38 new local Zika cases confirmed Friday, bringing total to 189

Channel NewsAsia 2 Sep 16;

SINGAPORE: 38 new cases of locally transmitted Zika virus infection were confirmed on Friday (Sep 2), bringing the total number of confirmed cases to 189.

In a joint statement, the Ministry of Health (MOH) and National Environment Agency (NEA) said that of the 38 new cases, 34 are linked to the Aljunied Crescent/Sims Drive/Kallang Way/Paya Lebar Way cluster.

They added that four new cases have no known links to any existing cluster, but did not specify where these cases were located.

The agencies added that vector control remains key to reducing the spread of the Zika virus.

NEA said it is continuing with vector control operations to control the Aedes mosquito population in Aljunied Crescent, Sims Drive, Kallang Way and Paya Lebar Way.

The agency said that as of Sep 1, 55 breeding habitats – comprising 30 in homes and 25 in common areas or other premises – have been detected and destroyed. Indoor spraying of insecticides, outdoor fogging and the oiling and flushing of drains are continuing.

NEA added that it has also worked through the Inter-Agency Dengue Task Force members to carry out vector control measures at their respective premises and assets, such as schools, construction sites, and expressway drains.

The agency said that its officers and grassroots volunteers have completed outreach efforts in the Aljunied Crescent/Sims Drive cluster, and are conducting outreach in the expanded cluster areas in Paya Lebar Way and Kallang Way.

NEA said it has also conducted vector control operations and outreach efforts in Bedok North Avenue 3. As of Sep 1, 19 breeding habitats – comprising 12 in homes and seven in common areas or other premises – have been detected and destroyed. Mosquito control measures are ongoing.

NEA added that there will be community outreach activities over the coming two weekends across the island to urge all residents to join in the collective effort in the fight against Zika by doing the 5-step Mozzie Wipeout, removing stagnant water and not littering.

"Premises owners should undertake vector control measures regularly, and ensure proper housekeeping within their premises at all times to remove potential mosquito breeding habitats. Residents also need to do their part to prevent mosquito breeding in their homes by doing the 5-step Mozzie Wipeout," it said.


38 new Zika cases reported on Friday, bringing total to 189
Today Online 2 Sep 16;

SINGAPORE — There are 38 new cases of locally transmitted Zika virus infection in Singapore, as of 12pm Friday (Sept 2), bringing the total number of cases to 189.

Of the new cases, four have no known links to any existing cluster, said the Ministry of Health (MOH) and National Environment Agency (NEA) in a joint statement. The 34 other cases are linked to the Aljunied Crescent/ Sims Drive/ Kallang Way/ Paya Lebar Way cluster.

The statement said the NEA has been continuing with vector control operations to control the Aedes mosquito population in Aljunied Crescent / Sims Drive / Kallang Way / Paya Lebar Way. As of Thursday, 55 breeding habitats (30 in homes and 25 in common areas/other premises) have been detected and destroyed.

The NEA has also conducted vector control operations and outreach efforts in Bedok North Avenue 3.

As of Thursday, 19 breeding habitats (12 in homes and 7 in common areas/other premises) have been detected and destroyed. Mosquito control measures are ongoing.

“There will be community outreach activities over the coming two weekends across the island to urge all residents to join in the collective efforts in the fight against Zika by doing the 5-step Mozzie Wipeout, removing stagnant water and not littering,” said the statement.

Cover up, stay in: Singaporeans wary as Zika spreads
Channel NewAsia 2 Sep 16;

SINGAPORE: Many of Singapore's five million people are covering up and staying indoors to avoid mosquito bites as health experts warned that the outbreak of the Zika virus in the tropical city-state would be difficult to contain.

One of the world's leading financial hubs, Singapore is the only Asian country with active transmission of the mosquito-borne virus, which generally causes mild symptoms but can lead to serious birth defects in pregnant women.

Authorities say they have found over 150 cases since the first locally contracted infection was reported a week ago, and with the virus spreading beyond the cluster where it was initially detected, more people are taking precautions.

"I'm not going to let her go outside much until Zika dies down," said Nat Bumatay, a self-employed mother, of her six-year-old daughter Sunshine. "Usually during short holidays, we go outside to the parks, go cycling, but now I will refrain."

A warm, tropical climate, forested areas and a network of public parks make outdoor activities popular across Singapore, especially during school holidays like the ten-day break that began on Friday.

Authorities have stepped up spraying insecticide and clearing stagnant water to prevent mosquito breeding, but many people said they were also avoiding the city's popular outdoor food centres and dousing themselves in repellent to avoid getting bitten.

"Prevention is better than cure," said Tomas Quong, a Filipino who has been working in Singapore for five years. "That's why I am wearing long sleeves."

Some fans of Nintendo's Pokemon Go mobile game are also becoming more cautious and crowds at outdoor Pokemon hotspots around the city are likely to be thinner. "I am still okay with outdoors, just not damp and dirty parks," said Nelson Ho, a 19-year-old gamer.

Pharmacies and supermarkets have reported a surge in mosquito repellent sales over the past week, with some running out of stock. Online retailers Lazada and Qoo10.sg have set up a Zika shop, while other enterprising Singaporeans trying to cash in are advertising mosquito net tents and "anti-bite" jewellery.


The outbreak coincides with a slowdown in trade-dependent Singapore. Worries about Zika could further crimp overall retail sales, United Overseas Bank economist Francis Tan said. "If it continues, people will generally not want to go out, so all the retail sectors will be slowing down," Tan said.

Zika could also increase concerns about tourism, a mainstay of the economy, especially with the city-state's key annual attraction - the floodlit Formula One Grand Prix race - due to start in two weeks. Several countries, including the United States and Australia, have advised pregnant women or those trying to conceive not to visit.

"It will certainly create a bit of caution in the minds of tourists and they may think about it twice," said Jonathan Galaviz, partner at consultants Global Market Advisors. "But I don't see Zika standing in the way of a successful F1 event or tourism flows in the short term."

Tourism arrivals topped 8 million in the first half of this year, around 1 million more than a year ago.

The Tourism Board has said it is premature to consider any impact on the industry, with at least two international chain hotels contacted by Reuters reporting business as usual. The promoters of the Grand Prix have also said planning for the event is going ahead "as per normal".

Several of those initially infected by the virus were foreigners, many believed to be among the thousands of migrant workers in Singapore's construction industry.

The latest tally includes two pregnant women, and officials and experts say the number of cases is likely to increase as the virus is likely to spread.

"The virus is extending beyond the square that was drawn out," said Leong Hoe Nam, an infectious disease specialist at Mount Elizabeth Novena hospital in Singapore. "We have re-draw the battle lines. We have to first admit defeat to Zika and accept that the whole country is at risk."

(Additional reporting by Nicole Nee, Natasha Howitt and Imogen Braddick; Writing by Miral Fahmy; Editing by Raju Gopalakrishnan)

- Reuters

Singapore a ‘role model’ in handling Zika outbreak: WHO
WONG PEI TING Today Online 3 Sep 16;

SINGAPORE — The Republic’s handling of the Zika outbreak “represents in many cases a role model”, said a senior World Health Organization (WHO) official on Friday (Sept 2).

Singapore has confirmed 189 cases, as of 12pm Friday, since news of the first locally transmitted case emerged on Saturday. Dr Peter Salama, Executive Director of WHO’s Health Emergencies Programme, pointed out the “enormous amount of epidemiological work, of lab work, of public health work, including vector control (and) the detailed follow-up including retrospective analysis of cases in Singapore”.

“And really, we have to congratulate the transparency and the quick reporting the government of Singapore have implemented in the case of this outbreak,” said Dr Salama during a meeting in Geneva for an update on the Zika situation during and after the Olympic Games held in Brazil.

The issues discussed included the latest findings on the virus’ geographic spread, natural history, and epidemiology. Current knowledge on microcephaly, the sexual transmission of the Zika virus and Guillain-Barre syndrome – a paralysing side effect suspected to be caused by Zika virus infection – were also shared.

Meanwhile, WHO reiterated its February position that Zika is still a public health emergency.

In the Friday meeting, Dr Salama also said the Brazilian government has “a very similar model” to Singapore’s approach, and has been “very successfully giving (the WHO) quick and comprehensive reporting”.

“We hope all other countries can do the same,” he said.

Low risk of Zika-related birth defects, say doctors
KELLY NG Today Online 3 Sep 16;

SINGAPORE — The links between Zika infection and birth defects in babies could be blown out of proportion, some doctors suggest, stressing that no scientific association has been drawn between the mosquito-borne virus and microcephaly, a condition where a baby is born with an abnormally small head.

Reiterating that the risk of microcephaly ranges between 1 and 13 per cent, experts such as infectious disease specialist Leong Hoe Nam, who is based in Mount Elizabeth Novena Hospital, said that risk levels for Singapore is likely to fall within the lower end.

The “extremely high rate” of Zika-hit pregnancies that result in newborns with deformities in Brazil — the epicentre of an epidemic that is now in 45 countries and territories worldwide — is an “outlier”, Dr Leong said.

The first alarms about microcephaly were raised last October, when doctors in the state of Pernambuco in north-eastern Brazil reported a surge in babies born with it. By the following month, 646 such births were reported in the state alone and Brazil declared a health emergency, Reuters reported in April.

Between 2001 and 2014, Brazil had, on average, about 163 cases of microcephaly a year.

In contrast, a retrospective study of French Polynesia’s outbreak between 2013 and 2015, published in the United Kingdom medical journal The Lancet, puts the risk of microcephaly at closer to 1 per cent.

Even in Colombia — the country second-most affected by the virus — updates from the World Health Organisation showed in July that the number of microcephaly births there stands at 21, despite recording nearly 100,000 Zika-positive cases.

Dr Leong said that the “disproportionately high” rates of microcephaly in Brazil could be due to environmental and cultural factors.

Agreeing, Dr Beh Suan Tiong, an obstetrics and gynaecology specialist, pointed to suggestions that a new pesticide introduced into water supplies in Brazil to curb the development of mosquito larvae may be a culprit.

Dr Beh, who operates his own practice at Thomson Medical Centre, said: “Most countries reported (just) 2 to 3 per cent of babies affected. Brazil is the only one which reported a higher percentage. Obviously, there is something wrong with their data ... There must be some other factors apart from Zika that may have aggravated the situation (there).”

Microcephaly may be caused by a wide spectrum of factors, including rubella, consumption of anti-epileptic drugs and alcohol abuse.

“If you don’t test for all, you cannot be 100 per cent sure it is due to Zika,” obstetrics and gynaecology specialist Dr Christopher Chong said.

Although some doctors have said that there is no reason to delay pregnancy during the Zika outbreak, experts interviewed by TODAY said that the epidemic may cause a dent in the country’s already-low birth rate.

“People are getting worried, especially those just married, and they may try not to get pregnant in the meantime. But a lot depends on how the virus spreads or is contained in the next few weeks,” Dr Chong said.

The experts acknowledge that it is difficult to draw deep inferences, given that Singapore is still in the “early days” of the infection. Dr Beh said: “We will probably need to wait for a couple more months, or years, before a clearer association can be established ... It will be especially when more countries, especially in Asia, start to report their numbers.”

Singapore is in a “good position” to shed light and establish trends in these areas, he added, given its recent widespread testing of suspected cases.

Associate Professor Joanne Yoong from the Saw Swee Hock School of Public Health agreed that “active case finding” should be seen as a strength of Singapore’s control programme.

“Interpreting the spike in cases is not straightforward ... Part of the high rate of discovery is due to the efforts of the authorities to uncover otherwise hidden cases,” she said.

Mum-to-be who tested positive for Zika also has dengue
KENNETH CHENG Today Online 3 Sep 16;

SINGAPORE — A pregnant woman diagnosed with Zika infection in Singapore tested positive for dengue too — unheard of here until now.

Mary (not her real name), 24, who lives in Sennett Avenue, feared the worst when she went to a general practitioner in Bedok South on Tuesday (Aug 30) night with fever and joint ache.

The entrepreneur, who is six months pregnant with her second child, was referred to Changi General Hospital (CGH), where she tested positive for dengue and was warded.

Although doctors said it was unlikely that she had Zika, they gave her a blood and urine test nonetheless. The urine test results came back at 2pm on Thursday, and she tested positive.

Speaking to TODAY over the phone on Friday, Mary said: “The doctor at CGH broke the news to (my husband and me) together very slowly, and he was quite sensitive about it. “I broke down for a while, but my husband helped.” That evening, she was taken to KK Women’s and Children’s Hospital (KKH) for further checks. As the viral count in her second urine sample had “gone down”, she was told that she had probably caught the virus about a week ago and was no longer infectious. She was discharged that same night.

So far, the authorities have announced that there have been two pregnant women diagnosed with Zika here, with both linked to the Aljunied Crescent-Sims Drive cluster.

Mary, however, neither works there nor has relatives living in those areas. She added that she has not been to that area recently.

When asked, the Ministry of Health (MOH) said it would not disclose any information relating to patients.

Zika infections during pregnancy have been linked to microcephaly, where a baby is born with an abnormally small brain and skull. Amniotic fluid testing can be done to screen for the Zika virus, which is spread by the Aedes aegypti mosquito — also responsible for transmitting dengue — but the MOH previously said that a positive test did not mean a baby would be born with defects.

Mary said that tests so far showed her baby was fine, but in four weeks, she would have to go for another check-up to see if there are signs of her baby “not growing normally”.

She underwent a baseline scan at KKH on Friday, but said she would probably see her private gynaecologist for a follow-up.

Regardless, Mary said she intended to follow through with her pregnancy. “No matter what, we’re still going to go through with everything,” she said, noting that the overall risk levels of microcephaly in foetuses of infected expectant women was low — between 1 and 13 per cent. "We will keep monitoring to keep a close watch and pray for the best.”

Recounting what she had gone through over the past few days, Mary said she was puzzled by her “unexpected” diagnosis for Zika.

She had a fever last week, but because she also had diarrhoea, she had attributed that bout to food poisoning.

For the past few weeks, she has taken precautions such as using mosquito repellent. “I always (douse) my son in mosquito repellent ... I did the same for me for the past few weeks,” she said. Her father and two-year-old son had also come down with fever, but have not gone for further tests.

Her son’s fever has subsided after taking paracetamol, but Mary said she would take him to the doctor if his temperature spikes again. Asked about the support her family had given her so far, she said they knew “nobody can do anything right now”.

She has not considered shifting to an unaffected area, but would continue taking precautions such as using mosquito patches and repellent. “There’s not much I can really do right now besides buying all this stuff off (the) shelves (and) staying indoors,” she added.

Zika outbreak will not sting Singapore’s economy: Analysts
Tang See Kit, Channel NewsAsia 2 Sep 16;

SINGAPORE: While startlingly swift, the outbreak of the Zika virus in Singapore is unlikely to create additional stress for the economy, which is already seeing growth faltering amid global headwinds, economists told Channel NewsAsia.

Since the first locally-transmitted Zika infection was confirmed last Saturday (Aug 27), dozens of newly-reported cases took the total number of people diagnosed with Zika to 151 as of Thursday.

Government agencies have since stepped up mosquito control efforts in high-risk clusters such as Aljunied and Bedok to curb the spread of the virus. While the recent spate of Zika infections has reminded many of the severe acute respiratory syndrome (SARS) outbreak in Singapore more than a decade ago, the economic impact of the latest mosquito-borne virus will likely be nowhere near, economists said.

“The impact of Zika would be marginal at worst,” said Nomura Singapore's economist Brian Tan. “Given the headwinds facing Singapore, I don’t think this is going to be the most significant issue for the economy.”

“People have been comparing this to SARS but it’s nowhere near as infectious or dangerous so we don't expect this to have that big of an impact,” said Mr Tan, adding that in terms of transmission, Zika is spread primarily via the Aedes mosquito and is not airborne.

OCBC’s head of treasury research and strategy Selena Ling agreed, noting that the SARS epidemic in 2003 was region-wide and dealt a big hit to the travel and hospitality sectors. However, Zika has thus far failed to spark fears of the same magnitude.

“Hence, I suspect it’s going to be a muted impact unless you see a prolonged scenario and more severe medical implications,” Ms Ling concluded.

Even as some businesses in the high-risk areas have noted a slowdown following the breakout of Zika in their neighbourhoods, economists told Channel NewsAsia that this will likely be temporary and may not accurately reflect overall economic activity among residents.

“It is a kneejerk reaction by consumers,” Nomura’s Mr Tan said. “Besides, the effect could be distributional. You may avoid having lunch at Aljunied but you’ll still need to have lunch so somewhere else could see a pick-up in activity. It’s more of a distribution of activity in terms of geography, instead of a drop in overall activity.”

Banner detailing mosquito control measures near Blk 102 Aljunied Crescent, where Singapore's first locally transmitted Zika infection was discovered.


Still, uncertainty has loomed over the local tourism sector, which accounts for nearly 10 per cent of the economy, as countries including Hong Kong and Australia issued travel advisories for visitors to Singapore. Meanwhile, Malaysia and Indonesia have also stepped up protective measures by introducing thermal scanners at border checkpoints and airports.

Experts say the upcoming Singapore Grand Prix scheduled from Sep 16 to 18 will be the key event to watch for any impact on the travel industry, but for now, most travellers seem to be staying on course with their plans in Singapore, according to airlines, hotels and travel agents that Channel NewsAsia spoke to.

A spokesperson for Singapore Airlines said in an emailed reply that the carrier has not “observed any demand shifts worth highlighting for travel to or from Singapore”.

Mandarin Oriental Singapore said it has received enquiries regarding travel safety to Singapore from travellers who have booked upcoming stays at the hotel. According to its director of communications Usha Brockmann, the hotel has "implemented an increased rota of health and safety standards in both back and front of house areas" as a safety precaution.

Local travel agency Chan Brothers similarly has not received any cancellations for its inbound tours, which are predominantly made up of groups travelling to Singapore for meetings, incentives, conferences and exhibitions (MICE), as well as educational-related trips, according to head of marketing communications Jane Chang.

Over at Star Holiday Mart, however, the travel agent had received around 10 to 12 cancellations as of Friday morning, alongside a rise in enquiries from concerned travellers regarding the state of the Zika virus outbreak in Singapore.

While general manager Dominic Ong said he is not too worried about the cancellations for now, there could be a cause for further concern if the outbreak of the Zika virus persists into October, where China begins its week-long Golden Week holiday. Mainland tourists made up nearly a fifth of the more than 8 million visitors to Singapore in the first half of 2016.

“There's the possibility that bookings from China may swing to somewhere else and there may be a reduction in tourists if (the rise in cases) doesn’t stop by this month. If the numbers stop then at least there’ll still be some confidence,” said Mr Ong.

The Singapore Tourism Board (STB) has since weighed in with the assurance that the city-state “remains a safe travel destination”.


As for other sectors like construction, where migrant workers have made up a sizable number of those tested positive, the impact will likely be marginal.

“You may get a couple of construction sites getting stop work orders but because this remains highly localised and given the ongoing destruction of mosquito breeding grounds, the impact will not be so widespread until it impacts the economy as a whole,” said Mr Tan, referring to the issue of a stop work order to a construction site at Sims Drive on Aug 27.

However, this does not mean that the government and businesses should rest easy.

IHS Markit’s Asia-Pacific chief economist Rajiv Biswas reckoned that the rapid escalation of confirmed locally-transmitted Zika cases remains a potential risk to the Singapore economy, particularly if the outbreak is not rapidly contained.

“With the Singapore economy already feeling the transmission effects of China’s economic slowdown and the impact of lower oil prices on the marine and offshore engineering industry, the Zika outbreak poses a further downside risk to the near-term economic outlook in the fourth quarter of 2016 and into early 2017.”

IHS Markit expects Singapore’s economy to grow at a “relatively moderate pace” of 1.7 per cent in 2017. However, a downside risk scenario where the Zika outbreak escalates and results in lower tourism arrivals, could prompt a cut in the gross domestic product (GDP) forecast, Mr Biswas added.

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