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In Hawaii

  • For emergency medical assistance anywhere in Hawaii, call 911 or go directly to the emergency room (ER) of the nearest hospital. For nonemergencies, consider an urgent-care center or walk-in medical clinic.
  • Some insurance policies require you to get preauthorization for medical treatment from a call center before seeking help. Keep all medical receipts and documentation for claims reimbursement later.

Infectious Diseases

Dengue Fever

  • In Hawaii the last dengue fever outbreak was in 2015-16; for updates, consult the Hawaii State Department of Health (
  • Dengue is transmitted by Aedes mosquitoes, which bite preferentially during the daytime and breed primarily in artificial water containers.
  • Dengue usually causes flu-like symptoms, including fever, muscle aches, joint pains, severe headaches, nausea and vomiting, often followed by a rash.
  • If you suspect you've been infected, do not take aspirin or NSAIDs (eg ibuprofen), which can cause hemorrhaging. See a doctor for diagnosis and monitoring; severe cases may require hospitalization.


  • Symptoms of this parasitic infection of the small intestine include nausea, bloating, cramps and diarrhea and may last for weeks.
  • To protect yourself, don't drink from untreated water sources (eg waterfalls, ponds, streams, rivers), which may be contaminated by animal or human feces.
  • Giardiasis is diagnosed by a stool test and treated with antibiotics.


  • Leptospirosis is acquired by exposure to untreated water or soil contaminated by the urine of infected animals, especially rodents.
  • Outbreaks often occur after flooding, when overflow contaminates water sources downstream from livestock or wild animal habitats.
  • Initial symptoms, which resemble a flu, usually subside uneventfully in a few days, but a minority of cases involve potentially fatal complications.
  • Diagnosis is usually through a urine test and treatment is with antibiotics.
  • Minimize your risk by staying out of bodies of freshwater (eg pools, streams, waterfalls); avoid these entirely if you have open cuts or sores.
  • On hiking trails, take warning signs about leptospirosis seriously. If you're camping, water purification and good hygiene are essential.


  • Staphylococcus infections are caused by bacteria, which often enter the body through an open wound. Community-acquired, antibiotic-resistant staph infections are increasingly common.
  • To prevent infection, practice good hygiene (eg wash your hands thoroughly and frequently; shower or bathe daily; wear clean clothing). Apply antibiotic ointment (eg Neosporin) to any open cuts or sores and keep them out of recreational water; if cuts or sores are on your feet, don't go barefoot, even on sand.
  • If a wound becomes painful, looks red, inflamed or swollen, leaks pus or causes a rash or blisters, seek medical help immediately.

Environmental Hazards

Bites & Stings

Any animal bite or scratch – including from unknown dogs, feral pigs, etc – should be promptly and thoroughly cleansed with soap and water, followed by application of an antibiotic cream covered by a clean bandage or dressing, to prevent wounds from becoming infected.

Hawaii is currently rabies-free. The state has no established wild snake population, but snakes are occasionally seen, especially in sugarcane fields.

  • The most effective protections against insect bites are common-sense behavior and clothing: wear long sleeves and pants, a hat and shoes.
  • Where mosquitoes are active, apply a good insect repellent, preferably one containing DEET (but not for children under two years old).
  • Some spider bites (eg from black widows or brown recluses) contain toxic venom, which children are more vulnerable to; for anyone who is bitten, apply an ice pack or cool water to the affected area, then seek medical help.
  • Centipedes also give painful bites; they can infiltrate buildings, so check sheets and shoes.
  • Leeches found in humid rainforest areas do not transmit any disease but their bites can be intensely itchy and may cause life-threatening allergic reactions.
Marine Animals

Marine spikes, such as those found on sea urchins, scorpionfish and lionfish, can cause severe localized pain. If this occurs, immediately immerse the affected area in hot water (as hot as can be tolerated). Keep topping up with hot water until the pain subsides and medical care can be reached. Do the same for cone shell stings.

Stings from jellyfish and Portuguese man-of-war (aka bluebottles) also occur in Hawaii's tropical waters. Even touching a bluebottle hours after it's washed up onshore can result in burning stings. Jellyfish are often seen eight to 10 days after a full moon, when they float into Hawaii's shallow near-shore waters, often on the islands' leeward shores. If you are stung, carefully peel off the tentacles with a gloved hand, then rinse the area well in sea water (not freshwater or urine), followed by rapid transfer to a hospital; antivenoms are available.


Vog, a visible haze or smog caused by volcanic emissions from the Big Island, is often (but not always) dispersed by trade winds before it reaches other islands. On the Big Island, vog can make sunny skies hazy in West Hawaiʻi, especially in the afternoons around Kailua-Kona.

Short-term exposure to vog is not generally hazardous; however, high sulfur-dioxide levels can create breathing problems for sensitive groups (eg anyone with respiratory or heart conditions, pregnant women, young children and infants). Avoid vigorous physical exertion outdoors on voggy days.