The state Department of Health confirmed Wednesday that 72 people have contracted dengue fever on Hawaii island, up by seven from Tuesday.

The onset of the disease — indicated by symptoms that include high fever and severe headaches — has been traced as far back as Sept. 11.

Health officials also indicated that the hot spot for dengue fever is shifting from South Kona to Ka‘u, although South Kona remains an area of high risk.

The latest Department of Health map, released Wednesday, seems to indicate that the area from Naalehu to South Point in Ka‘u is a high-risk area for exposure to dengue. That area apparently wasn’t listed as high risk in other maps.

Wednesday’s map was devoid of any numbers associated with any of the areas. It simply showed a risk assessment based on where people who have tested positive for dengue reported visiting and where mosquito activity has been observed.

Eight potential areas of exposure were classified by risk: high risk — South Kona and Ka‘u; moderate risk — Hilo and Pahoa; low risk — Waikoloa, Hawi, Waimea and Volcano.

Health officials deferred answering questions until today, when they will hold a news briefing.

The map released prior to Wednesday’s was dated Nov. 12 and showed potential sources of exposure to dengue on Hawaii island. That map showed that of the 78 visits to areas by people with confirmed dengue as of Nov. 12, 33 had possible exposure to mosquitoes in South Kona, 15 had possible exposure to mosquitoes in Waikoloa, nine had possible exposure in Ka‘u, six had possible exposure in Waimea, one had possible exposure in Hawi, four had possible exposure in Hilo, seven had possible exposure in Volcano and three had possible exposure in Pahoa.

As of Nov. 12, there were 34 people with confirmed dengue. That turned out to be an average of about two visits to areas per patient.

The common denominator was clearly South Kona, where 33 out of 34 visited.

Dr. Lorrin Pang of the Department of Health’s Maui County District, who has been on Hawaii island, told the Honolulu Star-Advertiser that migrant farmworkers, including coffee pickers, could be carrying the disease to other areas.

He said as seasonal coffee picking winds down in Kona, these migrant workers will likely move to Ka‘u to harvest macadamia and coffee, then may find work in Puna.

He suggested that many of these farmworkers may not seek medical care or want to report having the illness or submit to testing.

Pang said some individuals who get dengue may be carriers but not have the symptoms.

Dengue fever symptoms include fever, severe headaches, pain behind the eyes, joint and/or muscle pain and rash. Mosquitoes transmit the disease from infected people to others.

Health Department workers have been conducting assessments for mosquito activity, and may spray pesticide as a precaution.

The state health laboratory is performing all tests for dengue. The state contacted all commercial laboratories and advised them to refer all tests for dengue to its lab, rather than send specimens to mainland laboratories.

The state has had at least 14 cases of dengue this year unrelated to this outbreak, including a recent case of a Kalama Valley resident who contracted the disease on a trip to Southeast Asia.

People are urged to wear protective clothing and use insect repellent.

Anyone who may have had dengue recently but did not see a health care provider is urged to call 974-6001 or 322-4880 on Hawaii island; or the Disease Outbreak Control Division at 586-4586.