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  • Singapore: Dengue cases


    Dengue cases down but chikungunya up
    Fri, Dec 26, 2008
    The Straits Times

    By Salma Khalik, Health Correspondent

    WITH intensified efforts this year, Singapore's fight against dengue appears to have paid off, with 25 per cent fewer cases than last year.

    However, a newly emerged Aedes mosquito-borne illness is causing fresh concerns. Chikungunya cases continued their upward trend, with more than 40 cases a week in the past three weeks.

    Of the 43 cases diagnosed last week, 39 caught the virus locally, while the other four imported cases were from Malaysia.

    Last Friday, the Ministry of Health made chikungunya a notifiable disease.

    Although doctors have already been informing the ministry of all cases since the end of 2006, when Singapore saw its first imported chikungunya case, the change means that doctors could be penalised with fines or jail terms for not doing so.

    A ministry spokesman said this will enable the ministry to monitor the disease more closely. A circular has gone out to all doctors informing them of the change.

    The appearance of locally transmitted chikungunya infections in Singapore this year also worries infectious diseases experts.

    Although no one has died of the infection, chikungunya, unlike dengue, can be very debilitating. There is also the risk that it could become endemic, which means the disease would be here to stay, with no chance of wiping it out.

    The Health Ministry said the disease has not become endemic yet, as a large number of cases is still from overseas.

    Until this year, the few cases were all imported. But by the middle of this month, 388 people had caught the virus locally. A further 158 people who were infected were bitten by mosquitoes while overseas, primarily in Malaysia.

    The areas where people here are getting bitten by the Aedes mosquito have also spread from the northern part of the island to places such as Bedok Reservoir and Tampines in the east.

    Cases have also been on the increase, rising sharply since the end of July.

    Given the current rates of infection, Singapore is likely to end the year with more than 600 chikungunya cases.

    A spokesman for the National Environment Agency (NEA) said the Aedes albopictus mosquito, which is the main carrier of this virus, lives in forests and other heavily vegetated areas.

    This makes it 'a challenge to remove as many breeding habitats as possible in such areas,' she said.

    She added that the current rainy season is unlikely to be the cause of the increased rates. Instead, it has more to do with 'the movement of infected cases and the susceptibility of the population'.

    The NEA spokesman said it is fighting chikungunya the same way it does dengue - by finding and destroying mosquito breeding spots and educating the public about stagnant water.

    She added that the early and intensive exercise against the Aedes mosquito this year has staved off an anticipated dengue epidemic. Dengue epidemics tend to come in five to six year cycles.

    So far this year, 6,424 people have become sick with dengue and dengue haemorrhagic fever, 2,183 fewer than last year. 'Earlier this year, it was predicted that Singapore would experience major dengue outbreaks and the situation would be worse than last year,' she said.

    But instead of going up, the number of infections had gone down significantly, due to the $200,000 a day spent fighting the scourge this year.

    'This reversal in dengue trend, the first time in three decades, is a result of the enhanced dengue control strategy put in place by NEA,' said the spokesman.


    What is chikungunya

    SYMPTOMS: Sudden high fever, headache, fatigue, nausea, vomiting, muscle pain, rash and joint pain.
    These are almost similar to symptoms for dengue, the other Aedes mosquito-borne viral disease, except the joint pains for chikungunya can be excruciating, last for months and, in some cases, for more than a year.

    While painful and debilitating, the infection is not life-threatening.

    TREATMENT: There is no vaccine against it or medicine that cures it. Treatment is only for symptoms such as fever or pain.

    TRANSMISSION: The culprit for dengue tends to be the Aedes aegypti while the Aedes albopictus is more likely to spread chikungunya.
    However, both types of mosquitoes can spread both diseases.

    INCUBATION: It usually takes three to seven days from the time a person is bitten by an infected mosquito for symptoms to appear.
    However, people can sometimes become sick just two days after being bitten, or as late as 12 days after.

    SPREAD: The disease is spread when a mosquito bites an infected person. The virus replicates in the mosquito and is passed on to people subsequently bitten.

    PREVENTION: The best way to stop the spread of the disease is to prevent mosquitoes from breeding. This year, the National Environment Agency spent close to $200,000 a day and has a team of 500 people doing just that.
    A mosquito needs just a small spoonful of stagnant water to breed. The A. aegypti breeds well in indoor receptacles but the A. albopictus prefers forests and places with high vegetation.

    Those infected should wear long sleeves and long dresses or pants and use insect repellent to prevent getting bitten again by mosquitoes, which could continue the chain of transmission.


    This story was first published in The Straits Times on Dec 23, 2008.

  • #2
    Re: Singapore: Dengue cases down but chikungunya up


    Jan 29, 2009
    NEA monitoring dengue spike
    By Jessica Jaganathan

    SINGAPORE is keeping a close watch on dengue fever, with the number of deaths from the disease in neighbouring Malaysia doubling this month, compared to the same period last year.

    According to Malaysian news reports, dengue cases spiralled to 4,221 with 12 deaths in the first 23 days of this month compared with 2,103 cases, including five deaths, during the corresponding period last year.

    In Singapore, the number of dengue cases increased in the first three weeks over the same period last year.

    Altogether, 509 people caught the illness, compared to 341 during the same period last year.

    Last week, however, 126 people were infected, down from 144 cases in the previous seven days.

    The National Environment Agency (NEA) said it was monitoring whether the spike in cases in the first three weeks was simply due to short-term fluctuations, which are to be expected.

    It added that while a surge in the number of cases in the region may have an impact on Singapore, 'there is at present no evidence to show that the recent rise in dengue cases in Malaysia could lead to a corresponding increase in cases in Singapore'.

    An NEA spokesman said that Singapore's key strategy to prevent dengue outbreaks is still to keep the mosquito population low to reduce their chances of transmitting the disease.

    Read the full report in Friday's edition of The Straits Times.


    • #3
      Re: Singapore: Dengue cases


      Rare dengue type on the rise in Singapore
      Fri, Mar 20, 2009
      The Straits Times

      By Jessica Jaganathan

      DENGUE numbers are down but public health officers are on high alert.

      The reason: An unfamiliar dengue virus has emerged which has the potential to spark a major outbreak.

      Though officials said on Tuesday that they have managed to contain the Dengue-3 virus for now, they are still keeping a close watch on it, as it has not been seen here commonly for some 10 years.

      With low immunity to Den-3 in the population, people are more vulnerable to infection.

      Officials are concerned because cases increased more than three times last November and December, and were found mainly in two areas, sparking fears that transmissions were high and could spread.

      There are four types of the dengue virus, and people who have been infected by any one type are immune to it for life. But that still means that an individual can get dengue fever up to four times.

      In Singapore, two main types of the dengue virus have circulated in the past 10 years: Dengue-1 and Dengue-2, with the latter now predominant.

      Past data shows that outbreaks in 2005 and 2007 were preceded by a switch in the predominant type of dengue virus.

      In the past few months, researchers from the National Environment Agency (NEA) found that the third type, Den-3, had emerged in greater numbers in Little India and Geylang.

      On average, Den-3 makes up about 5 per cent of all dengue cases here. But in November and December last year, it increased to more than 17 per cent.

      Although the numbers dropped back to 5 per cent last month, after NEA officers went to war against mosquitoes in the hot spots, the authorities are still watchful.
      Because of the rarity of Den-3 here, Singaporeans' immunity to it is very low, said Dr Ng Lee Ching, head of the NEA's Environmental Health Institute.

      Alarm bells went off as well, when infections clustered in two areas, Little India and Geylang, for two consecutive months.

      'We straightaway launched our resources in these areas as we didn't want Den-3 to have a launching pad to spring out to the rest of Singapore,' said Mr Tai Ji Choong, head of operations at the NEA's environmental health department.

      If it did spread, NEA officials feared a worse outbreak than in 2005, which infected more than 14,000 Singaporeans and caused 25 fatalities, he said.

      They went to work on the main lines of defence that have been successful in reducing numbers in the past: eliminate breeding spots and rely on the research team's laboratory work to pinpoint where the dengue type was dominant.

      Officers are now posted permanently in the two areas to wipe out breeding areas and two additional pest control teams have been deployed to check tricky spots like roof gutters for breeding, he said.

      They are also keeping watch on neighbourhoods in the south-west, like Bukit Batok and Jurong as well as Woodlands and Joo Chiat, where there has been a sharp increase of 10 per cent to 20 per cent in Dengue-1 cases over this year.

      The numbers fell last month, said Mr Tai, but the possibility of a new outbreak remains.

      With warmer weather expected, NEA officers, together with other agencies, are stepping up efforts to reduce and remove possible mosquito breeding sites.

      The World Health Organisation (WHO) warned last week that 1.8 billion people in the Asia-Pacific region are at risk of being infected with dengue, which has been gaining in South-east Asia.


      • #4
        Re: Singapore: Dengue cases


        April 16, 2009
        Dengue cases on the rise

        WITH warmer weather looming, the number of dengue cases is set to rise.

        The total number of cases for the first 13 weeks of the year was 1,526, a 22 per cent increase compared to the same period last year.

        There are 14 hot spots with two or more infections identified so far, mostly in the West Coast areas.

        Most of the cases involve the Den-2 virus, one of the two common types found in Singapore.

        The National Environment Agency (NEA) maintains that weekly fluctuations in cases are to be expected in the normal course of the disease.

        But with the coming warm weather likely to increase the mosquito population, South West District Mayor Amy Khor has expressed concern over a possible surge in dengue cases in the next few months.

        Anticipating this, the South West Community Development Council swung into action, launching an anti- dengue initiative at Clementi Avenue 5 on Wednesday.

        It is working with the NEA, town councils, grassroots organisations and schools.

        The main thrust of the initiative is to prevent mosquitoes from finding fertile breeding spots.

        Said Dr Khor: 'The period from April to September every year is always very conducive to dengue and mosquito breeding. This year, we are launching the Mcaps Outreach@South West Programme to reduce the probability of mosquito breeding at home.'

        Read the full story in Thursday's edition of The Straits Times.

        Top five clusters

        A DENGUE cluster is formed by two or more cases occurring within 14 days, and when the victims' homes are less than 150m apart.

        A cluster is closed when no new case is reported 14 days after the last one.

        The West Coast area has the highest number of dengue cases currently. The first cluster, in West Coast Drive (Blocks 505, 506, 507, 508, 510 and 511), has 13 cases.

        The second cluster, in West Coast Drive (Blocks 95 and 113A) and West Coast Lane/West Coast Place, has eight cases.

        Two other clusters - Sirat Road/Highland Road and Boon Keng Road - each have six. Clementi Avenue 3 (Blocks 428, 430, 431 and 445) rounds up the top five clusters with four cases.

        For updates on dengue clusters, please visit the NEA's dengue website at


        • #5
          Re: Singapore: Dengue/chikungunya cases



          Fri, May 22, 2009

          S'pore's No. 1 dengue hotspot so far this year: West Coast

          By Koh Hui Theng

          MISTER Wong Kwong Wing, 61, discovered he was living in Singapore's No. 1 dengue hotspot so far this year - but only after his wife and son came down with dengue fever last month.

          The refinery supervisor was among seven residents in the West Coast Drive area who came down with dengue fever in late March.

          But the numbers soon rocketed in two months. As of Monday, the number of dengue cases in the area shot up to 42, forming the biggest dengue cluster to date.

          A dengue cluster occurs when more than two cases are reported within 14 days, and if the victims live within 150m of one another.

          In Mr Wong's case, his former residence, Hong Leong Garden Condominium, had 25 cases. Besides his family, his neighbours also fell ill.

          He told my paper that his family had planned to move out of the condo at the end of this month, as the place had been sold for en-bloc development.

          "But, after we came down with dengue, we decided to pack our bags immediately," he said. "My daughter's the last one standing but she may get it if we live (in the condo) any longer, so (it's) better (to) be safe than sorry."

          City Developments (CDL), which bought the 180-unit condo last December, said tenants will vacate their units by next month. Residents told my paper that the property has been in a state of disrepair for a while.

          A ground-floor resident, who wanted to be known only as Mr Liu, said: "The facilities were neglected. The management committee cleared the badminton court of leaves only a few days ago after repeated complaints."

          After the first dengue case was reported in late March, the National Environment Agency (NEA) served an order on the condo's management, allowing its officers to enter vacant units to check for mosquito breeding grounds.

          CDL said it has since "carried out pest-control measures, like regular oiling of potential breeding areas and fogging in common areas".

          Islandwide, over 2,100 dengue cases were reported from Jan 1 to Monday, an 11 per cent increase compared to the same period last year, said NEA.
          NEA said the West Coast currently has three active clusters - Jalan Mas Puteh/West Coast Walk/Jalan Mas Kuning, Block 508 West Coast Drive, and Jalan Mas Kuning.

          Those found guilty of breeding mosquitoes at home can be fined $200.


          • #6
            Re: Singapore: Dengue cases


            July 28, 2009
            Scientists stop dengue spread
            By Grace Chua

            A DENGUE outbreak here may have been stopped in its tracks by a team of scientists at the Environmental Health Institute.

            In March the scientists, studying common strains of the virus here, discovered the resurfacing of a third, less common type in Little India and Geylang, they alerted the National Environment Agency (NEA), which stepped up its infection control measures and manpower to rid these areas of mosquito breeding.

            On Tuesday, the institute's key findings on dengue and chikungunya were presented by its head, Dr Ng Lee Ching at the EU-Southeast Asia meeting on vector-borne diseases, organised by the Singapore Immunology Network under the Agency for Science, Technology and Research.

            For instance, there are four strains or serotypes of dengue. A switch in predominance from one strain to another is associated with outbreaks, as people have lower immunity to a new strain.

            Researchers also found that the chikungunya virus can replicate in mosquitoes and be ready to infect humans within just three days, compared to seven to 14 days for the dengue virus.

            That's why chikungunya can spread so fast - just as it did last year, when the first local infections struck here. Since the start of last year, there have been 803 local cases and 214 cases imported from elsewhere in Asia.

            Researchers are now also able to conduct genetic 'paternity tests' to discover which countries the virus came from, said Dr Ng.

            The institute is still studying the current malaria outbreak, she added.

            The disease, which resurfaced here with perhaps the largest local cluster in almost three decades, is transmitted by the Anopheles mosquito.

            Read the full report in Wednesday's edition of The Straits Times.


            • #7
              Re: Singapore: Dengue cases


              Singapore's dengue situation shows downward trend in 2008, 2009
              By Lynda Hong, Channel NewsAsia | Posted: 27 August 2009 1752 hrs

              SINGAPORE : The dengue situation in Singapore has shown a downward trend in 2008 and 2009 - the first time in three decades. And this is despite a global surge in dengue cases.

              Singapore's National Environment Agency (NEA) said the country is on track to buck the cyclical increase in dengue cases, particularly during the warmer months from April to July.


              Aug 27, 2009
              Dengue situation under control

              THE dengue situation in Singapore continues to remain under control, with the number of cases on a downward trend.

              Dengue cases usually follow a six-to-seven-year cyclical trend, with each year surpassing the one before. Singapore is now in the third year of a cycle that began in 2007.

              Overall, while the rest of the region has been battling an increase in cases, Singapore continues to buck the trend, recording 3,271 cases so far this year, compared to 7,031 last year and 8,826 in 2007.

              The number of breeding sites at homes has also been dwindling since 2007, from 0.25 oer 100 homes inspected to 0.13 this year.

              The National Environment Agency (NEA) plans to continue using its current strategy of keeping the situation under control, by deploying officers to check homes and construction sites for potential breeding sites.

              In the next few months, it will also continue to keep an eye for any possible switch in dengue strains, which may cause a spike in cases.

              This is the period when Singapore can typically register up to 150 cases a week.

              But for April to July this year, Singapore had only about 100 cases a week.

              NEA said 2008 saw a 20 per cent dip in the number of dengue cases, compared to the previous year. - CNA /ls
              Last edited by Shiloh; August 27th, 2009, 05:43 AM. Reason: Added 2nd article


              • #8
                Re: Singapore: Dengue cases


                Dec 8, 2009
                S'pore avoids dengue spike
                By Jessica Jaganathan

                DENGUE numbers in Singapore have remained low despite a recent nationwide alert in neighbouring Malaysia.

                While Malaysia has seen more than 36,500 cases and 78 deaths so far this year, compared to 41,034 cases and 90 deaths for the whole of last year, Singapore has seen a far bigger drop in cases.

                There have been 4,248 cases in Singapore so far this year, against 7,031 for last year.

                In Malaysia, where the weekly number of cases rose from more than 700 at the beginning of last month to more than 800 a week later, health officials blame the spike on the rainy season and public apathy.

                But in Singapore, the National Environment Agency says its multi- pronged approach - surveillance and enforcement, community outreach and education, and research - has helped to minimise outbreaks of mosquito-borne diseases like dengue.

                For example, the number of households fined for letting mosquitos breed increased from 5,443 in 2007 to 7,337 for the first 10 months of this year, with a corresponding drop in dengue cases.

                Read the full report in Wednesday's edition of The Straits Times.


                • #9
                  Re: Singapore: Dengue cases


                  Dengue cases in Singapore fall for 3rd straight year
                  By Ng Lian Chong/Cheryl Lim, Channel NewsAsia | Posted: 10 January 2010 1928 hrs

                  SINGAPORE: The number of dengue cases in Singapore has fallen for the third consecutive year.

                  4,452 people caught dengue last year, of whom eight died, according to the Ministry of Health. There were 6,754 cases in 2008 and 8,637 in 2007.

                  During a dengue epidemic in 2005, there were nearly 14,000 cases and 25 deaths.

                  Research on the virus suggests the number of dengue cases tends to spike every six to seven years. Hence, Singapore is likely to see a surge in cases within the next two years.

                  The National Environment Agency (NEA) says it will continue to target dengue hotspots, especially in outdoor areas like construction sites. It is confident it will be able to control the dengue fever situation in Singapore.

                  NEA's CEO, Andrew Tan, said: "So long as we keep up the vigilance, we will be able to keep the incidents low. Going forward, we will continue to have these strategies where we have to tackle the problem at the source. There is a lot of public education that needs to be done."

                  - CNA/ir