Precious Water

Precious Water
Water, essence of life

Friday, 5 October 2012

A new migrant may well appear

Some years ago, while working in a hospital, I was informed by a nursing staff that a Ms Juliana asked to see me in the ward. Visiting patients (friends and relatives) comes with the turf. When I walked into the 4 bedder ward, I saw a familiar face, a lady with long hair in bed.

She looked gaunt with exhaustion, a face turned ashen. From her livid lips, she appeared next to death’s door. I was shocked. She whispered and said she was down with dengue fever. There is no medicine for dengue and while most victims recover, some do succumb to dengue haemorrhagic fever which can be fatal. Fortunately, she recovered although it took months to get back to her usual self.

Dengue fever is an illness caused by infection with a virus transmitted by the Aedes mosquito. There are four types of this virus (serotypes 1 to 4) which can infect you.
Dengue fever and dengue haemorrhagic fever (a more severe form) are the most common mosquito-borne viral diseases in the world. In Singapore, dengue fever has been endemic since the 1960s.

In 2005/06, my daughter visited Kerala, India twice as part of school community involvement programme. Back then, I first learn of chikungunya virus, also carried by mosquitoes. The symptoms are similar to dengue although in some serious cases, complication of encephalitis (swelling, inflammation of the brain) sets in, a dangerous situation. Chikungunya is fairly common in parts of India. As parents, you can imagine our anxiety.

The first outbreak of chikungunya in Asia occurred in Bangkok, Thailand, in 1958. Since then, outbreaks have been reported in Cambodia, Vietnam, Laos, Myanmar, Malaysia, the Philippines, and Indonesia. In 2007, 10 imported cases were reported to Singapore’s Ministry of Health.

On January 14, 2008, a local case of chikungunya infection was detected through the general practitioners’ laboratory-based surveillance system. A total of 2,626 people who resided or worked within a 150-m radius of the index case-patient’s address were screened for chikungunya infection. The consequences of chikungunya are equally dreadful as is dengue.

Last month, the US experience the highest resurgence of West Nile disease, another virus passed on to humans from mosquitoes.

Originally from Africa, West Nile virus first appeared in Queens, New York in 1999. Crows were dying in large numbers. It took weeks before officials found out the culprit.  This virus lives in birds. Mosquitoes biting infected birds are themselves infected. This virus is then passed on to humans when these pesky mosquitoes draw blood.

As of September 4, 2012, 48 states have reported West Nile virus infections in people, birds, or mosquitoes. A total of 1,993 cases of West Nile virus disease in people, including 87 deaths, have been reported to CDC. That’s a high mortality rate of 4.3%, much higher than dengue or chikungunya.

Like dengue fever or chikungunya, there is also no drug or vaccine to counter West Nile virus. The best we can do is to prevent mosquitoes from infecting us in the first place; never mind what kind of mosquitoes. This calls for vigilance especially in minimising breeding sites, be it in flower pots, pails and all vessels containing stagnant water. For the privileged few living on landed properties, your roof gulleys are the usual culprits for mosquito breeding.

In the case of the West Nile, the key culprits were infected birds in the first place. It begs the question whether West Nile will eventually find its way to Singapore. After all, we are a natural refueling stop-over for many migratory birds. Furthermore, we are a city state with a history of imported chikungunya and deadly SARS before.  Who knows? An unwanted migrant may well surface.

Meanwhile, it is the stupid culex mosquito that is keeping me awake; better known as the common house mosquito. While not considered as much of a threat to our health as the Aedes mosquitoes, it is still an irritant we can do without.  

Side Notes:
No thanks to the Indons, the current haze makes it impossible to sleep without air-con. So while it is mosquito-free nights on air-con, their haze creates another set of hazards; respiratory associated problems. So now I am tearing from the haze and high electricity bill.

By Larry Greenemeier | October 1, 2012 |  Comments1

The emergence of international air travel in the 20th century enabled an unprecedented spread of ideas, cultures and communication. Unfortunately, modern aviation has also proved an effective means of spreading diseases. Air travel didn’t introduce worldwide pandemics, of course, but with tens of millions of scheduled international flights annually and hundreds of millions of passengers en route from high-risk areas, health officials are often hard pressed to pinpoint the source and cause of an international outbreak……

The first step when using the VBD-AIR tool is to input the name of the airport to be investigated, the month in question and the disease to be tracked—current choices are all mosquito-borne and include denguemalariayellow fever and chikungunya. …….

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