DENGUE OUTBREAK

DENGUE OUTBREAK:

(Update): 16.

Dr Lily Neo asked the Minister for the Environment and Water Resources if he will give an update on the present dengue outbreak and what more can be done to prevent the situation from worsening.

The Minister for the Environment and Water Resources (Assoc. Prof. Dr Yaacob Ibrahim): Mr Speaker, Sir, we have seen a sharp increase in dengue cases over the past two months. So far, the total number of dengue cases reported for the year is 146% higher than that reported for the same period last year, ie, 4,368, as compared to 1,779. As of this morning, 339 cases were reported for last week, bringing the weekly average number of cases this year to 156, compared to the weekly average of 64 cases for the same period last year.

Sir, cases are expected to continue to rise in the warmer months ahead, up to September, with the rise compounded by a switch in the predominant circulating serotype from Dengue-1 to Dengue-2.

NEA's strategy for dengue control is to suppress mosquito population by denying the Aedes mosquitoes the place

Column: 1026

to breed, what we call source reduction, since we cannot control factors, such as the temperature and the circulating virus. To this end, NEA adopts a multi-pronged approach of preventive surveillance, public education and community involvement, enforcement and research. I shall highlight some of the dengue control measures that have been taken by NEA and relevant agencies this year.

In April this year, NEA had initiated the Intensive Source Reduction Exercise (ISRE), well ahead of the traditional warmer months of June to September. Together with 25 agencies of the Inter-Agency Dengue Taskforce (IADTF), daily checks are carried out to search out and destroy mosquito-breeding habitats. Other than homes, checks are being done in outdoor areas, drains, buildings, construction sites, parks, vacant land, and any infrastructure or facility that can breed mosquitoes. Land agencies, such as LTA, HDB and SLA, have taken action to repair damaged structures that could lead to water stagnation, eg, sunken roof gutters, ground depressions and damaged drains. NParks has also proceeded to seal tree holes and apply insecticides to plant axils to prevent mosquito breeding in these areas.

Since end May, NEA has deployed an additional 300 officers from other departments in NEA, on top of its 500 environmental health officers, to carry out daily search and destroy operations to suppress the mosquito population. Particular attention is also being paid to 44 focus areas identified as susceptible to Dengue-2 outbreaks as these areas have not seen a predominant number of Dengue-2 cases in the last five years.

Sir, breeding in homes continues to pose a challenge. Thus far, domestic containers, flower pot plates and ornamental containers, both within homes and placed by residents outside their homes along the common corridors of

Column: 1027

flats, form a significant portion of the breeding habitats detected. To raise public awareness, NEA has carried out intensive media publicity, public outreach and educational campaigns, and given its full support to grassroots activities led by Advisors. NEA will continue with these efforts in the next few months.

Sir, NEA also provides daily updates on the locations of all dengue clusters on its website ( www.dengue.gov.sg ). This is to alert residents on dengue clusters within their neighbourhoods and enable them to take preventive measures. The Ministry of Health has also alerted all GPs on the current dengue situation. GPs have been advising dengue patients and those suspected of dengue to protect themselves and their household members from mosquito bites so as to protect their family members from contracting the disease.

Sir, the Environmental Health Institute (EHI) under the NEA has been conducting research on ways to enhance mosquito control measures. One such project involves the extensive deployment of ovitraps to monitor mosquito activity. This allows NEA to take pre-emptive action in areas where an increase in mosquito activity is detected. NEA will continue to use ovitraps to help pre-empt localised outbreaks and prevent dengue cluster formation and growth.

Since the beginning of 2007, NEA has taken enforcement actions - these include fines, stop work orders for construction sites, and orders to take measures to prevent mosquito breeding - against 355 construction sites, 1,156 domestic premises and 713 non-domestic premises, eg, factories and shophouses, for mosquito breeding offences. NEA will continue to take strict enforcement action against parties responsible for mosquito breeding offences.

Column: 1028

Sir, I would like to stress that our fight against dengue must be underpinned by collective efforts and commitment of all in our community. While NEA and other Government agencies continue to keep mosquito breeding in public areas in check, homeowners must play their part to rid their homes of stagnant water on a daily basis by doing the 10-minute Mozzie Wipe-out. I would like to urge our Town Councils, land agencies and homeowners to be vigilant in the fight against dengue.

Dr Lily Neo: First, I would like to commend NEA for all the comprehensive measures taken so far against dengue. May I ask the Minister whether he is concerned over the emergence of new uniquely Singapore strains of dengue over the years, which means that more people may be susceptible to the new strains of dengue? Does he expect this to be a recurring yearly phenomenon? Is it true that it may be the result of our past eradication method? Does he need to do more studies to ascertain this fact in order to better fight dengue?

Assoc. Prof. Dr Yaacob Ibrahim: Sir, I am not sure whether it is uniquely Singapore but, certainly, as Dr Neo will understand as a doctor, the strains will appear periodically, depending on basically the immunity within the community. We are now beginning to see a switch-over from Dengue-1 to Dengue-2, something we have not seen for the last five years. That means there will be a certain proportion of our population who have not developed immunity against Dengue-2.

Is this a yearly phenomenon? It is difficult to tell, but based on the data that we have, there seems to be a six to seven-year cycle in terms of the peak. We are about at that point in time where there is a surge upwards. Sir, this region is also endemic with dengue. And so we are in a dengue-endemic region and therefore we will see these surges occurring ever so often. We are now

Column: 1029

trying to study the phenomenon even better. The research arm of NEA, ie, EHI, is conducting several research projects, some of which are too complicated for me to explain. But the point is that we want to understand the phenomenon better and to be able to develop tools that can allow us to pre-empt any increase in mosquito activity. Ultimately, our responsibility is to remove breeding habitats as quickly as possible.

We work very closely with MOH to look at the possibility of developing vaccines. Hon. Members must have read that in the newspapers. Several agencies are coming together.

Sir, we will continue to do our part to support other agencies. But on the part of NEA, we will try and develop more tools to allow us to pre-empt so that we can do a better job. As I mentioned in my reply, it is still homeowners. Indoor breeding is still on the rise. I thank all the Advisors who have gone every weekend, including Dr Ahmad Magad, to deal with the cases in Pasir Ris. But I think we need to do a lot more to get our homeowners to switch and take on this 10-minute Mozzie Wipe-out as a daily habit.

There is a perception that sometimes it is not fatal. So, if I get dengue, I go to the hospital, seven days and I am out. That is not true. So we have to tell Singaporeans that this disease is very dangerous. It can be fatal. It has proven to be fatal. So we have to remind Singaporeans that they have a role to play.

Sir, as I have mentioned, in all my replies in public, I can check all the outdoors, I can fine all the Government agencies, but I cannot go into your house unless there is a complaint. But you must do your part. If not, I would have to come down harder.

Column: 1030

Mdm Ho Geok Choo: Sir, the Minister has given a very comprehensive listing of programmes that they are doing with regard to addressing dengue fever. I do not know whether in the Minister's programme he has also alerted the Town Councils on the need to comb through the parks and the landscape, because some of the varieties of plants and bushes that we have in our parks are actually collecting water. Despite the ovitraps, etc, I think these other areas we should also not neglect. I do not know whether it is the Minister's programme. If not, I would really appreciate it if we could have a more regular and vigilant inspection of the types of varieties of plants that we have in our parks and gardens. If need be, whether we have to actually remove and replant them.

I would appreciate it if the Minister could address that.

Assoc. Prof. Dr Yaacob Ibrahim: Sir, the short answer is, yes, we work very closely with the Town Councils. As I mentioned in my reply, NParks is also looking into the trees that they have, where there is a hole in between, they will seal it up. Town Councils are responsible for all the common areas. They know that they have to do their job because, if they do not, we will also have to fine them. But having said that, I must thank all the Town Councils for the cooperation that they have given to NEA.