Cheaper, faster dengue test kits on the way in Singapore

Labs to get NS1 kits, in hope that it will give dengue busters more time to act
Salma Khalik, Straits Times 7 Apr 08;

SINGAPORE is stepping up its fight against dengue with cheaper, faster test kits to be used on those suspected to be down with the fever.

Faster diagnoses mean faster information, so mosquito-busting teams can act earlier.

The National Environment Agency (NEA) hopes that the 15,000 NS1 kits it will issue to six laboratories by June for general practitioners' use will turn the tide against the disease.

An NS1 test kit can process blood samples from patients who have just fallen sick, while the cheaper of the two existing test kits is effective only five days after the onset of a fever, too late for teams to act on mosquito breeding sites.

There is another test on the market which is good, but costs $175 and is not used as often.

To popularise the use of NS1, the NEA will subsidise 60 per cent of the roughly $30 cost of each test.

A fast-acting test kit is crucial as it takes a mosquito about a week after biting an infected person to have enough of the virus to pass on to others.

This gives the NEA a one-week window to destroy the mosquitoes in an area where people have fallen ill. The earlier it knows where infections have occurred, the more time it has to act.

Singapore's war on dengue will be watched. An article in the World Health Organisation (WHO) Bulletin in February, praising the efforts made here to contain the scourge, said: 'Singapore has been a world leader in Aedes control for decades. Yet, if Singapore is unable to interrupt dengue transmission, it will likely be difficult for other endemic communities to do so.'

Dengue infections have been on the up worldwide, with about 50 million people stricken with it each year. The illness is now endemic in over 100 countries.

The WHO said that urbanisation, which concentrates people in cities, and widespread travel have helped to spread the four dengue viral strains.

Singapore is the only country with 'real-time' tracking of every person infected with dengue, every breeding spot, the dominant mosquito type and the virus in play in different areas.

A national task force - with members from over 20 agencies, including town councils - meets monthly to coordinate the fight against dengue.

The moves taken include islandwide sweeps of all housing estates, monthly checks of all construction sites and working with estate agents to ensure that buildings left empty by collective sales do not become breeding sites for mosquitoes.

Despite the publicity on the dangers of allowing mosquitoes to breed, more than 5,000 homes were fined for the offence last year.

To send a stronger message, the fine was doubled from $100 to $200 last Tuesday. Construction sites found breeding mosquitoes are fined $2,000 the first time, with higher subsequent fines.

Penalties are even higher if people living near these sites come down with dengue. When that happens, the sites are given stop-work orders, which stay in force until the place is cleaned up and given the nod by the NEA's Environmental Health Institute (EHI).

Last year, 44 worksites were told to stop work. This year, three have been given the order so far.