Another case of dengue fever was confirmed on Hawaii island Tuesday, bringing the number of locally transmitted cases to 11.

State officials said they are ramping up control efforts but are still trying to figure out exactly where mosquitoes are transmitting the disease. Disease hot spots apparently include Honaunau, Hookena and South Kona.

State epidemiologist Dr. Sarah Park said workers from the Department of Health’s Vector Control Branch have been dispatched to spray around the homes of affected residents and are assessing properties within a 200-yard radius.

A medical advisory has also been sent to Hawaii County clinics alerting them to the problem and urging them to report suspected dengue fever cases.

There are no reports of dengue fever on any of the other neighbor islands or on Oahu.

The onset of the symptoms of confirmed cases ranged from mid-September to late October, officials said. Those who have come down with the disease reportedly suffered from mild to moderate dengue fever, with symptoms that included headache, rash, nausea, and aches and pains in muscles and bones lasting about a week.

Anyone with a high fever in addition to any of the symptoms for dengue fever should see their doctor for evaluation, Park said.

Once a person comes down with the disease, he or she is a carrier for only about five days after the onset of symptoms. But with a few of the latest cases, individuals either went to work or went shopping during the early stages of their illness, Park said.

Dengue is a viral infection spread via mosquitoes that bite an infected person and then carry the virus to the next person. People cannot infect other people.

The last dengue fever outbreak in Hawaii was in 2011, when four people were infected on Oahu. In 2001, 122 cases of dengue fever were confirmed on three islands — Oahu, Kauai and Maui — with the most of the cases, 92, found in the rural Hana area.

Like the Maui outbreak, officials suspect that a traveler got bitten by an infected mosquito elsewhere and then brought the disease to the islands.

Residents and visitors are advised to protect themselves against mosquito bites by using a repellent containing DEET, repairing window and door screens to keep mosquitoes from entering buildings, and wearing light-colored clothing that covers and protects skin from biting mosquitoes.

Mosquitoes breed in areas of standing water, such as planters, old tires and pet water bowls. Officials urge residents to eliminate standing water to cut down on breeding mosquitoes.