Officials believe now is not the time to panic. They have a proactive plan that starts with securing the state's entry points.
Practice makes perfect, but how do you prevent a pandemic?
Since 2005's SARS and Avian Flu scare, Hawaii's Homeland Defense practices with drills, using ultraviolet light to kill bacteria at overseas terminals. It's the only surveillance system of the kind in the country.
"We are ready to address any form of condition or situation that might arise," said Transportation Director Brennon Morioka.
Recently that effort now extends to domestic flights. If a flight crew notices someone with swine flu like symptoms, they contact airport medical personnel.
"They have special training in influenza recognition, and screening and will do a swab of the patient," said Airport Medical Director Dr. James Ireland.
That sample will be sent to the state lab. There are roughly 20 reports filed a year, but blocking the flu's arrival isn't that simple.
"Surveillance isn't a barrier, it's a means to be able to detect as soon as possible when a disease is occuring," said State Epidemiologist Dr. Sarah Park.
The state asks you to be prepared. Good hygiene is a start.
"Hand hygiene, washing your hands, covering your cough, covering your sneeze," said Dr. Park.
But also think about how you'll respond to the potential health threat.
"It's relying on a combination of things and employing all of them to the full potential," said Dr. Park.
"We ask you to be vigilant, prepared and not over react," said State Health Director Dr. Chiyome Fukino.
Influenza or any other disease, city, state and federal agencies work together on this collaborative effort to calm concern.
This past weekend at Honolulu International Airport, a potential swine flu case was reported, but tests came back negative.
The state is also looking into a handful of other suspected cases in the community, including one that was recently in Mexico. But initial test results aren't in yet.
The state has also set up a special swine flu hotline at (866) 767-5044.