Sunday, June 16, 2013

Singapore - Evolution of dengue epidemic "at a critical juncture"

Environment and Water Resources Minister Dr Vivian Balakrishnan said Singapore has "reached a critical juncture" in the evolution of the dengue epidemic.

820 cases were reported last week, bringing the total number to 9,421. That is the highest ever in Singapore's history, surpassing even the previous peak during the 2005 epidemic.

The minister said it is going to get worse before it gets any better.

Apart from the rising numbers, there is evidence that dengue clusters are spreading across Singapore from the east, west to the northern regions.

There are four contributing factors to the current epidemic. Firstly, the Aedes mosquito is now predominant across the island. Secondly, the currently circulating dengue virus - Dengue Serotype 1 - has higher epidemic potential. Thirdly, the low immunity amongst the population makes people more vulnerable. Lastly, the hot and wet weather accelerates the life cycle of the Aedes mosquito and increases the likelihood of stagnant water accumulating.

Dr Balakrishnan said: "Our numbers are still rising and we are going into a peak dengue season so we cannot afford to lose control at this stage."

The National Environment Agency (NEA) will step up surveillance and inspection.

It will recruit another 300 officers over the next two months so that all premises in dengue clusters can be checked within a week.

Officers will be equipped with a new aerosol spray and it will be applied to dark corners of homes. The spray is said to last in the air longer and is more deadly to mosquitoes.

1.2 million insect repellents will also be distributed for free to households in dengue clusters.

Homes remain the top culprit for breeding spots.

Mr Balakrishnan said: "Infectious diseases are a test of special cohesion as a society and we need everyone to understand that our own health depends on the health of our neighbours and we need to exercise personal and collective responsibility for each other."

The Health Ministry has sent circulars to hospitals reminding them to be on heightened alert and give priority to returning A & E patients.

It has also released an additional 160 beds since March 2013, of which only 10 per cent are in use. By the end of the year, there will be another 90 beds added.

Dr Amy Khor, Minister of State for Health, said: “We have been working with every hospital, right down to the restructured hospitals to see where the added capacity can come from. And as the minister has said, the total absolute number of additional beds is there to cater to any surge in demand for beds due to dengue cases."

So far, only about 1.8 per cent of beds in public hospitals are occupied by dengue patients. Less than 30 per cent of dengue cases are admitted to hospital.

On the management of suspected dengue patients, authorities stressed that proper procedures are in place.

They added that most patients do recover from the disease.

So far, there have been two dengue-related deaths here this year.

The victims died after being discharged from A & E and re-admitted to hospital due to worsening conditions.

This has led some to raise concerns over the way suspected dengue cases are managed.

"Our doctors are working very hard on the ground... We can all sit down here and pontificate but there is no substitute for clinical judgement and one-on-one interaction for doctors. Our duty at the ministry level and administrative level is to make sure all the resources that are needed are available, so that whether you need beds, whether you need drugs, whether you need drips, whether you need any diagnostic tools, all those things are available, so that doctors can do what they do best," said Dr Balakrishnan. 

- CNA/xq/ir

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