Ready for that winter vacation to the Big Island?

You may want to think twice about going because a dengue fever outbreak in Hawaii is expected to last for a while.

As of Jan. 18, there were 223 confirmed cases, although 220 of the victims are no longer infectious. So far, the outbreak has been confined to the large island of Hawaii.

This latest burst of the virus is the first cluster of locally acquired dengue fever since a 2011 outbreak on Oahu. Experts have said the outbreak could last through the summer tourist season.

However, Dr. Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital, told Healthline that people shouldn’t be too worried.

He noted the viral illness is spread by mosquitoes. It cannot be spread from human-to-human contact. Few of the Hawaii cases involved visitors to the state, Sax added.

“The overall risk of contracting dengue fever is very low,” he said.

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Dengue Not the Only Threat

In addition, the first case of brain damage in the United States linked to the Zika virus was reported in Hawaii.

This was a few days after a Texas woman was diagnosed with the Zika virus after she traveled to Central America.

Zika can be spread through the same mosquitoes that spread dengue fever.

Recently, the virus has been in the spotlight because of mosquito-borne illnesses in Latin America and its effect on infants. Zika is linked to microcephaly, a rare condition in which infants are born with abnormally small heads.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that pregnant women consider postponing travel to any countries or regions with active Zika virus transmission.

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Dengue Is Common Worldwide

According to the CDC there are about 100 million cases of dengue per year across the globe.

Symptoms, which can begin within five to seven days after a person is bit, include a sudden fever, severe headaches, and rash, as well as pain in the eyes, joints, or muscles. Bleeding issues can also occur.

Within three or four days of the fever, a rash typically appears. In one to two weeks, symptoms usually go away.

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Climate Change Contributing

The World Health Organization (WHO) says dengue is the most dominant mosquito-borne viral disease in the world. Incident rates of dengue have increased 30-fold in the past 50 years.

WHO officials and others say climate change is one of the culprits because of the hot, wet weather it brings. In turn, that makes the environment more friendly for the Aedes aegypti and Aedes albopictus mosquitos, which carry viruses.

Other recent research indicates that El Niño weather patterns also can encourage the spread of dengue.