
Dengue Outbreak: Big Clean Up Campaigns Are Underway In Rarotonga
Caleb Fotheringham, RNZ Pacific Journalist
Big clean up campaigns are underway in Rarotonga to try stamp out mosquito breeding grounds.
The Cook Islands declared a dengue fever outbreak last Thursday (Friday NZT).
Outbreaks have also been called in Fiji, Samoa and Tonga, which have all had at least one death because of the viral infection.
The Cook Islands has had seven confirmed cases this month - all on Rarotonga. Three are active which are from the same household.
Pacific dengue cases surge, but don't cancel your holiday yet - health expert
An outbreak is declared in the Cook Islands when five cases of dengue is reported within a 15-day period.
Acting health secretary Dr Teariki Faireka said the last Cook Islands outbreak was declared in 2021.
"One of our goals is to stop it here on Rarotonga and to stop it from spreading to our smaller islands," Faireka said.
He said the outer islands did not have the resources to deal with severe cases of dengue.
Faireka said the Ministry of Health alongside the Prime Minister signed off on Operation Namu, which includes clean up campaigns and spraying.
On Friday, nonessential public servants were allowed to take part in a mass cleanup on Rarotonga instead of doing their normal job.
"We had a good turn out where everyone pitched in to help with the clean and we also identified areas that needed further support," he said.
"So vacant areas that have overgrown hedges or overgrown grass, that will be targeted within the next two weeks for cleaning at some point."
Mark Thomas, associate professor of infectious diseases at Auckland University, said dengue fever outbreaks are seasonal, supported by lots of rain.
"If there's plenty of small pools of water around the amount that would settle in an open coconut shell or in a tire that's lying on the ground, some small pool somewhere.
Then the mosquitoes increase their rate of breeding, there are more people getting bitten by mosquitoes, and more transmission of dengue from person to person by the mosquitos," he said.
The dengue cases on Rarotonga have been type one (DENV-1) and two (DENV-2).
Thomas said there are several variants, but people are unlikely to be infected by the same sub-type.
"They may be exposed in subsequent epidemics years later and then the second episode, that will likely be some years after the first one, may sometimes be much more severe than the first episode."
Muri Beach Club Hotel owner Liana Scott said the island was looking very tidy.
"That community spirit really comes alive whenever there's something that affects people and that's nice to see and of course dengue if you've had it before it's not the nicest."
Scott said one tourist had postponed their trip, concerned by underlying health issues.
She said most accommodation providers are lenient with their cancelation policies.
"It's not really a time to be strict in upholding the cancelation policies if people have a genuine reason for cancelling and most are not cancelling they are moving the date forward."
For most though, Scott said they can manage the risk with mosquito repellent and using insect screens.
"It's not rocket science, sometimes it's just making sure if you go on a cross-island track that you have your legs and arms covered."
Thomas said the aides mosquito, sometimes called the Egyptian mosquito, carries dengue.
"The ones that exist in New Zealand are typically night biting mosquitoes, whereas the ones that transmit dengue are day biting mosquitoes, so people should use insect repellent during the daytime and try and limit the ability of the mosquito to get at the skin.
"That sometimes means covering up more of your skin than you might otherwise do on a tropical holiday."
Thomas said the epidemic normally goes away as people build immunity and mosquito breeding grounds dry as the weather changes.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

RNZ News
a day ago
- RNZ News
Cook Islands Cabinet approves significant increase in tobacco tax
By Losirene Lacanivalu , Cook Islands News According to Cook Islands' 2022 STEPS survey, 35.5 percent of adults aged 25-64 are current smokers. Photo: RNZ / Rebekah Parsons-King Cook Islands Cabinet has approved a significant increase in tobacco tax, aiming to reduce smoking rates and combat non-communicable diseases. The Cabinet has recently approved the initiative set by Ministry of Health to increase the tobacco tax by NZ$125.50 per 1000 cigarettes or kilogram of tobacco annually for the next three years. Additionally, a five percent increase has been approved for each subsequent year. The tax increase will come into effect after the proposal is tabled and passed in parliament, according to the Ministry of Finance and Economic Management. The new tobacco taxation represents a 30 percent increase in the average price of a pack of 20 cigarettes over the first three years, raising the price from NZ$26.88 to NZ$35.54 by July 2027, says TMO. According to modelling estimates by the World Health Organisation (WHO), this tax is also anticipated to lower the smoking rate from 34.50 per cent to 33.4 per cent. According to Cook Islands' 2022 STEPS survey, 35.5 percent of adults aged 25-64 are current smokers. Smoking is more prevalent among younger men aged 18-44 (44 per cent) compared to older men aged 45-69 (26.2 per cent). TMO states that although the overall number of tobacco users in the Cook Islands has decreased over the years, young people are alarmingly initiating tobacco use at an earlier age, from an average of 19.7 years in 2015 to 17.8 years in 2022. It adds that tobacco use is one of the leading risk factors for non-communicable diseases (NCDs), such as cardiovascular diseases and cancer. "By making tobacco products less affordable, we aim to decrease tobacco use and its associated health risks, towards a healthier, smoke-free Cook Islands," Minister for Health Vainetutai Rose Toki-Brown said. However, prominent Cook Islander Mike Tavioni begs to differ, arguing that if the government, through the Ministry of Health, doesn't see the tax increase as profitable, then it should stop importing tobacco altogether. "On the left hand, the government agrees for the importation of cigarettes. And then on the right hand, the government through health says, don't smoke." Tavioni believes if the source - the importation of tobacco - is eliminated, people will be less likely to smoke. "Hypothetically, if the price of cigarettes from the factory is $5, so the government is making, what, 600% profit, right? Therefore, 200% goes to making sure the people with cancer are comfortable. The other 400% is for the government budget," he argued. "If it's not profitable to the government, why don't the government just wipe it? Why don't the government just say no more?" Tavioni says the government should consider increasing the tax on sugary drinks such as Coca-Cola to tackle NCDs. "The cigarette is just profit-making for the government. So if the government is convinced that it's bad for its people, then stop importing it. But they won't … Because it's lucrative, profitable for government, they allow it to be imported." A Cook Islander, who wished to remain anonymous, welcomed Cabinet's decision to increase the tobacco tax. The person believes it is a positive step that will lead to fewer smokers and benefit non-smokers as well. As a passive smoker, the person feels they are exposed to even more harmful chemicals when around smokers, putting them at greater risk of health issues. According to TMO, to address the significant burden of NCDs and tobacco use in the country, the Cook Islands has implemented strong policies and plans, including the Cook Islands Tobacco Control Action Plan 2023-2031 and the Tobacco Products Control Amendment Act 2024. The increase in tobacco taxation is a key component of the Tobacco Products Control Action Plan, says TMO. Minister Toki-Brown thanked the Cabinet Ministers for prioritising health, "through the approval of these tobacco taxation reforms". "I also thank Te Marae Ora Ministry of Health for its commitment to a better and heathier future for our children and people, the Ministry of Finance and Economic Management and WHO for their close collaboration." The Cook Islands has been a party to the WHO Framework Convention on Tobacco Control (FCTC) since 2004. Because of the Cook Islands' strong tobacco control measures, they were awarded the World No Tobacco Day Award 2025 by WHO last May 2025. Health Secretary Bob Williams accepted the award on behalf of Te Marae Ora from WHO's Director-General Dr Tedros Ghebreyesus on 19 May at the World Health Assembly in Geneva, Switzerland. "We congratulate the Cook Islands on their decision to increase tobacco taxes and their overall robust and comprehensive measures in tobacco control. Indeed, the World No Tobacco Day Award is well-deserved," said Lepaitai Hansell Blanche, officer-in-charge of the WHO Representative Office for Samoa, American Samoa, Cook Islands, Niue and Tokelau. "The Cook Islands' efforts set a strong example for the rest of the region to follow. We urge other Pacific nations to adopt similar measures and work together towards achieving tobacco- and nicotine-free islands." -This article was first published by Cook Islands News .


Otago Daily Times
a day ago
- Otago Daily Times
New 'rules of engagement' with alcohol lobby
By Guyon Espiner of RNZ New "rules of engagement" for health officials dealing with the alcohol industry are coming after a senior staffer complained a public health manager had been "way too friendly" with booze lobbyists. In May it was reported that Ross Bell, a manager with the Ministry of Health's Public Health Agency, had close engagement with alcohol lobbyists, who were granted input into the development of alcohol policies. References to a review of safe drinking guidelines were removed from a Health New Zealand website after an alcohol lobbyist complained to Bell. On the day the story was published, Deputy Director-General of Health Dr Andrew Old sent an email to staff saying Bell had "acted entirely appropriately" in his engagement with the alcohol industry. "Engaging with industry can, and has, yielded meaningful health gains for New Zealanders in the past - and will do so again," the email said. "However, we also know that some industry interests lead to public health harm, and so our engagement needs to be careful, mature, and intentional." Old invited Ministry of Health staff to respond. Dr Clair Mills, who provides advice to the Public Health Advisory committee, took issue with the engagement with the alcohol industry. "I do think there is a problem - at the very least, in terms of perception," she wrote to Old, in emails released under the Official Information Act. The alcohol industry's fight against Local Alcohol Policies - where communities set their own conditions for sale - revealed its motivations, Mill said. It contrasted with the "lack of community voice and power". RNZ's reporting revealed a series of emails between Bell and alcohol lobbyists, which showed close relationships, multiple meetings and exchanges of information. "I think the tone of the emails was way too friendly," Mills, whose career includes serving as Medical Director for Médecins Sans Frontières' and as Medical Officer of Health in Northland, said in her email to Old. "In my experience… these alcohol interests have zero interest in reducing harm (or sales of booze) and a huge purse to fund their lawyers." 'Perception becomes reality' Old responded to Mills saying stronger processes for health officials engaging with the alcohol industry were being prepared. "All good points - perception becomes reality after all," he told her. "Given we are expected to engage with industry, whether that's alcohol, food or anything else (except tobacco!) it would help to have some clear rules of engagement. I'm picking that up with our central MOH team." Tobacco lobbyists are shut out of policy making because New Zealand is a signatory to the Framework Convention on Tobacco Control (FCTC). Under the FCTC countries protect policy development from the "vested interests of the tobacco industry" as there is an "irreconcilable conflict between the tobacco industry's interests and public health policy interests". In contrast, the alcohol industry has input into policy development in New Zealand, including managing Fetal Alcohol Spectrum Disorder (FASD) and spending the Alcohol Levy, a $16 million fund to reduce alcohol harm, estimated in a 2024 report by NZIER to cost $9.1 billion a year. RNZ used the OIA to obtain 85 pages of emails detailing engagement between the Ministry of Health (MOH) and alcohol lobbyists, with Ross Bell emerging as the main conduit. One document describes a 90 minute meeting between lobbyists and MOH staff in February 2025 as "Alcohol industry reps and Ministry of Health regular meeting". The documents show the plan to manage FASD has been given to the alcohol industry. "Thanks for sharing the draft FASD plan," a wine lobbyist says in an email to public health officials, copying in a lobbyist with the spirits industry. The documents show alcohol lobbyists made their own submissions to MOH on how they believed FASD should be managed. The Spirits New Zealand submission runs to four pages but is entirely redacted by MOH under a section of the OIA designed to protect "the confidentiality of advice tendered by Ministers of the Crown and officials". RNZ has asked the Ombudsman to investigate whether the MOH can legitimately use this section of the OIA to protect correspondence from a spirits industry lobbyist. Alcohol industry's input The documents obtained by RNZ show Bell was receptive to requests from the alcohol industry. In November 2024 the Brewer's Association complained to Bell that references to a review of the low risk drinking guidelines were still on the Health New Zealand website, after it had already complained to him about it. It also took issue that the site linked to what other countries, including Canada, were doing with their advice on low-risk drinking. Bell intervened in an email to Health New Zealand in December 2024. "All work on this project will now pause. You will update relevant Health NZ websites to remove references to the review and also to other jurisdictions' guidelines (including the Canadian one)." Bell refused to be interviewed by RNZ but in a previous statement he said the material was removed from the website to avoid confusion, as the drinking guidelines were now led by the Ministry of Health not Health New Zealand which runs the website. He said that was an internal decision by MOH and that a review of the drinking guidelines was now on hold while the ministry considered its priorities. The documents obtained by RNZ show that Bell also shared the Alcohol Levy investment framework with wine and beer lobbyists in a November 2024 email. "As discussed and as promised, attached is the draft Alcohol Levy Investment Framework for your consideration and feedback," he wrote. The alcohol lobbyists then provided at least three pages of feedback on how the money should be spent. But again MOH is keeping all that information secret under the section of the OIA designed to protect "the confidentiality of advice tendered by Ministers of the Crown and officials". Minister for Mental Health Matt Doocey turned down RNZ's request for information on the Alcohol Levy but did release correspondence from alcohol lobbyists. Those documents included a July 2024 email to Doocey and his Cabinet colleague Shane Reti where the wine, beer and spirits industries pushed for greater involvement in setting alcohol policy. "We still believe industry has a lot to offer as government seeks to reduce harmful drinking," the booze lobbyists wrote. They pointed out that they funded the main education programme which teaches students about the impacts of alcohol. "We also fund, through our own social investment charity - The Tomorrow Project, an in-school theatre-based better drinking education programme called Smashed," the lobbyists told the Ministers. "Smashed is independently run and delivered by The Life Education Trust and reaches over 20,000 year 9 students every year." Filings with the Charities Services show that the beer, wine and spirits industries each paid $105,000 towards The Tomorrow Project, a charity entirely funded by the alcohol industry. The alcohol lobbyists also make a pitch for the government to "partner with industry" in deciding how to spend the Alcohol Levy and say they should be "working directly with officials" on reducing alcohol harm.


Otago Daily Times
a day ago
- Otago Daily Times
Faster treatment not always fairest
Anyone who has struggled to get elective surgery will not be surprised a report from the Auditor-general shows the post code lottery in healthcare is in better shape than they are. In the report, "Providing equitable access to planned care treatment", tabled in Parliament last week, John Ryan says the Pae Ora (Healthy Futures) Act requires Health New Zealand Te Whatu Ora to ensure Māori and other population health groups have equitable access to the health services they need. This means ensuring access to elective or planned treatment is based on clinical need, not background, circumstances or where they live. He concluded the way treatment is provided is often not equitable or timely. It depends on where you live. Those waiting longer are disproportionately those living in rural areas, those socially deprived, Māori, Pacific peoples, and those with disabilities. Thresholds to qualify for treatment are not consistent across the country, a throwback from the old district health board days, and although there is work under way to introduce national thresholds, this is not going to happen overnight. A national threshold has been introduced for cataract treatment. This meant about 1800 people were added to the waiting list in the Southern district. The report shows the huge variance in the orthopaedic thresholds. In Southern, for instance, your condition would need to be significantly worse to qualify for treatment than if you were in Canterbury or Auckland. The Auditor-general is far from the first to raise concerns the government's emphasis on using the private sector to provide more timely treatment could result in less equitable access to treatment. For a start, private hospitals providing outsourced treatment are not equally distributed across the country. (Health Minister Simeon Brown has downplayed this issue, citing the availability of the National Travel Assistance Scheme to help those who have to travel away from home for treatment. However, despite some improvement to the rates last year, this still leaves anybody travelling a long distance by car for treatment considerably out of pocket.) As the report notes, those selected for treatment in private would generally be non-complex patients. Patients with comorbidities making them unsuitable for treatment at the private hospitals were more likely to be Māori and Pasifika or socially deprived. Another issue raised in the report was the lack of translation services in some private clinics, so they might not accept patients with no or limited English language. Complex patients not suitable for private hospital treatment would remain on a waiting list in a public hospital while others with similar clinical needs would be treated privately. "This can complicate efforts to ensure that long-waiting routine patients are prioritised and, ultimately, that Health New Zealand provides treatment equitably for all New Zealanders." Making changes in one part of the stretched health system can often affect another part, something not always fully appreciated by policy makers. The report points out, for instance, when clinicians spend more time providing planned care, they have less time to provide first specialist assessments. Another concern of the Auditor-general is the lack of information about unmet need, and although he acknowledged this could be difficult, HNZ would benefit from a better understanding of it. "A good place to start would be to measure the level of unmet need from people who are referred for assessment but do not meet current treatment thresholds," he wrote. There have been calls for better understanding of unmet need for years, but little enthusiasm from politicians to assess this in a comprehensive way, possibly because they are fearful of what it would expose. Mr Ryan's planned care recommendations for HNZ include making a plan with clear times for introducing nationally consistent thresholds, acting to improve equity of access and ensuring faster access did not increase inequity, strengthening knowledge of unmet need, and clear public reporting on how long people wait for treatment, variations in access and how it will improve equity of access. The issues raised in the report should be taken seriously by HNZ and its political masters, but the government's almost simplistic focus on its narrow set of health targets does not convince us they will be.