But don't be lulled into letting guard down, expert warns
Jessica Jaganathan, Straits Times 9 Dec 09;
DENGUE numbers in Singapore have remained low despite a recent nationwide alert in neighbouring Malaysia.
While Malaysia has seen more than 36,500 cases and 78 deaths so far this year, compared to 41,034 cases and 90 deaths for the whole of last year, Singapore has seen a far bigger drop in cases.
There have been 4,248 cases in Singapore so far this year, against 7,031 for last year.
In Malaysia, where the weekly number of cases rose from more than 700 at the beginning of last month to more than 800 a week later, health officials blame the spike on the rainy season and public apathy.
But in Singapore, the National Environment Agency says its multi-pronged approach - surveillance and enforcement, community outreach and education, and research - has helped to minimise outbreaks of mosquito-borne diseases like dengue.
For example, the number of households fined for letting mosquitos breed increased from 5,443 in 2007 to 7,337 for the first 10 months of this year, with a corresponding drop in dengue cases.
But Professor Duane Gubler, who heads Duke-NUS Graduate Medical School's emerging infectious diseases research programme, said countries like Singapore, Thailand and Indonesia, which have low dengue transmission now, should remain vigilant, as it could be the lull between peaks.
'We need to assume that low numbers now are basically the valley before the next epidemic,' he said yesterday on the sidelines of the opening of the Emerging Infectious Diseases Conference 2009 organised by the school.
He added that with dengue being seasonal and peak transmission usually occurring here from July to October, agencies should focus on controlling mosquito breeding during the preceding months.
Also yesterday, the Duke-NUS Signature Research Programme in Emerging Infectious Diseases was officially launched.
Its main aim will be to create an early warning disease detection system across Asia by sharing data and analysing samples of dengue and 'zoonotic viral diseases' such as Sars which are transmitted from animal to man.
Duke-NUS is working with partners including research institutes, the local health authorities and universities in countries such as Sri Lanka and Vietnam, where there are emerging infectious diseases.
Scientists in these countries will then discuss the findings, with the aim of identifying possible causes of the diseases.
Illustrating the need for cooperative regional action rather than have individual countries trying to tackle diseases alone, Prof Gubler said: 'Because of its position as the financial and shipping hub of South-east Asia, and because it depends on thousands of migrant workers from all over Asia, Singapore is vulnerable to the importation of exotic diseases that can cause epidemics.'
It's not climate change
Neo Chai Chin, Today Online 9 Dec 09;
SINGAPORE - Factors such as population growth, urbanisation and globalisation - more so than climate change - are the principal drivers of infectious diseases re-emerging worldwide, an infectious diseases expert said yesterday.
Although experts agree that climate change affects how infectious diseases such as dengue are transmitted, the extent of its impact is actively debated.
"Climate change is important, no doubt about that. We need to do everything we can to stop the changes that are influenced by human activity, but it's not climate change that's the main driver of this global emergence of infectious diseases (EID)," said Professor Duane Gubler, director of Duke-NUS Graduate Medical School's emerging infectious diseases (EID) programme.
Other factors include changes in animal husbandry and the boom in air travel, he said on the sidelines of an international conference on EID held here.
Since 1980, a new human pathogen (agent that produces disease) has been identified every seven months. Sixty per cent of emerging infections can be transmitted between animals and humans.
A public health event occurs when all its risk factors align, said Dr David Heymann of the Centre on Global Health Security, Chatham House, in the United Kingdom.
For instance, the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 was stoked by animal-human infection, the spread by health care workers to the community and cross-border air travel.
To detect and identify viruses as they emerge, Duke-NUS is working with research institutes and health authorities in Vietnam and Sri Lanka to develop early warning surveillance systems.
Indonesia and Myanmar have also invited Prof Gubler to set up such programmes, and he hopes to work with other countries in the region.
The EID research programme has 43 staff on board, including 29 doctoral-level staff.
