Hawaii Dengue FeverQ – I have heard from one of my friends that I might want to cancel our Fifth Anniversary trip to the Big Island in Hawaii where I am holding reservations at Mauna Lani Resort. Is there any danger from mosquitoes? I am not sure if I should cancel or just hunker down and bring bug repellent.

A – As we are publishing, there have been more than 100 documented cases of mosquito-borne dengue fever on the Big Island. The vast majority of cases are local residents, many of whom live in more remote areas. But more than a dozen visitors have been affected.

Dengue fever symptoms include piercing pain headache and severe joint and muscle pain. Some sufferers say that it feels as though their bones are breaking. Even mild cases can cause hospitalization. The disease also causes a serious rash and body temperature as high as 104 degrees. The symptoms appear five to seven days after the initial bite.

Dengue Fever has been a problem in several Caribbean islands but this is the first time the disease has appeared in Hawaii. In many third world countries, Dengue Fever goes largely unaffected and is often fatal.

You will be safe if you use serious bug repellent and avoid areas where standing water exists. Walking into areas of heavy vegetation or jungle growth is not wise without proper precautions. With detection, the eventual survival rate is close to 99%.

We definitely think you should go on your trip. But be cautious about any time you may spend in remote areas of the Big Island. Fear nothing at night – almost all of the bites occur during daylight.

Dengue Fever is a subject you may wish to discuss with your travel counselor who can provide some specific advice. If you are headed for an island where Dengue Fever is an issue, we would advise that you discuss it with your physician or local travel health clinic.

We have been particularly concerned about exposure to this disease by guests on the larger cruise ships sailing out Florida to third world islands in the Caribbean. They often sign up for four-wheel drive and other adventure tours that take them into remote areas of the island where the disease may be prevalent. We do not wish to be alarmist, but Dengue Fever is one of those things that is rarely in the news but ought to be considered in making travel decisions.

Don’t let us bum you out on Hawaii. It is one of the world’s great vacation destinations and Mauna Lani is one of our most recommended resorts. Have a wonderful Fifth.