Friday, September 26, 2014

Dengue outbreak at Chestnut Avenue… due to construction site?

September 26
By Ruhong, SG Outbreak
Dengue cases are going up again, with 402 last week. The total number of dengue cases this year had crossed the 15,000 mark on 20 September.
Three people have died of dengue since the start of this year, with the latest being an 81-year old woman who lived at Serangoon North Avenue 1 on 13 September. In 2013, there were 22,000 dengue cases and seven died.
bukit panjang dengue cluster
The largest dengue cluster is currently located at Bukit Panjang.
The cluster was formed around 15 August with two cases at Chestnut Avenue. Then, the number of cases increased to 36 (2 September) and the latest count is 72 (24 September). All these based on the data collected from NEA’s website.
The 2014 satellite imagery from Google Earth shows that there is a construction site at Chestnut Avenue.
The total number of cases in the Bukit Panjang cluster is 120. Besides the 72 cases at Chestnut Avenue, the rest are reported in the HDB residential area at Petir Road. The block nearest to Chestnut Avenue, Block 201 Petir Road, is the second highest in the cluster at 16 cases.
Dengue is also reported in nearby Almond Avenue, forming a new cluster with four cases around 19 September.
This year, NEA had issued 49 Stop Work Orders, and 13 contractors have been prosecuted in Court for repeat offences.
How many of those 72 dengue cases at Chestnut Avenue were construction workers? Did NEA detect any mosquito breeding at the construction site? If yes, has NEA taken any enforcement action against the contractor?

Tuesday, April 29, 2014

This Bill Gates Infographic Reveals The World’s Deadliest Animal — And It’s Not Even Close

This Bill Gates Infographic Reveals The World’s Deadliest Animal — And It’s Not Even Close

Bill Gates posted the graphic below to his blog on April 25.
It shows how many people are killed by different species of animal every year. The big red block at the bottom might surprise you:
“The number of mosquito-caused deaths really is a mind-blowing thing. Other than humans killing humans during periods of war, most years, the mosquito wins,” the Mosquito Week trailer says.
The reason?
Mosquitoes carry terrible diseases, including: Malaria (which kills more than 600,000 people every year), dengue fever virus, Rift Valley fever virus, yellow fever, chikungunya virus, West Nile virus, Lymphatic filariasis, and Japanese encephalitis.
These mosquito-borne infections don’t just kill — they debilitate millions of people. Sometimes these people can’t work and can’t support themselves. Billions of dollars in productivity is lost in places where these debilitating infections run rampant — fueled by mosquitoes.
The deadliest of all is malaria, a parasitic infection that mosquitoes inject directly into our bloodstream when they bite. The parasites then travel to the victim’s liver, where they multiply and reproduce. Their babies travel the bloodstream, destroying the red blood cells.
Usually the infection doesn’t kill, but it’s so abundant in so much of the equatorial world that more than 200 million people are infected every year, and more than 700,000 die from the disease.
Here’s the areas of the world where Malaria is the worst, from the CDC:
malaria map cdc
The site is doing a whole series of posts for “Mosquito Week,” including a post about “What It Feels Like To Have Malaria.

Friday, April 27, 2012

#endmalaria: Twitter, Times Square Billboard Call for an End to Malaria

Twitter, Times Square Billboard Call for an End to Malaria

In honor of World Malaria Day, April 25, advocates for the end of the disease are campaigning on the social web with the hashtag #endmalaria — the very hashtag responsible for propelling Ashton Kutcher (@AplusK) to become the first Twitter user with more than 1 million followers in 2009.
Lady Gaga-backed tech startup Backplane created public service announcements, featuring the vocal stylings of Somali-born singer K’naan. Backplane hopes to use its social media expertise to propel Malaria into Wednesday’s most-viral conversations.
The above PSA, recorded by K’naan, highlights that Malaria is the most deadly disease in the world, killing one child every minute. That adds up to 1,500 children dying each day and 655,000 people dying each year. The campaign also points to the mosquito, the insect usually responsible for spreading the disease, as the most deadly creature in the world.

SEE ALSO: Team Coco Gets Behind World Malaria Day [VIDEO]

Kutcher wasn’t the last celebrity Twitter user to take the fight against Malaria to Twitter. Major Twitter personalities, such as Perez Hilton, David Arquette, Shaquille O’Neal, K’naan and Interscope artists The Kin are tweeting about the disease Wednesday.
The End Malaria message is also being featured on the NASDSAQ billboard in Times Square.
World Malaria Day was established by the World Health Assembly in 2007. The theme of this year’s awareness campaign is “Sustain Gains, Save Lives: Invest in Malaria,” reflecting the 33% drop in Malaria related deaths in Africa in the past decade.
Do you think Twitter is the best platform to spread awareness of Malaria? Let us know in the comments.

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Tuesday, April 10, 2012

Choked drains: PUB replies

PUB replies, 5th April 2012:

Dear Mr Jeff Ho

Thank you for your feedback.

2 We agree with your observations about the cleanliness of our drainage system. We recognise the challenges in keeping all our drains clean at all times and we are constantly trying our best to do it better. PUB has adopted the performance-based contracting approach for the cleansing maintenance of drains. Under this approach, which is a partnership approach, the contractors are required to cleanse the drains regularly to ensure that they are in good condition.

3 PUB officers carry out regular checks on the performance of our contractors and review the frequency of cleansing based on checks and public feedback. However, PUB officers are not able to be everywhere all the time to constantly check on all our 7,000 km of drains and the many thousands of drop inlet chambers (DICs) which can be choked up by fallen leaves. One of our approaches is also to engage the public to help us in giving feedback to us on specific areas where the drains are not well maintained or DICs are choked. Such feedback will definitely help us to improve our drain cleanliness.

4 On a separate approach, PUB is also trying to improve the design of drainage inlets along roads which allows leaves to be cleared easier by mechanical road sweepers and use of mechanical suction in our regular maintenance of drainage inlets. We will continue to work towards a more effective way of checking and cleaning such inlets, and also to improve the design.

5. PUB is also working very closely with the Department of Public Cleanliness (DPC) from NEA to improve the drain cleanliness . The DPC will ensure public areas are well-cleaned, and progressively integrate existing contracts by various agencies to achieve higher operational efficiency. The integration of cleansing functions for the public areas will be carried out in phases from 1 Apr 2012 onwards.

6. Thank you once again for your feedback and rest be assured that we will continue to do our best to improve our drainage maintenance work and keep our drains clean. Should you spot any further incidences of unclean drains, please do contact our hotline PUB-One (1800-2846600) or DPC hotline (1800-600-3333 or email

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Wednesday, April 04, 2012

PUB: Throwing money down the drain

30 Mar 2012

To: Dr Vivian Balakrishnan
cc: Dr Yaacob Ibrahim

Seven years ago in 2005, I started a blog,, to help NEA (then under Dr Yaacob as MEWR Minister) in identifying mosquito-breeding sites so that swift action can be taken to eradicate dengue which was
becoming pandemic then (see Straits Times article attached below, "Man starts blog to track mosquito sites", ST, Aug 17 2005).

Some of the main culprits that contributed to these breeding sites were choked drains as numerous spots were identified and photographed and then uploaded onto the blog.

It has been 7 years but the problem of choked drains remains. But instead of dengue, we now have floods!

In 2005, there was another problem: some of these choked drains/breeding spots were under the purview of NEA, some PUB, yet others under LTA, ... and Town Councils, etc... hence, the classical "Everybody thought that Somebody was attending to the problem but Nobody ended up doing it".

I fuly agree with another blogger, Phillip Ang ("PUB: Throwing money down the drain", theonlinecitizen, Mar 30, 2012- attached):

No amount of money (or Engineering?) will solve the flooding problem here in Singapore if the drains are not properly maintained and remain choked!



PUB: Throwing money down the drain

Posted by theonlinecitizen on March 30, 2012 3 Comments
~ By Phillip Ang ~

I understand PUB's predicament as a result of inclement weather but totally disagree with the planned usage of $750 million for upgrading. After having submitted numerous feedback reports on the state of our drainage system, there has been no assurance as to my emphasis on the need for proper maintenance, and the PUB has yet to take the necessary steps to ensure drainage inlets are free from blockage.
I am a keen observer and travel to different parts of Singapore, and my recent observations seem to suggest that the replies from PUB has not been followed with concrete action.
Along Dunearn Road and other places, many drainage inlets were observed to be choked with so much hardened sand that there is no more room for leaves to pass through.
Meanwhile, closer to my home, it is not uncommon to see such 'green' gratings.
And along East Coast Road, there is more of the same.
All these examples and thousands more like them resulted from months and years of neglect. The causes could be insufficient budget allocated to get things properly done, foreign workers who have been overworked by money-minded contractors and civil servants who are not in touch with the reality on the ground.
The government must conduct its own checks through an independent third party as it has been status quo with PUB for too long. With some 30,000 grassroots leaders vounteering their time for various initiatives, this could be executed without much complexity. Students on vacation are another alternative and their contribution and effort could be recognised through Community Involvement Programme (CIP) points. Motorists caught in jams could take note through casual observation and filter the feedback back to the authority, as could pedestrians.
It is prudent to note that existing drainage inlets complement new ones being installed, and installing swanky new drains without maintenance of the existing drainage network, is simply throwing the money down the proverbial drain. For the entire system to function smoothly, blockage has to be eliminated or minimised first. Unfortunately, PUB has been unable to ensure this even after much feedback.


Man starts blog to track mosquito sites

He e-mails NEA with photos of any potential breeding ground he spots

By Lee Hui Chieh
Aug 17, 2005
The Straits Times
CONCERNED by the rise in the number of dengue cases here, a man has begun a weblog posting pictures of clogged drains in an effort to tell the authorities where to take action.
Mr Jeffrey Ho, 51, a director of a financial services company, started about three weeks ago.
He said: 'I don't know if enough is being done. The National Environment Agency has a responsibility, but so do all of us - for our own homes and outside. The NEA can't be expected to be everywhere all the time.'

Fighting the mosquito menace has been almost an obsession for the father of two since his Newton condominium was plagued by the insects for a few months about two years ago.
One night during that period, his eight-year-old daughter ended up with more than 10 bites on her arms and legs.
Since then, Mr Ho has called NEA officials regularly to report problematic sites. He was inspired to set up his blog after reading about the success of similar efforts in raising awareness on other issues.
Now, whenever he sees a drain choked with litter or leaves, he whips out his mobile phone, snaps a picture of it and makes a note of its location. He then updates his blog and sends an e-mail with the picture and location of the drain to the NEA.
So far, officials have been prompt in replying to his feedback, clearing the drains and reporting investigation results, which he then posts on his blog.
Yesterday, the NEA said it welcomed proactive efforts by the public to fight dengue and urged people to contact it directly to report not just drains, but any suspected mosquito breeding ground.
Of the 2,800 calls it receives every week, about 430 concern mosquito problems.
The NEA cautioned against placing too much emphasis on drains rather than homes. Its investigations show that 75 per cent of mosquitoes found breeding in drains belong to the Culex species, while just 25 per cent are the dengue-carrying Aedes variety.
Of areas found breeding Aedes mosquitoes, drains make up just 6 per cent.
By comparison, homes make up 55 per cent of Aedes breeding sites, with most of the mosquitoes found breeding indoors in bamboo pole holders, flowerpots and pails.
Most of the remaining breeding areas are in other HDB common properties maintained by town councils, such as rooftops and bin centres.
The NEA is especially concerned with home breeding, said the head of operations of its environmental health department Dalson Chung, because the more dangerous sub-species of the Aedes mosquito is usually bred indoors.
This sub-species has more potential to spread infection, as it bites multiple times during a feeding session, while the outdoor-bred sub-species usually bites just once.
Still, Mr Ho said: 'Even Culex mosquitoes can be a nuisance. If my blog makes lives better for people, then it's good enough.'

NEA site checks up 10 per cent
THE National Environment Agency has increased its mosquito breeding ground checks by 10 per cent this year, and hired 160 pest control workers to help its own force of 140 officers further intensify such checks.
A total of 6,774 cases of dengue fever were reported in the first seven months of this year, more than double the 3,219 cases in the same period last year.
The numbers continue to climb, due to hotter weather and a switch last year in the dominant strain of dengue virus.
There are four main strains of dengue virus, all of which will become dominant at some point in time. Patients infected by one strain develop an immunity to it after they recover, but are still vulnerable to the other strains.
Every one to three years, for unknown reasons, another strain becomes dominant, and many succumb to it.
The switch in dominant strain led to an unusually large number of cases in the usually quiet months of January and February, when 2,207 dengue fever cases were reported, compared to 624 last year.

Copyright © 2005 Singapore Press Holdings Ltd. Co. Regn. No. 198402868E. All rights reserved.

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Thursday, June 18, 2009

Malaria: Why is action so slow in coming? (Straits Times, 18 June 2009)

Malaria: Why is action so slow in coming?

June 18, 2009 by admin   
Filed under News

By Salma Khalik, Health Correspondent from The Straits Times

DOCTORS are required by law, on pain of a fine and/or a jail term, to alert the Ministry of Health (MOH) within 24 hours of diagnosing a patient with certain infectious diseases.

This is so that the authorities can swoop in and nip the spread of these diseases - such as mosquito-borne ones like dengue, malaria and chikungunya - in the bud.

To be effective, notification must be prompt and follow-up action immediate.

The current outbreak of malaria has raised questions as to whether the notification system is imbued with enough sense of urgency.

By the time the National Environment Agency (NEA) activated its mosquito-busters, at least 17 more people had become infected.

Why did it take two to three weeks after Patient Zero surfaced for the NEA to swing into action?

An NEA spokesman said the agency was told of the Jurong cluster on May 25 - 22 days after the first patient there showed symptoms of malaria. It moved in with its search-and-destroy team the next day.

As for the Mandai cluster, it got the news on May 29, 13 days after the first patient there became ill. Fogging began the next day.

This is not the first time that a time lag between symptoms appearing in the first patient and NEA being told has resulted in more infections.

Singapore’s fight against chikungunya last year was also bugged by similar delays.

It is difficult to ascertain how many of the more than 100 locally-transmitted chikungunya cases last year, and the 250 so far this year, can be traced to the slow eradication of Aedes mosquitoes in the affected areas. But the existence of clusters of cases suggests that delay played a role in the spread of the disease.

The fact that a doctor’s failure to inform MOH of a notifiable disease like malaria within 24 hours could land him in jail for up to six months and/or a fine of up to $10,000 is indication enough that the law views the spread of such diseases seriously. Why then the delay?

The question has been posed to MOH several times, but no answer has been forthcoming.

The lapses appear to be in the reporting system. Either doctors are not reporting cases early enough, laboratories are taking too long to revert with test results, or ministry officials are not following up on tip-offs as quickly as they should.

Malaria is transmitted from patient to patient via mosquito bites. When someone is infected and symptoms appear, it means that the person has the malaria-bearing parasite in his blood.

The biting is done by the female Anopheles mosquito, which requires blood meals to go into breeding mode. A mosquito which picks up the parasites from the blood of an infected person passes them on to the next person it bites.

The only way to break the chain of transmission is to ensure that the patient is not bitten while still infectious. This means the patient either has to be kept in air-conditioned isolation and away from all insects, or all Anopheles mosquitoes in the vicinity have to be killed, and their breeding places destroyed.

In the recent outbreaks, people were getting infected and falling ill over a period of almost a month. This means several patients - and mosquitoes - were involved in spreading the disease.

The NEA is confident that it has wiped out the Anopheles mosquito in Jurong and Mandai, so there should not be any more infections there. If they had been alerted earlier, some of the victims could have been spared the fever, headache, chills and vomiting that come with malaria.

Laxity in reacting could see both malaria and chikungunya become endemic here - the way dengue already is. If they do become endemic, the fight to keep people from falling ill with these diseases will become more difficult.

Worldwide, about 240 million people are infected with malaria each year, and a million die from it.

Chikungunya rarely kills, but the illness is more severe than dengue. Its victims suffer from severe joint aches that can last weeks or even months.

Health Minister Khaw Boon Wan has warned that Singapore should not ‘belittle’ this malaria outbreak.

But perhaps Singapore’s malaria-free status for the past 27 years has bred a certain complacency, and chikungunya is relatively new. As a result, neither disease was on our radar screen, unlike dengue, which has been around for some time

But as Mr Khaw noted, it took a lot of effort for Singapore to become malaria-free. If the disease takes root here as dengue has, it will take a long time to eradicate it again.

Everyone - doctors, lab technicians and government officials - needs to take these diseases more seriously, and take action as soon as the diseases are detected.

Every citizen and resident in the country has a role to play too, since dengue, malaria and chikungunya are all spread by mosquitoes: Be assiduous in preventing this insect from breeding in the first place and none of these diseases will be able to spread.

No one is immune. The next person to be bitten by an infected mosquito could well be you.

Source: Straits Times

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Monday, February 16, 2009

Use 'MP' approach to stop mosquito breeding (ST Forum, 16 Feb 2009)

February 16, 2009 Monday
Use 'MP' approach to stop mosquito breeding
SINGAPORE is perennially plagued by mosquito-borne diseases. First, it was malaria, then dengue fever, and the latest - chikungunya.

But it is possible to make Singapore essentially mosquito-free.

To illustrate the problem, I would like to describe the situation in my estate at Cluny Park, where two recent cases of chikungunya prompted me to write this letter.

Leaves falling on the road are the responsibility of the National Environment Agency (NEA). But trees on the strip of land next to the road are the concern of the National Parks Board.

The strip of land is traversed by many side drains, which direct water on the road surface into monsoon drains. The monsoon drains are under the purview of the PUB, but the side drains are 'no man's land'.

The trees shed leaves constantly and the narrow side drains are usually choked with fallen leaves. They harbour stagnant water during wet weather and so produce mosquito larvae.

Private contractors, outsourced by the NEA, remove the leaves from the road surface, but they say clearing the side drains is not their job.

As a result, my estate is seldom free of mosquitoes during the wet season. My neighbours resort to frequent chemical fogging of their compounds - a futile measure that does not affect mosquito breeding, but adds harmful pollutants to the environment.

Once, I managed to persuade the NEA contractors to clear the side drains, and we were able to enjoy a mosquito-free period until the drains became blocked again.

As felling of trees is banned, a permanent solution to these problematic side drains is to cover them and their inlets with metal grilles to keep out fallen leaves.

The authorities respond promptly to complaints. But they solve only the immediate problem, not the fundamental factors that allow mosquito breeding.

There should be a systematic and holistic approach, as disjointed ad hoc measures of mosquito control have got us nowhere.

The NEA should divide the island into districts and assign an officer to each - like a Member of Parliament (MP) looking after a constituency. Residents in each district should have access to him. He would become familiar with his district and once mosquito breeding grounds are detected, he should take effective measures to ensure no recurrence.

His primary task is to pre-empt any situation that may lead to accumulation of stagnant water, such as drains obstructed by trash and leaves, littering of containers and plastic bags, untidy construction sites, unoccupied houses with ill-maintained gardens and swimming pools.

Dr Ong Siew Chey