Communicable Diseases Surveillance in Singapore 2012

22 November 2013

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Preface

I am pleased to present the Ministry of Health’s “Communicable Diseases Surveillance in Singapore 2012” Annual Report.

2012 was an eventful year for both the global and local infectious disease situation. In September 2012, the World Health Organization reported the first human cases of severe pneumonia linked to a novel coronavirus (now termed the Middle East Respiratory Syndrome coronavirus [MERS-CoV]). As at 1st October 2013, there were 139 cases of MERS-CoV globally, who were directly or indirectly associated with travel to, or residence, in several countries in the Middle East. MOH worked closely with healthcare professionals and institutions as well as other key stakeholders to enhance our surveillance and preparedness for this emerging infection. MOH also advised the public, particularly travellers to the region, on precautionary measures to be taken. This evolving situation underscores the importance of continuous vigilance and preparedness for new and emerging infectious diseases.

Locally in 2012, we encountered outbreaks of Hand, Foot and Mouth disease (HFMD) and microsporidial keratoconjunctivitis, while diseases such as tuberculosis continued to pose a concern for public health.

There was an 80% increase in the number of reported Hand, Foot and Mouth Disease (HFMD) cases in Singapore, from 20,687 cases in 2011 to 37,125 cases in 2012. The predominant virus causing HFMD in 2012 was coxsackieviruses type A, in contrast to 2011, when the majority of HFMD cases were due to Enterovirus 71 (EV71). Unlike EV71 infections, coxsackievirus infections are not associated with severe and fatal outcomes. No local cases with severe complications due to HFMD were reported in 2012. In response to the HFMD outbreak, public education was enhanced and increased spot checks on preschool centres were carried out. In addition, the Ministry of Health (MOH) also implemented mandatory closure of pre-schools with significant numbers of HFMD cases and prolonged transmission of the disease.

In May 2012, MOH investigated an outbreak of microsporidial keratoconjunctivitis affecting 53 participants in an international youth rugby tournament held in Singapore in April 2012. Our investigation revealed that a number of factors contributed to the outbreak, such as the extreme wet weather and muddy condition of the fields during the tournament, the type of rugby played and the limited washing facilities at the venue. To minimise the risk of microsporidial eye infections, MOH issued a press release and a health advisory to schools, sports associations, clubs and operators of sports fields.

The incidence of tuberculosis (TB) among Singapore Citizens and Permanent Residents in 2012 remained stable at 40.9 cases per 100,000 population. However, the number of TB cases among non-residents continued to rise in tandem with a rise in the number of immigrants. Key challenges for TB control include the need to curb on-going community transmission, which is often contributed by delayed diagnosis of infectious TB cases, and to ensure that patients are fully compliant with treatment till cure. The Ministry of Health completed its review of the Singapore TB Elimination Programme (STEP) in 2012. Measures to strengthen case detection and treatment will be rolled out progressively to enhance STEP in meeting the challenges ahead for TB control.

This report was published from the compilation of epidemiological information on communicable diseases collated through our close working relationship with the community of health professionals and our partner agencies. We thank all healthcare professionals and our partner agencies for their unwavering support and dedication in combating and minimising the threats of communicable diseases, so as to safeguard public health.

I hope that you will find this report useful. I look forward to your continued support and cooperation in the national surveillance of communicable diseases.

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Foreword [PDF, 545 KB]

Population Profile [PDF, 146 KB]

Overview of Communicable Diseases Situation [PDF, 153 KB]

Special Feature: [PDF, 763 KB]

International Outbreak of Microsporidial Keratoconjunctivitis following a Rugby Tournament in Singapore
Hand, Foot and Mouth Disease Outbreak in Singapore

1. Air-/Droplet-Borne Diseases [PDF, 2.08 MB]
Air-/Droplet-Borne Diseases [XLS, 77 KB]