Publication Date : 09-04-2013
Some Singaporeans may wonder why dengue fever is a recurring public health problem in a clean urban environment of stringent community health monitoring. Far from being eradicated after decades of vector control programmes and public education, the mosquito-borne disease is headed for another cyclical peak during the coming dry period. Ominously, the Communicable Disease Centre's veteran virologist Leo Yee Sin has warned of a "big-time epidemic" looming.
The World Health Organisation's recommendations - larval destruction at source and community involvement in control measures - have been standard procedures here. The National Environment Agency (NEA) reports impressive figures of homes visited and fewer places found with larval breeding. So why is Singapore fighting a rear-guard action against the Aedes mosquito?
The last recorded peak in 2005 had 14,200 cases, with 25 deaths. As the new projected peak could be higher, based on previous experience of large numbers of suspected unreported infections, it is possible the more virulent haemorrhagic form of the fever could also see a spike. There are serious implications for children, who are less able to cope.
The NEA's monitoring of disease clusters and areas vulnerable to viral transmission gives a clue about possible deficiencies. Most of these are not heavily wooded locations where source destruction is harder to carry out, but are built-up areas - Tampines, Toa Payoh, Bedok, Geylang, Hougang, Jurong, Serangoon, Yishun and some city locations like Claymore and River Valley Road.
It suggests the chain of larval growth starting in housing estates and other built-up areas is common. Apartment dwellers have simple steps to follow to stop mosquitoes from breeding, while those who live in houses are supposed to check roof gutters and drains. A serious situation warrants a no-nonsense approach as failure to comply endangers a whole precinct. If replicated elsewhere, whole communities are placed at risk.
Hence, strict law enforcement is critical, but this alone will not be sufficient if public complacency is found partly to blame. As indifference towards stagnant water found in households and commercial places poses a grave risk, community outreach to spread the message could also extend to town councils and members of residents' committees.
It may be useful to empower a wider group of trained people to inspect premises if NEA officers are swamped in an emergency. There is long-standing coordination in vector control measures among national agencies in charge of housing, parks, water resources, land transport and public health. A grassroots movement that engages residents in protecting their well-being directly would strengthen the bulwark.
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