As the number of confirmed Zika cases continues to climb, the Ministry of Health (MOH) has tightened reporting protocol for general practitioners (GPs) by requiring suspected cases of infections to be sent by ambulance to the Communicable Diseases Centre (CDC) for further tests.
Adding to the 41 cases made public over the weekend, the MOH said that as of noon on Monday (Aug 29), 15 more cases of locally transmitted Zika virus infection have been confirmed. The figure is expected to rise further: At least two patients contacted by TODAY said they tested positive for the Zika virus later in the day.
Among the new confirmed cases reported by the MOH on Monday, two were workers at a construction site at 60 Sims Drive - identified as one of the hotspots - who have since recovered. The remaining 13 either live or work in the Aljunied Crescent-Sims Drive area, said the ministry.
GPs around the island received a circular from the MOH on Saturday afternoon - a few hours before the first locally transmitted case was announced by the ministry in the evening - stating that suspected cases be sent to the CDC for blood and urine tests via ambulances dispatched by the MOH. The circular described suspected cases as patients who have fever, skin rash, joint and muscle pains, headaches or red eyes, and had been in the vicinity of the Aljunied Crescent-Sims Drive area.
On Monday, five patients were sent in two ambulances from Sims Drive Medical Clinic, where the first locally-transmitted case was discovered. Of these, two are women, aged 18 and 54, and three are men who work at a construction site in the clinic's vicinity. Across the road from the clinic, TJ Medical Clinic & Surgery's Dr Tan Thai Keng told TODAY that he had written referral letters for four patients to undergo further tests and directed them to the CDC immediately. These patients - three women aged 24, 26 and 32, and a 44-year-old man - were not sent by ambulance, he said.
One of the patients who told TODAY they had tested positive for Zika virus was a 54-year-old woman who wanted to be known only as Madam Ho. She said she was shocked to wake up on Monday with red spots all over her body and face. Mdm Ho was speaking to reporters outside Sims Drive Medical Clinic in the morning. Her face and arms were visibly swollen, while her eyes were red-rimmed. After she had received her test results in the evening, she told TODAY: "I feel very tired I am only worried that I may have spread it to my family members because I don't know when I was bitten." Madam Ho, who lives with her two children and son-in-law, said she has advised them to go for health checks.
Aljunied Crescent resident Amalina Yusoff was also diagnosed as a Zika patient on Monday. The 18-year-old student said she had recovered from fever on Sunday but started developing rashes all over her body.
Over the weekend, the MOH and the National Environment Agency (NEA) had warned that more cases could emerge. Beyond Aljunied Crescent and Sims Drive, other areas of concern include Khatib Camp, Sembawang Drive, Kranji Road, Joo Chiat Place, Senoko South Road, Toh Guan Road East and Lorong 101 Changi. On Monday, the MOH reiterated that "more previously undiagnosed" Zika cases would likely be uncovered, as it continues to work with GPs in the Sims Drive-Aljunied Crescent area to offer testing for patients who had fever and rash previously.
GPs and doctors said they are seeing women patients, including those who are pregnant, who are concerned about the outbreak.
Dr Beh Suan Tiong, who specialises in obstetrics and gynaecology at Thomson Medical Centre, said that some of his pregnant patients have requested to be tested. "We conduct tests based on necessityIf they do not exhibit the symptoms and have not travelled to Zika-affected countries or live in the Aljunied area, there are currently no guidelines for them to be tested," said Dr Beh.
Members of Parliament (MPs) for the areas flagged by MOH said they are taking precautions to manage the situation. MacPherson MP Tin Pei Ling said her grassroots volunteers had visited households in Aljunied Crescent over the weekend. They have also compiled a list of seven pregnant residents whom they will check on regularly, said Ms Tin.
Marine Parade Group Representation Constituency (GRC) MP Tan Chuan-Jin, who is also the Minister for Social and Family Development, was out and about on Monday at Joo Chiat Place, visting residents and giving out brochures and mosquito repellents.
Jurong-Clementi town council chairman Ang Wei Neng and Sembawang town council chairman Lim Wee Kiak said that their grassroots volunteers will step up efforts to alert residents and dormitory operators about the outbreak. Dr Lim said: "We've done this before, when we had a dengue cluster... (Times like these are) a good reminder to residents and grassroots organisations (to) look out for one another."
As of Sunday, the NEA has inspected about 3,600 out of 6,000 premises in the Aljunied Crescent-Sims Drive cluster for mosquito breeding. Thirty-six breeding habitats in homes and other common areas have been detected and destroyed. It has also commenced vector control operations in areas where cases from the Aljunied Crescent-Sims Drive cluster work or live. There is currently no evidence of local transmission in these areas, the NEA said.
Meanwhile, pharmacies islandwide are stocking up on mosquito repellent products following a surge in demand.
Unity Pharmacies said sales for mosquito repellent sprays and patches have gone up by about half in its 59 outlets across the island. A Guardian spokesperson said that compared to last week, sales of such products have, on average, doubled islandwide, with sales at its five stores in Aljunied increasing by more than four times.
Source: Government of Singapore