HONOLULU -- The state Health Department said they have now found 11 cases of dengue fever on Oahu.

Health officials said all patients contracted the disease outside of Hawaii.

Health officials are concerned about East Maui, where four cases of dengue fever have been confirmed. They are still investigating 41 other cases.

Dengue fever is spread by mosquitos. Symptoms include fever, nausea, body aches and a rash.

There is an outbreak of dengue fever in the South Pacific islands, according to health officials and travelers to that area are being warned to take precautions.