Three more cases of chikungunya found in Singapore

Three more cases of chikungunya have been found in Singapore, reports ProMedMail based on the People's Daily Online. The total number of chikungunya cases so far has been 48 in 2008.  The three new cases involve 2 foreign workers and a local delivery driver. Local transmission of the virus is assumed, as the patients have not left Singapore recently. The two foreign workers are treated in hospital, but the Singaporean driver was allowed to return to work.The Ministry of Health is carrying out active case detection in the location of these cases. The press release on the website of the Ministry of Health of Singapore also reveals that mosquito breeding sites have been found in the premises of 10 factories in the area, and the mosquito control has been initiated. The first case of chikungunya was reported in Singapore in January 2008. Mod TY on ProMedMail adds that the continuing chikungunya activity in Singapore, in spite of active efforts of breeding site reductions, represents a risk of introduction to countries which have significant populations of competent Aedes mosquitoes (such as the US), due to the significance of Singapore in terms of international trade and travel. Interestingly, the location of chikungunya cases mentioned in the report (Kranji Way) is quite close to the city of Johor Bahru in Malaysia. One would not be surprised to see additional chikungunya cases in that city.

Poll: Chikungunya in the South-Eastern United States

Do you think a chikungunya epidemic is credible threat in the South-Eastern United States?

On one hand, a competent vectors (Aedes albopictus) is present, climatic conditions are favorable, and international tourism offers plenty of opportunities for the importation of this disease. However, the human density is low compared to parts of the world where chikungunya epidemics occured, and the American lifestyle (driving cars, air-conditioning and window screens) limits the contact with vectors.

Please indicate your opinion using the online poll on the right. I will report back on its results.

Chikungunya outbreak in Sri Lanka rages on

ProMedMail reports that the chikungunya outbreak in Sri Lanka is ongoing. The number of cases mentioned is the same as in an earlier report.  The importance raising of public awareness and insanitary conditions [ample breeding sites] are cited in the current report. While these are undoubtedly important, I hope that the response to the epidemic is not left solely to the affected public. Isolation of infectious patients from bites of susceptible mosquitoes and immediate and major reduction of the adult and larval mosquito population by all available means is the only solution, unless the authorities want to let the epidemic run its course.

PRO/EDR> Chikungunya (03)- Singapore

Date: Thu 17 Jan 2008
Source: Reuters Foundation AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/SIN179469.htm >


The Ministry of Health said on Thursday [17 Jan 2008] 6 people in
Singapore have been infected by the mosquito-borne chikungunya virus.

"This is the 1st instance of local transmission of the disease.
Previous cases were imported, where patients caught the virus
overseas and brought it back to Singapore," a Ministry of Health
spokeswoman told Reuters.

To date, 2 patients have been admitted to the isolation ward of the
Communicable Disease Centre.

All 6 patients were living in close proximity to each other in the
southeastern part of the city-state. "It's still a localised
infection at the moment," she added.

The Ministry of Health has begun to screen people living or working
in the same area.

Chikungunya fever, like dengue fever, is a mosquito-borne disease,
characterised by sudden onset of fever, chills, headache, nausea,
vomiting, joint pain, back pain, and sometimes a rash. Most symptoms
last for 3-10 days, but joint pains may last for weeks to months.

The chikungunya virus was carried mostly by the _Aedes aegypti_
mosquito. It caused an epidemic that began in Kenya in 2004 and
spread to several Indian Ocean islands including the Comoros,
Mauritius, the Seychelles, Madagascar, Mayotte, and Reunion.

[Byline: Jennifer Tan; editing: Jeremy Laurence]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Chikungunya virus continues to spread in Southeast Asia. This report
provides another example of chikungunya virus being introduced into
an area where there are sufficient populations of competent mosquito
vectors to permit local virus transmission, similar to, but not as
extensive as the outbreak in Italy during the summer of 2007 (see
ProMED-mail 20071210.3980).

The report indicates that chikungunya virus was mainly transmitted by
_Aedes aegypti_. It was not clear if the report was addressing
chikungunya virus transmission everywhere (with chikungunya virus
transmission by _Ae. albopictus_ involvement in some other places) or
specifically in Singapore. ProMED-mail would appreciate clarification
if any other mosquito vectors were involved in this small outbreak,
and information about any mosquito control measures being taken as
well as occurrence of any additional cases.

ProMED thanks Dan Silver for providing a similar report from Singapore.

An interactive HealthMap/ProMED-mail map of Singapore can be accessed at
<http://healthmap.org/promed?v=1.4,103.8,6>. - Mod.TY]