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  Channel NewsAsia 24 May 07
Dengue epidemic could happen if trend is uncontrolled: MOH

Today Online 25 May 07
Spike in dengue cases; one dead Friday
Loh Chee Kong

Today Online 21 May 07
Dengue cases hit record high last week
More hospital beds expected by year end with dengue spike
Jasmine Yin

Channel NewsAsia 20 May 07
180 new cases of dengue this week

SINGAPORE: 180 new cases of dengue were reported this week, an all-time high and mirroring trends in 2005 when the disease hit epidemic proportions in Singapore.

For the first 19 weeks of this year, there were close to 1,500 dengue cases. That's nearly 50% higher than the corresponding period in 2006.

The Health Ministry says the spike may be due to a new dengue strain in Singapore - dengue 2 which is responsible for 60 percent of all dengue cases here so far.

Singaporeans who have contracted dengue are mostly immune to dengue 1 but they will be susceptible to dengue 2.

Health Minister Khaw Boon Wan said: "There are four strains in dengue. For many years, Singapore's is largely dengue 1, although dengue 2 is quite common in our neighbours. I was in Indonesia recently and I asked them, what's your most common strain and they said dengue 2. So that's the trouble. Within our region, there are different kinds of strains, so presumably, somebody must have brought the virus into Singapore and from there it just spreads."

Already, some hospitals are feeling the crunch as there are limited beds. The Health Minister said that since the beginning of the year, more than 60 beds have been added, with more to come throughout the year. But if dengue cases hit epidemic proportions, the number may be insufficient.

So, what can be done to solve the problem? The government says the National Environment Agency (NEA), Town Councils and grassroots organisations have been activated to search and eradicate potential sources of mosquito breeding in residential areas.

The NEA will also be working with shipyards, construction sites and other industries to stop mosquitoes from breeding.

But the public too will need to do their part. One example, littering. Discarded water receptacles contribute to nearly 15 percent of mosquito breeding. This can be prevented if people just throw their trash in the right places.

Dr Yaacob Ibrahim, Environment and Water Resources Minister, said that he is worried about the situation during the coming school holidays. "People may be away. If they don't do their part to seal all the toilet bowls.... we may have (dengue) numbers that are not pleasant for Singaporeans," he said.

The Minister appealed to Singaporeans to do their part - check their houses daily for potential breeding areas as it takes about seven days for the mosquito to procreate. And, one adult female mosquito can lay 300 eggs at one time. No one in Singapore has died from dengue so far this year. - CNA/ir

Today Online 21 May 07
Dengue cases hit record high last week
More hospital beds expected by year end with dengue spike
Jasmine Yin jasmine@mediacorp.com.sg

THE dengue situation in Singapore has reached fever pitch, with the weekly number of cases hitting 180 last week, an all-time high for this year. With a total of 1,488 cases recorded between January and May 12, which is a near 50-per-cent spike over the same period last year, initial signs are pointing to a repeat of the dengue epidemic in 2005, observed Minister for Health Khaw Boon Wan yesterday.

"We're already quite short of hospital beds and each time there is a surge (in dengue patients), it causes a lot of problems in the hospitals," he said after a community event in Sembawang.

Today reported on Friday that occupancy rates at some hospitals were hovering at between 88 and 97 per cent.

The surge in dengue incidents has been attributed to two factors: Warmer weather conditions, which facilitate breeding of the Aedes mosquito, and the shift in the predominant dengue strain from DEN-1 to DEN-2.

There are four virus strains, and recovery from one strain does not provide immunity from the other three. DEN-2 is prevalent in regional countries like Indonesia.

The National Environment Agency (NEA) found 60 per cent of dengue cases from a recent sample to be DEN-2.

This shift to a different strain "means a lot of people do not have immunity, like myself", Mr Khaw noted.

Speaking at a separate event, Environment and Water Resources Minister Yaacob Ibrahim said last week's figure was "too high", 938Live reported. "If it goes beyond 200, I think we really have a big problem," said Dr Yaacob.

By the end of this month, all households will receive a pamphlet, so "really the last piece of the puzzle is the residents", he added.

Whilst the relevant agencies keep tabs on the outdoor areas, the public can pitch in by checking for potential mosquito breeding grounds inside their homes and by disposing of their trash properly.

A recent NEA exercise found that litter, such as cans, bottles and packaging material, make up almost 15 per cent of mosquito breeding.

Meanwhile, more hospital beds can be expected by December and next year, said Mr Khaw. About 70 beds have been added since the start of this year, and he will raise this issue when Parliament sits today.

Today Online 25 May 07
Spike in dengue cases; one dead Friday
Loh Chee Kong cheekong@mediacorp.com.sg

SEVEN government agencies were present at a press conference yesterday to update the public on efforts to control the dengue problem, which has claimed its first life this year.

The media briefing on the subject at the National Environment Agency (NEA) building reflected not just a worsening dengue situation but also official concern that the public has yet to take the anti-dengue message seriously.

One key concern is that the number of breeding grounds found in homes has shot up. This even as government agencies and town councils go all out in their "search-and-destroy" missions to stamp out breeding sites in public places.

According to the NEA, from April to mid-May, larvae were found in 776 homes. Among the identified dengue clusters, residential properties accounted for 84.9 per cent of breeding sites.

"With the agencies doing so much, the mosquitoes, driven by their survival instincts, are not going to say, 'That's it. We are leaving Singapore.' What does it mean? These efforts may in fact drive the mosquitoes to look to households to lay their eggs," said Dr Steven Ooi, deputy director of the Ministry of Health's (MOH) Communicable Diseases Division.

He also revealed that an 85-year-old man had died from dengue on April 28. The man had suffered from chronic diseases, including diabetes, but preliminary tests show that the Dengue Shock Syndrome was the cause of death. His death came amid a spike in dengue cases over the past two months – that were characterised by intermittent rain and warm weather.

This month, an average of 167 cases have been reported each week, about three times the number in the same period last year, and also higher than during the 2005 dengue epidemic.

Based on past trends, dengue cases tend to peak every six years, said MOH. It added that "2006 was clearly seen as an inter-epidemic year" and this year marks the start of a new cycle.

While it was "improbable" that the number of cases would hit 2005's record levels, "if the trend is left unchecked, disease momentum will cause a worsening situation for 2008 and subsequent years," said MOH.

Since last December, there had been a shift in the predominant dengue strain from DEN-1 to DEN-2, which was last dominant in 2003. This could account for the recent spike in cases, as the immunity among Singaporeans over the last four years against the DEN-1 virus "offers little or no protection" to the DEN-2 virus, MOH added.

NEA's chief executive officer Lee Yuen Hee, who also chairs an inter-agency task force, said recent surveys showed that the public seemed to be aware of the problem and how to curb it.

"But in translating that into action, the public can do more," he said.

Channel NewsAsia 24 May 07
Dengue epidemic could happen if trend is uncontrolled: MOH

SINGAPORE: An 85-year-old retiree died from dengue shock syndrome on 28 April after being warded at the Tan Tock Seng Hospital three days earlier with symptoms of breathlessness, vomiting and fever.

More cases of dengue have since surfaced. The latest figures from the National Environment Agency (NEA) show that there were 210 cases last week, the highest reported number this year.

And NEA said foreign workers such as construction site workers, clerks and nurses accounted for 35 percent of reported cases. It said this could be due to their lower immunity to the virus strains found here.

Lee Yuen Hee, CEO, NEA, said: "We actually anticipated that there could be a rise in dengue cases because of the traditionally warmer weather at this point of time.

"It could be due to a combination of factors. It could be the switch from the stereotype from Type 1 to Type 2 or the intermittent rain that creates and recreates breeding grounds."

The NEA is working with 25 other government agencies to stop the Aedes mosquito from having a chance to breed by targeting sites outside residential areas such as construction sites and vacant plots of land.

Dr Ooi Peng Lim, Deputy Director, Communicable Diseases Division, Ministry of Health, said: "The mosquito is always striving to look for places to breed, so whilst these habitats are being eliminated, the mosquito is actively seeking new habitats. And these efforts may in fact drive the mosquito to look into households to lay their eggs."

And according to the NEA, some 85 per cent of breeding grounds are found in homes. "If we don't take heed, then we are giving the mosquito every opportunity to propagate itself, introducing infective virus into the community and triggering an epidemic," said Dr Ooi.

The Health Ministry said an epidemic could happen in the next two years if the trend continues uncontrolled. - CNA/so/yy
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