The Serious Business Of Dengue Prevention

Dengue 2016 Launch
Minister Masagos Zulkifli and others help hold up the banner showing the 5-step Mozzie Wipeout

It’s been a few years since I’ve been involved with the dengue prevention campaign, and you would think with a couple of years, the disease would have been controlled, or even eradicated.

Unfortunately, dengue fever is still prevalent. In fact, the number of dengue cases in Singapore is expected to hit 30,000 this year – higher than the record in 2013 when 22,170 cases were reported. And it’s come with a couple of challenges:

  • The Zika virus now making news around the world and akin to dengue fever, Zika is also carried and transmitted by the Aedes mosquito;
  • Campaign fatigue among people who are so accustomed to hearing about dengue this and that, that they become blasé about what needs to be done to prevent the disease from causing harm to them and our community.

But here’s the thing about dengue – prevention is, quite practically, in our hands. Essentially, the best way to prevent dengue is to prevent the breeding of its carrier, the Aedes mosquitoes, through the 5-Step Mozzie Wipeout, which can be incorporated into our daily household routine. The steps entail removing stagnant water in our homes, which are ideal breeding grounds for mosquitoes, to break the Aedes mosquito’s breeding cycle. By doing that, we can stop dengue transmissions through the bite of these pesky insects.

This year’s dengue campaign launch repeated previous campaigns’ exhortation to do the Mozzie Wipeout, but this time to consciously do it for 14 days – to effectively break the breeding cycle of the Aedes mosquito. To take effective control of the dengue situation, a penalty for households found to be breeding mosquitoes was also announced.

A few things of interest about the Aedes mosquitoes and dengue:

  • Only the female Aedes mosquito bites (because it needs the protein in our blood to develop its eggs).
  • The mosquito becomes infective about 7 days after it has bitten a person carrying the virus.
  • The mosquito is more prone to biting at dawn and dusk.
  • The average lifespan of an Aedes mosquito is two weeks, and during this time, it can lay eggs about three times.
  • Eggs can remain dormant in dry conditions for up to 9 months, after which they can still hatch if exposed to favourable conditions, i.e. water and food.

With that in mind, I’m going around the house to check for and remove potential breeding spots – like on our BBQ canvas sheet cover at the balcony, potted plant bases, our (not used often enough) bicycles, which may have tiny nooks where leftover rainwater may accumulate.

The other thing I’m concerned with is that many of us delegate our household chores to our hired help, and dengue prevention tasks like the 5-Step Mozzie Wipeout may be one of the chores that can be overlooked at times. I’m quite keen to make sure that this is done myself even if we have help at home.

For us, dengue prevention is a serious business, as I’ve reminded everyone over the years, our now 7-year-old son had to have two blood transfusions at 8 weeks old due to dengue fever. So he’s going to go around our apartment and do the Mozzie Wipeout with me regularly as well.

It’s no joke – there have been more than 5,900 reported cases of dengue since the beginning of the year. So get on it now, and make the Mozzie Wipeout part of your household routine.

Local Mosquitoes To Be Made Infertile

Dengue fighter gets up to speed. #mozziewipeout

A photo posted by Benjamin "Mr Miyagi" Lee (@miyagisan) on

Since May 2014, the NEA has been studying the feasibility of introducing Wolbachia-carrying male Aedes mosquitoes to help suppress the Aedes mosquito population in Singapore. Apparently, when these males mate with the female Aedes mosquitoes, their eggs do not hatch.

Here’s hoping that it all works, and we’re able to make these mozzies lose their mojo. In the meantime, community efforts in eradicating mosquito breeding habitats remain key to preventing dengue.

At the launch of this year’s “Do The Mozzie Wipeout Campaign”, I learnt of the outreach programme targeted at secondary school students in the South West district. Through the initiative, students are equipped with essential information on preventing the vector borne illness at home and at school, They are also tasked to spread the word about dengue prevention to residents living around their schools.

These roving ambassadors are called “Dengue Mobsters”, but don’t be afraid of them when they come knocking on your doors, because they’re not there to mob you – they’re just there to let you know how to prevent the spread of dengue, and give you a to-do list so you can also be a dengue fighter.

School Operations Managers will also have to attend forums to get them up to speed on procedures in the event of dengue outbreaks, as well as preventive measures for school premises.

At the South West of the country, workshops that began in 2013 will also continue to educate residents on maintaining mosquito-free gardens. By the end of May this year, “Garden Sheriffs” will also be trained, appointed, and armed with as much information as possible to stop the breeding of the dreaded Aedes mosquito.

I appreciate how difficult it is to maintain awareness of how dangerous dengue is, especially when the number of reported infections has fallen by 39% since last year. You can have dengue fighter kits packed with things like caps (2014), neck pillows (2015) and other paraphernalia – but it is difficult when people hear the same thing over and over again.

At last week’s launch, Minister Grace Fu and the Mayor of South West CDC were tirelessly going around Bukit Gombak Neighbourhood Centre, meeting people, and handing out these bags and explaining what was in them, including “Aunty, this one cannot eat one ok? It is granular insecticide”.

But please spare a moment to listen or read about preventive measures because there may be something you’ve missed out the last time. Or at least, think about how you can help with the outreach programme. For me, I think we should have forums for domestic helpers at these launches, seeing as how many of us delegate our housekeeping to this essential group of people.

It is also important to know that by far, most of the reported dengue breeding grounds have been in residences, and not construction sites and dormitories, and between February and March of this year alone, breeding habitats found in homes increased by 80%.

So please, for the sake of your families, do the mozzie wipeout, and stay vigilant.

Goodie Bags For To Fight Dengue With!
Goodie Bags For To Fight Dengue With!

Uncle gives up and takes a picture of a picture of mosquitoes instead. #mozziewipeout

A photo posted by Benjamin "Mr Miyagi" Lee (@miyagisan) on

Please Take Dengue Seriously

Read this first, then come back to this post.

Yes, you can die from dengue. But mostly, people don’t exhibit serious symptoms, and are often not ill enough to be hospitalized.

It’s been the same with this outbreak, and I’ve found that as a result, people are being a bit blase about the current epidemic despite the media blitz by the NEA.

Some people wait till they get a rash before going to the doctor. Here’s news for you: If you have dengue, and a rash appears, your platelets are likely to be crashing and you might need a blood transfusion.

Our experience with Kai at 8 weeks old shows how you can never be too careful. He didn’t have a fever, didn’t cry more than usual, and the only reason we took him to the pediatrician was because our confinement nanny said she hadn’t seen anything like the freckles he was sporting.

I remember being frustrated at the NEA for not being able to inspect the vacant apartments in our block because the owners had been uncontactable. That is apparently being changed, and officers are now able to break into homes to search for and destroy mosquito breeding grounds.

After Kai had dengue, I had immediately contacted the NEA to ask them to inspect our condo and our neighbours – with one particularly suspicious house turning up empty even though they had a disused swimming pool which was looking all green and slimy.

The officers had responded by inspecting our apartment regularly. I was indignant at first, until I was told that many complainants to the NEA were actually inadvertently breeding mosquitoes themselves – my mother included. She had complained about the excessive numbers of mosquitoes in her garden, and the NEA came and found aedes larvae in her flowerpots.

Even something as innocuous as a plastic tarp covering a motorcycle collects enough rainwater to breed mosquitoes – and a person has in fact been fined for doing so.

There have been over 6,000 cases of people contracting dengue this year so far. If it goes on at this rate, don’t be surprised if there are fatalities. The thing is, we can prevent this from happening by pitching in to get rid of mosquito breeding grounds.

So please, just do the five step mozzie wipeout check in your home. If not daily, then weekly.

Just 5 easy steps could save your life.
Just 5 easy steps could save your life.

Everyone Is Responsible For Fighting Dengue

Not the kind of boom you want

This year’s dengue outbreak is scary. So far this year, there’ve been 4,756 (1 Jan – 19 Apr) cases, and it looks like it might increase some more.

I’ve previously tweeted and posted on Facebook about this, and the reflex response from readers have been the same: “too much construction lah, it’s all in the construction sites”.

The NEA has reported that the majority of sites found to have bred mosquitoes have been homes. Now I’m not saying that the construction sites are not responsible at all, but the fact remains that no matter how much you want to blame someone else or some other site for the spread of this disease, the solution to breaking the vector cycle of is still firmly in your own hands.

Dengue is not an airborne transmitted disease – it is spread by the Aedes mosquito, which gets the virus from an infected person it stings. So the way to stopping the spread of the disease is to eradicate the breeding of the mosquito – which you will probably know, occurs in stagnant water.

The NEA has a dengue website at www.dengue.gov.sg with statistics and information pertaining to the disease. We’ve all seen in the papers news about the huge “cluster” of dengue in the one block in Tampines, and the dengue website has a map of “hotspots” as well.

This is both helpful and unhelpful, because while you are aware enough to avoid going to these hotspots for instance, you might downplay the fact that regardless of hotspots and clusters, people (the other vector) are mobile. They could get bitten, come back home to Toa Payoh, get bitten by another Aedes mosquito, and voila, another cluster and hotspot is created.

This outbreak has been so serious that the NEA has also implemented a Dengue Community Alert System, which displays three colour codes depending on the dengue situation, and the corresponding actions to take.

I hope you get the picture, and I appeal to everyone to “Do The Mozzie Wipeout”, a 5-step exercise to perform every day:

1. Change water in vases (on alternate days, if not daily)

2. Turn over all water storage containers so they don’t collect rainwater

3. Remove water from flower pot plates (on alternate days, if not daily)

4. Clear drainpipe blockages

5. Cover bamboo pole holders

The national anti-dengue campaign will be launched tomorrow (8am, 28 April) at Senja-Cashew Community Club, 101 Bukit Panjang Road. Do come if you can.

The NEA has also launched a new Facebook Page and they encourage people to follow @NEAsg on Twitter for dengue updates.

Again, I appeal to you to take action and not simply blame it on the construction sites. Naomi and I had a very serious close shave with Kai’s bout of dengue – and I will recount that ordeal in another blog post.

One mosquito bite

IMG_8089Last Wednesday night Naomi and Jessie the Confinement Nanny were wondering why Kai had started sporting a few freckles and moles on his face and body. We had no idea what was to follow.

Thursday morning saw a few more spots on his face, some reddish, some brown, and there was a bruise on his leg. A diaper soiled by weird coloured poop confirmed a trip to the doctor’s, where we were told to walk across the road from Paragon and get Kai warded immediately because it was suspected that his platelets were low, and that those spots weren’t moles or freckles, but bleeding under the skin. A check of his mouth showed more red spots on his upper palate.

We were terrified, but probably not as frightened as Kai was as he was taken to the treatment room for an intravenous plug to be inserted in his wrist, and several blood samples taken from him before he was handed back to us in our room, bruised and all cried out.

About an hour later, the results came back, and we were strangely relieved he had tested positive for dengue.

The doctor explained that his platelets were around 10,000 units per litre (a healthy level is 150,000 – 400,000 units) and that a transfusion was needed.

It turned out to be two transfusions before his platelet levels climbed out of the danger zone, and he stopped being bruised everywhere we held him. Even the blood pressure machine cuffs bruised him on the first two days. Apparently, spontaneous bleeding occurs when platelets fall below 30,000.

I had never heard of an 8 week old baby getting dengue, and as far as we could tell, neither had the nursing staff at the hospital, who kept telling us that Kai was being kept warded because of the availability of resources such as transfusions and medicines. We knew that it was also because dengue had the ability to turn things awry very very quickly. And that’s for adults.

But. thankfully, by Sunday, things stabilised enough for Naomi and I to take a walk out of the hospital and have dinner while Jessie took over the watch for a couple of hours. But probably the most relaxing meal outside the hospital was the one we had at home on Monday night when we were all home again after Kai’s platelet count had hit 78,000 in the morning.

The scary thing was that Kai didn’t have a fever throughout the episode, and we were really lucky to have gone in to the doctor’s on Thursday instead of doing the usual and practical wait and see.

The NEA response to my request that the entire Singapore be fumigated was measured and calm, and I was told that our block was fogged last Saturday, and that ‘measures are being taken with the management committee to try to make owners of vacant units open their premises for inspection’.

Then again, it wasn’t as if our apartment complex was swarming with mozzies in the first place. We hardly get any bugs in our flat. And as far as we know, Kai sported only the one mosquito bite on Monday night.

That’s all it takes.

IMG_7793
First signs: spots and a cut (from fingernail) that took a long time to clot

IMG_7993
The intravenous plug – must’ve hurt

IMG_7913
Not happy

IMG_7924
Where they take blood samples from – we think Kai’s traumatised by it now because he gets really uneasy when you take his socks off

IMG_8018
Sunday, and it’s finally out

IMG_8023
The nurse puts the plaster on

IMG_8038
That’s more like it. The smiles return