Mosquito spreading two types of fever

Chikungunya cases on the rise even as Singapore fights losing battle with dengue
Salma Khalik Straits Times 27 Apr 13;

THE Aedes mosquito is wreaking havoc in Singapore, spreading not just dengue fever but more recently the very painful chikungunya as well.

This month alone, 56 people have become sick with chikungunya - which translates from an African language as "to become contorted".

This is up from just 22 for the whole of last year. Symptoms include a sudden fever and severe joint swelling and pain. Victims often also suffer from muscle pain, headache, nausea, fatigue and rashes. It is rarely fatal and lasts between several days to a week - although some people have complained of continued joint aches for months and years.

In spite of the National Environment Agency's best efforts, the number of chikungunya infections has been growing over the past month - from six in the first week of April, to 15 in the second, and 35 in the third.

A Health Ministry spokesman said that of the 35 people infected last week, 27 are foreign workers and two are Singaporeans who live or work around the Kranji-Sungei Kadut area. The other six are residents in the Fifth Avenue, Sixth Avenue and Trevose Crescent area along Bukit Timah Road.

Meanwhile, Singapore also appears to be losing its fight against the spread of dengue, which has infected more than 5,000 people so far this year.

Both dengue and chikungunya are viral diseases that can be spread only by mosquitoes.

About 110 people were hospitalised for dengue last week out of the 510 who were infected. More will need such care this week as the number of infections continues to soar, with another 386 diagnosed with dengue since Sunday.

Experts have predicted a huge dengue epidemic this year as the current surge in cases comes before the usual peak during the hotter months in the middle of the year. The change in the dominant type of dengue virus means fewer people are immune to it.

There are four types of dengue viruses. Once infected, a person is protected against that viral type but can still be infected by any of the other three.

According to the Ministry of Health, about one in three people diagnosed with dengue end up in hospital - or about 1,600 of the 5,000 cases so far this year. In the 2005 epidemic, 14,000 people were infected and 25 died.

But Associate Professor Leo Yee Sin, clinical director at the Communicable Disease Centre, hopes that the experience doctors have gained over the past years will mean fewer or perhaps no deaths at all this year, even if infection numbers go up.

Up to $10m contract for campaign against dengue
Poon Chian Hui Straits Times 27 Apr 13;

SINGAPORE, in its fight against dengue, has awarded a contract worth up to $10 million to an advertising firm for year-round campaigns against the deadly disease.

The contract from the National Environment Agency (NEA) to DDB Worldwide is made up of two parts: $5 million for campaign costs from now till next March and another $5 million should the contract be extended another year.

The year-round campaign against the worsening epidemic starts tomorrow and there will be no let-up even during the months when the Aedes mosquito is lying low.

The disease peaks during the hotter months between May and October.

But this year, the 5,127 cases so far have already surpassed the 4,632 recorded for the whole of last year, official figures show.

Both DDB and NEA declined to comment on the contract but according to the tender documents, the key target group is housewives and working mothers.

This is likely due to the fact that seven in 10 breeding spots of the dengue-causing mosquitoes are found in homes, such as in containers and flower pots.

Singapore now has 48 dengue clusters, mainly in the east. The worst-hit area is Tampines Street 12, 21 and 22 where 124 people fell ill.

The battle will be fought on several fronts: from social media to grassroots events and roadshows at construction sites.

It will include using the traffic light warning system wherein banners in red, yellow and green colours are put up in dengue clusters to indicate the severity of the situation in the area.

This is on top of a "mozzie wipeout" drive to urge people to clear stagnant water in homes that can breed mosquitoes. But there is one nagging problem, according to the tender. People tend to become complacent when infection rates start to fall.

Public health experts have observed that people "naturally will not remain in a state of alert... unless the threat is constantly made visible to them", said the tender.

There is a need to inculcate a "sense of ownership", and have the messages communicated in an "intensive manner", it added.

Year-long campaigns, however, are a challenge, said Nanyang Technological University's Assistant Professor Marko Skoric from the Wee Kim Wee School of Communication and Information.

"Do you want to hear about dengue for a year? I'm not sure."

He suggested giving a variety of materials, rather than crafting a specific message, so people can continually discuss and reflect on the topic.

Social media like Facebook can be particularly useful.

"When you share a message, there's a certain sense of commitment," said Dr Skoric. "In the process, you may persuade not just others, but also yourself, that it's important to do something about dengue."