MOH made Chikungunya a Notifiable Disease

With intensified efforts, Singapore's fight against dengue appears to have paid off, with 25 per cent fewer cases than last year. However, a newly emerged Aedes mosquito-borne illness is causing fresh concerns. Chikungunya cases continued their upward trend, with more than 40 cases a week in the past three weeks.

Last Friday, the Ministry of Health made Chikungunya a notifiable disease. Although doctors have already been informing the ministry of all cases since the end of 2006, when Singapore saw its first imported Chikungunya case, the change means that doctors could be penalised with fines or jail terms for not doing so.

The appearance of locally transmitted Chikungunya infections in Singapore this year also worries infectious diseases experts. Although no one has died of the infection, Chikungunya, unlike dengue, can be very debilitating. There is also the risk that it could become endemic, which means the disease would be here to stay, with no chance of wiping it out.

Until this year, the few cases were all imported. But by the middle of this month, 388 people had caught the virus locally. A further 158 people who were infected were bitten by mosquitoes while overseas, primarily in Malaysia. The areas where people here are getting bitten by the Aedes mosquito have also spread from the northern part of the island to places such as Bedok Reservoir and Tampines in the east.

A spokesman for the National Environment Agency (NEA) said the Aedes albopictus mosquito, which is the main carrier of this virus, lives in forests and other heavily vegetated areas. This makes it a challenge to remove as many breeding habitats as possible in such areas.

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What is Chikungunya?

SYMPTOMS:
Sudden high fever, headache, fatigue, nausea, vomiting, muscle pain, rash and joint pain. These are almost similar to symptoms for dengue, the other Aedes mosquito-borne viral disease, except the joint pains for chikungunya can be excruciating, last for months and, in some cases, for more than a year.

TREATMENT:
There is no vaccine against it or medicine that cures it. Treatment is only for symptoms such as fever or pain.

TRANSMISSION:
The culprit for dengue tends to be the Aedes aegypti while the Aedes albopictus is more likely to spread chikungunya. However, both types of mosquitoes can spread both diseases.

INCUBATION:
It usually takes three to seven days from the time a person is bitten by an infected mosquito for symptoms to appear. However, people can sometimes become sick just two days after being bitten, or as late as 12 days after.

SPREAD:
The disease is spread when a mosquito bites an infected person. The virus replicates in the mosquito and is passed on to people subsequently bitten.

PREVENTION:
The best way to stop the spread of the disease is to prevent mosquitoes from breeding. Those infected should wear long sleeves and long dresses or pants and use insect repellent to prevent getting bitten again by mosquitoes, which could continue the chain of transmission.