Te Marae Ora declared an outbreak of Dengue Type 1 (DENV-1) on 27 February 2019. To date, there have been over 300 cases since 2019, with over 190 new cases reported since January 2020. There have been no deaths related to dengue.
A range of programmes have been put in place to mitigate against dengue including:
Dengue is a mosquito-borne disease caused by the dengue virus. It is transmitted to humans from the daytime bite of an infected female Aedes aegypti mosquito. The same mosquito also spreads other common mosquito-borne diseases such as chikungunya and zika. It is recognised by white markings on its legs. Dengue fever is common in tropical and sub-tropical climates such as the Cook Islands and the wider Pacific region.
The common signs and symptoms of dengue include:
If you feel one or more of these symptoms, you should call the Healthline and arrange to see a health professional.
Severe dengue symptoms include rash, mild bleeding in the nose or gums, and easy bruising. If left untreated, severe dengue can cause internal bleeding or even death.
There is no specific treatment for dengue but early detection and seeking proper medical care lowers chances of death or severe illness.
The female Aedes mosquitoes spends their lifetime in and around houses, and when they emerge as adults, fly an average of 400 metres. As a result, home owners and occupants are advised to clean around their homes and pay attention to any mosquito breeding sites or adult mosquitoes present in their homes. Mosquitoes tend to breed in stagnant water, such as empty containers, flower vases, discarded tyres hence it is important to empty or drain the water.
Most of the dengue cases, up to 97%, are based on Rarotonga. Te Marae Ora currently implements exit screening processes requiring travellers to obtain medical clearance prior to travel to the Pa Enua. Click here for more information.
The common pesticides used are:
These pesticides have two basic ingredients, pyrethrum and deltamethrin. These come in a concentrated liquid form and when mixed with the right amount of water (up to 5L), it is safe to use against a wide range of pests including mosquitoes and flies.
Takeaway/fast food outlet
Manufacturing and packaging
Seasonal (all food products including fish)
Special inspection (case or further investigation)
Market owner fee
Use soap and running water to wash your hands for 20 seconds, and dry well. You should wash your hands after:
Wash surfaces such as countertops before and after use. Ensure the cloths you use for washing dishes, wiping the bench and wiping the floor are different and separate. Ensure you keep raw meat away from cooked foods, fruit and vegetable.
Keep raw and cooked foods separate from each other – including utensils. Ensure meat such as chicken is cooked right through. It is important to check the expiry date on packaged foods and avoid eating this once the use-by date has passed.
The provision of good quality drinking water is essential to prevent a wide range of gastrointestinal diseases in the Cook Islands. The regulation of water supply, treatment and disposal is legislated through the Public Health Act 2004 and Ministry of Health Act 2013. Under the Public Health Act, this includes water in reticulated supplies and water in public swimming pools and swimming places.
The implementation of the Te Mato Vai project provides the opportunity to improve the provision of drinking water on Rarotonga. The establishment of a dedicated government water entity, To Tatou Vai ensures routine monitoring and quality control continues for water supplies. Te Marae Ora will maintain oversight in a surveillance and test capacity, with a focus on compliance and overall quality assurance for the public.
The Cook Islands Drinking Water Standards (CIDWS) are still in development. The CIDWS draws upon a broad range of public health and scientific research from other countries and jurisdictions, enabling Te Marae Ora to draft and tailor standards to suit our needs and expectations. The CIDWS will require water suppliers to develop and implement a drinking water safety plan to guide the safe management of water supplies, and prescribe maximum allowable concentrations of potentially harmful contaminants. Standards of bottled/packaged water are covered in the Food Act 1993.
Sanitation is the process of removing waste from water. It is essential to prevent the spread of water-borne diseases. Good sanitation requires a sewage system that can properly and safely remove human waste and other harmful products from the water, so it is safe to drink.
The Public Health (Sewage and Wastewater Treatment and Disposal) Regulations 2014 set outs the requirements for sanitation system upgrades and compliance. As at March 2020, more than 10% of residential and commercial properties on Rarotonga comply with the Regulations. However, many properties are yet to upgrade their sewage systems to comply with the Regulations. This is a concern, as poor water and sanitation is linked to transmission of water borne diseases such as cholera, diarrhoea, and typhoid which can cause death.
The annual Tutaka programme involves inspecting homes and properties around the Cook Islands to minimise health issues related to poor hygiene, sanitation, mosquito breeding places and other pests around the home. It is a long running public health programme since the 1930s. Te Marae Ora conduct the Tutaka four times a year.
The sale and supply of liquor is legislated through the Sale of Liquor Act 1991-1992 and requires the seller of alcohol to the public to have a licence. The conditions of the liquor licence are determined by the Liquor Licensing Authority. The conditions of the licence cover things such as:
Click here for information on applying for a liquor licence