Increased Travel-Related Illnesses Require Immediate Health Protocol Review for Hawaii Businesses

A recent uptick in travel-related cases of Zika, dengue, and influenza has been reported in Hawaii, prompting an urgent need for businesses, particularly those in the tourism and healthcare sectors, to re-evaluate and fortify their health and safety protocols. While these viruses are primarily travel-related, their presence necessitates a proactive approach to mitigate potential spread and operational impacts within the islands.

The Change

As of mid-January 2026, Hawaii has seen an increase in diagnosed cases of Zika and dengue fever originating from travelers returning to or visiting Oahu. Concurrently, seasonal influenza (flu) activity is also higher than anticipated. Public health officials are monitoring the situation closely, emphasizing that while direct local transmission is not currently widespread for Zika and dengue, the influx of cases underscores the importance of vector control and public awareness. The flu surge aligns with typical winter patterns but is noted to be more robust, indicating a greater community burden.

Who's Affected

Healthcare Providers

• Impact: Increased patient volume presenting with flu-like symptoms, potentially including travel histories that could indicate Zika or dengue exposure. Local clinics and hospitals face pressure to expand diagnostic capabilities and manage patient flow efficiently. Telehealth providers need to ensure protocols for remote diagnosis and referral are robust.
• Concern: Ensuring adequate testing kits, maintaining physician and staff availability, and managing potential supply chain disruptions for medical consumables. Licensing requirements for telehealth services operating across state lines may need closer examination in light of potential cross-border patient movement.

Tourism Operators (Hotels, Tour Companies, Vacation Rentals)

• Impact: Heightened guest concerns about health and safety, potential for employee illness impacting service delivery, and increased demand for enhanced sanitation services. Non-compliance with updated health guidelines could lead to negative reviews, decreased bookings, and reputational damage.
• Concern: Balancing enhanced cleaning protocols with operational costs and potential charges for deep cleaning if an outbreak is linked to a property.

Small Business Operators (Restaurants, Retail, Services)

• Impact: Increased employee absenteeism due to illness, potential for a dip in customer traffic if public health advisories escalate, and the need to implement or reinforce employee health policies. Operating costs may rise due to increased sanitization supplies or staff sick pay.
• Concern: Maintaining staffing levels during periods of increased illness, managing customer perceptions of safety, and minimizing disruptions to daily operations.

Remote Workers

• Impact: Personal health risks increase, requiring greater vigilance in personal protective measures and awareness of local health advisories. While not directly client-facing, illness can disrupt work output and income.
• Concern: Access to timely healthcare and understanding local public health guidance. The cost of living may indirectly be affected if businesses pass on increased operational costs related to health protocols.

Second-Order Effects

An increase in localized illness, even if primarily travel-related, can strain the limited healthcare infrastructure in Hawaii, leading to longer wait times for basic medical services. This reduced healthcare capacity could indirectly impact the availability of healthcare workers for businesses and increase the cost of employee health insurance. Furthermore, heightened public awareness of vector-borne diseases like Zika and dengue, coupled with increased flu cases, could lead to a perception of health risks for tourists, potentially impacting visitor numbers or traveler spending, thereby affecting the broader tourism-dependent economy.

What to Do

For Healthcare Providers

• Action: Implement enhanced screening protocols for patients presenting with febrile illnesses, specifically inquiring about recent travel history and common symptoms of Zika, dengue, and influenza. Review and update internal guidelines for diagnostic testing and patient isolation. Ensure adequate stock of antiviral medications and testing kits. For telehealth providers, verify cross-state licensing compliance and update remote diagnostic pathways. These reviews and updates should be completed within the next 7 days.
• Details: Evaluate current inventory of rapid flu tests, Zika/dengue serology kits, and personal protective equipment (PPE). Cross-reference telehealth service areas with current state licensing requirements. Brief clinical staff on updated symptom checklists and referral pathways.

For Tourism Operators

• Action: Immediately communicate updated health and safety protocols to guests via pre-arrival emails and in-room information. Enhance daily cleaning and sanitization routines, particularly for high-touch surfaces in common areas and guest rooms. Train staff on recognizing symptoms and reporting procedures. This should be executed within the next 7 days.
• Details: Update website FAQs to include information on health protocols. Provide staff with updated training on enhanced cleaning techniques and illness reporting. Consider offering virtual check-in/check-out options to minimize guest contact.

For Small Business Operators

• Action: Reinforce existing employee health policies, emphasizing the importance of staying home when sick and adhering to hygiene best practices. Provide clear guidelines on reporting illness and managing staff shortages. Consider increasing the availability of hand sanitizers in customer-facing areas. Initiate these reinforcements within the next 5 days.
• Details: Remind staff of sick leave policies and encourage regular handwashing. Ensure sufficient supply of hand sanitizer for employees and customers. Post clear signage about hygiene recommendations.

For Remote Workers

• Action: Increase personal vigilance regarding health and safety. Stay informed about local public health advisories and take precautionary measures such as diligent handwashing and avoiding crowded indoor spaces when feeling unwell. Monitor local news for any health alerts. No immediate business action is required, but personal preparedness is key.
• Details: Bookmark the Hawaii Department of Health website for the latest advisories. Ensure personal health insurance is up-to-date and understand your coverage for potential illnesses.