Update On Chikungunya Fever Situation(1)

25 Aug 2008

A new cluster detected at Lim Chu Kang

MOH has identified a new cluster of chikungunya fever at Lim Chu Kang.  The index cases were a 25-year-old Bangladeshi and a 41-year-old local working in the vicinity of the Lim Chu Kang Agro Technology Park located at Lim Chu Kang Lane 2.  30 workers were screened as part of active case detection in the area on 22 Aug 08 and three more workers (a 23-year-old Malaysian, a 21-year-old Chinese national and a 31-year- old Myanmar national) were found to be positive for chikungunya virus. The total number of cases linked to Lim Chu Kang stands at five. Investigations are continuing.

Officers from the National Environment Agency (NEA) have conducted intensive mosquito control operations at Lim Chu Kang Lane 2. As many as 20 officers have been deployed to conduct search and destroy operations in the area.  So far, 4 farms have been inspected and mosquito breedings have been detected in all the 4 premises. The NEA will proceed with enforcement action against the owners/occupiers of the premises. ULV fogging operations have also been conducted within the workers’ quarters.

Update on existing clusters

Pasir Panjang Wholesale Centre: One more case has been identified in a 52-year-old businessman who works in Pasir Panjang Wholesale Centre(PPWC). He developed symptoms on 18 Aug 08 and sought outpatient treatment that same day. He has no recent history of travel overseas prior to the onset of his illness. This brings the total number of cases to five.

NEA  has  extended its intensive mosquito control operations at the Pasir Panjang Wholesale Centre to the adjacent car mart as well at PSA Vista. As many as 20 NEA officers have been deployed in the area to keep mosquito breeding in check.  So far 8 mosquito breedings were found and destroyed. Enforcement action has been taken against premises owners found breeding mosquitoes. Fogging was also carried out within the wholesale centre as a precautionary measure.

Kranji Way: Two more cases of chikungunya fever were linked to the Kranji Way cluster. The first case is a 37-year-old Malaysian who works and stays at a temporary worksite along Kranji Way. He developed symptoms on 15 Aug 08 and sought outpatient treatment by a GP on the same day. He was subsequently admitted to TTSH on 21 Aug 08.  The second case is a 30-year-old Bangladeshi construction worker who works and stays at Kranji Loop. He developed symptoms on 17 Aug 08, sought outpatient treatment on 19 Aug 08 and was admitted to TTSH on 21 Aug 08.  Both of them have no recent history of travel overseas prior to their onset of illness. This brings the total number of cases to 35.

Mosquito breedings have been found and destroyed in 47 factory premises  so far. Up to 70 NEA officers have been deployed in the area to keep mosquito breeding in check.  As an added preventive measure, NEA has also extended its operations to areas beyond  Kranji Way, to include Kranji Loop, Kranji Rd and Kranji Link. Enforcement action has been taken. NEA has also served orders on owners/occupiers to ensure that they take the necessary measures to keep their premises free of mosquito breedings. Under the law, non-compliance with such orders can result in a maximum fine of $50,000.

Sungei Kadut: Three more cases of chikungunya fever linked to the Sungei Kadut cluster have been notified to MOH. The first case is a 30-year-old Chinese national who works and stays at Sungei Kadut St 1. The second case is a 34-year-old Bangladeshi who works and stays also at Sungei Kadut St 1. The third case is a 24-year-old Nigerian who works at Sungei Kadut St 3. This brings the total number of cases to eight.

Up to 25 NEA officers have been deployed to keep mosquito breeding in check. Operations have also been extended to the homes of cases and the surrounding neighbourhood, other than the workplace.  Thus far, mosquito breedings found in 27 factory premises have been destroyed. Enforcement action has been taken and orders served.

Additional local cases

Two additional single and sporadic cases have been notified to MOH. The first is a 61-year-old housewife who stays at Yishun St 72.  She developed symptoms on 9 Aug 08 and was admitted to hospital on 10 Aug 08. The second new case is a 47-year-old automation engineer working at Tuas Link 1. He developed symptoms on 20 Aug 08 and was admitted to hospital on 21 Aug 08. Both had no recent travel history outside Singapore.

NEA has been carrying out vector control operations in and around the cases’ residential premises, including their work places and places that they normally frequent. All premise owners are urged to check their premises daily to remove any stagnant water that may breed mosquitoes.

Overall situation

To date, a total of 150 cases of chikungunya fever have been notified to MOH in 2008. Of these, 70 were imported cases with history of travel to Johor (56 cases) and other states of Malaysia (six cases), Indonesia (four cases), Sri Lanka (two cases), and India (two cases). The rest were locally acquired infections which probably occurred at 18 separate locations. The local cases comprised 35 from Kranji Way, 13 from the Little India, eight from Sungei Kadut, five from Pasir Panjang Wholesale Centre, five from Lim Chu Kang, two from Teachers Housing Estate cluster, one from Farrer Road, one from Herford Road, one from Jalan Berjaya, one from Hougang St 22, one from Jalan Jelita, one from Miltonia Close, one from Queen Street, one from Segar Rd, one from Woodland St 81, one from Yishun Ave 6, one from Yishun St 72 and one from Tuas Link.

Ministry’s Advice to the Public

The Ministry advises persons who develop symptoms of chikungunya which include fever, joint pain and rashes to consult their doctors immediately.

Chikungunya fever, like dengue fever, is a mosquito-borne disease and the best way to prevent chikungunya fever is to take precautionary measures to prevent the breeding of mosquitoes. Persons infected with chikungunya fever should be isolated from further mosquitoes bites so as to reduce the risk of further transmission of the virus.

Chikungunya outbreaks continue to be reported in our region, including Johor. Therefore, the risk of imported cases leading to local transmission remains high.

Persons travelling to places with chikungunya fever are thus advised to take precautionary measures to protect themselves from mosquitoes and seek prompt medical treatment upon their return if they become unwell and develop fever.

Ministry of Health

National Environment Agency

25 August 2008