Dengue in Singapore 2020

What is dengue?

Dengue is a viral disease in many parts of the world. It is moving so fast that it is now considered pandemic prone. It is easy for dengue to flourish in poorer areas even if its in urban cities. If it is possible for it to flourish in urban area, can you imagine what can happen in the suburbs and the countryside? Dengue affects tropical and subtropical countries greater than other countries. It does not matter which area you live in, if you are in a tropical country, there is a higher change of you getting dengue.

How do you get dengue?

You can get dengue through mosquitos. That’s right, it is a mosquito borne viral infection. If you have dengue, you will notice it when you have serve flu like symptoms. This can sometimes lead to a potentially lethal complication called severe dengue.

Aedes, also known as the yellow fever mosquito, is responsible for the spread of dengue fever. They can also carry other diseases like chikungunya, zika fever, mayaro and many more.

In a short span of 50 years, the number of cases has increased by 30 times. Annually, there are around an estimated of 50 to 100 million infections. This means that almost half of the world’s population is at risk of getting dengue. If you think about it on a world scale, there is a 50% chance of you getting dengue.

This was first recognised in the 50s. when there were dengue epidemics in Philippines and Thailand. Today, it affects countries in Asia and Latin America the most. Dengue has managed to become one of the leading causes of death and hospitalisation for people living in this region.

This means that Singaporeans have a higher chance of catching dengue as compared to countries not in Asia.

What happens when you are infected?

Aedes can be easily recognised by the visible white markings on its legs. Other distinct markings are in the form of a lyre on the upper surface of its thorax. Even though they originated in Africa, you can now find them in tropical countries around the world.

When you are bitten by the Aedes mosquito, you can be infected. Humans have become the main carriers of this disease. On top of that, we are also multipliers of this virus as we are now a walking virus source for uninfected mosquitoes.

The virus can circulate in your body for 2 to 7 days. During which, you will start to develop a fever. If you are infected with the dengue virus, after your 1st symptoms appear, you can transmit the infection via Aedes mosquito.

When you recover from the infection, it provides you with a lifelong immunity against this particular strain. However, this immunity does not provide you with any protection against the other 3 types of dengue virus. If you do get sequential infection, it will then increase the risk of you developing severe dengue. The interval between infections and the sequence of infection is of particular importance.

Symptoms

When you are infected, you will start to develop flu like symptoms. It can progress into severe symptoms. The fever that develops with this disease can be fatal and it will vary according to the age of the person.

If you develop the following symptoms while running a high fever, please approach a doctor immediately:

• Severe headache
• Pain behind the eyes
• Nausea, Vomiting
• Swollen glands
• Muscle and joint pains
• Rash

There is an incubation period of 4 to 10 days after being bitten by an infected mosquito. You will then start to develop the above symptoms and it can usually last for 2 to 7 days.

There is a more serious version of this disease. It can become a potentially deadly disease due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

You have to look out for the following symptoms after your 1st symptoms occur. This can happen between day 3 to day 7:

• Severe abdominal pain
• Persistent vomiting
• Rapid breathing
• Bleeding gums
• Blood in vomit
• Fatigue, restlessness

Once you have any of the above symptoms, the next 24 to 48 hours can be very lethal. You will require proper medical care to avoid any complications and/or risk of death. Please seek medical assistance immediately.

Treatment

As of July 2020, there is still no specific treatment for dengue fever even though it started occurring in the 1950s.

You should always seek medical advice when you are feeling unwell. Make sure you rest and drink plenty of water. You may be prescribed with paracetamol or commonly known as Panadol. This can help to bring down your fever and reduce and sore in your joints. However, it is recommended that you not take aspirin or ibuprofen as it can increase the risk of bleeding.

Dengue in Singapore

Every week, more than a thousand cases of people getting dengue have been reported. Each week you can see that there are even more cases than the previous week. It is very alarming to see the figures increase so quickly when we are also dealing with another pandemic, Covid-19.

The total number of dengue cases in Singapore for year 2020, far surpasses the number of cases reported in 2019 and we are only in July!

Currently, there are 371 dengue clusters in Singapore which is a lot considering that Singapore is only a small island city. Of the 371 clusters, 133 clusters are deemed as red zone as they are of higher risk.

Every year, we face a dengue peak season and it is expected to last till end of October. This means that we not only have to fight against Covid-19, but we also have to protect our family members against Dengue as well.

During the routine check by NEA, they have found an increase in the incidence of Aedes mosquito larvae. A 5 fold increase has been found in homes and common corridors.

Penalty

Currently, households are issued a fine of S$200 if mosquito breeding is found at their homes. This is irregardless of the number of breeding habitats detected. For the 4th offence onwards, offenders will be then sent to court.

However, these penalties have now changed and are a lot harsher.

First-time offenders will be penalised with a S$200 fine for a single instance of mosquito breeding. If for multiple breeding spots is found, you will be fine $300 after a legal notice has been served. Repeat offenders will also be given heftier penalties or sent to court.

The enhanced penalties are as follows:

Penalty for mosquito breeding spots in homes

Covid-19 or Dengue?

So how do you tell if you have Covid-19 or Dengue since the symptoms are very similar. Luckily for us, researchers at the Nanyang Technological University (NTU)’s Lee Kong Chian School of Medicine have come up with a solution for that. They are able to tell if a person has Covid-19 or dengue in a mere 36 minutes! This is just one quarter of the time taken by current testing methods for the same diseases.

The team at NTU are using a method known as “direct-PCR”. This uses a series of commercially available enzymes and reagents that are resistant to inhibitor substances to overcome obstacles.

By mixing them together with patient swab samples in a test tube, the team is able to skip the RNA purification step. This allows them to perform the test on the sample directly. Furthermore, it can do so while producing accurate results in a shorter time.

You can read more about what the NTU researchers have done here https://www.straitstimes.com/singapore/health/ntu-researchers-develop-method-to-tell-if-someone-has-covid-19-or-dengue-in-just-36 .