Singapore: Local transmitted chikungunya fever detected

[Sally Furniss]

Re: Singapore: Chikungunya case detected in Holland area

Re: Singapore: Chikungunya case detected in Holland area

<table class="lan18" align="center" border="0" cellpadding="0" cellspacing="0" width="97%"><tbody><tr><td class="hei22" height="25" valign="bottom"> 3 more cases of chikungunya fever found in Singapore
</td> </tr> <tr> <td bgcolor="#ffffff" height="4">
</td> </tr> </tbody></table> <table align="center" border="0" cellpadding="0" cellspacing="0" width="50%"> <tbody><tr> <td height="8">
</td> </tr> </tbody></table> <table align="center" border="0" cellpadding="0" cellspacing="0" width="97%"> <tbody><tr> <td width="48%">
</td> <td class="hui12" align="center" width="26%">
</td> <td class="hui12" align="center" width="12%">
</td> </tr> </tbody></table> <table border="0" cellpadding="0" cellspacing="0" width="80%"> <tbody><tr> <td height="20">
</td> </tr> </tbody></table> SINGAPORE, Aug. 2 (Xinhua) -- Singapore's Ministry of Health (MOH) said Saturday it has found three new cases of chikungunya fever, bringing the total number of such cases to 48 so far this year.
The three cases, involving two foreign workers and a local delivery driver, are likely to be local ones as the three people have not traveled out of the country recently, said the ministry.
The two foreign workers are now in hospital for treatment, but the Singaporean driver has returned to work after timely medical treatment.
Currently, the ministry is carrying out active case detection at and around the site in Kranji Way and blood samples are being sent to the country's environmental health institute for testing.
Chikungunya fever, like dengue fever, is a mosquito-borne disease and the best way to prevent chikungunya fever is to take precautionary measures to prevent mosquito breeding.
The first case of Chikungunya fever, which is characterized by sudden onset of fever, chills, headache, nausea, vomiting, joint pain with or without swelling, and low back pain, was reported in Singapore in January this year.



http://rss.xinhuanet.com/newsc/english/2008-08/02/content_8909171.htm

 

[Sally Furniss]

Re: Singapore: Local transmitted chikungunya fever detected

Chikungunya 'not taken root here yet'

Viruses from local infections from three different strains so incidents aren't linked
By Lee Hui Chieh

THE number of people infected by chikungunya here continues to climb but, for now, the virus causing the mosquito-borne disease has probably not gained a foothold in Singapore.

The National Environment Agency (NEA) said its tests showed that the viruses that caused the first three incidents of local infection - in Little India, Teachers' Estate off Upper Thomson Road, and Farrer Road - belonged to different strains.

This means that the three incidents were not linked, said Dr Ng Lee Ching, head of the NEA's Environmental Health Institute, which conducted the tests.

Each time, the infection had probably been sparked by someone getting infected overseas bringing one particular strain of the virus here, she added.

And each time, the infection was stamped out so that strain did not spread further.

The institute's scientists established that the first three incidents had occurred separately by mapping the genetic code, or DNA, of the viruses in patients' blood samples. They found that the viruses were related to the one that caused huge outbreaks in islands in the Indian Ocean in 2006, where deaths were reported. But each was of a distinctly different strain.

It was unlikely that the second and third strains had mutated from the first in such a short time, Dr Ng said.

Public health officers have gone all out to track patients and destroy mosquito breeding sites. This is to ensure that chikungunya does not become as common here as dengue.

Having both similar diseases entrenched here will complicate diagnosis, treatment and containment.

Singapore is at risk as it hosts many travellers, the virus-transmitting Aedes mosquito flourishes here, and people here have no immunity against chikungunya.

It was spread for the first time in Singapore, when 13 people living or working in Little India contracted it in January.

In June, a retiree and her maid living in Teachers' Estate, and an expatriate housewife living in Farrer Road were infected.

Joining the list of local cases last month: A housewife living in Jalan Jelita off Holland Road, two foreign workers working and living in a site at Kranji Way, and a local delivery driver who went there.

Another 31 people here caught the disease while abroad this year; before that, 13 others had been infected overseas over 2006 to 2007.

The rise in the number of chikungunya cases here, both local and imported, mirrors a global trend, Dr Ng said.

Recently, outbreaks have been reported more often in Malaysia, Indonesia and India, and in previously chikungunya-free areas such as Italy.

The reasons for the upswing in infections are not known. But scientists believe that a contributory factor is the emergence of a certain strain of the chikungunya virus, which has mutated such that it can be carried by another sub-species of the Aedes mosquito - the Aedes albopictus.

Previously, the virus' main vehicle of infection was the Aedes aegypti, which is also behind most dengue cases.

The institute's scientists have yet to study virus samples

from this month's local cases but will be doing so.

Appealing to the public to help eliminate mosquitoes and their breeding sites, Dr Ng said: 'Chikungunya is not endemic here yet, so we still have a chance to keep it out. It is easier to do that than to try to get rid of it when it is established.'

http://www.straitstimes.com/Free/Story/STIStory_264291.html

 

[Giuseppe]

Re: Singapore: Local transmitted chikungunya fever detected

Fifth Chikungunya fever reported in less than a week

By Hasnita A Majid & May Wong, Channel NewsAsia | Posted: 05 August 2008 2307 hrs

SINGAPORE:

Another case of Chikungunya fever was reported in Singapore on Tuesday.

Channel NewsAsia understands a man caught the virus while he was in Malaysia recently.

This brings the total number of Chikungunya cases to five in less than a week.

The first case reported on July 31 involved a 60-year-old woman, while another three cases involving two foreign workers and a local delivery driver was reported on August 2.

In the latest case, the middle-aged man complained of fever and chills on July 31, a few days after he came back from Tangkak, Segamat, where he had gone to visit his family.

He was admitted to Mount Alvernia Hospital where he was diagnosed with the Chikungunya virus.

The man told Channel NewsAsia that besides himself, five other family members - all Malaysians - have also caught the virus.

His family received treatment in Malaysia.

An acute viral disease, Chikungunya is transmitted by bites from infected Aedes mosquitoes.
- CNA/yb
-
http://www.channelnewsasia.com/stories/singaporelocalnews/view/365105/1/.html
-------

 

[Commonground]

Re: Singapore: Local transmitted chikungunya fever detected

Aug 6, 2008
17 more workers in Kranji Way struck with chikungunya
By Lee Hui Chieh
ANOTHER 17 workers have been infected by the mosquito-borne chikungunya virus, making this the biggest outbreak in Singapore so far.
The latest cluster at Kranji Way brings the number of people infected in the area to 20.

The 17 were picked up during a screening of 282 workers in the area after two foreign workers and a Singaporean delivery driver fell ill last month.

Previously, the largest chikungunya outbreak here was also Singapore's first outbreak, when 13 people living or working in Little India came down with the dengue-like disease in January this year.

Separately, a technician who lives in Miltonia Close off Yishun Avenue 1 and works at Marsiling Industrial Estate, was also found to have contracted chikungunya.

He fell sick on July 18, and was hospitalised for five days.

None of the 10 people living with him were infected.

http://www.straitstimes.com/Latest+News/Singapore/STIStory_265174.html

 

[Sally Furniss]

Re: Singapore: Local transmitted chikungunya fever detected

Five new chikungunya fever cases found in Singapore
SINGAPORE, Aug. 13 (Xinhua) -- Five more people have come down with the mosquito-borne chikungunya fever in Singapore, said the Health Ministry (MOH) on Wednesday.
They include two foreign workers at Kranji Way, bringing the total number of cases linked to the northern industrial area to 30,said the ministry.
The two, a 48-year-old Indian and a 34-year-old Chinese National, have no recent history of travel overseas prior to their onset of illness, said the authorities.
The Ministry said it has also been notified of three other cases not related to the Kranji cluster.
So far this year, there has been 103 cases of chikungunya fever in Singapore.
Like dengue fever, chikungunya fever is a mosquito-borne disease, characterized by sudden onset of fever, chills, headache, nausea, vomiting, joint pain with or without swelling, and low back pain. The best way to prevent chikungunya fever is to take precautionary measures to prevent mosquito breeding.

http://news.xinhuanet.com/english/2008-08/13/content_9268437.htm

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://www.straitstimes.com/Breaking+News/Singapore/Story/STIStory_269066.html

9 more chikungunya cases
Latest cluster at Pasir Panjang Wholesale Centre; two workers and a kin test positive
By Gracia Chiang

Nine more local cases and a new cluster for chikungunya fever has surfaced.

The latest cluster is at Pasir Panjang Wholesale Centre, where a 32-year-old female worker tested positive for the mosquito-borne disease last Tuesday.

Her 61-year-old father later tested positive. He is still in hospital while she has recovered.

Last Thursday, a further blood screening of 184 workers at the centre detected a third person, a 44-year-old worker who came down with the disease there.

The National Environment Agency (NEA) immediately sent some 20 officers and 10 pest control operators to the centre, where four breeding sites were found.

These were destroyed, followed by fogging in the area.

Of the 10 staffing stalls at the centre whom The Sunday Times spoke to, none was aware that chikungunya had hit the place. They did, however, notice that there was an increased effort to clean the area.

One cashier at a supplier there, Madam Serene Lee, 41, said she was 'scared' but business would still go on. 'I have no backup plans but I'll have to be more careful, and take note if any of my workers or colleagues are not feeling well.'

Two additional cases have also been reported at Kranji Way, Singapore's largest chikungunya cluster to date.

The latest victims - a 52-year-old Singaporean and a 41-year-old Chinese national - bring the total affected there to 32. Both work there.

Up to 70 NEA officers and 20 pest-control operators have gone into action there and enforcement measures have been taken against the 52 factory premises found with mosquito breeding.

The NEA has since extended its operations to include other parts of the Kranji and Sungei Kadut areas.

Giving an update on the Sungei Kadut cluster, the Ministry of Health (MOH) said there has been a third chikungunya case there. She is a 61-year-old clerk who works in Sungei Kadut Street 1.

Across the island, three more chikungunya cases - all local males - have also been reported: in Segar Road, Jalan Berjaya and Queen Street. Two are aged 48 and the third is 65 years old.

The nine new cases bring the total number of local cases to 63 and the affected areas in Singapore to 15.

This year alone, there have been 117 cases of chikungunya fever, of which 54 were imported cases with a history of travel.

Speaking to reporters on the sidelines of an event yesterday, Health Minister Khaw Boon Wan, referring to cases in the region, said: 'I don't think it's the mosquitoes crossing borders but patients do cross borders.' There was a huge volume of people coming and going.

'Workers come here to work and Singaporeans go there to visit, and this is the durian season, so many go for durian trips as well.'

He added that the Kranji cluster had significant numbers of foreign workers who crossed the borders every day.

In Johor, chikungunya was a bit of a problem, so new cases were appearing practically every day.

He advised Singaporeans to take preventive measures and see a doctor as soon as symptoms emerged so that cases can be isolated.

He added: 'What you hope for is that it will not become like dengue. Once it becomes like dengue, when it becomes endemic in Singapore, it will be very hard to get rid of it until scientists come up with a vaccine.

'So we are doing our very best to make sure that chikungunya does not decide to stay here permanently.'

graciac@sph.com.sg

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://www.straitstimes.com/Singapore/Story/STIStory_269507.html

Going to Malaysia? Beware of mozzies
Chikungunya patients here were hit by a strain of the virus circulating in Malaysia
By Lee Hui Chieh

IF YOU are heading across the Causeway, stay well covered up and have insect repellent handy, as the record number of chikungunya cases in Malaysia is having a spillover effect here.

At least 82 of this year's 117 chikungunya patients were hit by a strain of the virus that has been circulating in Malaysia.

Of these 82, 43 caught the mosquito- borne disease that causes fever and joint pains in Johor while three others fell ill after visiting Malacca.

The remaining 36 contracted the disease in Singapore after being bitten by Aedes mosquitoes here, which had probably become infected after feeding on patients who returned from Malaysia, or one of the 36 after they fell ill.

Malaysia has reported a record high of 136 chikungunya patients this year, up from last year's tally of fewer than 100.

Tests by the National Environment Agency's (NEA) Environmental Health Institute showed that the strain of the virus in the 46 travellers' blood was identical to that found in the 36 infected here.

They include 32 workers from the largest cluster in Kranji Way, and four others living in Teachers' Estate off Upper Thomson Road, Jalan Jelita off Holland Road, and Miltonia Close off Yishun Avenue 1.

The institute's scientists mapped the genetic code, or DNA, of the viruses in patients' blood samples, and compared them against one another and against those from overseas. They found that the virus that caused the Little India outbreak resembled viruses found in India, while the one behind the Farrer Road cluster was similar to viruses in Sri Lanka.

This means that the two incidents were not linked, said the institute's head, Dr Ng Lee Ching. Each time, someone had probably picked up the virus overseas and passed it on to mosquitoes here that went on to infect other people.

But the viruses from patients at Teachers' Estate, Jalan Jelita, Kranji Way and Miltonia Close, were the same as that from patients infected in Malaysia.

So it is no longer possible to tell if each of these incidents was sparked off by a different infected traveller, or if the virus has gone into the community and is spreading from area to area, Dr Ng said.

But in any case, efforts to stop the disease from spreading further should not be relaxed, she said.

'So far, our clusters have mostly been small. It's better to have patients popping up one by one, than have many Kranji Way clusters. So every single case is still worth the effort of fighting,' she added.

The scientists have yet to test viruses from the latest incidents in areas such as Woodlands, Sungei Kadut and the Pasir Panjang Wholesale Centre, but will do so.

The Woodlands episode may have resulted from the virus being spread from an imported case to a local one.

Dr Charity Low, who runs a clinic in Woodlands Street 83, diagnosed her first chikungunya patient on July 22.

The 59-year-old teacher, who lives on that street, developed a fever, joint pains, rashes and throat ulcers, three days after returning from Johor. He had visited two friends there who had fever and joint pains.

Dr Low had his blood tested for both dengue and chikungunya, which cause similar symptoms, and was surprised when the results were positive for chikungunya.

Less than two weeks later, she received a second surprise. A 27-year-old housewife living in Woodlands Street 81 showed up with fever, joint pains and rashes. Tests showed that she too had chikungunya.

Dr Low said: 'She had no travel history, so most probably she caught it from my first patient or others in the area.'

Woodlands has had three other imported cases from Malaysia since July.

This year, 63 people here have been infected locally, and a further 54 overseas. Apart from those who caught the virus in Malaysia, four were infected in Indonesia, two in India and two in Sri Lanka.

The Health Ministry and NEA advise travellers to wear long-sleeved shirts and long pants, apply insect repellent and use mosquito coils while in chikungunya outbreak areas such as the Malaysian states of Johor, Malacca, Negri Sembilan and Perak; Indonesia and India.

Chikungunya patients should also protect themselves from being bitten again when they are ill, to prevent the disease from spreading further.

huichieh@sph.com.sg

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://www.straitstimes.com/Breaking+News/Singapore/Story/STIStory_269812.html

4 more have chikungunya
By Sujin Thomas

A 62-YEAR-OLD housewife from Choa Chu Kang is among four new people confirmed to have caught chikungunya, officials said on Tuesday.

The new cases stretched from Kranji to Pasir Panjang, bringing the total number reported this year to 128, according to the Ministry of Health and National Environment Agency (NEA).

The most recent cases were in three areas - Pasir Panjang Wholesale Centre, Kranji Way and Sungei Kadut - that have been battling outbreaks of the dengue-like disease in recent weeks.

The woman in the latest case developed symptoms last Saturday and was hospitalised the same day. She tested positive on Monday for the virus, which causes fever, nausea and muscle aches. In rare cases it can be fatal.

This comes about a week after her 32-year-old daughter and 61-year-old husband also tested positive for the virus.

Her daughter, who developed symptoms on Aug 8, has since recovered. Her husband remains in hospital.

The three had not travelled overseas recently and had stuck around their home and their workplace, the Pasir Panjang Wholesale Centre.

Officers from the NEA have fanned out across the Pasir Panjang fruit and vegetable distribution centre and the surrounding area. So far, they have found and destroyed five mosquito-breeding sites.

In the Kranji Way cluster, a 34-year-old Indian national who works and lives at Kranji Crescent tested positive for the disease.

Up to 70 NEA officers have been deployed in the area around Kranji Way, covering Kranji Loop, Kranji Road, Kranji Link and Sungei Kadut.

In the Sungei Kadut cluster, a 36-year-old Chinese national who works and lives at Sungei Kadut Street 1 and a 48-year-old Singaporean who works at Sungei Kadut Street 6 tested positive.

 

[KBD]

Re: Singapore: Local transmitted chikungunya fever detected

Singapore's MoH is reporting another ChikV cluster here:
http://www.moh.gov.sg/mohcorp/pressreleases.aspx?id=19814

News
Press Releases

Update On Chikungunya Fever Situation(1)

25 Aug 2008


A new cluster detected at Lim Chu Kang

MOH has identified a new cluster of chikungunya fever at Lim Chu Kang. The index cases were a 25-year-old Bangladeshi and a 41-year-old local working in the vicinity of the Lim Chu Kang Agro Technology Park located at Lim Chu Kang Lane 2. 30 workers were screened as part of active case detection in the area on 22 Aug 08 and three more workers (a 23-year-old Malaysian, a 21-year-old Chinese national and a 31-year- old Myanmar national) were found to be positive for chikungunya virus. The total number of cases linked to Lim Chu Kang stands at five. Investigations are continuing.

Officers from the National Environment Agency (NEA) have conducted intensive mosquito control operations at Lim Chu Kang Lane 2. As many as 20 officers have been deployed to conduct search and destroy operations in the area. So far, 4 farms have been inspected and mosquito breedings have been detected in all the 4 premises. The NEA will proceed with enforcement action against the owners/occupiers of the premises. ULV fogging operations have also been conducted within the workers? quarters.

Update on existing clusters

Pasir Panjang Wholesale Centre: One more case has been identified in a 52-year-old businessman who works in Pasir Panjang Wholesale Centre(PPWC). He developed symptoms on 18 Aug 08 and sought outpatient treatment that same day. He has no recent history of travel overseas prior to the onset of his illness. This brings the total number of cases to five.

NEA has extended its intensive mosquito control operations at the Pasir Panjang Wholesale Centre to the adjacent car mart as well at PSA Vista. As many as 20 NEA officers have been deployed in the area to keep mosquito breeding in check. So far 8 mosquito breedings were found and destroyed. Enforcement action has been taken against premises owners found breeding mosquitoes. Fogging was also carried out within the wholesale centre as a precautionary measure.


Kranji Way: Two more cases of chikungunya fever were linked to the Kranji Way cluster. The first case is a 37-year-old Malaysian who works and stays at a temporary worksite along Kranji Way. He developed symptoms on 15 Aug 08 and sought outpatient treatment by a GP on the same day. He was subsequently admitted to TTSH on 21 Aug 08. The second case is a 30-year-old Bangladeshi construction worker who works and stays at Kranji Loop. He developed symptoms on 17 Aug 08, sought outpatient treatment on 19 Aug 08 and was admitted to TTSH on 21 Aug 08. Both of them have no recent history of travel overseas prior to their onset of illness. This brings the total number of cases to 35.

Mosquito breedings have been found and destroyed in 47 factory premises so far. Up to 70 NEA officers have been deployed in the area to keep mosquito breeding in check. As an added preventive measure, NEA has also extended its operations to areas beyond Kranji Way, to include Kranji Loop, Kranji Rd and Kranji Link. Enforcement action has been taken. NEA has also served orders on owners/occupiers to ensure that they take the necessary measures to keep their premises free of mosquito breedings. Under the law, non-compliance with such orders can result in a maximum fine of $50,000.

Sungei Kadut: Three more cases of chikungunya fever linked to the Sungei Kadut cluster have been notified to MOH. The first case is a 30-year-old Chinese national who works and stays at Sungei Kadut St 1. The second case is a 34-year-old Bangladeshi who works and stays also at Sungei Kadut St 1. The third case is a 24-year-old Nigerian who works at Sungei Kadut St 3. This brings the total number of cases to eight.

Up to 25 NEA officers have been deployed to keep mosquito breeding in check. Operations have also been extended to the homes of cases and the surrounding neighbourhood, other than the workplace. Thus far, mosquito breedings found in 27 factory premises have been destroyed. Enforcement action has been taken and orders served.

Additional local cases

Two additional single and sporadic cases have been notified to MOH. The first is a 61-year-old housewife who stays at Yishun St 72. She developed symptoms on 9 Aug 08 and was admitted to hospital on 10 Aug 08. The second new case is a 47-year-old automation engineer working at Tuas Link 1. He developed symptoms on 20 Aug 08 and was admitted to hospital on 21 Aug 08. Both had no recent travel history outside Singapore.

NEA has been carrying out vector control operations in and around the cases? residential premises, including their work places and places that they normally frequent. All premise owners are urged to check their premises daily to remove any stagnant water that may breed mosquitoes.

Overall situation

To date, a total of 150 cases of chikungunya fever have been notified to MOH in 2008. Of these, 70 were imported cases with history of travel to Johor (56 cases) and other states of Malaysia (six cases), Indonesia (four cases), Sri Lanka (two cases), and India (two cases). The rest were locally acquired infections which probably occurred at 18 separate locations. The local cases comprised 35 from Kranji Way, 13 from the Little India, eight from Sungei Kadut, five from Pasir Panjang Wholesale Centre, five from Lim Chu Kang, two from Teachers Housing Estate cluster, one from Farrer Road, one from Herford Road, one from Jalan Berjaya, one from Hougang St 22, one from Jalan Jelita, one from Miltonia Close, one from Queen Street, one from Segar Rd, one from Woodland St 81, one from Yishun Ave 6, one from Yishun St 72 and one from Tuas Link.

Ministry?s Advice to the Public

The Ministry advises persons who develop symptoms of chikungunya which include fever, joint pain and rashes to consult their doctors immediately.

Chikungunya fever, like dengue fever, is a mosquito-borne disease and the best way to prevent chikungunya fever is to take precautionary measures to prevent the breeding of mosquitoes. Persons infected with chikungunya fever should be isolated from further mosquitoes bites so as to reduce the risk of further transmission of the virus.

Chikungunya outbreaks continue to be reported in our region, including Johor. Therefore, the risk of imported cases leading to local transmission remains high.

Persons travelling to places with chikungunya fever are thus advised to take precautionary measures to protect themselves from mosquitoes and seek prompt medical treatment upon their return if they become unwell and develop fever.


Ministry of Health
National Environment Agency
25 August 2008

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://www.bloomberg.com/apps/news?pid=20601124&sid=a9Geegg8o7Do&refer=home

Singapore's Virus Scourge Exposes Vulnerability to Asian Bugs
By Jason Gale

Aug. 29 (Bloomberg) -- Singapore reported more than 100 new cases of chikungunya fever this month, 10 times last year's total, as outbreaks elsewhere in Asia spread to the city-state through travelers and migrant workers.

The disease, which can trigger debilitating joint pain lasting months, probably caused sporadic infections at 18 separate sites this year, the Ministry of Health said in an Aug. 25 statement. The cases highlight the equatorial island's struggle to control virus-carrying mosquitoes and the threat of exotic diseases posed by international travel.

``In this day of rapid cross-border travel, Singapore, just like other countries, is at risk from the importation of viruses,'' said Ng Lee Ching, head of the nation's Environmental Health Institute. ``With the recent surge in importations, our risk of local transmission has increased significantly.''

Chikungunya is a reminder of globalization's role in the international spread of SARS, the deadly respiratory virus that probably infected more than 8,000 people worldwide in 2002 and 2003, including 238 in Singapore. The disease, first reported in southern China, cost Asian businesses an estimated $60 billion.

Until this year, Singapore found cases of chikungunya only in travelers who had caught the bug overseas. Since January, 70 ``imported'' and 80 locally acquired infections have been officially reported, almost two-thirds of which were in non- Singaporeans, according to ministry data.

Chikungunya, which means to become contorted in the Makonde language of southeastern Tanzania, was first recorded in Africa in 1953, and has infected people in 35 countries. There's no vaccine or specific treatment for the fever, rash and joint- swelling, which are usually nonfatal.

Ng says genetic analysis shows the viruses in Singapore are similar to strains from India, Sri Lanka and Malaysia.

A Passage From India

Fifteen Indian states and territories had a total of 1.39 million confirmed or suspected chikungunya cases in 2006, according to health authorities in New Delhi. Kerala and Karnataka have had cases as recently as this month.

Malaysia, linked to Singapore by a causeway, has had more than 1,500 infections since late July, according to the country's health ministry. Of Singapore's imported cases, 56 patients had been in the adjacent Malaysian state of Johor Bahru before their illness, Health Minister Khaw Boon Wan told Parliament on Aug. 27.

An outbreak in Italy last year, the first in Europe, provided an example of how chikungunya can take hold when an infected person enters an area and is bitten by a mosquito capable of transmitting the virus, and the insect then feeds on the blood of people who aren't immune to the pathogen.

The World Health Organization says 2.5 billion people globally live in areas where epidemics of chikungunya, and the potentially lethal diseases dengue and yellow fever, can occur.

Tiger Mosquito

A chikungunya epidemic hasn't erupted in Singapore, even though most of its 4.6 million inhabitants are susceptible to it.

That may be because one of the main transmitters of the disease here -- the Asian tiger mosquito, or Aedes albopictus -- is less inclined to hover inside homes, and also feeds on other mammals that don't catch the virus, said Duane Gubler, director of the emerging infectious diseases program at the Duke-National University of Singapore Graduate Medical School.

``The fact that you have got such widespread transmission but it's still sporadic is a good indication that it's not going to blow up into a big epidemic,'' Gubler said in an interview.

Public Health Cost

Chikungunya's persistence in Singapore may reveal a hidden public-health cost of lower-paid, unskilled laborers -- many of whom come from Malaysia and Indonesia, where the disease is endemic -- to work in the city's booming construction and shipping industries.

Singapore had about 757,000 unskilled and semiskilled foreign workers as of Dec. 31, according to the Ministry of Manpower. Laborers working in construction or manufacturing were paid a median gross monthly wage of S$800 ($564) last year, according to ministry data.

Chikungunya's persistence in Singapore may reveal a hidden public-health cost of lower-paid, unskilled laborers -- many of whom come from Malaysia and Indonesia, where the disease is endemic -- to work in the city's booming construction and shipping industries.

Many laborers are put up in ``unhygienic, very cramped'' dormitories by their employers at a monthly cost of S$150-S$200 per bed, said Jolovan Wham, executive director of the Humanitarian Organization for Migration Economics, a charity that supports foreign workers.

By comparison, the average daily room rate at a Singapore hotel was S$238 in July.

``You can imagine what kinds of conditions they would be living in if it's going to be so cheap,'' Wham said. ``Many companies are willing to cut corners.''

More Beds

Land for 11 dormitory sites was released during the past 18 months to provide about 65,000 more ``housing spaces,'' Acting Minister for Manpower Gan Kim Yong said this month. Efforts to improve housing must be supported by dormitory operators and employers by ``maintaining and enhancing standards of current housing facilities,'' Gan said.

At a three-story, corrugated-iron dormitory in northwestern Singapore, laundry, buckets and cooking paraphernalia clutter 54 bunk-bed-lined rooms, each ventilated by a single window lacking insect screens.

``Anytime you're importing a large number of laborers from a highly endemic area, and these laborers are housed in a communal area that is unscreened, you're at a high risk of creating a focal outbreak that can spread,'' said Scott A. Ritchie, a medical entomologist with the Tropical Public Health Unit Network in Cairns, Australia.

The National Environment Agency says foreign workers are an important target for its education and outreach programs. In response to the chikungunya cases, the agency produced more pamphlets in English, Mandarin, Malay and Tamil detailing ways foreign workers can protect themselves and prevent mosquito breeding, and is preparing versions in Bengali, Burmese, Tagalog and Thai. It also holds mandatory safety courses and seminars.

To contact the reporter on this story: Jason Gale in Singapore at j.gale@bloomberg.net.
Last Updated: August 28, 2008 20:56 EDT

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://health.asiaone.com/Health/News/Story/A1Story20080906-86160.html
Johor has the most Chikungunya cases
Sat, Sep 06, 2008
The Star

JOHOR topped the list of states with the most Chikungunya cases - more than half - recorded nationwide, the Sin Chew Daily reported.

Health Ministry disease control division director Datuk Dr Hassan Abdul Rahman said the ministry received reports of 1,703 Chikungunya cases this year.

He said Johor recorded the highest with 996 cases, equivalent to 58% of the total number of reports in the country.

He said Malacca came in second with 405 cases, followed by Perak (173), Negri Sembilan (92) and Selangor (26).

Johor also recorded the second highest number of dengue cases after Selangor with the ministry receiving a total of 1,014 dengue reports last week, he said.

Source: http://www.todayonline.com/articles/274616.asp

Chikungunya imported via Causeway
THE number of chikungunya cases here has gone up by 28 since Aug 25, with 16 of these being imported ? mostly from Malaysia.
.
Among the 16 were eight Singapore residents, with seven of them having travelled up-country, and the other to the Maldives prior to the onset of their illness.
.
The remaining eight comprised seven Malaysians, who either live in Johor or had made trips to Malaysia; and an Indonesian who had come to Singapore for medical treatment.
.
This prompted the Ministry of Health (MOH), in itsupdate on Friday, to caution that ?in the absence of avaccine, and the presence of the aedes mosquito, Singapore remains vulnerableand receptive to the introduction of chikungunya outbreaks.
.
?It is likely that cases will continue to occur as long as situations in neighbouring countries do not improve.?
.
Malaysia had reported an increase in the number of *suspected cases of chikungunya last week ? 224, *compared with only 179 the previous week.
.
Johor, Malacca, Perak, Penang and Sarawak were the most active states, according a Malaysian health ministry official.
.
Bernama news agency said on Thursday that *nationwide, there were a total 1,703 cases notified, with Johor registering the most: 996 cases.
.
Meanwhile, of the 12 new local cases here, 11 were linked to existing clusters such as Kranji Way, Lim Chu Kang and Sungei Kadut, while the 12th is a general worker living in Mandai Estate.
.
The latest figures take the total number of notified cases this year to 178 as of Thursday, said the MOH.

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://news.xinhuanet.com/english/2008-09/12/content_9951237.htm

22 new cases of chikungunya fever reported in Singapore
www.chinaview.cn 2008-09-12 20:28:01

SINGAPORE, Sept. 12 (Xinhua) --The Health Ministry Friday said that 22 new cases of mosquito-borne chikungunya fever have been reported since the last update on Sept. 5, bringing the total number to 200 cases this year.

The ministry said half of the 22 new cases were imported and the victims had a history of traveling to Malaysia.

Of the 11 local cases, two are part of a new cluster, seven are linked to existing clusters, while the remaining two are isolated cases that occurred in separate locations.

The National Environment Agency continues to conduct checks in those areas to eradicate mosquito breeding sites.

The health ministry has advised people who develop symptoms of chikungunya -- which include fever, joint pain and rashes -- to consult their doctors immediately.

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://health.asiaone.com/Health/News/Story/A1Story20080926-90109.html

Six imports among 13 new cases of chikungunya
Fri, Sep 26, 2008
my paper


AN ADDITIONAL 13 cases of chikungunya fever, including six imported cases, have been reported since the last update, said the Ministry of Health (MOH) and National Environment Agency in a joint statement yesterday.

As of Wednesday, a total of 231 cases have been reported this year.

Of these, 108 were imported cases from Johor (87 cases) and other states of Malaysia (12 cases), Indonesia (four cases), Sri Lanka (two cases), India (two cases) and the Maldives (one case).

The 123 local cases were distributed across 25 work and residential locations, including 41 cases in Kranji Way, 21 in Sungei Kadut, 13 in Little India, 10 in Lim Chu Kang, eight in Bah Soon Pah Road, five in Pasir Panjang Wholesale market, four in Mandai Estate, two in Teachers' Estate, two in Seletar Farmway and two in Bangkit Road.

In the six new imported cases, three Singapore residents and three Malaysians had travelled to outbreak-affected areas in Johor prior to their onset of illness.

Of the seven new local cases, six were linked to existing clusters while one was a seperate infection that occured in a new area.

The new local cases were reported in the following clusters:

Lim Chu Kang: Three cases in Lim Chu Kang Lane developed symptoms on Sept 16. This brings the total number of cases in the cluster to 10.

Sungei Kadut: One case in the Sungei Kadut vicinity developed symptoms on Sept 11. There are now 21 cases in total in this cluster.

Bah Soon Pah Road: One case in the Bah Soon Pah area developed symptoms on Sept 13. This cluster now has a total of eight cases. Mandai Estate: One case in Mandai Estate developed symptoms on Sept 5. This brings the total number of cases in the cluster to four.

The last case was identified as a 55-year-old businessman who lives in St Martin's Drive, which had no prior cases of chikungunya fever.

He developed symptoms on Sept 16 and recovered after receiving outpatient treatment. He had not travelled overseas recently and all his family members were unaffected.

Meanwhile, homeowners were served orders to ensure that they are not breeding mosquitoes in their premises. Under the law, non-compliance with such orders can result in a maximum fine of $50,000.

MOH advised people who develop symptoms of chikungunya - which include fever, joint pain and rashes - to consult their doctors immediately. The ministry will post weekly updates on its website every Wednesday.

For subsequent updates on the chikungunya situation in Singapore, please refer to the MOH website at www.moh.gov.sg

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://www.straitstimes.com/Breaking+News/Singapore/Story/STIStory_290075.html

Oct 13, 2008
Chikungunya a notifiable disease
By Salma Khalik HEALTH CORRESPONDEN

THE spread of chikungunya here is now severe enough for the authorities to take the fight against it one step further and make it a 'notifiable disease'.

The move will be made soon, a Health Ministry spokesman told The Straits Times.

Making a disease 'notifiable' means that once doctors come across a case, they must inform the Ministry of Health of it within 24 hours. Doing this allows health authorities to track cases, know when an outbreak is imminent and to take measures to contain its spread.

Read Salma Khalik's full story in Tuesday's edition of The Straits Times.

 

[Shiloh]

Re: Singapore: Local transmitted chikungunya fever detected

Source: http://health.asiaone.com/Health/News/Story/A1Story20081226-110524.html

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.

salma@sph.com.sg

--------------------------------------------------------------------------------

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.

SALMA KHALIK

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

 

[drjagathv]

Re: Singapore: Local transmitted chikungunya fever detected

Dengue fever and Chikungunya infections are still prevalent in Sri Lanka, we haven?t come across any reports of suspected Swine Flue infections in Sri Lanka, however it is prudent to adopt precautionary measures as there is a risk of spreading this infection towards Asian countries as well. Swine flue can spread from human to human and now there is a risk of becoming a pandemic as there are patients reported in more than two countries.

 

[sharon sanders]

Re: Singapore: Local transmitted chikungunya fever detected

Thank you.