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Certain types of infectious disease outbreaks can evolve quickly, ravaging communities and specific populations, and can be merciless in exposing the chinks in our armor of public health defenses.

Dengue fever’s spread across the Big Island has pointed out Hawaii’s deficiencies when it comes to this kind of crisis, and officials are struggling to organize limited resources to more effectively deal with the outbreak.

Gov. David Ige noted at a press conference Tuesday that the state has had only modest success in stopping the dengue outbreak. And that after a collaborative effort by the state, federal and local governments.

The outbreak began last September on the Big Island and is now 246 cases and counting.

“We’re making progress. The number of cases — they are fewer and farther between incidents,” Ige said.

U.S. Rep. Tulsi Gabbard last week publicly asked Ige to declare a state of emergency and further deploy the National Guard to help fight the disease. (The National Guard has been assisting the state Department of Health since last November, mostly on flying mosquito sprayers from Oahu to the Big Island.)

The U.S. Centers for Disease Control recently pointed out “critical deficiencies” in Hawaii’s preparedness to deal with such an outbreak that largely represent staffing shortages. In the budget cuts that followed the economic downturn of 2008, the Health Department cut the number of state vector control workers from 52 to 23 and the number of entomologists from four to two.

At the same time, the department’s communications staff — crucial to disseminating timely and accurate information during public health crises — was trimmed from five to one.

The costs of being prepared for a major disease outbreak are a drop in the bucket compared to the costs of being caught flat-footed.

Ige acknowledged the cuts on Tuesday, but said the state is managing by borrowing resources from around the state and concentrating them on the Big Island.

For its part, the Big Island is cross-training employees to provide extra staffing for its overall response, according to Hawaii County Mayor Billy Kenoi. For instance, recreation and maintenance workers are being trained in vector control, and emergency medical technicians are being sent out to do dengue testing for individuals who think they may have been exposed to the virus.

Overall, it’s a great example of island-style cooperation — pulling together and making do with what we have. Kenoi said many county employees are working seven days a week to help the island get out in front of a potential epidemic and stay there.

Containing Dengue, Preparing For Zika

This might be a workable, albeit patchwork, solution were it not for two other potentially disastrous dynamics.

First, there is no guarantee that dengue can be contained on the Big Island — by far, Hawaii’s largest land mass, making it the most resource-intensive when it comes to preventing a disease spread by mosquitoes. Already, cases have been diagnosed on Oahu and Maui, although they involved individuals who were infected while they traveled outside Hawaii and brought the disease home with them.

A mosquito-driven outbreak of dengue on either of these islands would seriously strain resources and expose our state to a major, immediate health threat.

Second, and much more troubling, is the relatively new appearance on the public health radar of the Zika virus. There is no cure or treatment for the fast-spreading disease, and it is carried by the same type of mosquitoes that spread both dengue and yellow fever.

Zika can cause symptoms similar to those of dengue — harsh, but in most cases, not life threatening — but it may be responsible for a rapidly growing number of cases of microcephaly in babies born to mothers infected with the virus.

How big is the potential threat? The World Health Organization took the rare step on Monday of declaring Zika a “global health emergency,” an action that WHO has only taken on three previous major disease outbreaks. WHO projects the Americas could see as many as 4 million cases of Zika over the coming year.

As two state legislators who both happen to be doctors and represent the Big Island have rightly pointed out, the costs of being prepared for such a disease outbreak are a drop in the bucket compared to the costs of being caught flat-footed. A Zika epidemic on our islands could devastate patients and families, severely tax our health care systems and potentially bring the state’s biggest industry, tourism, to a screeching halt.

How big is the potential threat? The World Health Organization projects the Americas could see as many as 4 million cases of Zika over the coming year.

With a large dengue outbreak currently plaguing the Big Island, and a far more dangerous virus potentially looming in the future, taking chances on a patchwork response system with resources already stretched to the maximum is a recipe for disaster.

Gov. Ige and DOH Director Virginia Pressler should make restoration of the vector control, entomology and communications positions eliminated seven years ago an immediate priority.

As the governor and senior administration officials continue to evaluate whether to declare a statewide emergency around dengue fever, this question should be their top priority: Will an emergency declaration allow us to take actions and mobilize resources now that might help in the ongoing fight against dengue, as well as prepare us for the eventual arrival of Zika?

If the answer is yes, there should be no further delay. As Ige said Tuesday, the reallocation of DOH resources to the Big Island already “makes us vulnerable in other areas.”

Translation: So far, we’ve been lucky. Fast action now will ensure Hawaii is prepared if that luck runs out.