Autochthonous dengue infections were identified on 3 of 6 islands (Table 1) . Exposures on Maui, Oahu, and Kauai accounted for 76%, 21%, and 3% of all recent dengue infections, respectively. Eighty (66%) of the laboratory-positive infections were from persons who stayed in the Hana area of Maui, an area with <2% of the island resident population (Figure 1 ). On Oahu, 20 (77%) of the infections occurred among residents of 2 nearly adjacent communities on the windward side with a combined population of 25,709 (<3% of the island's total). The heavily affected areas of Maui and Oahu both have thick vegetation and heavy precipitation (average annual rainfall >177 cm/year, 4 times the annual rainfall in Honolulu).