The flu is hitting hard on the mainland this season, but the state Department of Health is more concerned about norovirus in the islands.
State Epidemiologist Sarah Park said about six clustered outbreaks of norovirus, a major cause of gastrointestinal illness some refer to as "stomach flu," have been reported since early last month, mostly on Oahu in long-term care facilities. Tests indicate that outbreaks are not related and several are still active.
Outbreak sites have implemented measures to prevent further spread of the virus.
"The important thing for folks to realize is that although these cases are primarily in nursing home facilities, they really are just a sentinel indicating that we have norovirus widespread in the state," Park said.
The virus commonly results in nausea, vomiting, diarrhea and abdominal pain. It is contagious and difficult to kill.
There is also no vaccine and no proven treatment for it, Park said, but taking precautions like washing hands often, avoiding touching the face, and staying home if sick might help prevent the spread of infection.
In healthy adults, norovirus usually lasts a few days, "though you’ll be miserable," Park said, but symptoms can be severe, especially among seniors and those with weak immune systems.
No deaths have been reported related to these latest outbreaks.
While the kind of flu outbreaks being seen on the mainland hasn’t hit Hawaii, that doesn’t mean the state is out of the woods.
It’s too early to tell whether Hawaii will see an increase of flu to mirror widespread outbreaks in many other states, Park said, but "when we do see a rise in activity, it tends to be delayed about a month behind the mainland."
More than 40 states have already reported widespread geographic flu activity, according to the Centers for Disease Control and Prevention. Hawaii is the only state that reported only sporadic activity.
"People should keep in mind this doesn’t mean it’s not here," Park said. "We see flu disease year-round in Hawaii because we get visitors from all over the world, from both the Northern and Southern hemispheres, so there’s always this low, steady hum of flu virus here."
Park adds that whether Hawaii will see an increase in flu activity largely rests on public awareness and precautions taken, so the department urges those who haven’t done so yet to get vaccinated.
"A lot of people think, ‘Well, I’m not a kid and not an elderly person, so I’m not really at risk,’" she said. "You are at risk, just not as high a risk for getting severe illness or complications. We tend to focus on those high-risk groups, but that doesn’t mean it won’t happen to anybody else."
This year’s dominant flu strains, particularly the H3N2 strain that is believed to be causing much of the flu activity, are a match for the current vaccine. "That’s good news," Park said. "It means those still out there who haven’t been vaccinated still have time."
Despite widespread flu activity on the mainland, some local health care providers said there has been no notable increase in flu vaccinations recently.
Laura Lott, spokeswoman for Kaiser, said, "We focus on prevention and traditionally do a good job of getting members vaccinated if they want or need to, so there hasn’t been any unusual rush recently."
"There’s been a lot of media coverage in the last few days, and it’s good that people are aware of the potential (for widespread outbreak) but it’s also not too late to take the right steps. People can still get vaccinated and stay healthy."
Up to now, Kaiser has given nearly 65,000 flu vaccinations this season, similar to previous flu seasons.
Park cautions that even if vaccinated, it takes about two weeks for antibody levels to rise sufficiently, and vaccinated individuals can still pick up and transfer germs elsewhere, so it’s also important to practice good hygiene.
"That one sick person can be the index case that spreads it," she said.