| |
 THE incidence of dengue fever in Opera Estate in Siglap since early this month is notified as a cluster. In the language of the National Environment Agency (NEA), the term refers to two or more cases occurring in close proximity to one another within a fortnight, in a localised area. Opera Estate has had 10 confirmed cases as of last week. Most people will think the number is small. But it can be so misleading as to encourage indifference. This is the bane of disease surveillance. Residents of Siglap have been apprised of the steps to take to stop mosquito breeding at source. Yet not many people across the island would be aware they are to seal floor traps and replace toilet-seat covers, for example, besides having receptacles emptied or upturned, when they are going to be away for more than a few days.
The NEA can do only so much as a public health monitoring and enforcement agency, even with officers inspecting premises and public spaces daily when a single case is reported. For a fast-spreading mosquito- borne disease, an occurrence on this scale within just one small residential enclave in a district should be getting people’s defences up all over the island. Public-health surveillance in Singapore has justifiably been commended by the World Health Organisation for being comprehensive, with public education a large component. This has been how the incidence of community-wide scourges of old, like malaria and tuberculosis, has been brought down to levels comparable with those of nations with high standards of environmental health. But there are gaps in community responsiveness. The NEA reports that the number of dengue fever cases last year was not high for the historical peak year of sixto seven-year infection cycles experienced here.
An NEA measure called the local dengue incident rate for last year was only one-third of that recorded in 2005, the previous peak infection year. This is reassuring, until one learns that the absolute number for last year was 5,330 cases. It can reasonably be assumed that not a few Singaporeans would be astounded at how high the number seemed, relative to population size and the level of environmental cleanliness. The experience of Opera Estate can so easily be replicated elsewhere. NEA audits show that school buildings and construction sites have lower mosquito breeding rates compared with years past. But household care is by its nature patchy. Each dengue outbreak draws this lesson, and reminders go out. The warmer months between April and October are the peak dengue season, says the NEA. Time to look in all the odd corners in the home.
|