Tuesday, 18 October 2016

Taking the sting out of dengue

Singapore and 10 other countries approve dengue vaccine after 20-year wait
A new dengue vaccine developed by the Sanofi Pasteur Dengue Company is shown to AFP reporters at a hotel in Mexico City on Sep 9, 2016. The dengue vaccine is the culmination of 20 yrs of Sanofi Pasteur's commitment to discover and develop a vaccine against dengue for priority launch in Latin American and Asian countries where dengue is a major public health priority. Photo: AFP

Sanofi Pasteur, Sanofi's vaccines unit, said on Tuesday that its dengue vaccine, Dengvaxia, had received market approval in 11 countries.

To date the vaccine has been approved in Mexico, the Philippines, Brazil, El Salvador, Costa Rica, Paraguay, Guatemala, Peru, Indonesia, Thailand & Singapore, the statement said.

Dengue fever is a mosquito-borne disease caused by four virus serotypes (1 to 4) as categorised by the World Health Organisation. Overall, the disease is seen as a threat to about half of the world's population. Some 400 million people are believed to be infected annually.


More Than 10 Countries Give Nod To World’s First Dengue Vaccine

World’s first dengue vaccine, named as Dengvaxia, has been approved by 14 countries. Till date, the vaccine  is approved in Mexico, The Philippines, Brazil, El Salvador, Costa Rica, Paraguay, Guatemala, Peru, Indonesia, Thailand & Singapore.

The vaccine Dengvaxia is said to prevent two-thirds of dengue cases and also prevented 8 of 10 hospitalizations due to disease over the 25-month study follow-up period. The vaccine was developed by  Sanofi Pasteur. According to WHO, it was first licensed in Mexico in December 2015 for use in individuals 9-45 years of age living in endemic areas. It is given as a 3-dose series on a 0/6/12 month schedule.

Dengue is a mosquito-borne tropical disease having symptoms like high fever, headache, vomiting, muscle and joint pains amongst others. Generally, recovery takes less than two to seven days. However, in some cases, the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets or even death.


Dengue vaccine gets approval for use in S'pore
Dengvaxia is a new dengue vaccine developed by Sanofi Pasteur. Photo: AFP

The world’s 1st dengue vaccine will be available here in a few months, but the authorities will not be rolling it out as part of a national vaccination programme, because of its limited effectiveness among those who have not had the disease before.

Subsidies & Medisave will also not be able to be used for the vaccine Dengvaxia, which was developed by French pharmaceutical giant Sanofi-Pasteur.

On Tuesday (Oct 4), the Health Sciences Authority (HSA) announced it has approved the vaccine for use on individuals aged 12 to 45 for now, making Singapore the 11th country to approve its use.


Singapore approves the use of dengue vaccine, Dengvaxia
Following a number of countries–Mexico, Brazil, El Salvador, Costa Rica, Paraguay and the Philippines, the Singapore Health Sciences Authority (HSA) today approved the use of the Sanofi Pasteur dengue vaccine, Dengvaxia

The vaccine has been approved for use for the prevention of dengue disease caused by dengue virus serotypes 1, 2, 3 and 4 in individuals aged 12 to 45 years.

Dengvaxia works like a “booster” that is more effective in protecting individuals who already have baseline immunity due to a previous dengue infection, the health ministry notes. It is more effective in countries where there is high prevalence of dengue. The World Health Organization (WHO) does not recommend that countries implement a national vaccination program using Dengvaxia when the population to be vaccinated has a prevalence of previous dengue infection below 50 percent.

Singapore has relatively low prevalence of dengue infection compared to other Southeast Asian countries. For this reason, the vaccine will be less effective here, health officials said.  The Ministry of Health (MOH)’s Expert Committee on Immunization does not recommend rolling out Dengvaxia vaccination as a national program as it would not be a clinically and cost-effective means to tackling dengue infection in Singapore. However, individuals who wish to be vaccinated with Dengvaxia should have access to the vaccine, in consultation with their doctor.


What you need to know about the new dengue vaccine
Dengvaxia, the world's first dengue vaccine, is administered in three doses over a year. Studies have shown it is effective up to four years from the administration of the last dose.PHOTOS: AGENCE FRANCE-PRESSE

Q Will the new dengue vaccine help to protect me against all the different strains of dengue?
  • A Yes, but to a different extent depending on the strain. Against Den-1 and Den-2, which are the more common dengue strains in Singapore, vaccine efficacy is 50 per cent and 40 per cent respectively. The figures are 75 per cent and 77 per cent for Den-3 and Den-4.
Q Why is the vaccine not recommended for children under 12?
  • A In clinical trials, children aged between nine and 11 were vaccinated against dengue. Those who still contracted dengue infections afterwards had a 30 per cent higher risk of hospitalisation. Also, the children had three times the risk of developing severe dengue. These effects were not observed in those aged 12 and above. In fact, the risk of hospitalisation was reduced for the older age group after vaccination.
Q Why is vaccination not recommended for those aged above 45?
  • A A study conducted in Australia showed that people aged 46 to 60 had a very low antibody response to the vaccine, meaning that it is likely to be less effective at protecting people in this age group from dengue.


When Dengue Fever Becomes Severe Dengue
Severe dengue can occur in adults and children and is potentially life-threatening. It requires early detection and proper medical care

Dengue fever, an Aedes mosquito-borne viral disease, is widespread in Singapore, but its more lethal forms, dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS), referred to as severe dengue, are much less common.

Severe dengue can occur in both adults and children and is life-threatening. Children are especially at risk. Early detection and proper medical care lower fatality rates below 1 per cent, according to the World Health Organization (WHO).

Severe dengue initially presents with the common symptoms of dengue fever such as fever, intense headache, aches and pains, loss of appetite, nausea, vomiting, skin rashes and leukopenia (reduction in white blood cells). A positive tourniquet test is also a sign of dengue fever.

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Dengue infection continues to drop in Singapore; total cases to hit 30,000

After a month of steady increase, the number of dengue cases continued to drop in Singapore, with 125 new cases reported in the week ending October 8, said the National Environment Agency (NEA) on Tuesday.

On 27 September, NEA confirmed that nearly 12,000 dengue cases have been reported this year so far. About 176 dengue cases were reported in the week ending September 24 whereas 174 cases were reported in the previous week. Also, 25 new virus cases were reported between September 25 and 3pm on September 26.

The authorities said at present there are 20 dengue clusters in Singapore including 6 clusters which have been classified as high-risk. In the last record, the agency said that there were 35 dengue clusters in Singapore including 7 high-risk clusters.

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More than 30,000 dengue cases expected in Singapore this year: NEA, MOH

The number of dengue cases in Singapore this year may exceed 30,000, higher than the record of 22,170 reported in 2013, the National Environment Agency (NEA) and Ministry of Health (MOH) said on Thursday (Feb 18).

This is due to factors such as warmer conditions brought about by the El Nino weather phenomenon, faster breeding and maturation cycles of the Aedes mosquito population and a change in the main circulating dengue virus, said both agencies at a joint media briefing.

Singapore has seen more than 3,400 dengue cases reported since January, with two deaths so far.

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NEA reports 138 dengue cases, the lowest figure seen this year

The National Environment Agency (NEA) reported that over the past week (25 September to 01 October), there were only 138 cases of dengue, the lowest weekly figure seen this year.

This weekly figure is 35 cases fewer than last week. As of 3 pm on 3 October, it reported that another 20 cases were reported.

The total people infected with dengue have reached 12,034 cases. This has exceeded the total cases reported on the whole 2015 with 11,286 cases.

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175 cases of dengue, 56 of which from Yishun cluster
Baby sleeping under mosquito net ,provides mosquito nets to protect evacuees from dengue fever (Source : Shutterstock)

The National Environment Agency (NEA) reported that as of 3 pm on 24 September, another 175 cases of dengue were confirmed.

There were no rising in number this week from the last week. As of 3 pm on 26 September, NEA reported 25 cases.

The total people infected with dengue nearly reached 12,000. It have reached 11,964 cases since the start of the year. This has exceeded the total cases reported on the whole 2015 with 11,286 cases.

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New dengue cases in Singapore dip to 3-month low

The number of new dengue cases in Singapore fell to a three-month low and the second-lowest weekly figure this year, according to figures published on the National Environment Agency’s (NEA) dengue website on Tuesday (Sep 20).

A total of 175 dengue cases were reported in the week ending Sep 17, the lowest this year since 161 cases were reported in the week ending Jun 11.

About 11,760 dengue cases have been reported in Singapore since the start of the year. Seven people have died of the disease so far, with the latest fatality a 79-year-old man who lived in Eastwood Drive near Upper East Coast Road. There were four dengue fatalities in the whole of 2015.

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Dengue cases hit 11,343, surpass last year's figure
A dengue poster near a bus stop in Aljunied Crescent, where Singapore's 1st Zika cluster is located. ST FOTO: LIM YAOHUI

The total number of dengue cases in 2016 has surpassed the figure for the whole of last year, according to the latest updates on the National Environment Agency's (NEA) dengue website.

As of Monday (Sep 5), there have been 11,343 reported cases of the mosquito-borne virus - 57 more than the 11,286 cases recorded in 2015.

Last week saw dengue cases rise for the 3rd straight week to hit 311, the first time since March that the weekly figure has exceeded the 300 mark.

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Latest Dengue Data

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Dengue cases break 11k mark in peak season

The number of dengue cases in Singapore has crossed the 11,000 mark for this year, according to the latest figures from the National Environment Agency's (NEA's) Dengue Website.

As of Monday, a total of 11,053 cases of the mosquito-borne virus have been reported - just shy of the 11,286 cases in the whole of last year.

Last week saw the number of dengue cases rise to 274, an increase of 52 from the previous week.

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11-year-old male succumbs to dengue fever at KKH, eighth death this year

An 11-year-old male dengue patient had earlier passed away due to dengue infection at the KK Women’s and Children’s Hospital (KKH) on 30 August this year.

According to a joint release by the Ministry of Health (MOH) and the National Environment Agency (NEA), the boy was admitted to KKH on 30 August 2016 and passed away on the same day. His death was looked through by the State Coroner and the cause of death was declared and informed to MOH on 11 October 2016.

The patient's residence at Woodleigh Close was declared an active 2-case dengue cluster on 6 September. However, as NEA detected no breeding there and had closed the cluster since 14 September.

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11-year-old boy dies from dengue
An 11-yr-old boy died from dengue on Aug 30, said authorities on Tuesday (Oct 11) after a coroner's report confirmed the cause of death

The boy, a Singaporean, was admitted to KK Women’s & Children’s Hospital (KKH) on Aug 30 and died on the same day. The case was referred to the Coroner, and the Ministry of Health (MOH) was informed of the cause of death in the coroner’s report on Tuesday, said a joint statement from the MOH & the National Environment Agency (NEA).

The boy stayed at Woodleigh Close, an active 2-case dengue cluster, which was notified on Sep 6. No breeding was detected there. The cluster has since closed on Sept 14. The NEA will continue with routine surveillance to check for and destroy any potential breeding habitats, said the statement.


The boy is the 8th reported case of a dengue fatality this year.

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79-year-old man dies of dengue; 7th reported death in 2016
Aedes aegypti mosquitoes are seen at the Laboratory of Entomology and Ecology of the Dengue Branch

A 79-year-old Singaporean man died of dengue at Mount Elizabeth Novena Hospital (MENH) on Thursday in Singapore.

The Ministry of Health (MOH) and the National Environment Agency (NEA) in Singapore said the dengue patient had been admitted to MENH on July 30. But his condition deteriorated and he died on Thursday.


This is the seventh reported dengue death in Singapore in 2016.

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79-year-old man dies of dengue

The Ministry of Health (MOH) & the National Environment Agency (NEA) said on Thursday (Aug 4) that they have been notified of the death of a dengue patient at Mount Elizabeth Novena Hospital (MENH).

In a joint media statement, the agencies said that the patient was a 79-yr-old Singaporean male who lived at Eastwood Drive near Upper East Coast Road. He had been admitted to MENH on Jul 30 but his condition deteriorated and he died on Thursday.

This is the 7th reported dengue death in Singapore this year.

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Singapore reports 6th dengue death in 2016; 72-yr-old dies in Changi
A contractor fumigates a garden area to help prevent the breeding of Aedes mosquitoes at a residential estate in Singapore

The Singapore Ministry of Health (MOH) & the National Environment Agency (NEA) has said a 72-yr-old woman, who was admitted to Changi General Hospital, has become the latest victim of dengue infection.

She was admitted to the hospital on June 22, but her condition deteriorated and she died on June 25.

This year, this was the 6th reported dengue death in Singapore. In 2015, four people died of this disease.

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79-yr-old man dies of dengue, the fifth dengue-related death this year
A banner displaying the number of dengue cases at dengue hotspots in Tampines Ave 4. ST FOTO: KUA CHEE SIONG

A 79-yr-old dengue patient died on Sun (May 29) at Tan Tock Seng Hospital, two days after he was first admitted.

The Singaporean Chinese man had lived at Jalan Tenaga, an area located within an active six-case dengue cluster, the Ministry of Health (MOH) and the National Environment Agency (NEA) said in a joint statement on Sunday.

He is the 5th reported patient to have died from dengue this year, surpassing the 4 who died in the whole of 2015. The last death on March 22 was that of a 73-yr-old woman who lived at Poh Huat Road West.

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79-yr-old man dies from dengue

A 79-yr-old man has died from dengue, making him the 5th reported death from dengue this year.

The previous death from dengue was of a 73-yr-old woman who lived at Poh Huat Road West.

The Ministry of Health (MOH) and the National Environment Agency (NEA) said in a statement today that the man had been admitted to Tan Tock Seng Hospital (TTSH) on Fri, May 27.

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47-year-old Singaporean man dies from dengue; first death reported in 2016
Dengue cases have been on the rise since the turn of the year. In the week of Jan 10 to Jan 16, 628 cases were reported.ST FOTO: KUA CHEE SIONG

A 47-yr-old Singaporean man is the first person to succumb to the dengue virus in 2016.
Four people died from dengue last year.

In a joint press release on Sunday (Jan 24), the Ministry of Health (MOH) and National Environment Agency (NEA) said they were notified of his death at Khoo Teck Puat Hospital on Friday (24 Jan 2016).

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related:
Singapore's First Zika cluster of 2017