Ministry of Health, in collaboration with the Ministry of Agriculture, conducted two block sprays around public areas on Rarotonga as part of Operation Namu25 to control the spread of dengue fever on the island last week. Photo: Cook Islands Health Promotion
Big clean up campaigns are underway in Rarotonga to try to stamp out mosquito breeding grounds.
The Cook Islands declared a dengue fever outbreak on Thursday (Friday NZT).
Outbreaks have also been called in Fiji, Samoa and Tonga, which have all had at least one death because of the viral infection.
The Cook Islands has had seven confirmed cases this month - all on Rarotonga. Three are active which are from the same household.
An outbreak is declared in the Cook Islands when five cases of dengue are reported within a 15-day period.
Acting health secretary Dr Teariki Faireka said the last Cook Islands outbreak was declared in 2021.
"One of our goals is to stop it here on Rarotonga and to stop it from spreading to our smaller islands," Faireka said.
He said the outer islands did not have the resources to deal with severe cases of dengue.
Faireka said the Ministry of Health, alongside the prime minister, signed off on Operation Namu, which includes clean up campaigns and spraying.
On Friday, non-essential public servants were allowed to take part in a mass cleanup on Rarotonga instead of doing their normal job.
"We had a good turn out where everyone pitched in to help with the clean and we also identified areas that needed further support," he said.
"So vacant areas that have overgrown hedges or overgrown grass, that will be targeted within the next two weeks for cleaning at some point."
Mark Thomas, associate professor of infectious diseases at Auckland University, said dengue fever outbreaks are seasonal, supported by lots of rain.
"If there's plenty of small pools of water around the amount that would settle in an open coconut shell or in a tire that's lying on the ground, some small pool somewhere.
"Then the mosquitoes increase their rate of breeding, there are more people getting bitten by mosquitoes, and more transmission of dengue from person to person by the mosquitos," he said.
The dengue cases on Rarotonga have been type one (DENV-1) and two (DENV-2).
Thomas said there are several variants, but people are unlikely to be infected by the same sub-type.
"They may be exposed in subsequent epidemics years later and then the second episode, that will likely be some years after the first one, may sometimes be much more severe than the first episode."
Muri Beach Club Hotel owner Liana Scott said the island was looking very tidy.
"That community spirit really comes alive whenever there's something that affects people and that's nice to see and of course dengue if you've had it before it's not the nicest."
Scott said one tourist had postponed their trip, concerned by underlying health issues.
She said most accommodation providers were lenient with their cancelation policies.
"It's not really a time to be strict in upholding the cancelation policies if people have a genuine reason for cancelling and most are not cancelling they are moving the date forward."
But Scott said most people could manage the risk with mosquito repellent and using insect screens.
"It's not rocket science, sometimes it's just making sure if you go on a cross-island track that you have your legs and arms covered."
Thomas said the aides mosquito, sometimes called the Egyptian mosquito, carried dengue.
"The ones that exist in New Zealand are typically night biting mosquitoes, whereas the ones that transmit dengue are day biting mosquitoes, so people should use insect repellent during the daytime and try and limit the ability of the mosquito to get at the skin.
"That sometimes means covering up more of your skin than you might otherwise do on a tropical holiday."
Thomas said the epidemic normally goes away as people build immunity and mosquito breeding grounds dry as the weather changes.
