Thursday, 22 August 2013

The War On Mosquitoes

Update 23 Jan 2017: 458 cases of Zika infection reported in 2016

Minister for Health Gan Kim Yong stated that as of 31 Dec 2016, 458 Zika cases have been reported to the Ministry of Health (MOH) since the first discovered case of Zika infection in August last year.

This was one of his answers to the questions filed by Mr Ang Wei Neng, MP for Jurong GRC, who asked the Minister for Health whether he can provide an update on the spread of the Zika virus in Singapore, how many new Zika cases have been reported in November and December 2016, how many of these cases are of pregnant women, and what is the total number of pregnant women infected by the Zika virus in Singapore and of these, how many have given birth and whether any of these babies have birth defects.

The Minister said that the incidence of new reported cases has been on the decline. 12 cases were reported in November and 4 cases were reported in December. "In comparison, 283 cases and 43 cases were reported in September and October respectively," he noted.

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Tracking of Zika Cases and After-Effects

As at 31 Dec 2016, 458 Zika cases have been reported to the Ministry of Health.  The incidence of new reported cases has been on the decline.  12 cases were reported in November and 4 cases were reported in Dec.  In comparison, 283 cases and 43 cases were reported in September and October respectively.

As of 31 Dec 2016, a total of 17 pregnant women have been diagnosed with Zika and reported to MOH.  Four of the women have since given birth, and their babies show no signs of abnormalities thus far.  One had a miscarriage for reasons not linked to Zika while two pregnancies were terminated for personal reasons.  As the two foetuses were at early gestation, it is not possible to determine whether there will be Zika-related abnormalities.  The remaining 10 cases are in their 2nd and 3rd trimesters and their babies will be monitored over 3 years as part of the monitoring programme.  There is currently no obvious evidence to show that there are any Zika-related abnormalities.

MOH has put in place a programme to monitor infants whose mothers were exposed to the Zika virus during their pregnancies.  We will track their development until they are three years old. Given the presence of the Aedes mosquito here in Singapore, we are likely to continue to have Zika cases in Singapore.  Some of these cases may be undiagnosed as the infection may result in mild or even no symptoms.  I urge fellow Singaporeans to remain vigilant, and to do our part to prevent mosquito breeding so as to protect ourselves and our loved ones.

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Woman in her late 50s becomes first dengue death this year

Singapore has had its first dengue death this year. The victim, a woman who had been transferred from Changi General Hospital to Gleneagles Hospital under an existing agreement between the two, died on Wednesday.

The woman, believed to be in her late 50s, was moved to the private hospital at the end of last year. Her condition deteriorated and she was moved to intensive care. She died of dengue hemorrhagic fever.

More than 20,000 people were infected with dengue last year, and five died. The epidemic has continued into this year, with 437 people infected last week.

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Is the mosquito-borne Chikungunya virus taking root in Singapore?

The Aedes albopictus mosquito is the primary vector for chikungunya here. For a while, the dengue-like disease had seemingly been eradicated, but this year's outbreak has put paid to hopes of its demise - PHOTO: NEA

The mosquito-borne chikungunya virus appears to have become endemic in Singapore, after it had seemingly been eradicated.

The dengue-like disease took hold in April and there have been 924 cases this year - of which 881 were locally transmitted. Last week, there were 36 new cases.

The National Environment Agency (NEA) said the bulk of the infections have been in the Sungei Kadut and Bukit Timah/Holland areas, although four of last week's cases were in the Defu Lane and Defu Avenue areas.

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Latest Dengue Death in Singapore, Sparks New Warning

A contractor fogs a condominium garden in Singapore in an effort to kill mosquitoes, on Sept. 5. The Singapore government is running a vigorous campaign to eliminate mosquito breeding habitats to reduce the incidence of dengue fever

Authorities in Singapore are warning that Singapore’s most deadly outbreak of dengue fever since 2005 could get worse, after the disease claimed its seventh victim despite a vigorous effort by the government to control the epidemic.

More than 20,000 cases of the tropical, mosquito-borne disease have been identified in Singapore so far in 2013, spawning a series of multi-lingual YouTube videos about and a “Do The Mozzie Wipeout” campaign, launch in April, that promotes a series of at-home steps one can go through to kill mosquitoes and stop the disease from spreading.

In recent months the National Environment Agency, or NEA, has continued to boost measures to bring the rate of infection down by asking for public suggestions about how to make the fight against dengue more fun and engaging, particularly for children.

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7th person dies of dengue
Aedes mosquito (Photo: NEA)

A 53-year old woman has become the seventh local dengue death case this year.

In a joint statement, the Ministry of Health (MOH) and the National Environment Agency (NEA) said the dengue patient lived at Hougang Street 22.

MOH and NEA expressed their deepest condolences to the family of the deceased patient.

Dengue season likely to stretch till next year
Orchard Rd retailers step up efforts against dengue outbreak
Number of dengue cases may fall but community should remain vigilant: NEA
Unoccupied house not reason for dengue cases at Kovan Road
More mosquito breeding sites found in October
Dengue cases on the increase
35-year-old woman dies of dengue
Over 15,000 dengue cases as of September
Dengue cases on the rise, says MOH


Dengue this year has consistently been a big issue with over 20,000 cases reported so far this year. Despite this, NEA is not sure of the reasons behind the higher number of cases. 

There have also been 7 deaths due to the disease this year and authorities have warned the public that they must do everything they can to prevent the disease from spreading.

The number of reported cases each week has remained around the 400 to 500 mark while in previous years, the numbers would usually start to drop dramatically by this time of year.

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Why Singapore has lost the war against dengue

The Malaysian Insider, 20 Nov 2013

It is disturbing to read that dengue cases in Orchard Road continue to rise. For this year (the first 45 weeks), the average number of cases reported each day was around 62 for the whole country.

While Singapore has weathered many challenges, we seem powerless against dengue fever

The reasons we have not won the war against dengue fever are obvious. First, if one complains about mosquito infestation in one’s neighbourhood, there would be a one-off response. Without a permanent solution, the problem would recur in no time. Second, there is a lack of coordination in dealing with certain mosquito breeding sites.


Speaking to reporters on the sidelines of the Yuhua Open House, Ms Fu stressed the importance of keeping the surroundings free of mosquito breeding sites.

She added: “For patients of dengue fever, it’s also important for them to prevent themselves from (getting bitten by) the mosquitoes. 

“We have to stop the mosquito-to-human and human-to-mosquito transmission in order to control the incidence of dengue.

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Singapore – City of Dengue
Clean and green Singapore has a new name: City of Dengue

The deadly mosquito-transmitted disease has claimed its seventh victim this year – a 53-year-old woman who died from dengue on Saturday, 15 November, 2013 – and is showing no signs of abating. Even Orchard Road, the city’s most popular shopping belt, and Somerset are not spared the fever.

While this is attributed to a sudden spike in temperature conditions and weaker immunity against the dengue Type One virus, the lack of coordination in dealing with mosquito breeding sites between the National Environment Agency (NEA) and town councils coupled with poor upkeeping is, unfortunately, a recipe for disaster.

Additionally, drains clogged with fallen dead leaves, branches, twigs and trash tend to collect stagnant water, thereby creating potential mosquito breeding spots. The sudden climate change makes matters worse

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Singapore launches dengue web series, ‘The Silent War’ as outbreak nears 20,000 cases

The Singapore Ministry of the Environment and Water Resources (MEWR) has released the first two videos on the web series, “The Silent War” on their You Tube page this week, which documents the behind the scenes activities by the National Environmental Agency (NEA) during the 2013 dengue fever epidemic.

The Silent War is an 8-episode reality web series produced by Project Peanut.

The first episode titled “The Crisis” looks at the headlines behind the current outbreak, including the fact that some people have died from it.


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Dengue dread spreads to Orchard's offices, homes

The Orchard Road lights are up and ready to usher in the Christmas festivities. But an unwelcome visitor is threatening to spoil the party.

The number of dengue cases in the Orchard Cluster continues to climb, hitting 82 on Friday. What's more, the threat no longer seems limited to the Orchard Gateway construction site, as an increasing number of individuals working and living in the area have started falling prey to the mosquito menace.

The 53 construction workers at the site still make up the bulk of the cases in the cluster. But the remaining 29 victims come from the gaggle of high-end offices and homes in Orchard Road.


Taking the sting out of dengue

In 2008, it was reported that the Health Ministry would undertake an experiment to release genetically-modified mosquitoes to fight Aedes aegypti mosquitoes, the main carriers of the dengue virus. Was it a success? How effective have we been in efforts to control dengue fever? Deputy director-general of Health (public health) Datuk Dr Lokman Hakim talks to Chandra Devi Renganayar and Suzanna Pillay to get an insight into efforts to combat the scourge.

Question: Where were the genetically-modified (GM) mosquitoes first released?

Answer: Our original proposed trial site was in Pulau Ketam, but our preliminary surveys indicated that the site was unsuitable for the trial. Instead, a trial site in Pahang was found to be ideal and the release was conducted in this site. The trial, the first open release of male transgenic mosquitoes in Asia, was conducted on Dec 21, 2010, in an uninhabited forest (non-reserve forest land owned by the government off Jalan Tentera/Lebuhraya Bentong-Raub) in Bentong, Pahang.

NTU researchers launch new anti-dengue app which relies on community participation
NEA eyes drones in dengue fight

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Sixth dengue death this year

A 35-year-old Chinese woman has become the sixth local dengue death case this year.

A joint statement by the Health Ministry and the National Environment Agency, says they were notified of the death of a dengue patient who lived at Yishun Ring Road today (30/09). The patient's residence was said to be in a dengue cluster of three cases.

The NEA says its inspectors will continue with checks and conduct vector control operations in the area and residents are encouraged to cooperate.

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Insecticide-treated bed netting could wipe out mosquito-borne elephantiasis

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Dengue cases spike after weeks of decline

The number of weekly dengue cases reported has trended upwards after several weeks of decline.

From August 11 to 17 this year, 378 cases were reported, compared to 256 the previous week.

There have been 14,652 dengue cases reported so far this year. They included a 52-year-old man, who died on August 13, bringing the local dengue death toll to five this year.

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The War On Mosquitoes

How many have died from dengue fever in Singapore? The official position from the Ministry of Health (MOH) and the National Environment Agency (NEA) states "This is the fifth local dengue death case this year."

The actual number depends on whether you want to make the minister in charge look good/bad, and the mainstream media does that very well. The tally goes like this:
  • 1st victim, 20-year-old Singaporean Chinese male, lived in Hougang Ave 1, died 29 May 2013;
  • 2nd victim, 60-year-old Singaporean Chinese male, lived in Ang Mo Kio Avenue 3, died 9 June 2013;
  • 3rd victim, 86-year-old Singaporean Chinese male, lived in the Sembawang Road area, 25 June 2013;
  • 4th victim, a 66-year-old Singaporean Chinese male, lived in the Tanglin Halt area, died 8 July 2013;
  • 5th victim, 52-year-old Chinese male, lived in Corporation Walk, died on 13 August 2013.
The unvarnished truth is that there is a tie for 4th occurrence, an Indonesian male, who died on 25 June 2013. The victim contracted dengue fever overseas between 10 - 21 June 2013 and was subsequently sent to Tan Tock Seng Hospital for treatment on 23 June 2013. He was a foreigner who died in a local hospital, under competent medical care of doctors stationed locally. So 5 or 6 local dengue deaths, you choose the number to rank how well Vivan Balakrishnan is doing his job.

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Why Do Mosquitoes Bite Some People More Than Others?
Blood type, metabolism, exercise, shirt color and even drinking beer can make individuals especially delicious to mosquitoes. Photo by Flickr use

An estimated 20 percent of people, it turns out, are especially delicious for mosquitoes, and get bit more often on a consistent basis. And while scientists don’t yet have a cure for the ailment, other than preventing bites with insect repellent (which, we’ve recently discovered, some mosquitoes can become immune to over time), they do have a number of ideas regarding why some of us are more prone to bites than others. Here are some of the factors that could play a role:

Blood Type
Mosquitoes prefer people with Type O blood nearly twice as often as those with Type A. People with Type B blood fell somewhere in the middle

Carbon Dioxide
People who simply exhale more of the gas over time — generally, larger people — attract more mosquitoes than others

Exercise and Metabolism
Strenuous exercise which increases the buildup of lactic acid and heat in your body, makes you more attractive to the mosquitoes

Skin Bacteria
Mosquitoes are especially prone to biting our ankles and feet because they naturally have more robust bacteria colonies

Just a single 12-ounce bottle of beer can make you more attractive to mosquitoes

Pregnant women have been found to attract roughly twice as many mosquito bites as others, because they exhale about 21 percent more carbon dioxide and are on average about 1.26 degrees Fahrenheit warmer than others

Clothing Color
Wearing colors that stand out (black, dark blue or red) may make you easier for the mosquitoes to find

As a whole, underlying genetic factors are estimated to account for 85 percent of the variability between people in their attractiveness to mosquitoes—regardless of whether it’s expressed through blood type, metabolism, or other factors

Natural Repellants
Some researchers have started looking at the reasons why a minority of people seem to rarely attract mosquitoes in the hopes of creating the next generation of insect repellants.

Using chromatography to isolate the particular  chemicals these people emit, scientists at the UK’s Rothamsted Research lab have found that these natural repellers tend to excrete a handful of substances that mosquitoes don’t seem to find appealing.

Eventually, incorporating these molecules into advanced bug spray could make it possible for even a Type O, exercising, pregnant woman in a black shirt to ward off mosquitoes for good.

New discovery brings hope to universal dengue vaccine
A new strategy that cripples the ability of the dengue virus to escape the host immune system has been discovered by A*STAR's Singapore Immunology Network (SIgN)

The discovery, scientists said, brings hope to what may become the world's first universal dengue vaccine that can give full protection from all four types of the virus.

The dengue virus requires the enzyme called MTase, also known as 2'-O-methyltransferase, to chemically modify its genetic material to escape detection.

In this study, the researchers discovered that by introducing a genetic mutation to deactivate the MTase enzyme of the virus, initial cells infected by the weakened MTase mutant virus are immediately recognised as foreign.

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Florida Keys considering drones to fight mosquitoes
An agency in the Florida Keys could become the first in the nation to use this strategy. (Reuters Photo)
Getty Images - An agency in the Florida Keys could become the first in the nation to use this strategy. (Reuters Photo)

The Florida Keys agency charged with keeping the island chain's mosquito swarms at bay might become the nation's first to use drones to spot remote breeding grounds as part of efforts to eradicate the insect.

"If you try to get across the small islands it's back country, it's jungle," said Michael Doyle, executive director of the Florida Keys Mosquito Control District, who added the drones wouldn't replace boots on the ground, but would help turn eradication efforts into "smart bombing."

On August 26 the head of North Carolina-based Condor Aerial will demonstrate the Maveric drone on a test flight for officials in hopes of selling the $65,000 aircraft to one of the Sunshine State's most popular tourist destinations. 

related: NEA eyes drones in dengue fight

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Singapore's First Zika cluster of 2017