Updates: Kona COVID-19 McClusters, Beach Closures, Interisland Arrivals, MMMC

The Department of Health (DOH) reports there have been a total of 30 confirmed cases associated with a cluster of cases among McDonald’s restaurants in Kailua-Kona, up one case from Saturday.

75-5729 Kuakini Hwy. Google Street View

The new case is an employee at a third McDonald’s located at 75-5729 Kuakini Hwy.

That location has voluntary closed at this time. The total now includes 18 employees and 12 household members. DOH is conducting contact tracing for new cases and continuing to monitor employees and family members, all of whom are in isolation or quarantine. The DOH investigation of cases is ongoing.

McDonalds released the following state:

“Our highest priority is to protect the health and well-being of our people. We’ve been informed that additional employees from our Kona Commons, McDonald’s of Walmart Kona and Kailua-Kona locations have tested positive for the coronavirus and are connected to the previous set of confirmed cases. As soon as we were notified of the first confirmed cases, we immediately closed the restaurants to conduct a thorough sanitization procedure and notified The Hawaii State Department of Health. Additionally, we previously added protective barriers to limit contact in our restaurants. We’ve identified and reached out to all restaurant staff who had been in close contact with the employees who contracted the virus and advised they self-quarantine for 14 days. Under the guidance of the Hawaii State Department of Health, we have offered universal testing to our employees at each location. We are continuing to work closely with the Hawaii Department of Health to ensure the safety of our crew and customers.” – Patrick Lim, McDonald’s Owner Operator.

Officers Out in Full Force Educating and Enforcing Beach Closures 

Officers from the DLNR Division of Conservation and Resources Enforcement (DOCARE) and the Honolulu Police Dept. were out patrolling O‘ahu beaches Saturday, educating people on temporary rules put in place by Gov. Ige. Under a new emergency proclamation revealed Friday, all beaches under State of Hawai‘i jurisdiction are closed. People are only allowed to access State beaches to get to the ocean for exercise, and they must be following proper social distancing measures. DLNR Chair Suzanne Case and DOCARE Chief Jason Redulla commented, “This is necessary to try and flatten the curve of coronavirus infections, so life can begin to return to normal in Hawai‘i.” Violations of the emergency rules can carry fines up to $5,000 and a year in jail.

Department of Business, Economic Development and Tourism:

DBEDT is reporting the following interisland passenger numbers for Hawai‘i airports for April 16, 2020.

Maui Memorial Medical Center Death, Cluster Update

An adult male who was hospitalized at Maui Memorial Medical Center (MMMC) is the 10th COVID-19 death reported in Hawai‘i. The patient was in the 40-59-year age group and had no previous medical conditions. Exposure history may be travel-related.

Meanwhile, three additional people are under investigation as being potentially associated with a cluster of positive COVID-19 cases at MMMC. The DOH’s investigation at MMMC continues, and it appears the outbreak may have begun with a healthcare worker who reported to work while ill. A total 45 people (29 staff and 16 patients) are now associated with this cluster of cases. All have been appropriately isolated to prevent further spread of infection.

Maui Nursing Home Dealing With COVID-19

Hale Makua Health Services received word from the State of Hawaii Department of Health (DOH) that one Home Health patient has tested COVID-19 positive, and that one of six of our nursing home residents who were potentially exposed to COVID-19 during their stay at Maui Memorial Medical Center (MMMC) prior to being admitted to Hale Makua has tested positive. The nursing home resident who tested positive for COVID-19 received a negative test result on April 9, 2020. Because this individual was treated on the MMMC unit with the COVID-19 positive cluster of workers, the resident was re-tested on April 13, 2020, which resulted in the current positive received today, April 15, 2020. The resident is currently asymptomatic and in isolation.

On April 11, 2020, Hale Makua Health Services was notified by DOH that six nursing home residents were potentially exposed to COVID-19. Since then the resident noted above had a second test administered, which came back positive. The five other nursing home residents recently admitted from MMMC tested negative, have been in isolation since April 12, 2020, are being retested for COVID-19, and are currently asymptomatic. As per DOH’s recommendation, all of these residents have been moved to a separate wing for 14-day quarantine in private rooms with droplet precautions. All residents and staff who may have been exposed will be tested for COVID-19.

Home Health by Hale Makua is caring for its first positive COVID-19 patient. This patient presented with symptoms of COVID-19 after being discharged from the hospital, and was under observation by the DOH until being released from isolation on April 14, 2020. Out of an abundance of caution, all employees who had any contact with the patient are also self-isolating and have been tested for COVID-19.

“Our goal is always to ensure that we protect the health and safety of all those in our care so that we may continue providing services in the most appropriate care setting for our kupuna. We stands beside our employees, residents, patients and community members, to provide support and guidance in any way we can. We have already implemented many measures to ensure the safety and protection of all those in our care.” states Hale Makua Health Services CEO, Wesley Lo.

At Hale Makua nursing home and adult residential care home precautions include:

· Staff and vendors screened for respiratory symptoms and/or fever prior to entering the campuses since early March.

· All new admissions have been admitted to West neighborhood in Kahului since March 23.

· All employees have been required to wear face masks since April 2.

· All employees providing care to residents who may have been exposed to COVID-19 have been following appropriate PPE protocols since April 11, when the organization was notified by DOH of potential COVID-19 exposure.

· Visitors have been prohibited, except in certain circumstances deemed appropriate by an Administrator. Creative ways to keep residents in touch with loved ones have been implemented.

· Employees who work in other healthcare settings are temperature checked at the start and end of shift, in addition to wearing personal protective equipment (PPE) throughout their shift at Hale Makua.

· High touch surfaces are wiped down frequently.

Home Health by Hale Makua, precautionary measures to keep patients healthy, safe, and out of the hospital include:

· Continuing to provide education to staff and patients about preventative measures like social distancing, proper hand hygiene, and cleaning and disinfection protocols.

· Conducting staff meetings remotely instead of in person

· Increasing the use of teleworking among staff

· Providing increased support to our patients and families by telephone or telehealth calls.

· Preadmission screening protocols

· Staff screening protocols

· Pre-visit screening protocols for the entire household

· Pandemic visit protocols, to include limiting nonessential persons from the visit, source control, distancing, and appropriate use of PPE.

· Training our staff to provide COVID-19 specific education to all high risk patients and household members.

Mr. Lo concludes, “I would like to give a heartfelt ‘thanks’ our dedicated employees who have gone above and beyond to meet the challenges of this crisis, and are the heart of our workforce. Because of them we are doing all that we can to fight COVID-19, and protect our residents, patients and each other. We are stronger together. And together we will get through this crisis, helping each other and our Maui community.”

DOH Clarifies McDonald’s COVID-19 Cases, 12 Employees Positive

DOH is investigating a limited, localized community spread of COVID-19 among employees at a Kona food establishment. 

DOH Director Dr. Bruce Anderson identified the business as a McDonald’s restaurant. Fortunately, the restaurant, like many food establishments, had previously implemented social distancing measures to protect customers and prevent exposure prior to an employee testing positive.

 The establishment has closed its operation and performed enhanced cleaning. The twelve (12) employees who have tested positive are in isolation and exposed employees without symptoms are self-quarantined at home. Two individuals are both employees and live in the same household.

The investigation is ongoing and based on findings so far, DOH does not believe this outbreak poses a risk to the general public. The department is continuing to work with the restaurant to ensure all possible precautions are being taken to prevent further spread of disease.

There is no risk to the public, as only workers were involved, and the restaurant was taking necessary physical distancing measures to protect customers.

DOH Launches New Website Dedicated to COVID-19

Today, the Hawai‘i Department of Health (DOH) unveiled a new website for the public to access the latest information on COVID-19 in Hawai‘i. The State of Hawai‘i has mobilized an inter-agency collaborative effort to keep the community safe and healthy. The website, hawaiicovid19.com went live at 3 p.m.

Screen shot of new website

The website provides timely information and resources on the coronavirus, including guidance on how to prevent and mitigate community spread, common symptoms of COVID-19 and frequently asked questions.

“By providing our family and friends, our neighbors and our visitors with accurate information, we keep our community healthy and we keep Hawaiʻi a welcoming place to live and visit.” the site stated. “Don’t spread the virus. Don’t spread misinformation. And let’s prepare together. Always share aloha.”

Sign up to receive updates at health.hawaii.gov/updates.

DOH Issues Spring Break Guidelines

With thousands of students off from school for spring break beginning next week, the Hawai‘i Department of Health is issuing guidelines families can follow to protect themselves against COVID-19 infection. Family members who are especially vulnerable include those who are 60 years and older, have a compromised immune system, or have existing health conditions such as diabetes, lung disease or a heart condition.

“We know that traditionally spring break is a time when families go on trips or spend more time at the malls, theaters, restaurants, and other places where the public gathers,” said Bruce Anderson, director of the Hawai‘i Department of Health. “We are urging families to be circumspect and exercise extra precautions to minimize the risks of COVID-19 transmission.”

New website to go live next week
The Hawai‘i Department of Health, in collaboration with other state agencies, is also developing guidelines for schools and for businesses and nonprofit organizations that are planning large-scale public events. These guidelines will be posted on a new, user-friendly website dedicated to providing easy access to COVID-19 facts and figures and timely updates. 

With an average of more than 7,000 page views of the Department of Health’s COVID-19 related webpages and more than 350,000 website visits since Jan. 20, the new separate website, scheduled to go live next week, will be easier to easy to navigate for the public.

Preventive measures
The Hawai‘i Department of Health has issued the following spring break guidelines to manage the spread of COVID-19 in communities across the state:

  • Consider avoiding crowded or congested areas, including large public gatherings such as concerts, sporting events, conventions, religious gathers and other community events (the Hawai‘i Department of Health defines “large” gatherings as 100 people or more and allows for social distancing of people being six feet apart);
  • Avoid non-essential travel to COVID-19 high-risk destinations;
  • If you or a family member is sick, remain home except to receive medical help; and
  • Avoid those who are sick and have flu-like symptoms such as coughing, fever, and shortness of breath.

Minimizing risks
“While we do not want to limit family activities or recommend cancelling their plans for spring break, we are urging families to take steps to minimize their risk of infection,” Anderson said. “Many of these guidelines are the same messages that we have been issuing since the COVID-19 outbreak, but have heightened relevance during the spring break because the potential for person-to-person transmission with an infected person exponentially increases and this could lead to additional cases of COVID-19 infection in our state.”

If families are planning to go to the malls, movies and other locations, they should implement safe hygiene practices.

  • Cover coughs and sneezes with a tissue, then throw the tissue in the trash;
  • Wash hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, after blowing their nose, coughing or sneezing;
  • Avoid touching high-contact public surfaces such as phones, doors, tables, keys, bags and lights;
  • Use alcohol-based hand-sanitizers containing at least 60% alcohol; and
  • Clean frequently touched surfaces and objects on a routine basis.

Social distancing
“Here in the islands, we value a culture of aloha that is expressed with hugging and kissing,” Anderson said, “but we would like families to consider practicing ‘social distancing,’ which recommends staying at least six feet—a distance of two arms-length—between people.” 

These new practices may seem odd at first, but are effective in promoting health and wellness.

  • Forgo hugging and kissing as greetings or farewells;
  • Present a lei without a hug or kiss; and
  • Handshakes are acceptable but remember to wash your hands,

Scheduled trips
The Centers for Disease Control and Prevention and Hawai‘i Department of Health also have specific guidelines for families who choose to travel outside the state for spring break:

  • When returning home to Hawai‘i, the Hawai‘i Department of Health recommends family members monitor their health for a 14-day period from the time you left the area with widespread, ongoing community spread;
  • If anyone in the family who went on the trip develops symptoms of a serious, sudden respiratory illness that includes a combination of fever, cough and shortness of breath, have mild symptoms (e.g., no fever but cough), are 60 years or older, or have underlying medical conditions, contact a healthcare provider before going to a medical facility; and
  • Specific guidelines on travel are available at: https://www.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html

Flu shots
A flu shot is another valuable tool to prevent and effectively manage COVID-19. Although the flu shot does not protect against COVID-19, it will reduce the number of flu cases. This helps to reduce anxiety and frees up healthcare professionals to focus on people affected by COVID-19.

DOH Steps Up Testing for COVID-19

Hawaii is shifting its COVID-19 response efforts into higher gear this week by launching a statewide surveillance testing program to identify cases of community spread of the coronavirus. This additional layer of testing helps detect COVID-19 cases earlier so that appropriate steps can be taken to contain the virus.

Community spread is defined as cases that cannot be traced back to a traveler or to those who came in contact with a person who has coronavirus.

About 200 COVID-19 tests will be conducted each week under the new program. Samples collected for influenza testing from patients with respiratory symptoms will be randomly selected and also tested for COVID-19. These samples are collected by healthcare providers in doctor’s offices and other outpatient settings. The information will help responders understand the scope of such a spread when it occurs.

“This is a major new development in our state’s prevention and mitigation efforts,” said Bruce Anderson, Director of Health. “We’ve been asking for this capability and working with the CDC for weeks to get this program in the field. It will help us focus our prevention and response efforts so that we can keep our communities safe and informed about how the virus is affecting our state.”

The Department of Health (DOH) is partnering with the Centers for Disease Control and Prevention (CDC) to implement the additional testing. Hawaii is one of many jurisdictions throughout the country that is implementing the program.

Anderson said the tests, which will be conducted by the DOH’s State Laboratories Division in Pearl City, will enable the state to identify and notify persons who test positive and take additional actions to try to stop the spread of the virus. DOH will contact the provider and patient in the event of a positive result and provide further guidance.

The Department of Health’s State Laboratories Division is expected to receive up to 400 samples per week from participating healthcare providers and will randomly select and test 200 of these for COVID-19 testing. A sample involves taking swabs from the back of the nose or throat of patients with flu-like symptoms such as fever, coughing, or shortness of breath.

Anderson noted that this new surveillance testing program is being conducted in addition to ongoing testing for Persons Under Investigation (PUI) that is already taking place throughout the state. A PUI is a person who meets the following criteria: has fever and cough or shortness of breath, has traveled to a location that has been affected by the virus, and whose healthcare provider has consulted a disease investigator with the DOH’s Disease Outbreak Control Division.

Hawaii received its COVID-19 laboratory test materials from the CDC in early February and was unable to conduct testing because of defects in the materials received. The DOH State Laboratories Division staff worked closely with the CDC around the clock to complete the validation process and receive approval from the CDC to move forward with the testing procedure in Hawaii on Feb. 28 using the federal criteria for selecting samples for testing. On March 5, the CDC expanded the criteria for testing to include persons with symptoms who had traveled to areas outside of China with known spread of COVID-19. Physicians work with DOH to determine testing of patients who meet the criteria for prioritized testing for COVID-19.

If you have general questions about coronavirus, call 2-1-1 or text 877-275-6569. For the latest information on COVID-19 in Hawaii, visit health.hawaii.gov/covid19. For national information and resources, go to coronavirus.gov.

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.