The state Health Department said two cases of dengue fever were locally acquired on Hawaii island, and another four cases are under investigation.

“Although dengue is not endemic to Hawaii, we do have the mosquito species capable of transmitting the disease,” state epidemiologist Dr. Sarah Park in a press release. “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.”

Further testing and confirmation with the Centers for Disease Control and Prevention is pending.

The department sent out a medical advisory to clinicians in Hawaii County earlier today to alert and urge them to report possible dengue fever cases.

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

The dengue virus is transmitted through the bite of an infected mosquito. Symptoms that usually begin within a week of a bite include fever, joint or muscle pains, health or pain around the eyes and rash.