14/05/2016

First case of Zika virus in Singapore

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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48-year-old man who travelled to Sao Paulo
Residents walking in Watten Estate, on May 13, 2016, after the first case of imported Zika virus infection was found.ST PHOTO: DESMOND WEE

The 1st imported case of the Zika virus infection has been reported in Singapore on Friday (May 13).

The patient is a 48-yr-old male Singapore permanent resident who had travelled to Sao Paulo in Brazil from Mar 27 to May 7.

The Ministry of Health (MOH) and the National Environment Agency (NEA) said in a joint statement that they were informed of the case on Friday.

related:
Putting Zika virus into perspective
Fumigation, checks for mosquitoes under way in Watten Estate
6 things to know about the virus, spread by the Aedes mosquito
Watten Estate residents worried; some say mosquitoes a problem there
Zika virus 'likely to reach S'pore, so mosquito control vital'

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How Singapore's first case of Zika infection was spotted

When Singapore's 1st confirmed Zika patient went for a check-up at Mount Elizabeth Novena Hospital 10 days ago, he almost did not get hospitalised.

According to Dr Leong Hoe Nam, the infectious diseases expert who first diagnosed him, his symptoms were so mild that it was "difficult to justify even getting him admitted".

The 48-yr-old permanent resident had a fever, head and muscle aches, and rashes - symptoms easily mistaken for a viral fever.

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Going to Zika-hit places? Take precautions

People who visit countries where the Zika virus has been detected should protect themselves from mosquito bites, said the authorities in a health advisory yesterday.

For example, they can wear clothing that covers as much of their skin as possible, apply insect repellent and use wire mesh screens or mosquito nets.

In yesterday's joint statement, the Health Ministry and National Environment Agency also advised people who return from affected countries to monitor their health for 14 days.

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40 mosquito breeding spots destroyed in Watten Estate area: NEA

The National Environment Agency (NEA) said on Monday (May 16) that it has inspected about 700 premises in Watten Estate since Singapore's first imported Zika case was diagnosed last Friday. 

It added that 40 mosquito breeding habitats have been detected and destroyed in the neighbourhood where the patient lives. Of these, 26 were found in homes while the remaining 14 were in common areas. 

In a Facebook post on Monday, the agency said officers have been distributing Zika information leaflets and insect repellent to residents in the area.

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Neighbours of Singapore's first Zika victim are worried
FIRST CASE: The Zika patient lives in Watten Estate in Bukit Timah

For the past two months, Madam Cindy Chan has been reminding her grandchildren to check for new mosquito bites on their bodies after reading about the Zika virus.

The 62-year-old retiree told The New Paper yesterday evening: "My daughter sat the two kids down and explained what the Zika virus was, what causes it and so on.

"We told them to tell us immediately when they see a new bite on their body, but thankfully, they haven't had any."

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First Case of Zika Virus Infection in Singapore

The Ministry of Health (MOH) and National Environment Agency (NEA) were informed on 13 May 2016 of the first imported case of Zika virus infection in Singapore. The patient is a 48-year-old male Singapore Permanent Resident who had travelled to Sao Paulo, Brazil from 27 March to 7 May 2016. The patient developed fever and rash from 10 May and was admitted to Mount Elizabeth Novena Hospital on 12 May 2016 and isolated.

The patient was tested positive for Zika virus infection on 13 May. He will be transferred to the Communicable Diseases Centre at Tan Tock Seng Hospital for treatment and isolation to minimise the chances of being bitten by mosquitoes and spreading the infection in the community. The patient is currently well and recovering. He will only be discharged upon being tested negative for the Zika virus.

MOH is screening the patient’s household members. They have been advised to monitor their health and seek medical treatment if unwell. MOH and NEA will also actively alert residents in the vicinity to seek medical attention should they develop symptoms of fever and rash.

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First case of Zika virus reported in Singapore
The dreaded Zika virus has finally made its way to Singapore

Zika has been most notoriously linked to microcephaly, which causes babies to be born with abnormally small brains and skulls.

Symptoms include slight fever, headache, conjunctivitis, aching joints, heat rash, muscular pain, and general discomfort.

According to the government statement, the NEA is upping its operations to control populations of Aedes mosquitos which carry the virus, in the area.

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Singapore reports first Zika case

The Zika virus is spread by the Aedes mosquito, which also transmits dengue.

There is already a high incidence of dengue fever in Singapore, which has a warm and humid tropical climate with rainfalls all year round.

While the Zika virus usually causes mild symptoms, such as skin rashes and headaches, it is suspected to cause abnormally small head sizes in newborn children, a condition called microcephaly, when mothers contract the virus during pregnancy. Brazil has seen a rapid increase in such cases.

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Singapore reports first Zika case

The current Zika outbreak began in 2015 in Brazil where some 1.5 million infections have been reported and since then the epidemic has spread to other countries in the Americas as well as two cases in Europe and now one in Singapore.

There is no vaccine or cure for Zika, which in most people causes only mild symptoms -- a rash, joint pain or fever.

While the virus is typically spread by mosquitoes, some cases of sexual transmission from infected partners have been detected.

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Singapore reports first case of Zika virus

The Zika virus is spread by the Aedes mosquito, which also transmits dengue.

There is already a high incidence of dengue fever in Singapore, which has a warm and humid tropical climate with rainfalls all year round.

While the Zika virus usually causes mild symptoms, such as skin rashes and headaches, it is suspected to cause abnormally small head sizes in newborn children, a condition called microcephaly, when mothers contract the virus during pregnancy. Brazil has seen a rapid increase in such cases.

related:
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Singapore reports first Zika case

The Ministry of Health said the 48-year-old male foreigner, who is a Singapore permanent resident, had visited Sao Paolo from March 27 to May 7.

He developed a fever and rash from May 10 and was admitted to hospital two days later and isolated, the ministry said in a joint statement with the National Environment Agency (NEA).

Brazil is the hotbed of the mosquito-borne Zika virus outbreak, with the virus blamed for birth defects in babies born to infected women.

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Zika's explosive spread
An Aedes aegypti mosquito is seen on human hand in a laboratory of the International Training and Medical Research Training Center (CIDEIM) in Cali, Colombia, on Jan 28, 2016. Photo: Reuters.

The World Health Organization (WHO) had earlier this year sounded the alarm over the Zika virus, saying that it is “spreading explosively” in the Americas that as many as four million people could be infected by the end of the year. Singapore on May 13 saw its first imported case of Zika virus infection.

The US Centers for Disease Control and Prevention (CDC) has confirmed that “there is no longer any doubt that Zika causes microcephaly” — a condition that causes babies to be born with abnormally small heads and other severe brain defects. TODAY looks at how the virus is carried by mosquitoes, its symptoms and the birth defects it could cause.

related: First imported case of Zika virus infection

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What you need to know about Zika
SINGAPORE: A 48-year-old man who had visited Brazil was announced as the first imported case of Zika in Singapore on Friday (May 13). Health authorities said he is "well and recovering" and has been isolated, but it urged residents living in his neighbourhood to monitor their health.

The following are some questions and answers about the virus and current outbreak:
  • How do people become infected?
  • How do you treat Zika?
  • How dangerous is it?
  • What are the symptoms of Zika infection?
  • How can Zika be contained?
  • How widespread is the outbreak?
  • What is the history of the Zika virus?
  • Can Zika be transmitted through sexual contact?
  • What other complications are associated with Zika
related:
Singapore reports first imported Zika case
Could exposure to dengue help build immunity against Zika?
Puerto Rico reports 1st case of Zika-related microcephaly

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6 things to know about the virus, spread by the Aedes mosquito

According to a journal published by MOH in March 2014, 2 tourists from Canada and Germany were diagnosed with Zika fever after returning from Thailand in 2013. That same year, Australia also reported a case of Zika fever in a returning citizen from Indonesia. These cases may have indicated the presence of an outbreak of the virus in Thailand and Indonesia, the journal said.

In January 2016, Taiwan had its first reported case of the virus. A 24-yr-old man from northern Thailand was hospitalised in the country after travelling there for work on Jan 10.

Here are some important things to know about the virus:
  • What is the Zika virus?
  • What are the symptoms to look out for?
  • Can the virus be treated?
  • Is the virus really linked to a birth defect?
  • How many countries have reported active transmission of the virus?
  • Should other regions be worried?
related: Birth defects linked to Zika virus still rising in Brazil

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Tropical Asia braces for Zika as Thailand appears to steer clear

Tropical Southeast Asian countries said on Friday they were bracing for the mosquito-borne Zika virus, with Malaysia saying it could "spread quickly" if introduced, but Thailand appeared to be bucking the trend with just a handful of cases a year.

Zika, linked to severe birth defects including babies born with abnormally small heads, is wreaking havoc in Brazil where the government has deployed more than 200,000 troops to eradicate mosquitoes.

The World Health Organization (WHO) said on Thursday that the virus was "spreading explosively" and could infect as many as four million people in the Americas.


Now Vietnam reports its first two cases of the Zika virus - one in a pregnant woman
The Zika virus is thought to cause microcephaly, a disease characterised by unusually small heads that can result in developmental problems in babies. Pictured is a baby in Brazil with microcephaly

Two women in Vietnam have been infected with the Zika virus, health ministers have announced. The younger of the patients is eight weeks pregnant, they added.

The Zika virus, which is carried by mosquitoes and transmitted to humans, is thought to cause microcephaly. Characterised by unusually small heads, microcephaly can result in developmental problems in babies.


It is not clear if either of the women have recently travelled abroad, or whether they were infected with Zika in Vietnam.

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Zika Virus: Prevention, Symptoms and Pregnancy

As a mosquito-borne disease, Zika spreads among mosquito populations and from mosquitoes to humans. Some research suggests the virus may transfer from person-to-person through sex or transfusion. But, there has only been one reported case of each type of infection.

The mosquitoes that spread Zika are the same that carry Dengue fever and chikungunya. Areas affected by Dengue could potentially harbor Zika as well. Typically, a mosquito becomes infected when it feeds on a person who has Zika. This mosquito then spreads the virus to other humans through bites.

Rarely, a mother infected with the virus will pass it on to her child in utero. This form of transmission is under investigation by global health organizations. There have been no reports of infants contracting the virus through breast feeding.

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Zika Virus Vaccine Possible With Help of Primate Research
The president of the Foundation for Biomedical Research argues that primate work is key to finding a vaccine for the Zika virus

The Zika virus just got more dangerous.

U.S. officials recently confirmed that the virus causes birth defects. Brazilian scientists, meanwhile, have discovered that it may also affect the brains of adults. Several patients with Zika are suffering from an illness similar to multiple sclerosis.

"Most of what we've learned is not reassuring," said Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention."

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The Zika virus
Zika fever in Southeast Asia and islands of the Pacific Ocean

Zika virus was first isolated in 1947 from a sentinel rhesus monkey stationed on a tree platform in the Zika forest, Uganda. The virus is a member of the Flaviviridae family and is a single-stranded RNA virus with a positive-polarity RNA genome.

It is transmitted to humans by mosquitoes, and thus far, only Aedes mosquitoes are known to be the vector of Zika virus. The Aedes species that can carry the virus includes Aedes africanus, Aedes apicocoargenteus, Aedes luteocephalus, Aedes furcifer, Aedes vitattus and Aedes aegypti.3 Other pathogenic vector-borne flaviviruses include dengue, West Nile, Japanese encephalitis and yellow fever.

The first human case of Zika virus infection was reported in Nigeria in 1954. Subsequently between 1968 and 2002, 606 strains of Zika virus including 10 human strains were isolated in Central and West Africa.2 Other than being endemic in Africa, Zika virus is also present in Asia. In 1966, Zika virus was isolated from a pool of Aedes aegypti mosquitoes caught from shop houses in Pahang state of Malaysia.2 Seven patients in Central Java of Indonesia were reported to be infected with Zika virus in 1977.