But should we worry about the current dengue outbreak? NUS Saw Swee Hock School of Public Health’s Alex R Cook gives some perspective to the outbreak.
SINGAPORE: To understand the current dengue outbreak, it is useful to think back to the situation in the years following independence.
The proportion of houses in which active breeding can be found is around 1 or 2 per cent. To feel the effect this has had, you need only compare how many bites you get in other regional capitals to how many at home. Today, the limiting factor preventing runaway transmission is the availability of mosquitoes, not the availability of susceptible people, leaving us at a higher risk of an outbreak sparking off, like it has recently.The age profile of cases has also shifted away from children, towards adults and, increasingly, older adults, who may be at a greater risk of complications or death.
But that same study also found that recorded cases used to be just one in 14 infections, so past outbreaks were much bigger than they looked. What this means is that although it looks like the dengue iceberg is getting bigger, actually all that has changed is that more lies above the surface, in plain sight.Since Singapore’s early successes, dengue has become ever harder to control, precisely because the effect of those early successes was to lower immunity.
Until a new vaccine becomes available that can be taken by those who have never been infected by dengue before, we can but maintain and enhance our vector control.Promising results have emerged from NEA’s pilots of Wolbachia biocontrol in Braddell, Nee Soon and Tampines. By releasing male mosquitoes — males are vegetarian and don’t bite — which have been treated with the naturally-occurring bacterium Wolbachia, the offspring of their partnerships with wild females do not hatch.
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