Authorities up measures to reduce Zika virus risk in Singapore

Due to the presence of Zika in the region and the volume of travel by Singaporeans and tourists, it is "inevitable that there will be imported cases of Zika into Singapore in time to come", say the Health Ministry and NEA.

Channel NewsAsia 27 Jan 16;

SINGAPORE: A set of control measures to reduce the risk of the Zika virus taking hold in the local population will be introduced, said the Ministry of Health (MOH) and National Environment Agency (NEA) on Wednesday (Jan 27).

The authorities said it is “inevitable that there will be imported cases of Zika into Singapore in time to come” due to the presence of Zika in the region and the volume of travel by Singaporeans and tourists.

Already, Taiwan had reported an imported case of Zika virus infection from Thailand on Jan 19. Other countries with ongoing Zika outbreaks include Brazil, Cape Verde, Colombia, El Salvador, Honduras, Martinique, Panama, and Suriname.

As such, authorities said the measures that will be implemented include:

Travellers to countries with Zika virus infection will be advised to protect themselves from mosquito bites by wearing long, covered clothing, applying insect-repellent, and sleeping under mosquito nets or in rooms with wire-mesh screens to keep out mosquitoes. Health advisory posters will be placed at the airports for outbound travellers.

Returning travellers from affected areas are advised to seek medical attention if they develop symptoms of Zika such as fever, skin rashes, joint and muscle pains, headaches and red eyes in the next 14 days.

In the event of a case of Zika virus infection in Singapore, NEA will step up intensive vector control. Together with members of the Inter-Agency Dengue Task Force, NEA will intensify search and destroy efforts to control the Aedes mosquito population.
AEDES MOSQUITO PRESENCE INCREASES RISK

They added that there is a high risk of subsequent local transmission as the Aedes mosquito vector is present here, and the virus may become endemic in Singapore. The Zika virus is transmitted through Aedes mosquitoes and vector control remains the mainstay to prevent transmission of the virus.

According to MOH and NEA, the Zika virus infection has been added to the List of Notifiable Infectious Diseases under the Infectious Diseases Act. MOH is also raising awareness of Zika virus infection among the medical community so that doctors stay vigilant against possible suspect cases.

“All confirmed cases will be admitted to a public hospital until they recover and test negative for the virus,” said MOH and NEA. “Admitting them into a single room at the hospital will also minimise their risk of being bitten by mosquitoes while they are carrying the virus, which may result in further local transmission.”

- CNA/xk

Government expects total number of dengue cases in 2016 to be high
"Besides checking homes, NEA has also intensified checks for other areas, including construction sites, and taken stern action against those found breeding mosquitoes," says Environment and Water Resources Minister Masagos Zulkifli.

Channel NewsAsia 27 Jan 16;

SINGAPORE: The Government expects the total number of dengue cases in 2016 to be high, with cases spiking earlier than usual.

At least 11,200 dengue cases were reported in 2015 and in the last two months of the year, more than 193,000 inspections were conducted, with about 4,000 breeding habitats removed.

More than 1,000 households in dengue clusters were also fined in 2015.

Under the Control of Vectors and Pesticides Act, households within dengue clusters found with breeding habitats can be fined up to S$5,000.

Environment and Water Resources Minister Masagos Zulkifli said in Parliament on Wednesday (Jan 27) that the current penalties have been effective in keeping re-offending rates low.

He said: "Besides checking homes, NEA (National Environment Agency) has also intensified checks for other areas, including construction sites, and taken stern action against those found breeding mosquitoes.

“In 2015, more than 900 Notices to Attend Court were issued to construction site contractors and at least 100 court prosecutions were taken against contractors for repeat offences. In the same period, more than 100 Stop Work Orders (were) issued to construction sites to ensure that proper mosquito control measures were put in place before construction was allowed to resume."

About S$2.5 million is set aside each year by the authorities to develop dengue surveillance and control tools. Additional funds have also been committed to develop a method which can prevent mosquito eggs from hatching.

On measures to prevent a Zika virus outbreak in Singapore, Mr Masagos said the Health Ministry is working with NEA to enhance ongoing laboratory surveillance of sample Zika infections.

"Zika is a notifiable disease under the Infectious Diseases Act,” he said. “However, the Zika virus is also transmitted by the same type of mosquitoes that transmit dengue. Therefore, whatever we do for dengue, if we are effective, will be effective also to prevent Zika from spreading. "

- CNA/xk

High number of dengue cases expected this year
LOUISA TANG QIANROU Today Online 28 Jan 16;

SINGAPORE – The number of dengue cases this year is expected to be high, with cases spiking earlier than usual, said Minister for the Environment and Water Resources Masagos Zulkifli in Parliament today (Jan 27).

More than 11,200 dengue cases were reported last year, lower than in 2013 and 2014, but there have been more cases in the past few months compared with corresponding periods in previous years, said Mr Masagos, who was responding to a question from Mr Gan Thiam Poh (Ang Mo Kio GRC) on whether current enforcement and fines were enough to deter owners of properties that are breeding mosquitoes.

Property owners in dengue clusters found with breeding habitats can be fined up to S$5,000. Mr Masagos said last year, more than 1,000 households in dengue clusters were fined. The current penalties have been effective in keeping reoffending rates low, but stiffer penalties will be introduced if necessary, he said.

The Ministry for the Environment and Water Resources has also set aside S$2.5 million each year “to conduct multi-disciplinary research in controlling the mosquito population”, for example, to develop surveillance and control tools such as Gravitraps.

And more than S$3 million has been committed over the next three years to developing a novel method of suppressing the Aedes mosquito population. The Ministry is also tracking the development of the dengue vaccine Dengvaxia, he said.

The number of reported cases of dengue remained high last week with 622 cases reported, higher than any week reported last year, with the National Environment Agency noting there has been a switch in dominant dengue serotype from DENV-1 to DENV-2.

In an article on the dengue outlook for the year in the Ministry of Health’s epidemiological news bulletin published this month, researchers noted that vector control efforts have delayed the exposure to dengue infection till adulthood, and “paradoxically” reduced population immunity to the virus.

Studies of blood donor samples by the Environment Health Institute showed that the epidemic in 2013 made little contribution to raise herd immunity, and Singapore’s resident population remains “highly susceptible” to dengue epidemics associated with any of the four serotypes.

The researchers also noted that the effects of the El Nino phenomenon will contribute to a rise in cases in the coming months, noting that after El Niño peaked in December 1997, there was a spike in dengue cases in January 1998, followed by another in August.

Also, while DENV-1, DEN-2 dengue cases have been dominant, other serotypes have also emerged in clusters. A new strain of DENV-3 was first detected in the week of 31 May to 6 June last year and has consistently been detected since then, while another strain has been circulating since April last year, mainly in the western area of Singapore.

A new strain of DENV-4 has also been circulating since last February in the Tai Hwan Close and Heights area in Serangoon. The researchers noted that El Niño could also affect local epidemiology, “due to the inevitable expansion of genetic diversity of the virus and more frequent introduction of new viruses”.


Singapore to step up surveillance for Zika virus
Today Online 27 Jan 16;

SINGAPORE — As it is “inevitable” that the Zika virus will eventually be imported to Singapore, authorities are stepping up measures to detect and potentially control infections, the Ministry of Health (MOH) and the National Environment Agency (NEA) said in a joint statement today (Jan 27).

In the wake of recent outbreaks in South America and a case reported in Taiwan, the MOH and NEA advised travellers to countries with local transmission of the Zika virus to protect themselves from mosquito bites. Pregnant women should reconsider their travel plans to countries with ongoing outbreaks and local transmission, given the increasing evidence of a link between Zika virus infection during pregnancy and brain malformation in their foetuses and infants, they said.

The agencies also said returning travellers from affected areas should seek medical attention if they develop symptoms of Zika such as fever, skin rashes, joint and muscle pains, headaches and red eyes and posters will be placed at airports to serve as reminders.

Since 2013, the NEA has had an ongoing surveillance programme for the virus, and no cases have been detected in Singapore so far, but the possibility of undetected cases could not be ruled out as most infected persons may display mild or no symptoms, NEA and MOH said.

Zika virus infections have also been added to the List of Notifiable Infectious Diseases under the Infectious Diseases Act, while the MOH is raising awareness of such infections among the medical community. Any confirmed cases will be admitted to a single room at a public hospital until they recover and test negative for the virus, to minimise the risk of being bitten by mosquitoes while they are carrying the virus, which is also transmitted by Aedes mosquitoes.

Asked about such infections in Parliament today, Environment and Water Resources Minister Masagos Zulkifli said if any Zika cases are found here, the NEA will step up its vector control activities around the case area. But, he stressed that stamping out the breeding of mosquitoes is key to reducing such threats. “If we are effective with this, we can also stop Zika from spreading when it comes to Singapore,” he said. ADDITIONAL REPORTING BY LOUISA TANG


'Challenging' to stop spread of Zika virus in Singapore: Health Minister
If a case of Zika virus infection is detected in Singapore, vector control operations will be stepped up to prevent further transmission of the Zika virus infection, says Minister Gan Kim Yong.
Channel NewsAsia 28 Jan 16;

SINGAPORE: The Ministry of Health (MOH) and the National Environment Agency (NEA) will take necessary steps to contain the spread of the Zika virus, but Health Minister Gan Kim Yong said it may be "challenging" to prevent the virus from spreading and eventually becoming entrenched in Singapore.

Mr Gan said on Thursday (Jan 28) that the presence of the Aedes mosquito vector here is one reason for his assessment. The mild, non-specific nature of the symptoms in the majority of infected patients will also make surveillance "difficult", he added in his written response to MP Lim Wee Kiak's parliamentary question.

The MOH and NEA on Wednesday announced it is upping control measures to prevent the onset of the virus. Some of these measures include issuing advisories to travellers heading to areas with Zika outbreak.

Mr Gan said MOH has issued a medical circular to increase the awareness of Zika among the medical community. As the virus has been included in the list of legally notifiable diseases, all medical practitioners and diagnostic laboratories are required to notify MOH of suspect and confirmed cases of Zika virus infection within 24 hours, he reiterated.

"If a case of Zika virus infection is detected in Singapore, vector control operations will be stepped up to prevent further transmission of Zika virus infection. MOH will also actively look for additional cases in high risk areas in relation to the case," the Minister said.

"Confirmed cases will be admitted to a public hospital for further management and public health precautions will be taken to ensure that they are not bitten by mosquitoes."

He added: "We urge the public to do its part by remaining vigilant and taking appropriate precautions to prevent mosquito breeding."

- CNA/kk