaurant or eatery serving raw or undercooked foods.

The advisory states, “Consuming raw or undercooked meats, poultry, seafood, shellfish, or eggs may increase your risk of foodborne illness.” Pregnant or immunocompromised individuals are also advised not to consume any raw or undercooked foods.

For more information on the department’s new restaurant rules and food safety program go to http://health.hawaii.gov/san/

Two Cases of Dengue Fever Confirmed on Big Island of Hawaii – Investigating Others

The Hawaii State Department of Health (DOH) is investigating two confirmed and four probable cases of dengue fever in Hawaii residents and visitors that was locally-acquired on the Big Island of Hawaii.

Mosquito Bite

Further testing and confirmation at the U.S. Centers for Disease Control and Prevention (CDC) is pending. The department sent out a medical advisory to Hawaii County clinicians earlier today to alert them and urge them to report suspect dengue fever cases.

“Although dengue is not endemic to Hawaii, we do have the mosquito species capable of transmitting the disease,” stated State Epidemiologist Dr. Sarah Park. “It’s likely an infected traveler infected the local mosquito population, which led to this cluster, so we want the public to be aware of this mosquito-borne disease and the steps they can take to prevent infection.”

“Our local environmental health assessments have not found significant mosquito activity in the affected area,” added Hawaii District Health Officer Aaron Ueno. “As a precautionary measure the department is conducting mosquito prevention activities such as spraying with consent from property owners.”

Symptoms of dengue fever typically begin within a week after a bite by an infected mosquito and can include fever, joint or muscle pains, headache or pain behind the eyes, and rash. Persons who have the above symptoms should contact their healthcare provider and avoid further exposure to mosquitoes, which is also the best means of prevention.

Dengue virus is most often transmitted through the bite of an infected mosquito. Travelers to areas with infected mosquitoes where dengue fever is endemic are at the highest risk of acquiring the disease. Mosquitoes breed in areas of standing water (such as planters, old tires and pet water bowls). Use mosquito repellents containing 20–30 percent DEET and wear long sleeves and pants in areas where mosquito-borne disease is a concern. For tips on mosquito control, go to http://health.hawaii.gov/san/files/2013/06/Vector-mosquitohandout.pdf.

For more information on dengue fever, visit the DOH website at http://health.hawaii.gov/docd/dib/disease/dengue/.

Department of Health Now in Charge of Medical Marijuana – Rules Change

The Hawaii State Department of Health has completed the transfer of the medical marijuana registration program from the Department of Public Safety. The program officially became part of the Department of Health on Jan. 1, 2015. Hawaii is one of 23 states along with the District of Columbia that allows medical marijuana use.

Possession of a valid medical marijuana registration card issued by the Department of Health and based on the written certification of a physician permits the lawful cultivation, possession, and use of marijuana for medical purposes.

Act 177 was signed into law in June 2013 and authorized the transfer of the 14-year-old program to the Department of Health. As a health initiative, the medical marijuana program is better aligned with the Department of Health’s mission and the department’s experience in working with patients and health programs that involve public outreach, education and safeguarding patient privacy.

Act 178, which was also signed into law in June 2013, amends sections of the existing law. The Department of Health has made the following changes to comply with the law:

  • Law Enforcement 24/7 Online Verification – In accordance with Act 178, the Department of Health will provide 24/7 subject verification to designated law enforcement officers. Although no confidential information will be released, designated law enforcement officers will be able to verify if an individual has a valid medical marijuana registration card should the need arise for official law enforcement purposes. Designated officers are being trained by the department.
  • Registration Fee Increase -The patient medical marijuana registration fee has increased from $25 to $35 effective Jan. 1, 2015. A new, convenient online application and payment system makes the application process easier and faster. A portal administration fee of $3.50 will be charged for the required online services. “We’re working to make the medical marijuana program more accessible to Hawaii residents who may have a qualifying debilitating medical condition and could benefit from medicinal use of marijuana,” said Scottina “Scotty” Malia Ruis, medical marijuana program coordinator with the Department of Health.

The Hawaii Department of Health has also initiated a number of upgrades to the medical marijuana program:

Click to enter site

Click to enter site

  • New Medical Marijuana Website – The Department of Health has established a website with information on the medical marijuana program at www.health.hawaii.gov/medicalmarijuana This is the most complete and up-to-date source of information for patients, physicians, law enforcement officials and the public. The site’s home page features a sign-up box for automatic medical marijuana program updates. This is the best way to keep abreast of all improvements and changes as the Department of Health’s medical marijuana program develops.
  • Phone Information Hotline – The Department of Health has established a phone hotline with recorded messages on different aspects of the medical marijuana program. The phone number is 733-2177. Toll free numbers have also been established for neighbor island residents: Hawaii Island residents may call 974-4000, ext. 32177; Maui residents may call 984-2400, ext. 32177; and Kauai residents may call 274-3141, ext. 32177.
  • New DOH Medical Marijuana Registration Card – This month, the Department of Health began issuing its new medical marijuana registration card, which includes the location of the where the marijuana is grown and the name of the primary care physician. The new card is thin and wallet-sized like an insurance card making it easier for patients and caregivers to keep with them whenever they are in possession of medical marijuana. The new white card with a colored Department of Health logo will replace the long familiar Department of Public Safety “blue card.”
  • Physician Education – Physician outreach and information sharing through planned conference calls has been ongoing to ensure healthcare providers have accurate information about the program. Physicians who are currently certifying patients for the program are emailed information about conference calls and other updates.

Beginning Jan. 28, DOH will hold public hearings for the proposed adoption of Chapter 11-160, Hawaii Administrative Rules for Medical Use of Marijuana. This proposed new chapter will include the process for DOH to consider approval of additional debilitating medical conditions for medical use of marijuana; physician requirements to participate in the program; registration of qualifying patients and primary caregivers; monitoring and corrective action; administrative procedure; and confidentiality of information. The proposed rules are posted at http://co.doh.hawaii.gov/sites/har/admrulechange/default.aspx

Public hearings are scheduled in each county as follows.

  • Jan. 28 (10:30 a.m.-12:30 p.m.) in Hilo, Hawaii at the State Office Building conference rooms A, B and C located at 75 Aupuni St.
  • Feb. 2 (10:30 a.m.-12:30 p.m.) in Honolulu, Oahu at the Diamond Head Health Center room 418 located at 3627 Kilauea Ave.
  • Feb. 3 (10:30 a.m.-12:30 p.m.) in Wailuku, Maui at the State Office Building third floor conference room located at 54 South High St.
  • Feb. 5 (10:30 a.m.-12 noon) in Lihue, Kauai at the State Office Building basement room located at 3060 Eiwa St.

Requests or questions related to the upcoming public hearings may be sent to medicalmarijuana@doh.hawaii.gov

Medical Use of Marijuana Program Transferred to Department of Health

Effective January 1, 2015, Hawaii’s Medical Use of Marijuana Program was transferred from the Department of Public Safety to the Department of Health, according to Act 177.   Act 178  amends sections of HRS 329 Part IX , some notable changes, which became effective January 1, 2015, are:

  • “Adequate supply” changes from “three mature marijuana plants, four immature marijuana plants, and one ounce of usable marijuana” to “seven marijuana plants, whether immature or mature, and four ounces of usable marijuana at any given time.”
  • Notification of changes to information on the application – if the information provided to the department of health for registration changes, the registered program participant MUST report this change to the department of health “within ten working days” of the change. The previous requirement was “within five working days”

To get a complete understanding of ALL changes to the law, please read Act 178.

Medical MarijuanaClick Here to Learn What’s New About the Program

Click Here to Learn What’s Staying the Same

Click Here to Download the General Information FAQ

Other Documents related to Hawaii’s Medical Marijuana Program

Act 228 SLH 2000.  Hawaii’s initial Medical Use of Marijuana law.

Act178 SLH  2013 –  Makes several changes to the current law (such as: “adequate supply” of medical marijuana changes to 7 plants, regardless of maturity; useable marijuana changes to 4 oz; increase in registration fees from $25 to $35; and other changes) please read Act 178 for more information.

HRS-329 Hawaii’s Uniformed Controlled Substances Act (see part IX – Medical Use of Marijuana).

Department of Public Safety Medical Marijunana Program Info

U.S. Department of Justice “Update to Marijuana Enforcement Policy  Aug. 29, 2013.

U.S. Department of Justice “Formal Medical Marijuana Guidelines”  Oct. 9, 2009.

Department of Health Operating Air Monitoring Stations in Response to Lava Flow Activities

The State of Hawaii Department of Health is currently operating three (3) air monitoring stations in the Pahoa and Leilani estates area in response to the current and ongoing eruption and lava flow activities.  These monitors detect the presence of air borne particles that may result from the burning materials (vegetation , grass, brush, and other materials).

air quality guide

The data and information being collected by these monitors can be viewed at the following web site:  http://emdweb.doh.hawaii.gov/air-quality/ , click on “Quick Look” then go to “Puna Special Sites”.