MOH investigates third malaria cluster at shophouses near Admiralty Road East

Nicholas Fang, Channel NewsAsia 29 Jul 09;

SINGAPORE: The Ministry of Health (MOH) is currently investigating a third malaria cluster involving four cases of suspected local transmission of vivax malaria near a row of shophouses located at the junction of Sembawang Road and Admiralty Road East.

In a statement, MOH said the first case is a 24-year-old Singaporean female who works in a vicinity of the shophouses.

Her illness onset was on June 30 and she was admitted to hospital on July 20.

She does not have any recent travel history or past history of malaria.

The second and third cases involve a 49-year-old Singaporean male and a 40-year-old Singaporean female who are colleagues and had frequented a coffeeshop at the row of shophouses.

The male patient had onset of illness on July 11 and was admitted to hospital on July 15.

The female patient had onset of illness on July 12 and was admitted to hospital on July 17.

The fourth case is a 24-year-old male foreign worker who was picked up during the Ministry of Health's active case finding in the vicinity.

He stayed at a nursery beside the row of shophouses and first had symptoms on June 12

He was admitted to hospital on July 28.

The first three cases have since recovered while the fourth case is currently warded in CDC.

This latest cluster is not related to the two earlier clusters as none of the four cases had visited Jurong Island or Mandai/Sungei Kadut prior to their onset of illness.

Upon notification of the cases by MOH on July 28, the National Environmental Agency (NEA) has initiated vector control operations at the site of the outbreak.

Larviciding of potential mosquito breeding habitats has been carried out and adult mosquito trapping operations were conducted on the night of July 28.

13 adult Anopheles mosquitoes were found but all tested by the Environmental Health Institute to be negative for malaria parasites.

Mass fogging in the area was carried out on Wednesday.

Stakeholders in the area have been alerted to step up mosquito prevention measures in the premises under their charge.

The NEA is monitoring the situation closely and will continue with intensive vector control operations.

MOH is monitoring the situation closely and will update the public on any new developments.

The symptoms of malaria include fever, chills, muscle pains, joint pains and headache.

MOH advises the public that anyone experiencing these symptoms and had visited the affected area in the past four weeks should seek immediate medical attention.

The ministry said the best way to prevent malaria is to avoid frequenting places where the mosquito vector is known to be active.

This mosquito vector bites mostly at dusk and at night.

If you cannot avoid going to these places, then wear clothes that completely cover the arms, legs and put on insect repellent.

As a precautionary measure, residents living in the vicinity are advised to use mosquito coils and repellents, and sleep under mosquito netting. - CNA/vm

Four cases found there, bringing total number of victims since May to 28
Salma Khalik, Straits Times 30 Jul 09;

New malaria cluster in Sembawang area
A NEW malaria cluster has emerged, dashing hopes that the malaria outbreak which started in early May has finally been contained.

Four people in Sembawang have been found to be infected locally so the fight to prevent malaria from becoming entrenched here is still on.

Three of the victims are Singaporeans while the fourth is a foreign worker living in a nursery there.

All are likely to have been bitten by the Anopheles mosquito in the vicinity of a row of shophouses at the junction of Sembawang Road and Admiralty Road East.

The first victim was the 24-year-old foreign worker, who fell ill on June 12. But he did not seek treatment so his illness did not come to light until the second victim, a 24-year-old woman working in the area, became sick on June 30.

The Ministry of Health said she had no recent travel history nor a history of malaria.

She was admitted to hospital on July 20 and the worker on Tuesday, after he was diagnosed.

A joint statement from the Ministry of Health (MOH) and the National Environment Agency (NEA) said the worker was identified through MOH's 'active case finding in the vicinity'.

The other two victims are colleagues who frequently ate at a coffee shop in the area. The man, 49, fell ill on July 11 and his female friend, 40, the following day. They were hospitalised on July 15 and 17 respectively.

All the Singaporeans have since been discharged.

The MOH informed NEA of the local infections on Tuesday. The agency swung into action that night and caught 13 adult Anopheles mosquitoes. But none carried the malaria parasite.

Yesterday evening, it fogged extensively in the area. The Anopheles mosquito, which spreads malaria, is most active at dawn and dusk.

The authorities said the latest cluster is not linked to the one on Jurong Island where eight foreign workers were infected, nor to the one at Mandai/Sungei Kadut, where 16 people have caught the disease.

The last case in those clusters fell ill at the end of last month. For an outbreak to be considered over, 30 days must pass without new cases cropping up.

The latest cases bring the number of people who have caught malaria here since May to 28 - the biggest outbreak Singapore has seen in years.

The MOH advises people who have been in the area in the past month, and who have fever, chills, muscle pains, joint pains and headache, to see a doctor immediately as malaria is a serious illness.

Singapore needs to wipe out the new cluster fast to retain its status as a malaria-free country - something it had achieved at much cost in 1982.

But Health Minister Khaw Boon Wan told The Straits Times that it is not an easy job to keep Singapore malaria-free as it is endemic in the region.

'But we have not done too badly. Some local clusters will emerge now and then and together with NEA, we will root them out as we did in the past,' he said.