First Case of Zika Virus Infection in Singapore

1.           The Ministry of Health (MOH) and National Environment Agency (NEA) were informed on 13 May 2016 of the first imported case of Zika virus infection in Singapore. The patient is a 48-year-old male Singapore Permanent Resident who had travelled to Sao Paulo, Brazil from 27 March to 7 May 2016. The patient developed fever and rash from 10 May and was admitted to Mount Elizabeth Novena Hospital on 12 May 2016 and isolated.

2.            The patient was tested positive for Zika virus infection on 13 May. He will be transferred to the Communicable Diseases Centre at Tan Tock Seng Hospital for treatment and isolation to minimise the chances of being bitten by mosquitoes and spreading the infection in the community. The patient is currently well and recovering. He will only be discharged upon being tested negative for the Zika virus.

3.            MOH is screening the patient’s household members. They have been advised to monitor their health and seek medical treatment if unwell. MOH and NEA will also actively alert residents in the vicinity to seek medical attention should they develop symptoms of fever and rash.

Vector Control

4.            The patient’s residence at Watten Estate is not an active dengue cluster. NEA has intensified vector control operations to control the Aedes mosquito population in the areas around the case’s residence. NEA has redeployed additional officers from other areas to conduct the stepped up operations. NEA has also commenced outreach efforts and distributed Zika information leaflets and insect repellents to residents living in the area. NEA’s intensified vector control operations include:

• Inspecting all premises, ground and congregation areas upon case notification;

• Conducting mandatory treatment such as ultra-low volume (ULV) misting of premises and thermal fogging of outdoor areas to kill adult mosquitoes;

• Increasing frequency of drains flushing and oiling to prevent breeding; and

• Public education outreach and distribution of insect repellents

5.            As the majority of people infected with the virus do not show symptoms, it is possible that some transmission may already have taken place before the first confirmed case of Zika was notified. Hence, even as NEA conducts operations to contain the transmission of the Zika virus, residents are urged to cooperate fully with NEA and allow its officers to inspect their premises for mosquito breeding and to spray insecticide to kill any mosquitoes. NEA may need to gain entry into inaccessible premises by force after serving of requisite Notices, to ensure any breeding habitats are destroyed quickly.  

6.            To minimise the risk of any spread of Zika in Singapore, it is critical that all of us as a community take immediate steps to prevent mosquito breeding in our homes by doing the 5-step Mozzie Wipeout every alternate day, and protect ourselves from mosquito bites by applying insect repellent regularly. 

Health Advisory

7.            We advise residents of Watten Estate, Casa Perla, Hillcrest Arcadia, The Arcadia and Watten Hill Condominium to monitor their health. They should seek medical attention if unwell, especially if they develop symptoms such as fever and rash. They should also inform their doctors of the location of their residence.

8.            Travellers to countries with local transmission of the Zika virus should protect themselves from mosquito bites by wearing long, covered clothing, applying insect-repellent, and using wire-mesh screens or mosquito nets. (Please refer to the MOH website at www.moh.gov.sg/zika for a list of countries with Zika outbreaks and local transmissions.)

9.            Those who have returned to Singapore from affected areas should monitor their health for the next 14 days and consult a doctor if they have symptoms of Zika, such as fever, skin rashes, joint and muscle pains, headaches and red eyes. They should inform the doctor of the areas that they have travelled to. 

10.         While there is currently no evidence that women are more likely to get Zika virus infection, the consequences can be more serious if a pregnant woman is infected, as the Zika virus infection can cause microcephaly in the unborn foetus of pregnant women. As a precaution, pregnant women should consider postponing non-essential travel to countries with ongoing outbreaks. They should also reconsider their travel plans to areas that are not experiencing outbreaks but have reported local transmission of Zika virus. If they must travel to affected areas, they should undertake strict precautions against mosquito bites.

11.         Pregnant women with a travel history to affected areas who develop symptoms of Zika such as fever and rash should consult their doctors for testing for Zika infection. Those without these symptoms but who are concerned that they have been infected with the Zika virus should consult and follow the advice of their doctors regarding monitoring of the pregnancy.

12.          Male travellers returning from areas with ongoing outbreaks of Zika should adopt safe sexual practices (e.g. consistent and correct use of condoms during sex) or consider abstinence for at least four weeks after their return.  If they are sexual partners of pregnant women, they should adopt these precautions throughout the women’s pregnancy. This is consistent with the advice given by the World Health Organization.

13.         MOH will provide updates on any further developments and our latest public health risk assessments. Singaporeans should refer to MOH’s webpage on Zika (www.moh.gov.sg/zika) for the latest health advisory.

MINISTRY OF HEALTH AND NATIONAL ENVIRONMENT AGENCY

13 MAY 2016