Dengue Alert

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

2009-06-18T20:11:00.001+08:00

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

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

2009-02-16T11:02:00.001+08:00

http://www.straitstimes.com/ST%2BForum/Story/STIStory_338838.html

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

Breakthrough on dengue? (Straits Times, 3 Jan 2009)

2009-01-03T11:10:00.001+08:00

http://www.straitstimes.com/Breaking%2BNews/Tech%2Band%2BScience/Story/STIStory_321128.html

Jan 3, 2009

Breakthrough on dengue?

There is no known cure or vaccine for dengue fever, which is transmitted by mosquitoes and kills more than 20,000 people each year. -- ST PHOTO: ALPHONSUS CHAN

SYDNEY - AUSTRALIAN researchers funded by US billionaire Bill Gates on Friday claimed a breakthrough which could help in the fight against dengue fever by stopping the often deadly disease in its tracks.

University of Queensland researchers said they have successfully infected the mosquito which spreads the tropical disease with a bacterium which halves its 30-day lifespan, thereby reducing its ability to transmit dengue to humans.

Scientists hope their work will help halt the spread of the painful and debilitating disease which affects up to 100 million people each year.

'The key is that really only very old mosquitoes are the only ones that are able to transmit the disease,' said researcher Professor Scott O'Neill.

'What we've done is put this naturally occurring bacteria into the mosquitoes that actually halves their adult lifespan so they don't live long enough to be able to transmit the virus.'

The research published Friday in the journal Science is the result of injecting 10,000 mosquito embryos with a bacterium that occurs naturally in fruit flies but has never been detected in dengue-carrying mosquitoes.

Prof O'Neill said the test was designed to see whether the bacterium reduced the lifespan of the insects without killing them or preventing them from breeding and was able to be passed on to offspring.

He said while the laboratory tests, which involved researchers allowing the bacteria-infected mosquitoes to bite their arms because the species needs human blood to breed, had been successful, it would be several years before the technique would be tested in the wild.

'It's really a preventative strategy for preventing dengue fever outbreaks and what we've done is show that it's possible to be done in a laboratory,' he told AFP.

'The next stage is now to move it into a more realistic field setting.'

There is no known cure or vaccine for dengue fever, which is transmitted by mosquitoes and kills more than 20,000 people each year. Also known as 'breakbone fever,' symptoms include high temperatures and muscle aches.

The Bill and Melinda Gates Foundation donated US$10 million (S$14.4 million) to an international research team led by the University of Queensland into a means of defeating dengue fever in 2005. -- AFP

Today (15 Sept 2007) - 15 Town Councils fined

2007-09-15T19:54:00.000+08:00

http://www.todayonline.com/articles/211400.asp

Hot News // Weekend, September 15, 2007
15 Town Councils fined
Fifteen of the 16 Town Councils have been fined for breeding mosquitoes in the first eight months of this year – all of them repeat offenders.
.This revelation came as the National Environment Agency released the figures for the first time this year. It did not, however, name the Town Councils.
.Non-residential offenders, such as Town Councils and other public agencies, face a $200 fine for mosquito-breeding in the first three instances; further offences mean an appearance in court.
.In addition, 3,820 homes, including nine that were repeat offenders, were fined for mosquito breeding between January and August.
.Dr Yaacob Ibrahim said penalties would be stepped up if Singaporeans remained non-compliant.

Today (13 Sept 2007) - Long-term solutions needed to fight mosquito-borne diseases

2007-09-13T13:36:00.000+08:00

http://www.todayonline.com/articles/210874.asp

Voices // Thursday, September 13, 2007
Long-term solutions needed to fight mosquito-borne diseases

Letter from See Leong Kit

I refer to the report, "Woman, 53, is dengue's latest fatality" (Sept 12).
.This is the seventh death caused by dengue fever this year. To date, 6,530 people have been infected — three times more than in the same period last year. In 2005, 14,210 people were infected and 25 of them died, including a 10-year-old student.
.We now face the threat of chikungunya fever. Both viral diseases are spread by the same Aedes mosquito. Between December last year and May this year, the Health Ministry had reported eight confirmed chikungunya cases.
.While members of the public have to play their part to prevent mosquitoes breeding, public officials should also work on finding long-term solutions in tackling such mosquito-borne diseases. The National Environment Agency (NEA) should co-ordinate its efforts with other government bodies such as the Building & Construction Authority (BCA) and the Land Transport Authority (LTA).
.Have the NEA and BCA ever held a joint comprehensive review of the design and construction features of high-rise and low-rise buildings that contribute to mosquito breeding?
.Will the BCA set design rules for developers to follow?
.The NEA identified roof gutters to be a major breeding ground for mosquitoes. Yet many older bus stops still have roof gutters.
.Why don't the NEA and LTA seal off these gutters?
.Surely this would have been a quick and inexpensive solution?
.The roof gutters of houses are often difficult to reach and few home owners bother to clean them.
.Could the relevant agencies introduce new laws that ban the use of gutters in houses?
.Perhaps the NEA should also consider introducing legislation to cover these areas as well: Rooftop water tanks, lift wells, basement water-sumps, as well as drains and basement car parks.

Straits Times (4 Sept 2007) - Most people infected with dengue go undiagnosed

2007-09-04T11:13:00.000+08:00

http://www.straitstimes.com/Free/Story/STIStory_154487.html

Sep 4, 2007

Most people infected with dengue go undiagnosed

NEA finding means there are many more carriers here than originally thought

By Arti Mulchand

MOST people who are infected with dengue here are not diagnosed with the disease.
A study of blood samples collected from some 3,500 people living in six dengue hot spots has shown that only one in five victims is diagnosed with the disease.
The others either have only mild symptoms, which they brush off as a garden variety fever or cold, or show no symptoms at all, said the National Environment Agency (NEA), which conducted the study.
This is alarming, the agency added, as it means there are many more dengue carriers here than originally thought. Dengue is spread when an Aedes mosquito bites an infected person, and then transfers the virus to other people it bites.
To help combat the problem, doctors in dengue hot spots have been asked to conduct blood tests on patients who show flu-like symptoms.
People with symptoms such as fever and rash are also being encouraged to slap on mosquito repellent as a safety precaution.
VIDEO
Dengue hotspot: Bukit Batok(3:10) This year, 6,318 people here have been diagnosed with dengue.
However, the study shows this figure is only 'the tip of the iceberg', said Dr Christina Liew, a medical entomologist from the Environmental Health Institute (EHI) - the NEA's research arm - who was involved in the research.
She has a message for anyone feeling unwell: See a doctor, and use mosquito repellent as a pre-emptive measure, so the disease is not spread further.
Dr Ng Lee Ching, head of the EHI, told The Straits Times that the ongoing study, which began in May, showed that half of those who tested positive for dengue showed no symptoms, and did not know they had been infected.
Of the rest, more than half had symptoms such as fever or aches, but were not diagnosed as having dengue.
Dr Ng said that getting more people tested for dengue will help increase the reporting rate for the disease and allow the NEA to identify problem areas faster, as well as assess the population's immunity.
The revelation that most of those who have dengue go unnoticed comes just as weekly figures for the disease here dipped below 200 for the first time since mid-May.
Last week, there were 192 dengue cases, the fourth week in a row that the figure has fallen below warning levels.
However, this level is 'not comfortable', and the fight is far from over, said Mr Tai Ji Choong, head of operations of the NEA's Environmental Health Department.
In fact, in some areas, such as Bukit Batok, the situation is still worrying.
The cluster around Bukit Batok Street 31, 32 and 34, for instance, could set a new nine-year record - there have been 73 cases there in the last 57 days, and it is still active. The current record was set in 2005, with 74 cases in Yishun Street 72.
And despite the cooler weather - mosquito breeding and activity dip along with the temperature - there are other factors at play, said the EHI's Dr Ng.
This year, for example, a new type of dengue - Den 2 - is dominant, so more people are susceptible as they have no immunity to the strain.
She added that cooler weather does not always translate into lower dengue figures.
In 2004, for example, figures remained at warning levels through the year-end period, although that is not the traditional dengue season because of the cooler, wetter weather. And from July to September the following year, even through temperatures fell, the number of cases went up.
High year-end figures also have implications for next year's dengue situation: When the warmer weather sets in, the situation will likely get worse.
'The more we suppress the dengue cases now during the lull period, the more we put ourselves at an advantage when the warmer months come,' said Dr Ng.
arti@sph.com.sg
BUKIT BATOK ONE IS WORST DENGUE HOT SPOT NOW, SINGAPORE

Systemic flooding problem at Boon Lay/Jurong West

2007-08-28T11:07:00.000+08:00

Date: Mon, 27 Aug 2007 20:05:47 -0700 (PDT)

From: Jeff Ho denguealert@yahoo.com

Subject: Re: Drains along boon lay way in front of blk 517A Jurong West

To: Chuan Hoe LIM < LIM_Chuan_Hoe@pub.gov.sg >, YAP_KHENG_GUAN@PUB.GOV.SG
CC: PUBone@singnet.com.sg , Lee Yuen Hee lee_yuen_hee@nea.gov.sg, tckhoo@pub.gov.sg , Halimah halimah@ntuc.org.sg, Ibrahim Yaacob mewr_yaacob_ibrahim@mewr.gov.sg, Swarni Kaur swarnikaur@yahoo.com.sg

28 Aug 2007

To: PUB

If there is a systemic problem - fix it.

Do no insult the intelligence of Singaporeans, please!

Rgds
www.denguealert.blogspot.com
=========================================
Swarni Kaur wrote:
Thank you for your reply.
I strongly disagree with you that the hoardings (above the drain) caused the flood.
When it flooded last week, there was only a wooden ladder in the drain.

fyi There were also many occurences of flooding after the drain repairs/upgrade, just that I didnt bother to write.

To me, the entire Boon Lay/Jurong West is very flood prone and PUB has not solved the problem.
I will keep all posted when the drain flood again in the very near future.

I take the effort to tell PUB the problem but instead of solving the problem and analysing the root cause, I see that you are trying to give excuses and find scape goats.
sigh!

----- Original Message ----From: Chuan Hoe LIM To: swarnikaur@yahoo.com.sgCc: PUBone@singnet.com.sgSent: Thursday, 23 August 2007 12:32:18Subject: Drains along boon lay way in front of blk 517A Jurong West
Dear Ms Kaur Please refer to your feedback of drain overflow onto the sidetableduring the storm on 18 Aug. We have checked and found the cause to besome obstruction to flow from the hoardings erected over the drain by theTown Council. The obstruction has since been removed.2 Thank you for your feedback. Please contact my colleague Mr SiewSoon Wing at HP 92334298 directly, should you observe any obstruction todrains or occurrence of flooding.Yours faithfullyLim Chuan Hoe WilliamDeputy DirectorLim Chuan Hoe William (Embedded image moved to file: pic03970.gif) DeputyDirector (Embedded image moved to file: pic32684.gif) Catchment &Waterways Department (Embedded image moved to file: pic00246.gif) Tel :67313529 (Embedded image moved to file: pic19902.gif) Fax : 67313137 (Embedded Privileged/Confidential information may be contained in image moved to this message. If you are not the intended recipient, file: please notify the sender immediately. Visit our website at pic15726.jpg) http://www.pub.gov.sg ----- Forwarded by Irene TONG/PUB/SINGOV on 20-08-2007 01:59 PM ----- Swarni Kaur To Kheng Guan YAP/PUB/SINGOV@SINGOV, 19 Aug, 2007 PUBone@singnet.com.sg 03:28 PM cc NEA Contact/NEA/SINGOV@SINGOV, Halimah , Yuen Hee LEE/NEA/SINGOV@SINGOV, PUB Teng Chye KHOO/PUB/SINGOV@SINGOV, 75557@stomp.com.sg, Jeff Ho , MEWR Yaacob IBRAHIM/MEWR/SINGOV@SINGOV Subject Re: Drains along boon lay way in front of blk 517A JW A few weeks after I wrote the following email, PUB upgraded the drain infront of blk 517A JW.But on 18th Aug, the heavy rain flooded the bank again. So the upgrade wasnot effective.Waste public $Residents of Boon Lay have been suffering from flood every few months.9th Apr: http://singaporeseen.stomp.com.sg/viewPost2532.aspx18th Aug: http://singaporeseen.stomp.com.sg/viewPost4920.aspxPUB, pls do something effective.----- Original Message ----From: Swarni Kaur To: YAP_KHENG_GUAN@PUB.GOV.SG; PUBone@singnet.com.sgCc: Contact_NEA@nea.gov.sgSent: Monday, 9 April 2007 11:00:41Subject: Drains along boon lay way in front of blk 517A JWWish to inform that on last SAT about 3PM, the skretch of Boon Lay Way infront of Blk 517a Jurong West Str 52 was flooded. The road was flooded too.On Sat PM, the water level was about 80-100cm above the drain.Every year, this drain will flood 2-3 times.Pls look into this.thx!

AP (31 Jul 07) - WHO: Asia to be worse hit by dengue fever outbreak in decade

2007-07-31T15:05:00.000+08:00

http://news.asiaone.com/News/AsiaOne%2BNews/Asia/Story/A1Story20070731-20351.html

Margie Mason
Tue, Jul 31, 2007AP (Associated Press)

WHO: Asia to be worse hit by dengue fever outbreak in decade
HANOI, Vietnam (AP) -- Dengue fever is raging across Southeast Asia, prompting the World Health Organization to warn that the region could face the worst outbreak of the mosquito-borne virus in nearly a decade.
The disease, sometimes called the "bone breaker" illness because of the excruciating joint pain it causes, has flared across the region from ultramodern Singapore to poor Vietnam. There are four different types of dengue, and none have a cure or vaccine.
Cambodia is currently one of the most worrisome spots, where the disease has attacked about 25,000 people and killed nearly 300 children under age 15 so far this year. That's about three times more than the number of cases for all of 2005, according to WHO.
Sick children have overwhelmed ill-equipped hospitals there, forcing babies burning up with fever to wait for beds outside with IV drips attached to their arms.
The last major outbreak to hit Southeast Asia was in 1998, when about 350,000 cases were reported regionwide, including nearly 1,500 deaths. Indonesia and Thailand were not included in that tally.
John Ehrenberg, WHO's regional adviser on vector borne diseases, said it could potentially reach that level again this year.
"It looks like it might be a bad year," he said. "I think we're in the building-up stage, but it could very well peak by August or September."
Malaysia has seen a 50 percent jump in cases this year over the same period in 2006, with more than 1,000 patients admitted every week for the past month and 56 deaths recorded through June, according to Health Ministry figures.
In Indonesia, more than 100,000 infections have been reported this year, including 1,100 deaths. That compares to 114,000 cases and the same number of fatalities for all of 2006, said Nyoman Kandun, a senior Health Ministry official who predicted the number will hit 200,000 by year's end.
More than a dozen children infected with dengue filled beds in Jakarta's Tarakan Hospital. Some had IV drips in their hands while others had tubes coming from their noses.
Muhammad Wildan, 5, was hospitalized last week and remained in critical condition due to internal bleeding. Doctors said he's lucky his family did not wait any longer to bring him in.
"It did not come to us that it was dengue," said Padmi Sari, the boy's grandmother. "We thought it was just a common fever."
Singapore, known for its spotless streets and cutting-edge health facilities, has also not escaped dengue this year. The government has reported nearly 5,000 cases and at least three deaths. Early rains also caused a surge in cases in Thailand with more than 20,000 cases reported through June, including 17 deaths, officials said.
In Vietnam, which also typically logs a high number of annual cases, health officials have seen a 40 percent increase over last year reporting more than 33,000 infections this year and 32 deaths.
In addition to joint pain, rashes, nausea, severe headaches and high fever that typically accompany the disease, patients stricken with a more serious form, called dengue hemorrhagic fever, can experience internal bleeding, liver enlargement and circulatory shut down.
"You don't want to have people staying at home and starting to bleed," Ehrenberg said. "By the time they go to the hospital they're in shock and they will die."
The disease is not nearly as lethal as malaria, which kills more than 1 million people annually. But WHO estimates dengue infects up to 50 million people every year worldwide, mostly in Asia and Latin America. About a half million of those cases are severe, and some 19,000 deaths were recorded in 2002.
"We always think next year it will get better, but we always find next year it gets worse," said Kroeger Axel, a dengue research coordinator at the WHO in Geneva. "There's a very clear upward trend."
He said outbreaks run in cycles, occurring roughly every four years. Mosquitoes breed in stagnant pools of water ranging from flower pots to old tires, and residents across the region are urged to avoid letting water collect near houses.
--------
Associated Press reporters Heng Sinith in Phnom Penh, Cambodia; Sean Yoong in Kuala Lumpur, Malaysia; Tran Van Minh in Hanoi, Vietnam; and Zakki Hakim in Jakarta, Indonesia contributed to this report.

=================================================================

[QUOTE=margaret1424;68204]Why always blame the govenment when something happens? Stop complaining and play a part by helping to look out the breeding place of the mosquitoes and reporting them to the authorities. This will helps not only yourself, your loved ones but also the country. Be proud that you are a Singaporean![/QUOTE]Yes, I am proud to be a Singaporean. But if we don't blame the government first, they will blame the people ! This is what they are doing already, finding scrapgoats so that someone will appear in the papers or TV in shame breeding mozzies as 'pets'.The truth is, our eco-system is lop-sided. That is why mozzies start appearing everywhere. The Nature Society should come in and advise what natural enemies of mozzies we can introduce to balance the situation, eg. lizards, guppies, frogs, PAP MPs !
Posted by: somethingwrong at Wed Jul 25 11:27:46 SGT 2007

[quote=margaret1424;68204]Why always blame the govenment when something happens? Stop complaining and play a part by helping to look out the breeding place of the mosquitoes and reporting them to the authorities. This will helps not only yourself, your loved ones but also the country. Be proud that you are a Singaporean![/quote]The Way I See It:Do you question the government as a proud singaporeans why they forget to fog all the sewerage and drainage system as well as the lift pits and lift motor rooms in the island? These places have the most mozzie you know if you love your country and happen that you forget to complain? :D
Posted by: ILostMyBall at Tue Jul 24 17:18:15 SGT 2007

Why always blame the govenment when something happens? Stop complaining and play a part by helping to look out the breeding place of the mosquitoes and reporting them to the authorities. This will helps not only yourself, your loved ones but also the country. Be proud that you are a Singaporean!
Posted by: margaret1424 at Tue Jul 24 14:54:31 SGT 2007

Dirty drain - Jurong East Str 31

2007-07-11T14:13:00.000+08:00

Date: Tue, 10 Jul 2007 23:19:17 -0700 (PDT)

From: Jeff Ho denguealert@yahoo.com

Subject: Re: Dirty drain - Jurong East str 31

To: pub_one@pub.gov.sg , tckhoo@pub.gov.sg , pubone@singnet.com.sg

CC: halimah@ntuc.org.sg , amy_khor@mewr.gov.sg , YAP_KHENG_GUAN@PUB.GOV.SG ,Lee Yuen Hee lee_yuen_hee@nea.gov.sg, Contact_NEA@nea.gov.sg , Swarni Kaur

To: Relevant authorities
11 Jul 2007

Pls ensure the affected drains are cleaned up soon before it becomes another Aedes breeding ground (if it hasn't already become one).

Rgds
http://www.denguealert.blogspot.com/

=======================================

Swarni Kaur wrote:

see the photo of these dirty drains at the junction of jurong east str 31 and boon lay way.
They have not been swept for a month - see the grass growing on the rubbish.

cc: Ms Halimah, MP for Jurong
Ms AMy Khor, Mayor for SW CDC

Dengue experience: ministers' shortcomings and to-do list - ST (3 July 2007) - Dengue cases hit epidemic level again

2007-07-03T12:11:00.000+08:00

Date: Mon, 2 Jul 2007 21:07:59 -0700 (PDT)
From: Jeff Ho
Subject: Dengue experience: ministers' shortcomings and to-do list - ST (3 July 2007) - Dengue cases hit epidemic level again
To: mewr_yaacob_ibrahim@mewr.gov.sg, mah_bow_tan@mnd.gov.sg,
khaw_boon_wan@moh.gov.sg
CC: lee_hsien_loong@pmo.gov.sg, reach@reach.gov.sg, amy_khor@mewr.gov.sg,
"HuiChieh@ Straits Times" ,
"Letters@ Today" , tnp@sph.com.sg, arti@sph.com.sg,
taniat@sph.com.sg, dawntan@sph.com.sg, "Radha@sph Basu" ,
"Chee Kong@Today Loh" , salma@sph.com.sg,
ST Forum

To: Ministers Khaw Boon Wan (MOH)/Yaacob Ibrahim (MEWR)/Mah Bow Tan (MND)
cc: Prime Minister Lee Hsien Loong
cc: REACH
cc: Straits Times/Today/TNP

3 July 2007

Someone from my household had the misfortune to be down with dengue last week. But fortunately, she is now out of the CDC and recuperating at home. I understand from NEA there is another case across the road in my neighbourhood (Newton/Bukit Timah area) during the same period, so with these 2 cases occurring near each other, it would be updated as one of the many clusters although I note that the NEA website has yet to do so - refer link http://app.nea.gov.sg/cms/htdocs/category_sub.asp?cid=239 .

One good thing I learnt from almost first-hand experience is the observation that despite the last major outbreak in 2005, the lessons are still not learnt (or if learnt, not applied). Consequently, it is very easy for the outbreak to get out of hand again and again and again until and unless priorities are set and tackled by all concerned - households, NEA, MOH, MND, PUB, doctors, town councils, etc...

Let me share with you just 2 very basic but important observations which indicate major shortcomings that may have contributed to the recent outbreak. And since this involves inter-ministerial effort, and given the apparent ineffectiveness of the ministries working together (hence the current outbreak again), I shall set out to detail the To-do's for each minister how each should tackle the problem at his ministry:

AAA. "Preventive" measure:

In my condo, there have been many recent change of owners (due to the hot property market), as a result of which, some of the units were bought by foreigners hoping to re-sell them at a profit (just to highlight this point, one unit had barely changed hands before a "For Sale" sign was put up almost immediately. This was some 6 months ago but the unit is still vacant and unsold by the new buyer). Some months have passed but the units remain vacant - and since the owners are foreigners who do not reside here, they will remain vacant. Therefore, such vacant units are perfect for the Aedes mosquitoes - undisturbed for them to multiply manifold for many generations! And yet (despite my previous appeals for such "vacant" units to be the first to be inspected since any breeding inside these vacant units do not affect their owners (who do not stay there) or their families), the government (NEA?) is powerless as they wouldn't enter such premises without the owners' permission! (Just an example - NEA has not been able to enter one of the "identified" vacant units in my condo as they are unable to contact the owner since last week - by the time permission is granted (if ever it is granted), many generations of Aedes would have been hatched!).

Since there are confirmed cases in our estate, why isn't this a top priority?

I can foresee problems with this "missing link" where occupied houses (less likely to have breeding in the premises given the dangers posed to the occupants/loved ones) are subjected to inspection but the vacant units (more likely to have breeding since owners do not stay there) are not. This is exacerbated by the fact that more vacant units are coming up with the enbloc fever now, and the fact that many of the units are bought by foreigners (who do not stay here) for investment/speculation.

Moreover, Singapore regulations do not require these foreign owners to appoint local agents to "maintain" these units, unlike countries like Australia where I understand it is mandatory (correct me if I am wrong).

To-do's for Dr Ibrahim (MEWR) and Mr Mah (MND):

1. Make it mandatory for "vacant" units (unoccupied by owners or lessees) to be maintained by a local agent if the owner is a foreigner not residing here;
2. Mandate regulatory powers to enter households (forcibly) after 2 (or 3?) failed attempts to contact owners - especially for those in dengue clusters.
3. Thorough combing of houses and common areas in or around clusters (daily basis). I believe you have seen photos of clogged drains and filthy public areas, etc..., so I shall not belabour on this point but to add that I have always found it ridiculous that fingers have always been pointed to homeowners (be specific: homeowners of vacant units?) as the main culprits but evidence and reports have proven otherwise, with public areas like drains etc just as prone to breeding. (See my blog on dengue, www.denguealert.blogspot.com for more details).

BBB) For those infected with dengue:

1. My domestic helper first reported having fever on Saturday, 23 June while I was outstation. When the fever failed to go away, I brought her to a GP on Monday, 25 June upon my return to Singapore. GP's prognosis: unlikely to be dengue since (1) rashes only appearing on wrists and not the whole arms and legs; (2) temperature did not stay high at around 39 degree Celcius consistently throughout as her temperature fluctuated between 37 and 39 degrees. She was given anti-fever medicine. Believing the GP, I did not insist on blood test to confirm his prognosis.

2. Her condition improved intermittently but when the high fever returned on Thursday morning, I brought her to another 24-hour out-patient clinic at a nearby private hospital. The GP also said it was unlikely to be dengue as rashes appeared only on wrists and not on arms, legs and body. He however asked if I would like to have a blood test done on her to be absolutely sure, which I insisted since I suspected she might have the dengue. True enough, the blood test results an hour later confirmed my suspicion. She was later admitted to Tan Tock Seng Hospital (CDC).

3. So, for some 6 days (from Saturday, 23/6 to Thursday, 28/6) during her fever period, if any Aedes mosquito happened to have bitten her and then another person, the other person would have been infected, and the chain would go on, and on, and on....

4. The lesson learnt: Many people, including doctors, still do not know a lot about dengue, so despite all the assurances by the doctors about symptoms, the safest bet is still the blood test to confirm if dengue exists.

Given the gravity of the situation now, why isn't blood test for fever patients mandatory, or at least the first to be ordered? The blood test is pretty straight forward and fast (within an hour or so), so why not? The danger of not doing it is that someone with dengue may be missed out or wrongly disgnosed (like my maid - twice - until the blood test) and allowed to recuperate at home (most likely the source of the infection) with the high probability of her being bitten by an Aedes mosquito again for onward transmission to another healthy persson, and the transmission continues...

Despite all our painful dengue experience in 2005 and now, and the glorification of our Sars experience in 2003, such experience unfortunately is not put to good use.

To-do's for Mr Khaw, Health Minister:

1. All fever cases seen by private and public doctors must undergo a blood test to confirm dengue.
2. Report all such fever cases (potential and confirmed dengue) to a central database for tracking of clusters
3. Issue renewed advisory (with help from the local media?) about dengue symptoms since the public/doctors may have wrong ideas about such symptoms, which "may" include (extracted from Straits Times, 2 June 2007, "Dengue Strikes" - refer link, http://bp1.blogger.com/_zAPonigry-4/RmOD5A9cDiI/AAAAAAAAABM/GlEEugRozdo/s1600-h/st+(2+june+2007)+-+dengue+strikes+-+graphic.jpg :

a) Intermittent high fever (my maid had this symptom although not consistently);
b) body aches (my maid had this symptom);
c) exclude nausea (my maid did not have this symptom, so do not include this symptom, otherwise those without nausea may have the wrong impression they do not have dengue);
d) exclude diarrhoea (my maid did not have this symptom, so do not include).
e) rashes (on wrists and/or arms and/or legs and/or body but NOT ALL of these body parts as some doctors believe).

CCC. At the end of the day, minimising the spread of dengue should ideally involve both AAA and BBB above (eliminating breeding areas for the Aedes and preventing adult Aedes mosquitoes from biting an infected person), and the availability of a vaccine (still some years away), but since total elimination of all breeding areas (including forested areas and public areas) is almost impossible, what the government can zero in is to prevent adult Aedes from biting infected persons. (If you care to go through my blog www.denguealert.blogspot.com set up during the 2005 outbreak, I had proposed this too but the idea has not been taken up). How did my maid get infected? Most likely because she was unfortunate enough to be bitten by an infected mosquito after it had bitten an unsuspecting dengue patient (during the intervening "feverish" period before he/she is confirmed to be stricken with dengue via the blood test and/or while recuperating at home with fever - as in my maid's case).

MOH can easily achieve this by requiring all fever cases to see a doctor for a blood test to confirm if dengue exists, and if so, isolate them so that the chain can be broken (a valuable experience from the Sars days). At the same time, re-activate fever screening at all important points (immigration, public buildings, religious gatherings, etc... where masses are expected) to identify those with fever (another Sars invaluble experience) - such
heat-sensing machines are already in place in many areas).

Well, today's Straits Times report says it all - "Dengue cases hit epidemic level again", so do not wait for the situation to get worse (like in 2005) before taking appropriate action belatedly (reactively instead of pro-actively).

My maid remarked in disbelief, "Singapore is so clean (meaning "first world"?) when compared to her home town in Indonesia (meaning not-so-clean "third world"), but how could it happen here?"

When will the supposedly first-world Singapore government ever learn?

Rgds
www.denguealert.blogspot.com
==================================================

ST (3 July 2007) - Dengue cases hit epidemic level again

http://health.asiaone.com.sg/wellnessatwork/20070703_002.html

Dengue cases hit epidemic level again

By Arti Mulchand - Jul 3, 2007
The Straits Times
381 cases last week, crossing epidemic level for second time this year.

THE dengue situation has crossed into epidemic levels for the second time this year - the weekly number of cases here hit 381 last week.
That brings the number of people with dengue in the first 26 weeks of the year to 3,597. Three people have died.
Anything above 378 cases a week is considered an epidemic. The situation first crossed that line in the week of June 10, when it hit 401 cases.
There was a slight let-up last week, though Associate Professor Leo Yee Sin, clinical director of the Communicable Disease Centre and head of Tan Tock Seng Hospital's infectious disease department, had warned that it would be temporary.
She said: 'The number of cases is likely to fluctuate week by week, and it is likely that the level will remain high for the next few months.'
She is confident the figures will not match 2005, when there were 14,209 cases and 25 deaths, but only if 'all necessary measures' are put in place.
'All effort is needed to keep the numbers down,' she added.
The figures are expected to stay high until the usual mid-August or September peak. There were another 40 cases in the past two days alone.
There are now 78 areas where dengue is actively transmitted. In 15 of them, at least 10 people have been hit.
The situation remains bad in areas like Kim Keat, which has 31 cases, and where the dengue-spreading Aedes aegypti mosquito has been biting for close to a month.
It is also no better in the West Coast, where, between West Coast Road, West Coast Drive, West Coast Walk and Jalan Mas Puteh, there has been a combined 53 cases of dengue, and where the disease has been actively transmitted for more than 11/2 months.
Both the National Environment Agency (NEA) and the Ministry of Health (MOH) urge the public to be on even higher alert and to stay vigilant against mosquito breeding.
Those in known clusters should be extra careful, said the NEA. It advised spraying insecticide each morning in dark corners - for example, behind curtains and sofas - to get at mosquitos in hiding, and to apply mosquito repellent.
All clusters are listed on the Campaign Against Dengue website ( www.dengue.gov.sg )
MOH also reminds the public they should seek immediate medical attention if they have a fever. If diagnosed with dengue, they should use mosquito coils, nets and repellent to stop the disease being transmitted further.
'There should be no let-up in our efforts to break the chain of transmission. Continued vigilance is necessary,' said an MOH spokesman.

arti@sph.com.sg

Govt should provide evidence (photos, names..) before accusing home owners for breeding mosquitoes! - CNA (12Jun07) - Second dengue death

2007-06-13T19:23:00.001+08:00

"Name And Shame" culprits breeding mosquitoes?

Sent to the Singapore Government:

=======================================
"With more dengue cases detected at home, Dr Amy Khor, Senior Parliamentary Secretary, Ministry of the Environment and Water Resources, has urged Singaporeans not to let their guard down."

Channel News Asia (12 June 2007), "Second dengue death shows we need to be more alert: Dr Khor"

12 June 2007

Again, we hear of PAP MPs, Ministers, Parliamentary Secretaries, Senior Parliamentary Secretaries, civil servants all pointing the accusing fingers at home owners (just rhetoric but without any substantiation like photos, data, names, etc..) for breeding mosquitoes.

On the other hand, there is equally no shortage of accusing fingers from the public (all with "evidence" like photos, names of those responsible like PUB, NEA, etc..) at government agencies for their failure to maintain public areas like drains, etc.. before they are clogged, resulting in them becoming potential mosquito breeding grounds.

Based on the above, how can Dr Khor confidently claim that "more dengue cases detected at home,... " without any substantiation while the public backed their claims with evidence? Like Ms Kaur said, "..it is not fair to "push all the blame" to the people" when such accusations are not backed by evidence.

Like I suggested in my June 1st email (attached below), the government should

";Name And Shame" culprits breeding mosquitoes? (click on link for more details, or visit companion site, Name N Shame: A listing of mosquito breeders, litterbugs, etc.. ).

Is the government up to the challenge because such "naming and shaming" might well reveal the true culprits to be the government agencies themselves?

Probably that's why the government is so reluctant to implement this solution even if this solution may well work to deter those responsible for breeding mosquitoes - the source of yet another outbreak not long after the major one in 2005.

Rgds

http://denguealert.blogspot.com/

==========================================================

Swarni Kaur <> wrote:

Dear MP,

You were quoted in today's paper that "in spite of the efforts to promote the fight against dengue, Singaporeans were still complacent. People still think they are invincible. We need people to understand that it can really happen to them."

While it may be true that some singaporeans are complacent or ignorant, but it is not fair to "push all the blame" to the people. But the reality is that there are a lot of room for PUB and NEA to improve.

See the following websites and these photos that I have taken.

1) Stagnant water on grass patch along Boon Lay Way. Near Jurong East Sports complex

2) leaves, rubbish and stagnant water in drain along Jurong Town Road. Outside snow city.

http://singaporeseen.stomp.com.sg/viewPost3412.aspx

http://www.straitstimes.com/ST%2BForum/Story/STIStory_128318.html

http://www.denguealert.blogspot.com/

http://singaporeseen.stomp.com.sg/viewPost3377.aspx

http://singaporeseen.stomp.com.sg/viewPost3446.aspx

Maybe PUB and NEA too think that Singaporean are invincible to dengue.

Regards!

==============================================================

http://www.channelnewsasia.com/stories/singaporelocalnews/view/281776/1/.html

SINGAPORE: With more dengue cases detected at home, Dr Amy Khor, Senior Parliamentary Secretary, Ministry of the Environment and Water Resources, has urged Singaporeans not to let their guard down.

A second dengue related death was reported on Monday.

293 dengue cases were reported last week, up from 227 cases the week before.

The Aedes mosquitoes are increasingly adaptable and can breed even in a 20-cent coin size pool of water.

Dr Khor said everyone needs to play a part to bring down the numbers.

"We have found home breeding to have increased in the last couple of months. So we really need to make sure that everyone's involved, not just the managers, town councils... not just the pest control people, but also the residents.

"We do not hope that this will revert to what we have seen in 2005 but we really need to take precautions, put in a lot more effort to be vigilant and alert in order to... prevent this from escalating up to 2005 levels," Dr Khor added. - CNA/yy

Straits Times (12 June 2007) - Drain (outside NUS Law along Bt Timah Rd) still choked despite calling NEA, PUB

2007-06-12T10:25:00.000+08:00

"Name And Shame" culprits breeding mosquitoes?

http://www.straitstimes.com/ST%2BForum/Story/STIStory_128318.html

June 12, 2007
Drain still choked despite calling NEA, PUB
DENGUE cases have been on the rise in the past few weeks and the National Environment Agency (NEA) has been sending pamphlets to households, reminding residents to do their part in preventing mosquito breeding.
However, I have noticed a rather-alarming scene along Bukit Timah Road, where a roadside drain outside the NUS Law Faculty has been choked with weeds for the past few months, resulting in water stagnating in the drain.

I called the NEA hotline and was told that PUB Waterworks, which was responsible for maintaining the drain, would be notified. I made the call in the beginning of May, but nothing was done after a few weeks.

When I called the NEA hotline again, I was told that PUB Waterworks had been informed, and was given its telephone number so that I could remind it personally.

Upon calling the PUB, an officer told me that he would inspect the drain that day. However, a few weeks have passed, the weeds have not been cleared and the drain is still choked.

If residents have been told to do their part against mosquito breeding, shouldn't government agencies, which are responsible for taking care of public areas, set an example by doing their part as well?

Cheong Sooi Peng (Mdm)

PUB/Boon Lay Drive - TNP (6June07) - 100m of drain found clogged in dengue hotspot. PUB slaps maintenance contractor with demerit points

2007-06-07T20:24:00.000+08:00

"Name And Shame" culprits breeding mosquitoes?

To: NEA
cc: REACH

7 June 2007

I believe Ms Kaur has been highlighting this stretch of drain since months
ago but the situation does not seem to have improved, despite the heightened
dengue risk in recent months.

Rgds
============================================
Date: Mon, 15 Jan 2007 08:00:04 -0800 (PST)

From: Swarni Kaur <>Subject: drains near parc vista and boon lay driveTo: YAP_KHENG_GUAN@PUB.GOV.SG, jenlee@sph.com.sg, S_Satish_APPOO@nea.gov.sg,Contact_NEA@nea.gov.sgCC: tckhoo@pub.gov.sg, lee_yuen_hee@nea.gov.sg, denguealert@yahoo.com
see photo of choked drains outside parc vista condo and boon lay drive.
these photo are taken on 7th Jan.
========================================

http://newpaper.asia1.com.sg/news/story/0,4136,132314-1181167140,00.html?

DANGER DRAIN
100m of drain found clogged in dengue hotspot. PUB slaps maintenance contractor with demerit points
DENGUE cases are on the rise, and we have to stop the mozzies from breeding.
By Teh Jen Lee
06 June 2007
DENGUE cases are on the rise, and we have to stop the mozzies from breeding.
But last week, the drains along Boon Lay Drive were clogged and full of stagnant water.
When The New Paper went down to investigate, we found at least 100 metres of the drain along one side of the road blocked with sand, leaves and trash. There was some clogging of the drain on the other side too.
No mosquito larva could be seen, though the water was murky.
It was obvious from the stagnant water and rotting waste that the drains had not been cleared for a long time.
Local residents were jittery. Especially as there is an active dengue cluster in the area, with cases reported in five blocks along Boon Lay Drive.
Pointing at the clogged drain, housewife Lim Lay Hwa, 43, said in Mandarin: 'It's definitely possible for mosquitoes to breed in the water. I've heard of seven cases of dengue in this neighbourhood.'
She was worried about her three children aged 2 to 9, getting dengue.
She noted that the drains used to be better kept. 'Maybe it's because some blocks of flats around here have become empty recently when people moved out,' she said.
Said Madam Rosnah Mahad, 42, a housewife cycling past the clogged drains: 'Of course I am concerned. The authorities should clean it up.'
Another resident, who gave his name only as John, said: 'It seems like this area has been neglected. My mother almost died from dengue 10 years ago. I know how scary it can be. I really hope something is done.'
He said the area is home to many foreign students and workers, and more should be done to educate them on the dangers of the disease.
Ministry of Health figures have shown that roughly 30 per cent of dengue cases here involve foreigners.
The National Environment Agency (NEA) and the Public Utilities Board (PUB) are jointly responsible for ensuring that drains do not become breeding grounds for mosquitoes.
In reply to our queries, Mr Tan Nguan Sen, PUB's director for catchment and waterways, said its contractors are engaged under a performance-based contract to maintain the drains.
This rewards good performance and penalises shoddy work.
PENALISED
'Under this system, the contractors will have to clean as often as it is needed to keep the drains clean and litter-free, and they will be paid more if more cleaning is needed. However, if they fail to keep the drains clean, they will be penalised,' he said.
'The contractor in charge of Boon Lay Drive and Boon Lay Avenue failed to meet the standards and has been given demerit points, which will affect future performance evaluations.'
He added that the clogged drains have since been cleared.
'PUB welcomes all public feedback. All feedback received will help to strengthen our system, especially as Singapore has more than 7,000 km of drains and canals. The public can contact us at our 24-hour call centre PUB-One at 1800-2846600,' Mr Tan said.
A spokesman for NEA said it will apply granular insecticide to prevent mosquito-breeding whenever it comes across water stagnation in drains.
As for educating foreign workers on dengue, NEA has developed and distributed anti-dengue materials in English, Mandarin, Malay, Tamil, Bengali, Burmese, Thai, Tagalog and Sinhalese.
The number of dengue cases reported between 20 and 26 May is 259.
Weekly figures are released every Tuesday. The number of cases for the week of 27 May to 2 Jun will be released at noon today.

Jalan Besar Town Council & PUB? - Fwd: Clogged drains. Good breeding spots? (Sims Drive/Sims Place)

2007-06-06T14:30:00.000+08:00

'May I suggest that perhaps the government can adopt the "Name and Shame" (visit related site http://namenshame.blogspot.com/ to view listing of these culprits) strategy by identifying which areas that have been found to be breeding mosquitoes and under whose responsibilities (eg town councils, PUB, outsourced contractors, developers, individual household residents, etc...) with the corresponding Corrective Work Order (CWO) of "area cleaning" for culprits? 'http://denguealert.blogspot.com/2007/06/choked-and-overflowing-drain-and-sum.html

denguealert@yahoo.com

===================================================
Reply from NEA:

Subject: Clogged drains. Good breeding spots?

To: denguealert@yahoo.com
CC: Nordin SULAIMAN , PUB One ,Damian LEE , Feedback@jbtc.org.sg
From: Zulkarnain HASSAN BAKTEE Zulkarnain_HASSAN_BAKTEE@nea.gov.sg

Date: Wed, 6 Jun 2007 10:58:56 +0800Dear

Sir

I refer to your email feedback as appended below

In our recent check on 6 Jun 07 although no mosquito breeding was detected in the drain , potential habitats such as discarded containers found in the vicinity were removed immediately. We had also alerted to PUB to spruce up the road side drains and the Town Council to cleanse the HDB drains.

We are continuing our close surveillance of the estate

We will continue to work with all parties concerned to ensure a safe and clean environment and monitor the site closely.

Please contact our Managerof the area Mr Nordin Sulaiman at Tel 68546443 should you need further assistance.

Thank you for your feedback.

Sincere regards
Zulkarnain H Baktee
Manager
Customer Relations, Surveillance & Intelligence
Central Regional Office
National Environment Agency
DID +65 68546408
Fax +65 62739641

==================================================
Date: Sun, 27 May 2007 22:21:21 -0700 (PDT)

From: Moonbeam <>

Subject: Clogged drains. Good breeding spots?

To: denguealert@yahoo.com

Hi,
Attached are fotos taken of the drain in front of Blk 52 Sims Place last Thurs (24 May 07).

Sims Drive/Sims Place has been a dengue cluster for quite a number of weeks and the areas have been expanding. There's a lot of mosquitoes in the area, and from the condition of the drains there, it seems as though the drains are the cause of the presence of mosquitoes.Weird that no one has cleaned up the drains yet.

HDB & Town Councils - ST (6 June 2007) - Ltr: New methods and strategy needed to curb mosquitoes

2007-06-06T14:22:00.000+08:00

http://www.straitstimes.com/ST%2BForum/Story/STIStory_126303.html

June 6, 2007

New methods and strategy needed to curb mosquitoes

THE National Environment Agency should concentrate not only on households in its drive against mosquito breeding but also on other areas, such as drains in HDB estates and manholes along roads.
Most of the drains in HDB estates and manholes have stagnant water for long periods. They are not flushed or fogged regularly.
Unless the authorities carry out regular maintenance, these are real problems. Unlike private estates where fogging is done once a week, there are no such measures in HDB estates.
Lim Keng Hian
===============================================================

THE article, 'Dengue situation worrying, says head of CDC' (ST, June 2), is indeed worrying.
In an US experiment, it was found that less than 4 per cent of mosquitoes were killed with fogging. The most effective method is to eliminate them when they are in the larva stage in stagnant water as once they are able to fly, it is very difficult to kill them.
The uptrend in dengue cases is a cause for concern. Perhaps the National Environment Agency should look at non-traditional methods, and breeding places such as coconut trees planted in HDB areas.
Danny Chua Hock Chye

Straits Times (1 June 2007) - Ltr: NEA staff should have told him to call PUB

2007-06-05T16:01:00.000+08:00

http://www.straitstimes.com/ST+Forum/Story/STIStory_124781.html

The Straits Times
June 1, 2007

NEA staff should have told him to call PUB

ON MAY 25, I noticed that the drain along Jalan Loyang Besar (near Aloha Loyang) was again choked with overgrown weed and fallen leaves. I called the National Environment Agency (NEA) hotline to alert the staff to the problem. The officer assured me that she would pass my feedback to the relevant officer.
Three days later, I went to check on the drain. It was still choked. So I called NEA again. I was shocked when another officer told me that the choked drain comes under PUB. She asked that I call PUB instead.
I called the PUB hotline and an officer promised to have the matter looked into. Meanwhile, the drain is still choked.
It is ironic that while the CEO of NEA was making a big effort to declare war on mosquito breeding, the officer manning the NEA hotline adopted a different attitude.
It seems that whoever is responsible for the upkeep of the drain has failed in their duty. In the past five to 10 years, I had often been the one to clear the overgrown grass and debris.

Ong Kim Soon

Sunday Times (3 June 2007) - Citizen vigilantes step up fight against dengue

2007-06-04T12:07:00.000+08:00

June 3, 2007

Citizen vigilantes step up fight against dengue
Singaporeans have been taking part in the war against dengue fever, calling the NEA's hotline with tip-offs. Here, an NEA health officer is applying insecticide to the roof gutters of a house in Yishun. -- MUGILAN RAJASEGERAN
THE National Environment Agency (NEA) may have waged war on dengue fever, but it is still scant comfort to worried Singaporeans who have taken to alerting the authorities on where Aedes mosquitoes might be found.
Some write in to the newspapers. Others forward pictures of drains littered with leaves or refuse to The Straits Times' interactive online portal Stomp. But most are calling the NEA's hotline with tip-offs.
The agency got 2,502 calls last month, up from just 802 in April.
One man, at least, has taken dengue vigilance to another level. Mr Jeffrey Ho, 53, started a blog (www.denguealert.blogspot.com) during the last outbreak in 2005 to track potential breeding sites.
He has been taking pictures of drains choked with leaves, water or litter, posting them on his blog and sending them off to the NEA too.
Since about three months ago, he began getting more contributions to his blog from fellow dengue watchers, some with pictures of other clogged drains around the island.
'Most people don't know which drain falls under which agency's jurisdiction, so it can be quite frustrating sometimes.'
All public roadside drains are maintained by the Public Utilities Board's (PUB) contractors while individual land agencies or occupiers are responsible for the drains within their premises.
So town councils would take charge of those in their HDB estates, while JTC manages those in their industrial estates.

Read the full story in The Sunday Times.

"Name And Shame" culprits breeding mosquitoes?

2007-06-04T11:28:00.000+08:00

Straits Times (2 June 2007) - Dengue Strikes

2007-06-04T11:13:00.000+08:00

Straits Times - 2 June 2007:

http://www.straitstimes.com/Free/Story/STIStory_125187.html
June 2, 2007

Scientists stumped by 2 dengue findings here
Strains of disease found here and victims differ from elsewhere in region
By Tania Tan
UNDER INVESTIGATION: Health Minister Khaw Boon Wan visited Sembawang Drug Rehabilitation Centre to review the situation there. -- CHEW SENG KIM
SCIENTISTS studying dengue fever here are stumped on two fronts - that uniquely Singapore strains seem to have risen here and that young adults are most hit by the fever.
Early results from an ongoing islandwide study show that the strains of the virus circulating here could be evolving differently from those in other parts of the region.
Dr Martin Hibberd, a dengue researcher and associate director of infectious diseases at the Genome Institute of Singapore, said: 'It's possible that almost all the strains we see now are found exclusively in Singapore.'
Preliminary findings of the Early Dengue (Eden) infection and outcome study also suggest that young adults here - those over 21 - are more often victims of the disease than their counterparts in other Asian countries where the disease is endemic.
In Indonesia and India, for example, dengue victims are much younger - children.
In the region, the chance of meeting an infected Aedes mosquito carrying the virus is once every six months.
RELATED LINKS
Dengue strikes
Here - because of stringent vector control - the chance of getting bitten by an infected mosquito is about once every 10 years, what Dr Hibberd calls 'a statistical rarity'.
Adults are therefore more likely to be bitten - simply because they have been around longer.
But dengue infection in adults is not well studied here. Instead, most records are of cases of infection among children, said Dr Hibberd.
Even guidelines on treatment and management of the disease from the World Health Organisation were developed with young patients.
With so little to fall back on, doctors and scientists here have their work cut out. They have therefore pulled out all the stops in this fight against disease-bearing mosquitoes.
Eden, launched in 2005, is a collaboration between the Novartis Institute for Tropical Diseases, Tan Tock Seng Hospital and the National University of Singapore (NUS).
The study, which tracks the progress of disease development in volunteer patients with fever, hopes to shed light on how adult immune systems respond to dengue, and how best to treat the disease.
Another islandwide study by the National Environment Agency is investigating the proportion of people with immunity against different types of dengue.
Because not enough is known about the disease, vaccines are difficult to develop.
Some drugs are already in clinical trial phase, but researchers have yet to strike upon the 'perfect' vaccine, even after 20 years, said a Novartis spokesman.
A key hindrance is the fact that there are four types of dengue.
Vaccines that do not protect against all four types could do more harm than good, in that patients could end up developing more severe symptoms, said Associate Professor Paul Ananth Tambyah from NUS' Yong Loo Lin School of Medicine.
'That is a very high standard that most modern vaccines cannot meet,' he said.
taniat@sph.com.sg

Choked and overflowing drain and sum pit at jct of Gentle and Buckley Road - across from Revenue House

2007-06-01T11:07:00.000+08:00

Sent to REACH and NEA on 1 June 2007:

Date: Thu, 31 May 2007 20:05:06 -0700 (PDT)

Re: Choked and overflowing drain and sum pit at jct of Gentle and Buckley Road - across from Revenue House

To: REACH
cc: NEA CEO

1 June 2007

Please see attached photos taken at the subject junction on 31 May 2007 at around 1.34 pm.

You will note that the chokage at the sum pit and surrounding drains had caused the water to overflow. But fortunately, the overflowing water resulting from the chokage was not serious enough to cause any flooding around the area.

What is worrying is that because of the chokage (probably caused by uncleared fallen leaves, litter, etc..), it is potentially a fertile breeding ground for mosquitoes, given that the dengue is back.

Why is it that despite all the efforts that have been put in by the various government agencies (the formation of the inter-ministerial committee to tackle the menace since the major outbreak in 2005), the lessons are still not well learnt?

Well, of course, complacency is partly to blame.

And perhaps coupled with that, an attitude of "It is someone else's responsibility"? (By the way, is this affected area (public drains and sum pit) mentioned herein the responsibility of NEA? PUB? Outsouced contractors? Who else?

May I suggest that perhaps the government can adopt the "Name and Shame" (visit related site http://namenshame.blogspot.com to view listing of these culprits) strategy by identifying which areas that have been found to be breeding mosquitoes and under whose responsibilities (eg town councils, PUB, outsourced contractors, developers, individual household residents, etc...) with the corresponding Corrective Work Order (CWO) of "area cleaning" for culprits?

I can understand its reluctance (as the culprits might well be its own agencies (like NEA, PUB, MOE, HDB, etc..) or areas under its management (like PAP town councils), but in the interest of public health and accountability, the government should be transparent in identifying who the real culprits are. Otherwise, we will keep having the perennial problem again and again....

Rgds
Jeff
http://www.denguealert.blogspot.com/

Clogged drains at Blk 52, Sims Place (a dengue cluster): Good breeding spots?

2007-05-29T12:18:00.000+08:00

Sent to REACH and NEA on 29 may 2007:

Jeff Ho wrote:

Date: Mon, 28 May 2007 21:16:17 -0700 (PDT)

From: Jeff Ho denguealert@yahoo.com

Subject: Clogged drains at Blk 52, Sims Place: Good breeding spots?

To: reach@reach.gov.sg

CC: Yuen Hee LEE LEE_Yuen_Hee@nea.gov.sg , 75557@stomp.com.sg,Alias , ONN Alias_ONN@nea.gov.sg , Aminah YUNOS Aminah_YUNOS@nea.gov.sg , Ann WONG Ann_WONG@nea.gov.sg , Chin Boey CHIA CHIA_Chin_Boey@nea.gov.sg , Dalson CHUNG Dalson_CHUNG@nea.gov.sg , Fung Yin PANG PANG_Fung_Yin@nea.gov.sg , Hameed MASDI Hameed_MASDI@nea.gov.sg , Hui Tiak TAN TAN_Hui_Tiak@nea.gov.sg , Jamal MAJID Jamal_MAJID@nea.gov.sg, John GERIZIM John_GERIZIM@nea.gov.sg , Kahlik ISMAIL Kahlik_ISMAIL@nea.gov.sg , Kheng Seng LEE LEE_Kheng_Seng@nea.gov.sg , Kim Kee LIM LIM_Kim_Kee@nea.gov.sg , Kok Choy HUI HUI_Kok_Choy@nea.gov.sg , Lisa KOK Lisa_KOK@nea.gov.sg , PUB Teng Chye KHOO tckhoo@pub.gov.sg , R Chandramogan R R_Chandramogan_R@nea.gov.sg , Raja CHONNAMUTHU Raja_CHONNAMUTHU@nea.gov.sg , Ravindran NAIR Ravindran_NAIR@nea.gov.sg , S Satish APPOO S_Satish_APPOO@nea.gov.sg , Sara BOH Sara_BOH@nea.gov.sg, Selvanayagam INTHRALINGAM Selvanayagam_INTHRALINGAM@nea.gov.sg, Siti Suriani ABDUL MAJID Siti_Suriani_ABDUL_MAJID@nea.gov.sg, Song Joo LIM LIM_Song_Joo@nea.gov.sg, Subramaniam RAMASAMY Subramaniam_RAMASAMY@nea.gov.sg, Yaacob IBRAHIM Yaacob_IBRAHIM@mewr.gov.sg, Zulkarnain HASSAN BAKTEE Zulkarnain_HASSAN_BAKTEE@nea.gov.sg

To: Feedback Unit
cc: various NEA officers

29 May 2007

see attached email from concerned resident.

Moonbeam <> wrote:

Date: Sun, 27 May 2007 22:21:21 -0700 (PDT)

From: Moonbeam <>

Subject: Clogged drains. Good breeding spots?

To: denguealert@yahoo.com

Hi,

Attached are fotos taken of the drain in front of Blk 52 Sims Place last Thurs (24 May 07). Sims Drive/Sims Place has been a dengue cluster for quite a number of weeks and the areas have been expanding. There's a lot of mosquitoes in the area, and from the condition of the drains there, it seems as though the drains are the cause of the presence of mosquitoes. Weird that no one has cleaned up the drains yet.

Singapore's health minister says dengue outbreak worsened by spread of new strain

2007-05-25T14:45:00.000+08:00

http://hosted.ap.org/dynamic/stories/A/AS_MED_SINGAPORE_DENGUE_ASOL-?SITE=ASIAONE&SECTION=SOUTHEAST&TEMPLATE=DEFAULT&CTIME=2007-05-24-03-18-33

May 24, 3:18 AM EDT
Singapore's health minister says dengue outbreak worsened by spread of new strain
By GILLIAN WONG Associated Press Writer
AP Photo/Wong Maye-e
SINGAPORE (AP) -- A strain of dengue new to Singapore is impeding efforts to stem the spread of the mosquito-borne disease that has infected hundreds in the affluent city-state this year, a top health official said Thursday.
Health Minister Khaw Boon Wan said the current rise in infections, including a record 210 cases last week and one fatality, evoked memories of a 2005 epidemic that killed 25 in the tropical island-nation of 4.5 million.
"I'm quite worried about the dengue trend," Khaw told reporters on the sidelines of an infectious diseases exhibition.
Authorities said earlier this week that Singapore recorded a nearly 50 percent increase in dengue infections in the first 4-1/2 months of this year compared to the same period in 2006.
Dengue cases reported from the start of January to May 12 rose to 1,488 - up from 993 in the corresponding period last year, the Health Ministry said.
Singapore defines an epidemic as more than 378 cases a week, local media reported.
The disease, which causes joint pain, high fever, nausea and a rash, is endemic to the region. In severe cases, it leads to internal bleeding and sometimes death.
Khaw said the emergence in Singapore of a different dominant type of dengue was compounding the problem.
"What is a little against us is because of the strain, the strain type. It is ... largely new to the population here," Khaw said. "It's troublesome because many people have no current, existing immunity."
The dengue virus now predominant in Singapore is believed to be the same as in neighboring Indonesia, and is different from the main active strain in Singapore over the past few years, according to local media reports.
Those previously infected with other types of dengue are not immune, and may even face a higher risk of complications when infected with a different strain, The Straits Times newspaper said.
Health officials have been combing public housing estates in search of mosquito breeding sites. Dengue-carrying insects can breed in tiny pools of water found in flower pots, discarded bottles or cans, or old tires.
The Health Ministry said the recent spike in infections is likely due to warmer weather during this period of the year, which is conducive for breeding mosquitoes and the spread of dengue.
© 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

So many clogged drains. No wonder there's dengue.

2007-05-21T16:20:00.000+08:00

http://singaporeseen.stomp.com.sg/viewPost3052.aspx

From Yew Tee to Bukit Timah, one STOMPer has spotted potential dengue hotspots at clogged drains around Singapore.
Regular STOMP contributor, 51-year-old AG Lee, most recently emailed STOMP about his concerns about the rise in dengue cases in Singapore, and wonders if clogged drains like these might contribute to this worrying trend.
He came across these drains clogged with rubbish near a bus shelter at the Yew Tee industrial estate (main picture).
He also spotted a similar sight near the Anak Bukit flyover along Bukit Timah Road, where rubbish and overgrown grass had been clogging up the drains there (pictured)

He wondered if there could be more done by the authorities to prevent these spots from turning into dengue danger zones.
STOMP has contacted the National Environment Agency (NEA) and the PUB for comment. Watch this space.

Another dirty street near Aljunied MRT - potential dengue breeding gound

2007-05-21T15:31:00.000+08:00

See another dirty street in singapore.

http://singaporeseen.stomp.com.sg/viewPost2981.aspx

Why is this drain so dirty?

William Lim, 47, was appalled that the drain behind Aljunied MRT station was dirty and clogged up with rubbish.The production manager was on Geylang Lorong 25A, near the roundabout behind Aljunied MRT station where cars drop off and pick up passengers, yesterday evening (14 May).He was there with a friend at about 5pm to 6pm when he noticed the drain.He told STOMP, “It looked like the drain was not cleared for a long time. The water is stagnant, and there were newspapers and rubbish in there.”“I am so shocked that there is this kind of drain in Singapore.”

AP (21 May 2007) - Singapore records sharp rise in dengue cases, possibly from spread of new strain

2007-05-21T15:17:00.000+08:00

http://hosted.ap.org/dynamic/stories/A/AS_MED_SINGAPORE_DENGUE_ASOL-?SITE=ASIAONE&SECTION=SOUTHEAST&TEMPLATE=DEFAULT&CTIME=2007-05-21-01-05-18

May 21, 1:05 AM EDT
Report: Singapore records sharp rise in dengue cases, possibly from spread of new strain

SINGAPORE (AP) -- Singapore recorded a nearly 50 percent increase in dengue infections in the first 4 1/2 months of this year compared to the same period in 2006, news reports said Monday.
Dengue cases reported from the start of January to May 12 rose to 1,488 - up from 993 in the corresponding period last year, The Straits Times newspaper reported.
Singapore had 180 new cases of dengue reported last week, an all-time high, according to local TV news station Channel NewsAsia.
Health Minister Khaw Boon Wan said the sharp rise could be caused by a different strain of the virus spreading in the tropical city-state of 4.5 million, the paper reported.
One man is believed to have died this year from dengue fever, the paper said, without giving details.
The Health Ministry had no immediate comment on the reports.
Health officials have been combing public housing estates in search of mosquito breeding sites. Dengue-carrying insects can breed in tiny pools of water found in flower pots, discarded bottles or cans, or old tires.
Like several other Southeast Asian countries, Singapore reported a higher-than-usual number of dengue infections in 2005.
The disease, which causes joint pain, high fever, nausea and a rash, is endemic to the region. In severe cases, it leads to internal bleeding and sometimes death.
At least 19 out of Singapore's 4.2 million people died last year from the disease.
© 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Re: Feedback On Drains and Road - St Michael's Road

2007-05-08T13:43:00.000+08:00

Sat, 5 May 2007

Thank you for your reply. I agree with you that if the leaves have been left there for sometime, then the contractor is not doing its job and this not acceptable. I have asked my officers to be more thorough in checking on the contractors. Thank you once again for your feedback.
Regards
Lee Yuen Hee
Chief Executive Officer
The National Environment Agency
DID +65 67319887
Fax +65 62352611

NEA's removal of leaves and litter in (public) drains done only once a week!!

2007-04-25T09:59:00.000+08:00

"Of greatest concern is the removal of leaves and litter in drains and surrounding grass verges which is also, at best, done once a week."

The Straits Times - ST Forum
April 25, 2007
Monitor NEA contractors' work in dengue hotspots

DR ONG Siew Chey's letter, 'More trees? Take care that we don't breed mozzies' (ST, April 21), highlighted a disturbing fact: that the sweeping of public places is not as frequent as the National Environment Agency (NEA) seems to think.
NEA contractors seem to have broken down the job formerly done by street sweepers into four parts:
Emptying of trash cans at bus stops and sweeping the immediate area (by a truckload of sweepers moving from one bus stop to the next).
Sweeping of main roads using a large truck with vacuum hoses and brushes.
Sweeping of side roads using a smaller vehicle using similar methods.
Removal of leaves and other litter in public drains and grass verges (also by a team of men) and bagging the refuse for later collection.
The cleaning of bus stops seems to be done nightly and the sweeping of main roads, on a daily basis.
However, the sweeping of side roads is done once a week at most. My neighbour has made it easier by regularly sweeping the roadside leaves into a pile. This pile stays uncollected for days.
Recently, fruit trees produced a bumper harvest. Ripe fruit from an absent neighbour's house fell onto the road and were not removed for at least two weeks.
Of greatest concern is the removal of leaves and litter in drains and surrounding grass verges which is also, at best, done once a week. This is very poorly done - fallen branches are left on the grass next to drains, and I even saw one man using a leaf blower to blow cut grass into the monsoon drain, to avoid sweeping it from the grassy areas. Is it any wonder that when the rains finally come after a dry spell, flooding sometimes occurs in places that never experienced flooding before?
NEA has stated before that dry weather is when mosquitoes breed outdoors. This is because heavy rain will wash mosquito eggs and larvae away, except in containers and pools. Therefore, if dead leaves which collect water are left undisturbed in dry weather, mosquito eggs may hatch. It is time that the NEA employed people to monitor its contractors' performance, especially in dengue hotspots.
Gwee Jin Eng (Ms)
====================================================

The Straits Times - ST Forum
April 21, 2007
More trees? Take care that we don't breed mozzies

I AM happy to know that more than 100,000 plants and trees will be planted in our garden city over the next year. However, it is important that the right types of trees are chosen.
We are all aware of the danger of mosquitoes breeding in stagnant water in drains, flower pots and gutters but we seldom pay attention to the leaves that fall from trees.
In the Botanic Gardens fallen leaves are in abundance but the maintenance is so good that they do not constitute a hazard.
The same thing cannot be said for the other side of Cluny Park Road. Many of the trees there have large thick leaves that take weeks or even months to decay. Fallen leaves are found everywhere.
Those in the monsoon drains and on road surfaces get washed away during a heavy rain, but those in the small side drains and on roadsides are rarely cleared, contrary to the claims by private contractors of the National Environment Agency in their flyers.
Aedes mosquito eggs are known to withstand dryness for long periods, and while the small pockets of water on fallen leaves that attract mosquitoes to lay eggs may dry up before hatching takes place, the eggs will hatch with the next rain. I once counted six larvae on one leaf.
It is important for us to choose wisely the trees to plant because of our environment. I hope the authorities will choose those with small or delicate leaves that do not collect pockets of water or which will decay easily.
Dr Ong Siew Chey

Feedback On Drains and Road - Anson Road

2007-04-23T20:27:00.000+08:00

Date: Sun, 22 Apr 2007 23:31:25 -0700 (PDT)

Subject: Re: Feedback On Drains and Road - Anson Road

To: Jeff Ho , YAP_KHENG_GUAN@PUB.GOV.SG,
jenlee@sph.com.sg, S_Satish_APPOO@nea.gov.sg, Contact_NEA@nea.gov.sg
CC: lee_yuen_hee@nea.gov.sg, Nordin SULAIMAN ,
Alias ONN , Aminah YUNOS ,
tckhoo@pub.gov.sg, lee_yuen_hee@nea.gov.sg, SIMON_TAY@NEA.GOV.SG,
CHUNG/MEWR/SINGOV%SINGOV ,
Jeff Ho , Kheng Seng LEE ,
Hui Tiak TAN ,
Ji Choong TAI ,
Selvanayagam INTHRALINGAM ,
Kim Kee LIM

See these photos are taken on 13th Apr.

To date, these drop inlet chamber are still choked with leaves.

These leaves were there since the heavy rain in Dec 06.

Of course, if Anson road is flooded again, the usual excuse will the

"The storm was an intense one and the amount of rainfall that fell was 105mm, the bulk of which fell in a twenty minutes period at about 3pm. This rainfall was very intense when we compare it to the average rainfall for the whole month of Apr which is only 178.9mm in a typical year. Prior to this occasion, we have not had feedback of flooding at this location."

cc: Chairman and CEO of NEA, CEO of PUB

Dengue comeback - choked public drains again?

2007-04-20T19:41:00.000+08:00

Date: Fri, 20 Apr 2007 04:38:40 -0700 (PDT)

Subject: Re: drains near parc vista and boon lay drive

Sent to NEA & PUB'

Hi NEA,

I'm back, now that the dengue is back with us again! Have the problem areas highlighted by Ms Kaur been fixed? I hope it has (since it's been more than 3 months old now), but then again, with NEA, one never is sure.

I still see many public drains still choked - I shall whip out my phone-camera again. I hope you guys (NEA, PUB, LTA, town councils, etc...) are not playing "tai-chi" again - shifting blame from one entity to another, at the expense of poor residents.

Rgds

Swarni Kaur wrote:
see photo of choked drains outside parc vista condo and boon lay drive.
these photo are taken on 7th Jan.
----- Original Message ----

From: Swarni Kaur

To: YAP_KHENG_GUAN@PUB.GOV.SG; jenlee@sph.com.sg

Cc: mewr_yaacob_ibrahim@mewr.gov.sg; tckhoo@pub.gov.sg; lee_yuen_hee@nea.gov.sg; denguealert@yahoo.comSent:

Wednesday, 27 December 2006 9:07:34

Subject: Flood buster loves checking drains

Hi Mr Yap,

I refer to the New Paper article dated 23rd Dec 06 which mentioned that you spent your "free time" looking at drains instead of shopping. I admire the dedication and drive that you have towards your work.

After my children caught dengue fever a few years ago, like you, I have been monitoring the cleanliness of our drains in Singapore too.

Unfortunately, your NEA counterparts (and their contactors) have been slack in keeping the drains clean. See the attached photo and string of email correspondences.

Thus, it is not surprising for me to read in TNP that
"PUB's technical team and contractors also had to clear 1500kg of flood debis from drains in Olive Road.. The floods has washed down tree branches, cardboard boxes and even a refrigerator".

It is pointless spending precious taxpayer money building world class drainage infrastructure, if NEA can't keep it clean of rubbish.

I hope that MEWR, together with NEA and PUB can work hand in hand to keep Singapore clean, free of dengue. Hopefully, we do not have to wait for the next heavy rain to tell us that our drains are full of rubbish.

cc:
Dr Yaccob Ibrahim, Minister for MEWR
Dr Amy KHOR, Senior Parliamentary Secretary for MEWR
Mr Khoo Teng Chye, CEO PUB
Mr Lee Yuen Hee, CEO NEA.

Today (17 Aug 2006) - Roof gutters: A new national standard for roof drainage has been introduced

2006-08-22T12:15:00.000+08:00

To: HsienLoong Lee - lee_hsien_loong@pmo.gov.sg

CC: Yaacob Ibrahim - yaacob_ibrahim@mewr.gov.sg,
CC: "Feedback@MCYS" - Feedback_UNIT@mcys.gov.sg

"...the government may also consider mandating roof gutters (a source of breeding that is hard to maintain because of accessibility) be changed/improved to prevent ponding..." (see link http://denguealert.blogspot.com/2005/09/letter-to-prime-minister-make.html for full message)

To: Prime Minister Lee Hsien Loong

cc: Dr Yaacob Ibrahim - MEWR Minister
cc: Feedback Unit

22 Aug 2006

I am indeed heartened to read of the government finally taking up my suggestion of regulating roof gutters in private homes (refer to attached and link to the blog), one of the many sources of mosquito breeding.

Let's partner in our on-going fight against this menace as this fight involves everyone.

Rgds
Jeffrey
http://www.denguealert.blogspot.com/

===============================================================================

http://denguealert.blogspot.com/2005/09/letter-to-prime-minister-make.html

Friday, September 02, 2005

Letter to the Prime Minister - Make Singapore dengue-free
(see link above for full message)
===================================================================

http://www.todayonline.com/articles/136872.asp

Today, 17 Aug 2006
SingaporeSnippets

.Getting roofs in line
.A new national standard for roof drainage has been introduced.
.The revised code of practice includes a new section on the prevention of mosquito breeding, setting out specifications for the design of roof gutters, rainwater outlets and rainwater down pipes.
.The revised standard has been introduced to help construction companies abide by the designs and procedures spelled out by the National Environment Agency (NEA).
.Last November, the NEA banned roof gutters for all new developments in a bid to prevent mosquito breeding. Only if a waiver has been obtained in writing from the agency are exceptions to the rule permitted. — 938Live

The New Paper (24 June 2006) - Number of dengue cases up in May and June

2006-06-26T11:52:00.000+08:00

Sent to NEA:

26 June 2006

Now that the number of cases has gone up, I'd suggest NEA put up the "Weekly Cluster List" which was terminated sometime last year or early this year when the number of cases decreased. I hope they will not wait till the outbreak gets out of control before doing so.

I note the largest clusters are at Farrer Court and Victoria Park.

Rgds
Jeffrey
www.denguealert.blogspot.com

=======================================================================
http://newpaper.asia1.com.sg/news/story/0,4136,108831-1151186340,00.html?

Number of dengue cases up in May and June
Brother hitThen, within a day... sister hit
WHEN they got home, there was a note from their father waiting for them.
By Teh Jen Lee
24 June 2006
WHEN they got home, there was a note from their father waiting for them.
It showed the drawing of a mosquito and read: 'We missed you.'
The brother and sister had a good laugh, but could not hide the painful memories of suffering from dengue.
Mr Joe Choo, 21, a national serviceman, and his younger sister were hit within a day of each other.
Both had spent nearly a week in hospital enduring things like constant jabs of the needle and throwing up.
At one point, things got so bad for Mr Choo that the doctor told him an accidental fall could leave him paralysed as a result of internal bleeding.
Family members being hit by dengue within such a short time of each other may become more common as dengue cases doubled from 43 in early May to 85 last Saturday. (See graphics.)
Recalling his ordeal, Mr Choo said: 'I woke up with a splitting headache and a fever of 39.5 deg C.
'I had diarrhoea and vomitting for the next two days.'
His sleep was interrupted as he had to go to the toilet every hour.
'From my throat all the way down to my stomach, I had this uncomfortable feeling. I felt very weak and had very little appetite,' he said.
There was a taste of bile in his mouth from throwing up too much.
'The loss of fluids made my blood very concentrated. At one point, the doctor told me that if my blood got any thicker, I would get the haemorrhagic form of dengue fever,' said Mr Choo.
Of the 19 who died from dengue last year, many had succumbed to dengue haemorrhagic fever, a more severe form of the viral disease.
Mr Choo's platelet count was also very low, going down to 68 when the normal is 150 to 400.
Platelets are necessary to enable the blood to clot.
An SMS alert was sent out to his church friends, asking them to pray because his platelet count was 'dangerously low'.
He was admitted to the Communicable Disease Centre on 15 Jun. A day later, his 15-year-old sister, Shi Hua, was also hospitalised there, but in a different room.
The Secondary 3 student had fever for six days before her platelet count went below 90 and she had to be admitted to hospital.
She said: 'When my fever started, I had no idea it was dengue.
'It was the first time I had to endure so many needles and blood tests.'
Once, a nurse had to insert the needle three times before finding a vein to take a blood sample.
She was also bored with being cooped up in a single-bed room.
Even after she was discharged on 20 Jun, she was asked to stay at home for a few more days.
She had her brother for company - he was discharged a day earlier but is on hospitalisation leave until Monday.
The siblings have had their blood pressure taken so many times that the equipment left red lines on their forearms. The marks are still visible several days after they were discharged.
Dad Choo Ngiap Lee, 52, who penned the note, was on a work-related trip abroad when his eldest and youngest child fell sick.
His other daughter, aged 17, was spared from the virus.
Said the businessman: 'They go out so often, Joe to NS camp and Shi Hua to school, it's hard to know where they got bitten. If it's at home, I can take care of it but outside, it's hard.'
Mr Choo always makes sure that there are no breeding spots in his Rosyth Road apartment as he regularly checks the potted plants for stagnant water.
Members of his extended family who occupy the same block have also done their part.
His sister, Madam Irene Choo, 49, an administrative clerk, said in Mandarin: 'We've always been careful so we didn't have to do anything extra after my nephew and niece came down with dengue.'
Since last month, dengue cases have surfaced in areas as far apart as Boon Lay Place, Lengkok Bahru, Commonwealth Close, Commonwealth Drive, Phillips Avenue and Serangoon North Avenue 1.
The largest dengue cluster this year was found early this month in Farrer Court and Victoria Park, both of which are residential areas.
Seventeen people came down with dengue fever within a fortnight.
Copyright © 2005 Singapore Press Holdings Ltd. Co. Regn. No. 198402868E. All rights reserved.Privacy Statement and Conditions of Access

Striats Times (23 June 2006) - Ltr: NEA not able to access mosquito-hazard premises

2006-06-26T11:50:00.000+08:00

June 23, 2006
NEA not able to access mosquito-hazard premises

I REFER to the article, 'Dengue cluster at Farrer Road condo' (ST, June 16).
I wrote to the National Environment Agency (NEA) on Feb 18, following Minister for the Environment and Water Resources Yaacob Ibrahim's call for all Singaporeans to be the 'eyes and ears' in the fight against dengue, because I was deeply concerned about the hazard posed by a neighbour's premises in Toh Tuck Place.
There were numerous empty fish-tanks and earthenware pots. There were also flower-pots and pans left out in the open for months.
A disused washing area had been turned into a miniature pond to grow water hyacinth but there were no fishes within.
NEA officers were invited to view the premises from the vantage point of my home. They agreed in writing that there was an environmental hazard, and assured me that appropriate measures would be taken to resolve the problem.
However, after four months, the problem had not been rectified. The NEA has not been able to access my neighbour's premises despite three letters being sent to the owner.
In this time, I wonder how many batches of mosquitoes have hatched and flooded our neighbourhood.
There has been a definite increase in the number of mosquitoes in our area and my grandchildren, aged two months to two years, are getting bitten many times each day.
This has caused me anxiety as it is well known that dengue tends to affect the young and the elderly more seriously.
Must there be a cluster of dengue cases before the NEA can enforce inspection of such premises?
Why wait when there is already a clear and present danger?

Dr Kam Hwee Beng

CNA (25 May 2006) - 117 dengue cases in May, NEA steps up public education

2006-05-25T19:53:00.000+08:00

http://www.channelnewsasia.com/stories/singaporelocalnews/view/210286/1/.html

Posted: 25 May 2006 1843 hrs

117 dengue cases in May, NEA steps up public education
By Dominique Loh, Channel NewsAsia

The National Environment Agency has again upped its ante on dengue, in anticipation of the warmer months ahead when conditions are most ideal for the Aedes mosquito to breed. The number of dengue cases in the first few weeks of May was 117. Although this figure is still below the 449 reported in the same period last year, the NEA is stepping up its public education programme to stem the tide. As NEA officers comb households throughout Singapore, more and more breeding sites are cropping up. 17 sites out of every 10,000 HDB homes visited in April were found to be breeding mosquitoes compared to just four in March. For apartment homes, 33 mosquito-breeding sites were found - 24 more than in March. Even more were found in landed homes, with the number doubling from 50 in March to nearly 120 in April. To educate home owners of its five-step 10-minute daily routine that can help reduce mosquito-breeding sites, the NEA is sending out information packs. Virtually all households in Singapore will receive a pack containing information on how you can prevent mosquitoes from breeding in your home. NEA hopes to complete the distribution to the more than one million households in Singapore by early June. And with the upcoming June holidays, the NEA has some useful travel tips as well. Said Dalson Chung from NEA's environmental health department: "Before they leave home for the holidays, I'd like to urge the public to seal up the gully traps, make sure the mosquito does not go in and breed. Also, the toilet bowl, they can cover it. For the plants, they can put in insecticides to prevent breeding in stagnant water." The NEA is also urging the public not to litter because it is one of the major contributing factors. Discarded garbage can be a potential water receptacle for breeding sites. - CNA/ir

Copyright © 2006 MCN International Pte Ltd

Litter on Jurong East Ave 1 from Jurong Polyclinic to Street 31

2006-04-28T10:36:00.000+08:00

Sent to NEA on 28 Apr 2006:

I want to highlight that the skretch of Jurong East Ave 1 from Jurong Polyclinic to Street 31 are littered with paper, water bottles, sweet wrappers etc etc.

Those litters along street 31, I saw it on Mon AM and today Fri AM, the same litters are still there.

Like I said before, it is NEA responsibilities to ensure that the contractor are doing the jobs that they are paid for. Dont waste taxpayers money!

In the above example, it is clear that the contractors did not "cleansed every morning" like have you said, not even once in 5 days!

I wonder ..why...NEA dare not impose liquidated damages or terminate the contracts.

I should not have to write NEA every now and esp for this area is a repeated case which I highlighted in my email dated 1st Mar.

Ref: WK642464211 : Vector - Potential Mosq Breeding at ANG MO KIO STREET 62

2006-04-24T20:00:00.000+08:00

Reply from NEA on 24 Apr 2006:

Ref: WK642464211

Dear Mr Jeff Ho,

Thank you for your feedback in respect of puddles of water on the ground.

Our officer from Central Regional Office will look into the matter and reply to you shortly. Please call me or email Contact_NEA@nea.gov.sg again if NEA can be of further service.

Thank you for your time and interest.

Sincerely,

Chong Wan Kee
Public Relations Manager
Tel: 1800-CALL NEA [1800-2255 632]
National Environment Agency Call Centre

NCS Building at Yio Chu Kang - after so many months...

2006-04-12T10:12:00.000+08:00

Sent to NEA (problem encountered when uploading photo):

After so many months, the field near NCS building (YCK) is still not done yet.

First truckloads of soil was dumped to the small field, causing all the annoying insects to migrate to our residence.
And now after so many months, nothing is being done to the field. As you can see on the pictures, the grounds have so many puddle of water, even long after the rain has gone.
We also noticed that after a few days of rain, we will have mosquitoes coming into our flats.

We think it is about time something is done to this fields.
Thank you.

Why are public drains not scrutinised? - Straits Times (7 Apr 2006): Govt acts to pre-empt dengue epidemic

2006-04-07T14:13:00.000+08:00

Sent on 7 April 2006:

To: Dr Yaacob Ibrahim - MEWR
: Feedback Unit

7 Apr 2006

Dear Dr Ibrahim,

I refer to the article in the Straits Times, "Govt acts to pre-empt dengue epidemic" (ST, 7 Apr).

While I applaud the government's proactive efforts in curbing dengue this year (after the painful lesson last year when the NEA was caught off-guard during the dengue outbreak), I note there is a glaring absence of any mention of NEA's efforts regarding checks on public drains which are the responsibilities of both the NEA and town councils.

As you will recall, most of last years' identified breeding spots were found in public drains (and not homes), so it is disheartening to read of focused efforts targeting at homes while leaving out any mention of NEA's efforts towards the main culprit, the public drains! (Refer above article - "...Homes will be checked every six months, hawker centres and schools every three months, and construction sites - notorious breeding grounds - will come under NEA scrutiny every month...")

Perhaps there are such plans which the media failed to mention, so it would be good if the public can likewise be kept informed of such plans.

Thank you

Best Regards
Jeffrey
www.denguealert.blogspot.com

Feedback on Blk 517B MSCP Jurong West St 52

2006-04-07T10:43:00.000+08:00

Sent on 5 Apr 2006 to West Coast-Ayer Rajah Town Council:

See the photo of water flooding at the car washing bay of Blk 517B jurong West multi-storey carpark. With so many problems in my estate, sometimes i wonder if my estate is managed by potong pasir or hougang town council. I wont be surprised that the 2 opposition wards are better maintained because
1) they are not complacent
2) they dun want to get complaint
3) they dun want to general cleanliness to be a election issue and cause them to lose votes.

--- Toh Peirong <tohpeirong@wcartc.org.sg> wrote:---------------------------------

Dear Swarni,

Thank you for your kind feedback. All the feedbacks that you mention about the Blk 517B MSCP have been rectified on 03/04/06. Regarding the Leaky linkway, we will be carrying out another water test and follow up on those leaky areas on 05/04/06 (Wednesday).

If you have any other maintenance feedback, please do not hesitate to contact me at tel no. 68964864 (DID) or email me at wcartcbl@wcartc.org.sg, so that I can look into the feedback promptly. We thank you once again for your feedback.

Toh Peirong
Property Officer
West Coast - Ayer Rajah Town Council

Today (7 April 2006) - NEA ups anti-mozzie efforts

2006-04-07T10:41:00.000+08:00

Singapore News // Friday, April 7, 2006
NEA ups anti-mozzie efforts

Checks for breeding sites to intensify as dengue cases are expected to go up as weather turns warmer

EXPECT a knock on your door at least once every six months from National Environment Agency (NEA) officers looking for potential breeding habitats of mosquitoes.
.These efforts, which are expected to reach an approximate 1.1 million households and other public premises, are part of an ongoing surveillance system started since January this year.
.Though the number of dengue cases has dropped for the first quarter, compared to the same period last year, NEA is stepping up its efforts against the Aedes mosquito.From January to March last year, there were over 2,800 cases of dengue reported. For the same period this year, the number was 749.
.But as Singapore heads for a warmer and wetter season, NEA will intensify the combing of public areas for a month, starting from April 17.
.Said Environmental Health Department head Dalson Chung: "With the warmer months that are coming up in May, June and July ... based on the last year's trend, we can expect the dengue cases to go up.
."So, to reverse this trend, we will be intensifying our search-and-destroy operations ... At the same time, we'd also like to urge all the households to continue to be vigilant and practice their 10-minute, 5-step Mozzie Wipeout campaign.
."Together, I think we can reduce the number of breedings in homes and also outside homes."
.NEA will also designate inspectors to the various constituencies in Singapore to work with officers from town councils and the Inter-Agency Task Force, deploying up to 1,500 inspectors for the task.
.The inspectors will conduct checks on all premises in Singapore every three to six months. "Breeding is the only thing we can step up on for dengue prevention, since other factors such as temperature, weather and our immune system to the virus is out of our control," said Mr Chung.
.For homes found with potential breeding grounds, NEA officers will educate and give verbal advice on ways to eliminate them.
.But $100 fines will be issued if actual mosquito larvae are found in the home. The amount will be doubled for repeat offences. — Cheow Xin Yi

Mosquitoes breeding at Blk 517B Jurong West

2006-04-05T12:54:00.000+08:00

Sent to NEA on 3 Apr 2006:

Instead of spraying oil into the drain, shouldnt town council address the root cause ie repair the drain ? Isnt pouring oil into the drain, polluting the water of singapore? Imagine all the hawker start pouring oil into the drains at their backlane ?

Also, 1-2 weeks/months these contractors may forget to spray oil into the drains and mosquitoes larva will start to breed again. Denque will spread again.

See Feb email from NEA, this is not the first time mosquitoes are found in Blk 517B JW.

Mosquitoes breeding at Blk 517B Jurong West

2006-04-04T12:12:00.000+08:00

(Note: Problem encountered in uploading photos)

Sent to NEA on 2 Apr 2006:

See photos.

The drains in and around Blk 517B jurong West Str 52 (Multi-storey car park) are choked and filled with stagnant water.

And I saw mosquitoes larva breeding at Deck 5B.

Appreciate it if NEA officers could check it out.

Will NEA be imposing a fine on West Coast Town council?

River Valley Swimming Complex - Tadpoles, dead bird found in disused pool

2006-04-03T13:05:00.000+08:00

http://newpaper.asia1.com.sg/news/story/0,4136,104355-1143928740,00.html?

River Valley Swimming Complex
Tadpoles, dead bird found in disused pool
FOR some, the old River Valley Swimming Complex holds good memories.
By Nicole Na
01 April 2006
FOR some, the old River Valley Swimming Complex holds good memories.
That may vanish if they see the state it is in now.
Three years after the complex was closed to the public in April 2003, it resembles a pond.
The New Paper visited it on 20 Mar.
Large drifts of dead leaves were seen floating on the murky water with moss and algae growing on its sides.
Worse, a decomposing bird was found among layers of dead leaves inside the pool.
The children's pool was in a slightly better condition as it was drier, but there were tadpoles in the muddy water.
Has it become a dengue hot-spot?
The Singapore Land Authority (SLA), which took over the complex in May 2003, said that they have been fogging the complex regularly.
Those who used to use the pool regularly were disappointed to hear about its poor state.
Said Mr Koh Horne Kuan, 48, a telemarketing manager: 'I used to frequent the pool when I was younger, to de-stress after work. The fact that the pool is now so dirty upsets me.'
Said Miss Tan Mia Joo, 36, a film producer: 'I'm quite sad that it ended up this way. The leaves and dead bird are understandable, as they could happen within a few days.
'But the algae? That must have taken a few weeks or even months.'
FUTURE IN LIMBO
Added Miss Tan: 'It's quite strange as Singapore is normally very efficient. When something closes down, another building will usually take its place.'
Miss Christine Lim, 30, a corporate communications assistant manager, suggested: 'Instead of closing the pool down, it should have been upgraded so that people would go back there.'
But its future appears to be in limbo.
Last year, the Singapore Sports Council (SSC) unveiled plans to lease a number of unused swimming pools, but this was not among them.
The complex earlier belonged to the SSC.
According to an SLA spokesman, it cannot tender the site for rental as it is being studied for redevelopment by other agencies, such as the Urban Redevelopment Authority (URA) and National Parks Board (NParks).
Both the URA and NParks told The New Paper that at the moment, there are no concrete plans for its redevelopment.
In the interim, it is occasionally used as a location for film shoots and corporate events.
After SLA took over, it has been maintaining the site, which includes 'pruning trees and sweeping away litter and debris' every fortnight.
The SLA also said that rain water which has collected in the pool is pumped out once every three months.
The SLA spokesman said: 'The last time the pool was drained prior to 20 Mar was in mid-December 2005.
'In light of the dengue outbreak late last year, SLA has also upped the frequency of fogging and oiling the pool from two to four times a month.
'The pool is also frequently checked by the National Environment Agency to ensure that the water is free of mosquito breeding.'
Caretaker Liam Peng Fock, 67, claims that he has not fallen sick in the six months that he has been working there.
As for the dead bird, SLA removed it the next day.
Copyright © 2005 Singapore Press Holdings Ltd. Co. Regn. No. 198402868E. All rights reserved.

Feedback On Drains and Road - St Michael's Road

2006-03-30T11:50:00.000+08:00

Sent to NEA:

See the big styrofoam box in the drain outside st michael's lodge.
The almost 100% covered-up drop-inlet-chambers and the dirty drain near richmond condo.
These debris will eventually flow into kallang river and end up in Marina Barrage and it will become a dumping ground instead of water-sport centre or reservoir.

CBD area - Anson Road

2006-03-30T11:38:00.000+08:00

Sent to NEA:

See our business and commericial district. BTW, the drop-inlet-chambers are still not clean.

Feedback On Drains and Road - Yung Sheng Road/Taman Jurong CC

2006-03-29T12:03:00.000+08:00

There is a flood of contributions (with photos) today, 29 Mar 2006. The following was sent to the NEA today:

===========================================================

See the mess outside taman jurong cc and your officer can report the place as clean. Remind me of Johore.

Hopefully when Minister Tharman visit the CC in Apr, the area will be sparkling clean!

Feedback On Drains and Road - Boon Lay Way

2006-03-29T11:09:00.000+08:00

Sent to the NEA CEO on 29 Mar 2006:

In your email below, you claimed that the drains were"satisfactorily maintained".

See yesterday, your cleaners managed to sweep 20-30 bags of dirt!

Also the cleaners should clear the rubbish immediately instead of leaving it overnight. What happen if this is a road side bomb left behind by terrorist?

Police pls commend and enforce.

The last time I saw such thorough cleaning was during the dengue outbreak in Oct/Nov. Since then, NEA has slacken again. NEA need to review your standard! Hope we do not need another dengue outbreak then we start to clean up again.

Garden City ?

MM Lee's GRC: Dirty drain off Anson Road - in front of Tanjong Pagar Complex

2006-03-28T12:56:00.000+08:00

Sent to NEA on 28 Mar 2006:

See dirty drain off Anson Road in front of Tanjong Pagar Complex.

Coincidentally, this is also in MM Lee's GRC.

Re: Feedback On Drains and Road - Jurong East Str 32 and Ave 1

2006-03-27T14:35:00.000+08:00

Sent to NEA on 27 Mar 2006
cc: MM Lee and Minister of Environment and Water Resources. :

=======================================
Date: Mon, 27 Mar 2006 10:20:44 +0800 (CST)

Re: Feedback On Drains and Road - Jurong East Str 32 and Ave 1

To: Selvanayagam INTHRALINGAM Selvanayagam_INTHRALINGAM@nea.gov.sg, TCKHOO@PUB.GOV.SG, LEE_Yuen_Hee@nea.gov.sg

CC: LEE_KUAN_YEW@PMO.GOV.SG, YAACOB_IBRAHIM@MEWR.GOV.SG, Jeff Ho denguealert@yahoo.com

cc: MM Lee and Minister of Environment and Water Resources.

See attached photo of the drains along jurong east str32, opp blk 311.

The cardboard and coconut in the drains were there since early Mar. The surrounding areas (including jurong east ave #1 which you claimed to be "sufficiently maintained") are littered with lots of plastic bottles, plastic bags, cigarettes boxes etc.

Check it out and pls ensure that the outsource companies do their work and dun waste taxpayer money.

CEO - PUB and NEA, unless NEA contractors do a good job in cleaning up the drains, the debris will eventually flow into Singapore river and drainage system and make it polluted. And the next big rain comes, the choked drains will cause another flash flood.

NEA/PUB will give excuses that the heavy rains co-incide with the high tides again.

NEA & PUB can work closer together to make singapore water even cleaner and less polluted. It is almost 3 decades, I think we have achieve much more than MMLee's standard/dreams set in 1977.

http://www1.moe.edu.sg/learn@/singaporerivertrail/sec/G041_Dunman_Sec/river_cleaning.htm

If you are not interested in doing your job well, there are a lot of retrenched workers out there who would love your job and possibly lower pay.

ps: more dirty photos of singapore coming up over the next few days....

Mosquitoes are back - source: ovitraps?

2006-03-27T14:30:00.000+08:00

Sent to NEA:

27 Mar 2006

I am surprised that NEA did not manage to locate breeding areas when the residents are attacked by up to 10 mosquitoes on some days/nights!

What about the ovitraps set up all over the areas - don't they show up anything or are they actually the source of the breedings?

The logical conclusion is that if the mosquitoes did not come from the drains or other breeding areas, then they possibly must have come from the ovitraps?

Filthy area/drain at Wallich Road near Wallich Bldg

2006-03-25T11:51:00.000+08:00

Reply from Tg Pagar Town Council:

I refer to your e-mail about the filthy drain at Wallich Road near Wallich Building. We have referred the matter to the National Environment Agency( NEA ) as the drain is maintained by them. We will also checked with them next week to confirm that they have cleared the drain.

Simon Koh

General Manager

Tanjong Pagar Town Council

========================================

Sent to Tg Pagar Town Council:

The drain at subject location is filled with filth. Who is responsible for cleaning?

For your additional information, I am attaching a letter in today's Straits Times, "Sadly, Singapore is not as clean as it is said to be" (ST, 24 Mar) which highlights the present sorry state of Singapore's once-proud claim to being a "clean city". ======================================================================

http://straitstimes.asia1.com.sg/forum/story/0,5562,379937,00.html?

March 24, 2006

Sadly, Singapore is not as clean as it is said to be

I agree with the concerns about the horrendous littering in Singapore. This problem seems never to end. When I first came from Sri Lanka to Singapore nine years ago I was amazed to see how beautiful and clean Singapore's neibourhoods were. I used to write letters to my friends and even produced newspaper articles about this clean and green tiny city state. Last year when I was living in West Coast I came across litter more often on our strolls. I consoled myself that the litter was unintentionally thrown. But the problem became worse. Tissue paper, cigarette butts, drink cartons, plastic bags, etc marred the beautiful flower bushes. When we moved to the Serangoon area four months ago, I saw how things had become worse. Whether it's an HDB estate or private housing development, the situation is the same. Most of the owners or domestic helpers who bring their dogs out do not clean up after them. Just look at the mess near Nanyang Junior College's new signboard. Some schools in the area seem to close their eyes to the litter even within their premises. Spitting is another problem. Recently we saw two teenage school girls drinking fruit juices in a double decker bus and they left behind the cups where they sat. I'm sad to hear that a friend who came to the National University of Singapore to do some research say that "Singapore is not as clean as it is said to be." With a heavy heart, I said "It used to be." There's no need to be a Singaporean to love Singapore. When I was young, my parents said "love your country and also love and respect the place where you are living in." We must not always expect the country to do its part for us. We must do our duty as well. If the elders are not listening, the young must be educated about it. The authorities can organise mass cleaning drives. If the younger generation is not trained to be responsible and patriotic what will the future be?

Sagarika Rathninde (Mrs)

Feedback On Drains and Road

2006-03-24T20:40:00.000+08:00

Exchange of emails between resident and NEA:

If you find those areas reasonable clean, I think your standard is far to low. Over next few days, I will arm my camera and I will send you the photos.

--- Selvanayagam INTHRALINGAM<Selvanayagam_INTHRALINGAM@nea.gov.sg> wrote:>

Dear Ms K

We refer to your feedback dated 20 Mar 2006 to NEA which was copied to our CEO Mr Lee Yuen Hee.

2. Thank you for your feedback. We wish to clarify that NEA had initiated action on your feedbacks dated 20 Feb and 1 Mar 2006. We had also replied to you via email on 22 Feb and
2 Mar 2006 on the actions taken.

3. We had again re-checked the drains and drop-inlet-chambers along Anson Road and found that, although there were some leaves in them, they were in a satisfactory condition. Action was taken to remove the leaves.

4. As for your feedback about the drain in front of Taman Jurong CC , our inspection on 20 Mar 06 showed that the drain was in a satisfactory condition. No rubbish was observed in the drain. We also did not detect any foul smell. Further , our re-inspection of the drains at Boon Lay Way and Jurong East Avenue 1 showed that the drains were, similarly, satisfactorily maintained.

5. The cleaning of public areas, public roads, pavements and drains are either carried out by National Environment Agency's workers or contractors appointed by us. We set specific performance standards to ensure that the cleaning of streets, pavements and drains under our contractors' purview are carried out according to a set schedule. We conduct regular checks to monitor their performance. Penalties are imposed on contractors who do not meet the prescribed performance standards.

6. Once again, we thank you for your valuable feedback.

Sincerely

S INTHRALINGAM
for HEAD
ENVIRONMENTAL HEALTH DEPARTMENT
NATIONAL ENVIRONMENT AGENCY

Ref: DT63139140 : Neglected Street at JURONG EAST AVENUE 1

2006-03-21T20:12:00.000+08:00

Sent to the NEA on 20 Mar 2006:

I wrote to NEA on 20th Feb to highlight that the drains and Drop inlet chamber along Anson Road were dirty.

1 month has past yet no one has clean up these area.

On 28th Feb, again I wrote to highlight other roads that were dirty, same thing, it is still not clean.

Over the weekend, I noticed that drain in front ofTaman Jurong CC was full of rubbish and it stinked.

CEO NEA, appreciate your kind attention and if your officers could ensure that the cleaning contractors are cleaning the streets and not paid for doing nothing.

Jeff Ho, maybe you could start a blog to post photo of dirty areas in Singapore.

(Note from Jeff Ho: Yes, a blog has been set up - visit http://www.towncouncils.blogspot.com .)

Perpetually choked drain outside 32/34 Chancery Lane

2006-03-20T09:29:00.000+08:00

Flwg sent to NEA on 20 Mar 2006:

This drain seems to be perpetually choked as I have written in on numerous occasions before - perhaps it is advisable to fix the "real" problem rather than just getting the cleaners to clear the drain.

I have also asked NEA's Mr Chia to investigate the recent complaints by residents of Gilstead Rd/Gentle Rd/Buckley Rd areas (in the vicinity of this drain in Chancery Road) that the mosquitoes are back the last 4 weeks or so.

Choked drains along Moulmein Road - near Sinaran Road and CDC

2006-03-09T19:08:00.000+08:00

Sent to NEA:

9 Mar 2006

See attached photos - choked drains everywhere along this stretch of Moulmein Road!

Damaged Drain At Langsat Road (inbetween 148 & 152)

2006-02-23T20:20:00.000+08:00

Following sent to the NEA on 20 Feb 2006:

I refer to the badly damaged drain at the a/m address.

4 months have past.

Appreciate it if the authorities could into look into this and repair the drains.

Choked drains at Bukit Timah Road/Dunearn Road/Gilstead Road and Scotts Road - leaves at open and covered drains

2006-02-21T20:48:00.000+08:00

21 Feb 2006

You will note the choked drains are back - even though the ENV Minister has declared the war on dengue has been won barely a week ago!

Please do not let your guards down - because the mozzies will be back in no time if the public drains are not properly maintained, as was the case last year when the menace went out of control, precisely because the guards were down.

Who maintains the drains - open or covered? Obviously, they are not doing a good job!

For open drains, everyone can see if they are choked, but for covered drains, they are not visible unless the covers are lifted, so it is very important that they be maintained regularly.

If you look at 2 of the photos attached (at Scotts Road and Dunearn Road), the open portion of the drains are filled with fallen leaves which extend all the way under the covered portion of the drains as well.

Gentle Road - stagnant water at drain near house numbers 41 & 44 Gentle Road

2006-02-13T08:57:00.000+08:00

Sent to NEA:

13 Feb 2006

Please do the needful to clear the chokage. Thanks.

FB200601/0109 : Choked drain at PIE/Adam Road flyover to Changi Airport (7 Jan 2006)

2006-02-06T19:24:00.000+08:00

Sent to NEA:

cc: Dr Yaacob Ibrahim - Minister for Environment

6 Feb 2006

It's been a month since I reported on the stagnant water at the subject location, but to date, I have not received any response from the NEA.

If indeed there was mosquito breeding at the site, they would have produced 3 or 4 generations by now.

Rgds
Jeffrey
www.denguealert.blogspot.com

Channel News Asia (30 Jan 2006) - NEA to implement new pre-emptive system to fight dengue

2006-01-30T20:28:00.000+08:00

Posted: 30 January 2006 1847 hrs
NEA to implement new pre-emptive system to fight dengue

By Farah Abdul Rahim, Channel NewsAsia

SINGAPORE : It may be the festive season but the National Environment Agency (NEA) is not letting up in its fight against dengue.

It is implementing a new pre-emptive strike where officers will do thorough sweeps of all premises even before a dengue case is reported in the area.

The number of dengue fever cases has declined, with some 190 cases reported since January compared to more than 800 during the same period last year.

And there were less than 50 dengue fever cases reported last week.

But NEA says the public must continue to stay vigilant and take preventive measures against mosquito breeding at home, especially with the flowers and plants bought for the Lunar New Year.

"During the Chinese New Year period, many of us buy lucky bamboo, cherry blossoms and pussy willows, and all these are placed in water pots. We encourage the public to change water on alternate days to prevent mosquito breeding," said Dalson Chung from Environmental Health Department at the National Environment Agency. - CNA /ls

Call For Enforcement : Choked Drains At Kent Road And Owen/Dorset Road Junction

2006-01-27T09:50:00.000+08:00

Received from NEA on 26 Jan 2006:

Please refer to your feedback to MCYS feedback Unit dated 19 Jan 2006.

Upon receiving your feedback, we immediately deployed our workmen and spruced up the drains.

We agree with your comments that a permanent solution is the best way to solve the problem. We are aware of the condition of the drains and have liaised with our counterpart in the Drainage Department (PUB) to carry our repairs to the site. You may wish to note their contractor are currently carrying out repairs to the drain at junction Owen Road and Dorset Road.

We will continue to work closely with Drainage Department to rectify all defective drains in the area progressively. In the meantime, we will carry out oiling regularly to prevent mosquito breeding.

Thank you for the feedback.

Yours faithfully

Nordin Sulaiman
Manager (Tg Pagar GRC2)
Sanitation and Vector Control
Central Regional Office
National Environment Agency

Choked drain at PIE/Adam Road flyover to Changi Airport (7 Jan 2006)

2006-01-25T16:31:00.000+08:00

Sent on 25 Jan 2006:

25 Jan 2006

Re your 9 Jan email below, may I have your response on action taken, if any.

Thank you.

Choked drains at Blk 54 Kent Road/Mergui Road junction and Owen/Dorset Road junction

2006-01-19T20:37:00.000+08:00

Sent to NEA on 19 Jan 2006:

Attached are photos taken this evening at the 2 trouble spots, one of which (the Owen/Dorset Road junction) is a perpetual problem which needs a permanent solution rather than ad-hoc measures.

Please do the needful to clear the chokages that result in stagnant water - perfect breeding ground for mosquitoes.

Weekly dengue cluster update - last update: 31 Dec 2005

2006-01-17T12:26:00.000+08:00

Reply from MOH, 16 Jan 2006:

Thank you for your feedback.

The weekly update of the dengue clusters has ceased because over the past 2 months, the number of dengue cases have dropped drastically and theMinistry of Environment and Water Resources has announced that the situation is under control.

For your information, the number of cases is still updated in the weekly "Infectious Diseases Bulletin" available on the MOH website at:http://www.moh.gov.sg/corp/publications/listmore.do?id=pub_title_commdisease&cid=pub_newsletters

Thank you.

Best Regards,
Jerome Lee
Marketing Comms Executive
Ministry of Health

Choked drains at: Chancery Lane, Bukit Tunggal and Gentle Road

2006-01-11T13:23:00.000+08:00

Reply from PUB on 11 Jan 2006:

Thank you for your feedback.

We have investigated this matter and found that few sections of the drain have sunken which causes the water to pond in the drains. We will replace the sunken portion of the drain to prevent ponding of water in the drains.

Yours sincerely
Choy Wai Kwong
Senior Manager
Catchment And Waterways
Public Utilities Board

Weekly dengue cluster update - last update: 31 Dec 2005/Minister says dengue under control

2006-01-10T16:24:00.000+08:00

Sent to NEA:

Date: 10 Jan 2006

http://www.moh.gov.sg/corp/publications/details.do?cid=pub_title_dengue&id=32866310

I note the last update was up to 31 Dec 2005. ( Location of Active Clusters* (as of 31 Dec 05) ).

The site mentioned update was to be done weekly (Note: From 1st Nov 2005, the figures on this page will be updated on a weekly basis.).

Why hasn't one been done for the 1st week of Jan 2006 yet?

========================================================

Channel News Asia

Posted: 08 January 2006 1703 hrs

Environment Minister says dengue situation under control

By Patwant Singh, Channel NewsAsia

SINGAPORE : Singapore's dengue situation is under control, says Environment and Water Resources Minister Yaacob Ibrahim. The number has dropped from more than 700 cases at the peak to the present 84 cases weekly. Dr Yaacob was the Guest-of-Honour at a public health carnival organised by the South West District on Sunday. He emphasised the importance of community efforts in helping to spread the message about preventive measures against dengue. He also outlined the priorities for his Ministry this year. Dr Yaacob said: "Cleanliness is something that we want to tackle a bit more seriously. We want to work with our partners so that we can roll out the messages, so that everyone understands that they are responsible and they have a role to play. Beyond that we are looking at, for example, the issue of air pollution would be important. "I was in Montreal for the climate change conference. We have mentioned this about the Kyoto Protocol and this are the other issues that we are looking at." - CNA/de

Copyright © 2006 MCN International Pte Ltd

Choked drains at: Chancery Lane, Bukit Tunggal and Gentle Road

2006-01-09T13:48:00.000+08:00

Received from NEA, 9 Jan:

We refer to the feedback on choked drains at in front of No.34 Chancery Lane (Opp. Chancery Grove), 7 Bt Tunggal Rd and F/O 39 Gentle Rd dated 5 Jan 2006.

2. We had conducted mosquito surveys at the implicated area but no mosquito breeding was detected. Our checked showed that the drains mentioned were sunken and accumulated fallen leaves were observed in the drains. Our contractor had since spruced up the drains and they were cautioned to maintain the drains according to schedule. We will penalize them for any cleansing lapses found. We had referred the defective drains to PUB (Drainage) for repairs.

3. Thank you for your feedbacks. Please contact our manager of the area Mr Nordin Sulaiman at Tel 62639312 or email to nordin_sualaiman@nea.gov.sg should you require further assistance..

Sincere regards
Zulkarnain H Baktee
Manager
Customer Relations, Surveillance & Intelligence
Central Regional Office
National Environment Agency
DID +65 63702602
Fax +65 62739641

Choked drain at PIE/Adam Road flyover to Changi Airport (7 Jan 2006)

2006-01-07T12:16:00.000+08:00

Sent to NEA on 7 Jan 2006:

Please do the needful at another perpetual stagnant-water drain. Thanks

Choked drains at: Chancery Lane, Bukit Tunggal and Gentle Road

2006-01-05T10:56:00.000+08:00

Sent to NEA:

5 Jan 2006

By just doing a cursory drive past this morning, at least 4 spots in the Newton/Novena neighbourhood (Chancery Lane, Bukit Tunggal and Gentle Road) have been identified with choked drains.

Mind you, these are all within 200-300 metres of each other. Just imagine if this were to happen all across the island - be prepared for another dengue outbreak!!

Choked drains at Owen Road and Dorset Road junction

2005-12-28T18:13:00.000+08:00

Reply from NEA on 24 Dec 2005:

We have since cleared the leaves in the drains at Owen Road and DorsetRoad.

The stagnation of water in the drains is due to structural defects in the culvert at site.

Our counterpart in the Drainage Department has gone down to the site and informed us that they will be carrying out repairs to the drains soon.

Pending rectification works, we will continue to maintain the site andensure no mosquito breeding.

Thank you for the feedback.

Wishing you a merry Christmas.

With best regards
. Nordin SulaimanManager (Tg Pagar GRC2)
· Sanitation and Vector Control
· Central RegionalOffice·National Environment Agency
· DID+65 62639312 Fax+65 62739641

Inclusion of dengue breeding sites on NEA webpage

2005-12-21T13:05:00.000+08:00

Reply from NEA on 21 Dec 2005:

To: Jeff Ho denguealert@yahoo.com

CC: Dalson CHUNG Dalson_CHUNG@nea.gov.sg, John GERIZIM John_GERIZIM@nea.gov.sg

From: Ginny TAN Ginny_TAN@nea.gov.sg

Date: Wed, 21 Dec 2005 10:48:48 +0800

Dear Jeff,

We thank you for your suggestion once again.

Mosquito breedings can be found anywhere as long as there are favourable habitats.

NEA officers would destroy any breedings they detected but they might not find all breedings.

We need every member of the public to play their part by keeping their homes and environment free of potential habitats.

We will post the list of potential breeding habitats on our website so that members of the public would be aware of them and alert us when they come across them.

Best regards

Ginny Tan
Manager (Situation Room), Operations
Environmental Health Department
The National Environment Agency
DID +65 67319053
Fax +65 67345787

Inclusion of dengue breeding sites on webpage / Owen & Dorset Road drains

2005-12-16T11:17:00.000+08:00

Sent to NEA on 16 Dec 2005:

Thank you for your email.

There are basically 2 main reasons why I suggested that NEA put up a list of sites where rampant mosquito breeding is found:

1. It acts as an alert to the residents in the neighbourhood to be extra vigilant, especially when there is widespread breeding in the area. Let me illustrate an experience I had with NEA to reinforce this point. Back in August 2005 during the height of the dengue outbreak, I had requested for NEA to put up a listing of dengue clusters - for the very same reason that if residents in the neighbourhood were made aware of the outbreak in the area, they would be extremely vigilant about it. As usual, NEA's initial response was that the publicity via educational banners and posters in the affected area was sufficient. (see attached email from Ginny Tan dated 16 August 2005 for details). The to-and-fro bewteen me and NEA took all of 3 weeks or so before NEA finally saw the merit of the suggestion and finally decided to put up the Dengue Cluster list under the Ministry of Health's website - http://www.moh.gov.sg/corp/publications/details.do?cid=pub_title_dengue&id=32866310. I always believe more information is better than less (especially during such situations when all Singaporeans are called on to play a role in eliminating the outbreak), but somehow from this experience, I get the feeling that NEA is reluctant to share such information as doing so might subject itself to more questions and challenges as to its effectiveness and efficiency. If you need help from every resident in Singapore to play his or her part, then you should provide the necessary tools (like more information) for them to be effective.

2. I note there has been a slackening in the dengue fight of late - perhaps because there is now less publicity on dengue and also because the number of cases has dropped. I hope NEA does not fall into the complacency trap and give Singaporeans the false sense of security that dengue is now in control. Once this happens, we will go one full circle again. Like I said, the fight is always on-going until and unless Singapore becomes dengue-free; even then we must always remain vigilant because once our guards are down, the mosquitoes will be back. To illustrate this point, I've noticed that the drains are now back to their old state again - choked and hardly maintained. I've attached some photos taken at the Owen/Dorset Road area - this seems to be a perpetual problem. Whatever happened to the increased resources?

Rgds
Jeff
http://www.denguealert.blogspot.com/

===================================================
Subject: Re: www.denguealert.blogspot.com: Known dengue case in Geylang East -Central Grove: NEA to publish weekly update of known dengue clusters?

To: Jeff Ho

CC: Dalson CHUNG - Dalson_CHUNG@nea.gov.sg

From: Ginny TAN - Ginny_TAN@nea.gov.sg

Date: Tue, 16 Aug 2005 15:35:16 +0800

Dear Jeffery,

Thanks for your feedback.

Some of these dengue areas are Teck Whye, Woodlands, Upper Boon Keng,Yishun and Ang Mo Kio.

NEA informs residents in the affected areas by sending them dengue alert letters which advises them to get rid of potential mosquito breeding habitats.

NEA also place dengue educational banners and posters up in the affected areas so that everyone including residents of surrounding estates would be aware of the dengue cluster situation in their neighbourhood. Such banners display information like how many cases are there and location of the dengue cluster and when the first case started.

Best regards
Ginny Tan
Manager (Situation Room), Operations
Environmental Health Department
The National Environment Agency

Choked drain outside The Metz showflat - Devonshire Road

2005-12-07T00:11:00.000+08:00

Sent to NEA:

Pls take necessary action to clear choked drain. Thanks

Choked drain outside Life Bible Presby Church, Gilstead Road

2005-12-05T20:43:00.000+08:00

Sent to NEA:

Please do the needful to clear the choked drain. Thanks

To the NEA: No resting on laurels - yet !!!

2005-11-29T19:21:00.000+08:00

Sent to Feedback Unit - MCYS on 29 Nov 2005:
====================================
Hi Izan,

Thank you for your email.

I am disappointed that NEA would not be responding to me on my query. Does it mean that since NEA have taken steps to contain the recent outbreak, they will stop answering questions raised by the public? Mind you, the outbreak has not been contained yet even if the number of cases has dropped. I don't think NEA would like to give the impression that they have successfully contained the outbreak just because they have met their goal of halving the number of cases. Do they need reminding that there are still some 145 dengue cases weekly (the week of Nov 20th), hardly considered "contained".

All I wanted to know was whether NEA would be publishing the list of breeding clusters on its website (just like the current practice of publishing a listing of dengue clusters on its website). I strongly feel this piece of information is very useful and helpful too for the public so that everyone can do his or her part by being extra vigilant if he or she happens to be staying in the affected areas.

Is it that difficult to answer?

As Dr Yaacob himself pleaded, everyone has a part to play in fighting dengue, so efforts to contain the disease must be ongoing. Therefore, no resting on laurels - yet.

Jeff
www.denguealert.blogspot.com

--------------------------------------------------------------
Izan SIDEK wrote:

Dear Mr Ho

Thank you for your feedback dated 28 Nov 2005 which has already been forwarded to NEA.

2. Please be informed that NEA have taken the necessary steps to contain any outbreak. As such, NEA shall not be replying to you.

Thank you

Regards

Izan Sidek (Mr),
Executive Officer, Feedback Unit
DID: (65) 6354 8044
Fax: (65) 6354 8128
Website: www.feedback.gov.sg

Straits Times (23 Nov 2005) - Early action plan to stop a repeat dengue outbreak

2005-11-28T21:12:00.000+08:00

To: NEA
cc: Lee Hui Chieh - Straits Times

Date: 28 Nov 2005

I refer to the article, "Early action plan to stop a repeat dengue outbreak" in the Straits Times of 23 Nov 2005.

The pro-active approach to be taken by the NEA in identifying threshhold breeding clusters before an outbreak is a step in the right direction, and I applaud them for their efforts.

I would however suggest they go one step further in publishing these areas when they become available so that residents living in and around these areas can be more vigilant.

Just like the publication of the dengue clusters has been instrumental in bringing the number of dengue cases down from its peak a few months back, this new list (breeding clusters) will also serve to prevent such clsuters from turning into dengue clusters when pro-active measures are taken before they get worse.

Stagnant water at drain/sump pit near the junction of Gentle/Buckley Roads & outside 45A Gilstead Road

2005-11-26T15:14:00.000+08:00

Reply from NEA on 25 Nov 2005:

Kindly refer to your email appended below.

Our investigation showed that the level of the sump pit at the junction of
Gentle Rd and Buckley Road has since been raised. The stagnation of water is due to the clogged connecting covered drain in the area.

As for the drain in front of 45A Gilstead Road, the stagnation of water is due to some hardened cement in the drain.

We have requested the relevant authority to flush the closed drain at Buckley Road and and rectify the problem of hardened cement at Gilstead Rd.

In the meantime, we will continue to oil the site regularly to prevent mosquito breeding at the sites.

Thank you for the feedback.

Best regards
Nordin SulaimanManager (Tg Pagar GRC2)·
Sanitation and Vector Control· Central RegionalOffice·
National Environment Agency·
DID+65 62639312 Fax+65 62739641

Stagnant water at drain/sump pit near the junction of Gentle/Buckley Roads & outside 45A Gilstead Road

2005-11-18T12:34:00.000+08:00

Sent to NEA:

Hi - Photos taken on 17 Nov attached. Can the relevant authorities please take the necessary action to remove stagnant water at the following locations - especially the sump pit at the Gentle/Buckley Road junction to be raised as it causes perpetual stagnation of water? Thanks.

Vacant properties at 47/49 Moonstone Lane & Upper Serangoon Road - Singapore Aerated Water (opposite the old Upper Serangoon Fire Station)

2005-11-08T12:25:00.000+08:00

Contributor's email forwarded to NEA on 7 Nov 2005:

To the officer-in-change,

I noticed there is an increase in the number of mosquitos in my estate - 31 Moonstone Lane. There have been two cases of dengue in my estate in the last year. One of which one happens to be my wife. Would the authorities please check on the vacant factory along Upper Serangoon Road - Singapore Aerated Water (opposite the old Upper Serangoon Fire Station). You will notice crates of bottles all stacked up in the front of the vacant factory. The factory seems to be unattended for many years already and I am not surprised if it is a breeding ground for mosquites.

There are two more vacant warehouse on the left of 31 Moonstone Lane. Believe they are 47/49 Moonstone Lane. Appreciate if the authorities could look into it as well.

PREVENTION IS BETTER THAN CURE !

Choked drain at Chancery Lane - across the road from Chancery Grove main entrance

2005-11-07T10:03:00.000+08:00

To: NEA

Please clear the choked drain at Chancery Lane. You will note the stagnant water is almost 3-inches deep! Thanks

Jeff
http://www.denguealert.blogspot.com/

Straits Times (4 Nov 2005) - One man's strategy against dengue pays off in Serangoon

2005-11-06T13:00:00.000+08:00

Today (2 Nov 2005) - Reply from PUB: Drains built to allow natural drainage

2005-11-05T00:09:00.000+08:00

Drains built to allow natural drainage

Letter from Yap Kheng Guan
Director, Drainage
Public Utilities Board (PUB)

PUB thanks Mr Jeffrey Ho Loon Poh for his letter "Drains in S'pore just do not drain", (Oct 29).

.In Singapore, we tend to experience short but heavy bursts of rain. As such, our drains are designed to handle high volumes of water efficiently.

.We agree with Mr Ho that drains should be designed, taking advantage of the natural gradient of the ground as much as possible.

.However, where the grounds are steep, such as at the Adam Road/PIE ramp mentioned by Mr Ho, a steep drain will cause the rain water to flow very rapidly which can cause flooding at the bottom of the slope during a heavy downpour.

.We have therefore designed the drains there in tiers instead, to break the flow of water so as to prevent a rush of water at the bottom.

.All drains are designed with a gradient, including the tiered drains at the Adam Road/PIE ramp.

.This allows the water to be drained naturally by gravity.

.PUB and NEA have inspected the drains at the locations mentioned by Mr Ho and found that there were natural flows of water there.

.This may not be apparent to the naked eye or in a still photo. There were some silt deposits which impeded the flow slightly but these have been removed.

.PUB is aware that there are some old drains where the gradient is too gentle and we have a programme to review and systematically upgrade these old drains.

.Similarly, these works are also being carried out by town councils for drains managed by them, such as those in common corridors and carparks.

.Stagnant water is often caused by fallen branches, rubbish, clods of earth and so on, that obstruct the flow of water.

.The public can assist by alerting NEA at 1800 225 5632 and PUB-One at 1800 284 6600 to such blockages and refrain from littering.

Electric New Paper (30 Oct 2005) - Jurong West Street 41 - 24 dengue cases within 2 weeks

2005-11-02T11:59:00.000+08:00

To: The New Paper
cc : NEA

Your 30 Oct article, "Jurong West becomes S'pore's ..." refers (attached below).

It was reported that, "It is unlikely, though, that the hole would be breeding ground because the area is fogged regularly."

I would like to point out that this is misleading as fogging does not render the stagnant water in the hole to be a non-breeding ground for the mosquitoes as fogging only kills adult mosquitoes, not larvae in the stagnant water.

Perhaps NEA can comment on this? We do not want readers/residents lulled into a false sense of security after reading thiis report.

Thanks

Jeff
http://www.denguealert.blogspot.com/

========================================================

Electric New Paper

Jurong West becomes S'pore's...

Panic street

Bird flu FEAR: 12 mynahs found dead

Dengue DANGER: 24 cases within 2 weeks on same street

THIS could be the hottest of Singapore's dengue hotspots - Jurong West Street 41.

By Tan Hsien Chong

30 October 2005

THIS could be the hottest of Singapore's dengue hotspots - Jurong West Street 41.

It is a small street off Jurong West Avenue 1 near Jurong Lake, and home to the latest person to die of dengue, part-time cleaner K S Goh, 65.

His death on Wednesday morning brings the official dengue toll in Singapore to 19 this year.

One case does not a hotspot make, but just look at these other facts:
Since 17 Oct, at least 24 new cases of dengue were reported in the area .

There has been an average of two new cases a day.

Going by figures on the NEA website, the Jurong West Street 41 area may have the largest number of new cases reported over this period.

A dengue cluster is formed when two or more cases occur within two weeks of each other and the homes of the victims are not more than 150m apart.

So scaredcoffee shop owner is MOVING OUT & GIVING UP

MOSQUITOS have driven one man out of his business and his home.
To most, this might sound like a joke.

But mozzies are no laughing matter for Mr Mike Lee, 54, or anyone else at Jurong West Street 41.

The final straw for the coffee shop owner was when he discovered that one of his customers died from dengue fever. At the end of this month, he plans to pack up his business.

LEAVING HIS FLAT

He will also move out of his flat.

Both the coffee shop and the flat are in Block 482 at Jurong West Street, which has become a dengue hotspot.

Since 17 Oct, at least 24 new cases of dengue have been reported in the area.
And Mr Lee is nervous.

Just three days ago, one of his regular customers, part-time cleaner K S Goh, 65, died from the disease.

It was the 19th dengue death in Singapore this year.

Mr Lee told The New Paper, in Mandarin: 'Yes, he (Mr Goh) used to come here to eat. I just called him 'uncle'. I didn't know his name.'

Asked if he was serious about abandoning a business that started only six months ago, he replied: 'What? You think I'm joking?

'Why don't you come back in a few days and see if I'm still here?'
The New Paper checked the Chinese papers this week and found that he had indeed placed advertisements for someone to take over the coffee shop.

TOO MANY CASES

He said: 'I'm scared. There are so many dengue cases. You hear about one case here, one case there.

'If you get bitten you may just die. I don't have that much money to spend on doctors.'
Mr Lee is not the only one nervous about the dengue outbreak.

He said they have scared off his customers and affected his business.

'They tell me they don't like to sit around outside. It's dangerous. They might get bitten.'
Over the past two months, his business has dropped by 30 to 40 per cent. He said he could not even afford the rent, which works out to $150 a day.

The New Paper visited the shop on Wednesday and Thursday afternoon. A regular customer, a 50-year-old unemployed man who wanted to be known only as Ah Tan, said he stopped hanging around the shop after dark for fear of mosquitoes.

He said in Mandarin: 'These insects come out at night. I'm scared.'
He is wrong. The Aedes mosquito, which carries the virus, usually bites in the day, though it can also attack under artificial light at night. Ah Tan added that he had been a regular at the shop for a few months. He lives nearby.

He said: 'A few months ago, there would be maybe 20 to 30 people here during dinner. Nowadays, there is hardly anyone.'

Could be any other reason for business to be so bad? Mr Lee replied, deadpan: 'Yes. Maybe my cooking is very bad.'

NO CUSTOMERS

Both times The New Paper was there, the dessert stall was closed and only the drinks stall was open.

The cooked food stall operates only at mealtimes.

The rows of cigarette boxes usually on display at the drinks stall had been removed.
Mr Lee spends his day sitting at a table, reading the papers or watching a Chinese drama serial on the coffee shop television set.

Now and then, he gets up and walks around.

Once, he pointed at someone in the carpark and said: 'Look, there's his (dengue victim Mr Goh's) wife.'

Dressed completely in black, she was walking with one of her daughters towards her husband's wake.

From his coffee shop, Mr Lee can see all that goes on in the street.
He hears all the dengue stories, both the real ones and the rumours that can take a life of their own.

He sometimes gets wind about 'those construction workers who got bitten last month', or 'that vegetable seller who was another victim but just recovered from dengue'.

But dengue is no spectator sport. And Mr Lee has had enough of such depressing stories.
He said: 'I had moved into a flat in the same block as the shop because I was working here.
'Now that the shop is closing, I'm going to move out too.'
He said he had not yet found a new place to live and was not sure where he would set up shop again.

When told that there were dengue cases in other areas too, such as Tampines and Toa Payoh, he laughed and waved it off.

'Aiyah, those are small cases lah. Nothing compared to here.'

She keeps futile vigil over danger hole

EVERY day, supermarket cashier Haslinda Hashim, 22, looks out of her third-storey flat at a pool of stagnant water below.

The sight worries her.

She recently recovered from dengue fever and she is concerned that mosquitoes might breed in the pool.

There is some construction work being done on her block, and the project has left a 3m-by-3m hole in the ground (pictured above). The hole is always filled with water.

It is unlikely, though, that the hole would be breeding ground because the area is fogged regularly.

Ms Haslinda fell ill about three weeks ago, and went to see a doctor. 'I was giddy and nauseous and I had high fever,' she said.

When she did not get better after resting for a few days, she went to see the doctor again, and he said she might be suffering from dengue.

On 11 Oct, she was hospitalised.

Ms Haslinda said: 'Luckily I went in time. I stayed in hospital for five days. Then I got better, and went home and had six days MC. But I was still very weak.'

This close call has made her more alert to the dangers of dengue. She is also aware that there have been many cases reported on Jurong West Street 41, where she lives.

She said: 'I don't really know why there are so many (cases) here. Maybe it's because there is a lot of construction work going on around here.'Though worried, she does not know what she can do about it.

'It's the area, not inside my house,' she said. 'I can't do anything about it.'

Asked why she has not contacted the authorities, she said she thought someone else might have done so already.

Like her, a 50-year-old housewife, who wanted to be known only as Madam Liew, expressed helplessness.

RESIDENTS CONCERNED

She said: 'I know that there are some dengue cases in the area. But I really don't know what to do to prevent these problems.'

Others, however, feel they should do whatever they can.

'We are conscious that there are a lot of cases in the area, and we know that it has been on the hotspot listing,' said Ms Naeema Begum, 24, a teacher at Twinkle Mind Childcare in Block 478.
'We check the children for bites every day. And we make sure that no stagnant water collects in the potted plants.'

She said none of the kids at the centre had come down with dengue so far.
Ms Haslinda is especially worried about her 4-year-old son, Muhd Ashrabb.
She said: 'My son always gets bitten because he likes to sleep near the window.
'Every night before I sleep I spray insecticide.'

Housewife Huang Si Xiu, 58, who lives in Block 480, shares similar concerns.
She said: 'I'm worried, especially for my grandson. I bought covers for all my bamboo pole holders.'

She said she knew three people in neighbouring blocks who had suffered from dengue. All of them have since recovered.

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

Letter in Today (29 Oct 2005) - Drains in S'pore just do not drain

2005-10-30T09:52:00.000+08:00

http://www.todayonline.com/articles/81104.asp

Drains in S'pore just do not drain

Thorough review, redesign needed for sustainable efforts in fight against dengue

Letter from Jeffrey Ho Loon Poh

I refer to Channel NewsAsia's report, "More than 1,000 mosquito-breeding sites found during 6-week carpet combing exercise" (Oct 27), which noted that "the main problem areas were drains … And PUB has checked 300km of drains and started work on 10km that require minor repairs".

.One of the reasons why so many of the public drains are favourite spots for collecting and retaining stagnant water is because they are almost level, without any gradient to allow for drainage (hence, the drains in Singapore are a misnomer because they don't drain!). I have taken some photographs at various locations to illustrate my point.

.The drains along Chancery Lane and Gentle Lane are debris-free, so the only reason there is stagnant water is because the water doesn't drain.

.The greatest irony is the entry ramp to the PIE from Adam Road (coming from Farrer Road), where the engineers who designed and built this stretch of drain intentionally "levelled" the drains along the otherwise naturally sloping ramps.

.Is it any wonder why so many of the drains are potential breeding grounds for mosquitoes? I believe it is imperative that any dengue measures must be sustainable and not one-off during outbreaks only.

.Currently, to ensure stagnant-water-free drains, various town councils and agencies have to deploy hundreds of workers to clean and flush them regularly.

.This is not an efficient way to optimise resources, notwithstanding the fact that such jobs create employment.

.While this may suffice as a stop-gap measure, the permanent solution is to do a thorough review and re-design or revamp of all those drains that do not have sufficient gradient to allow good drainage.

Choked Drain in front of PUB Jurong Pumping Station near Jurong Lake

2005-10-29T10:43:00.000+08:00

Reply from PUB on 28 Oct 2005:

Subject: Re: Choked Drain in front of PUB Jurong Pumping Station near Jurong Lake
1800 X DENGUE (7B6FCF1C59)

To: denguealert@yahoo.com
CC: PUB One , PUB WSOC PUB_WSOC@pub.gov.sg,
MCYS Feedback Unit Feedback_UNIT@mcys.gov.sg,
NEA dengue dengue@nea.gov.sg

From: Ming Hwang CHAN CHAN_Ming_Hwang@pub.gov.sg

Date: Fri, 28 Oct 2005 18:05:48 +0800

Dear Mr Jeff,Thank you for your email.

We noted that the drain in front of PUB Jurong Pumping Station near Jurong Lake have a tendency to collect stagnant water.

We agree with you that stagnant water poses a risk to public health due to its potential for mosquito breeding and dengue outbreak. Thus, PUB has immediately mobilised manpower to clear the choke and stagnant water for this particular instance. Thereafter, we will request our colleagues in NEA to increase their frequency of their regular cleansing this particular drain.

As you know, NEA has done a remarkable job in ensuring the overall cleanliness in Singapore which is leading to the high standard of public health, which we all enjoy currently. In addition to the increased cleansing frequency, PUB will shortly evaluate the necessity for further re-grading for this drain. We have previously re-graded this particular drain on 27 Dec 04. Nevertheless, there is a limit to steepen the gradient, due to fixed levels both upstream and downstream. We will optimise the gradient as far as is possible.

Lastly, you may be interested to know that an inter-agency Taskforce is reviewing the design and maintenance standards for drains in Singapore currently. Their findings and recommendation will be presented to the Dengue Coordination Committee by end-year.

In conclusion, we wish to thank you for making the effort in bringing this matter to our attention. And we look forward to working together in assisting NEA in ensuring the high standards of public health, for the best interest of the nation.

Sincere thanks and warmest regards.

Chan Ming Hwang

Mystery of the widespread water stagnation at drains across Singapore solved?

2005-10-25T10:49:00.000+08:00

To: Feedback Unit - MCYS

cc: Prime Minister Lee Hsien Loong
Minister for the Environment and Water Resources - Dr Yaacob Ibrahim

Further to my 21 Oct email below, attached please find photos taken today (24 Oct) at the flyover ramp entering the PIE from Adam Road coming from Farrer Road.

You will note that there is water stagnation at the drain there, possibly because of the lack of gradient to allow water flow. This is most puzzling because not only did the flyover engineers not make use of the "natural" gradient of ramp when constructing the drain (to allow drainage), they had chosen instead to "level" the drain (hence the "steps" that can be
seen from the photos), causing water stagnation - potential breeding grounds for mosquitoes. It is bad enough when drains constructed are not sloping, but to "level" a naturally sloping drain, I fail to understand the rationale behind such designs.

(By the way, I've noticed all these entry/exit ramps to/from expressways have similar "stepped-up" almost-level drains, so all potential mosquito breeding grounds).

As I've previously mentioned on numerous occasions (refer my 2 Aug 2005 posting - http://denguealert.blogspot.com/2005_08_01_denguealert_archive.html), in addition to the weekly cleaning of the drains (to remove water stagnation), why not do a thorough review to see the need to re-design all these drains that do not have sufficient gradient to allow water flow. This was a common observation in the many drains I've seen across the island (not just those at the flyover ramps mentioned above), the drains are almost level, hence water collected does not drain easily, resulting in water stagnation. That's why there are so many mosquito breeding spots in the drains across Singapore.

Isn't it better to fix the "source" of the problem, rather than the "symptoms"?

Jeff

Perpetual stagnant drain water at Owen/Dorset Road junction (corner at Chr Outreach to the Handicapped premises)

2005-10-20T10:21:00.000+08:00

The following sent to NEA:
========================================================
I've noticed this drain seems to be perpetually choked. As previously suggested, this might be due to the fact that there is hardly any gradient to allow flow (perhaps common with many such drains throughout Singapore - public or private).

I note in today's Straits Times (18 Oct 2005) that the "...PUB would be carrying out minor repairs to about 10 km of drains at some 250 locations islandwide....The repairs are for sections of drains that are sunken or damaged, and will help prevent water stagnation."

Questions:

1. There is however no mention of any improvements/repairs to be done to drains that do not have sufficient gradient to allow water flow to prevent water stagnation too. Will this (sufficient gradient) be included as part of the repairs?

2. Will drains inside private & public properties - condos, companies, government entities like schools etc.. be also reviewed (and repaired if necessary) to ensure no stagnation?

3. Is the above stretch of drains at the Owen/Dorset Road junction part of the 10 km to be repaired?

Thanks.

Reproduction of my 24 Sep email to NEA: Why is law not equally applied to Town Councils and govt agencies when their areas are found breeding mozzies?

2005-10-13T10:47:00.000+08:00

http://denguealert.blogspot.com/2005/09/why-is-law-not-equally-applied-to-town.html

http://denguealert.blogspot.com/2005/07/welcome-to-dengue-alert-fight-against.html

Reproduced from my 24 Sept posting (in fact, the call to fine town councils and government entities if they are responsible for breeding mosquitoes goes way back to Feb 2005 per my letter published in the Today newspaper of 24 Feb 2005, "Mosquitoes breeding in public places ...If found, fine responsible govt entities, contractors" - visit my introductory blog dated 29 July 2005 for details - link, http://denguealert.blogspot.com/2005/07/welcome-to-dengue-alert-fight-against.html . It's been 8 months since then but, hey it's better late than never!):

Why is law not equally applied to Town Councils and government agencies when their areas are found breeding mosquitoes?

To: Feedback Unit - MCYS
: NEA

cc: Dr Yaacob Ibrahim - Minister for the Environment and Water Resources

Extract of letter published in Straits Times online forum, 23 Sept 2005 by Mr Henry C W Suriya (in Red below or visit link, http://straitstimes.asia1.com.sg/forum/story/0,5562,342368,00.html ) listing problem areas in Singapore's fight against dengue and suggested improvements.

However, one big area seems to have been "glossed over": Town Councils.

Why is there double standard in law enforcement - NEA fines households and construction sites who breed mosquitoes but not areas under Town Councils' management (and other government agencies)?

If this anomaly is not addressed, Singapore will never be able to control the breeding of mosquitoes because town councils (who are responsible for a big chunk of the public areas in Singapore) and other government agencies can get away scot-free without punishment when found breeding mosquitoes - NEA should apply the law equally to all, including government agencies like NParks, SLA state land, MOE's schools, PUB, town councils, etc..., not just private residents and corporations whose properties are found breeding mosquitoes.

Town Councils collect conservancy fees from residents (which are quite substantial), and such fees should be used prudently to maintain their areas.

Regards
Jeff
http://www.denguealert.blogspot.com/

Town Councils and other government agencies to be fined if areas under their care found breeding mosquitoes

2005-10-11T09:07:00.000+08:00

Reply from NEA on 10 Oct 2005:

=============================================
I refer to your email to Feedback Unit dated 24 September 05.

2. We wish to inform you, as announced by our minister, that from next year town councils will also be subjected to fines should mosquito breeding be detected in common areas under their maintenance.

3. With regard to mosquito breedings detected in areas maintained by other public agencies, the agency responsible is also fined.

4. We thank you for your feedback.

Best Regards.
Sri Hernani Mohamed Affandi
Environmental Health Executive
Environmental Health Department
The National Environment Agency
DID +65 67319427
Fax +65 67319749

NEA considering publishing a weekly listing of cluster sites found breeding mosquitoes

2005-10-07T10:17:00.000+08:00

Reply from NEA 6 Oct 2005:

===========================================================
Dear Sir

Please refer to your email dated 29 September 05 to Feedback Unit.

2. We will take your suggestion into consideration.

3. We thank you for your feedback in our effort to fight against dengue.

Best Regards.
Sri Hernani Mohamed Affandi
Environmental Health Executive
Environmental Health Department
The National Environment Agency
DID +65 67319427
Fax +65 67319749
===========================================================
Our Environment -- We CareThis message may contain confidential information under the purview of the Official Secrets Act. Unauthorized communication or disclosure of such information is an offence under the Official Secrets Act. If you are not the intended recipient of this message, please notify the sender and delete it. Do not retain it or disclose the contents to any person as it may be an offence under the Official Secrets Act. Find out more about how we can work together to help Singapore keep a clean and healthy environment at http://www.nea.gov.sg

Jeff Ho
29/09/2005 10:07

To: MCYS Feedback Unit/MCYS/SINGOV@SINGOV
cc: NEA dengue/NEA/SINGOV@SINGOV, "Letters@ Today"
Subject: Can NEA publish a weekly listing of cluster sites found breeding mosquitoes?

In an article in Today (29 Sept 2005 - see below), it was reported that of the 220 mosquito-breeding habitats found over the weekend, some 70% were found in public areas (like scupper drains, discarded recepticles in the open, etc.)

Over the last two weekends when intensive combing for mosquito-breeding sites was done, a total of 329 breeding sites were found. What is more worrying is that some 4,139 potential breeding sites have been found during the these two weekends (Straits Times, 29 Sept - "Shop assistant dies from dengue; third victim this month").

While the decision by the NEA to publish the weekly "Location of Active Clusters" is a step in the right direction, what is equally useful is to include another weekly listing of cluster sites found breeding mosquitoes.

Hopefully, with this new listing, residents will be more vigilant to ensure their areas are regularly maintained. Besides, it can act as a deterrent as I'm sure both residents and town councils will not want their areas to be listed too frequently?

Jeff Ho

Business Times (5 Oct 2005) - Personal accident policy may cover dengue fever: lawyers

2005-10-06T10:13:00.000+08:00

Published October 5, 2005

Personal accident policy may cover dengue fever: lawyers

They cite English case law - but most insurers disagree

By DANIEL BUENAS

(SINGAPORE) Amidst the spate of dengue cases in recent weeks, a debate has arisen in insurance industry circles over whether people with personal accident policies are covered against the disease.

Lawyers and industry watchers that BT spoke with said that in a dispute between a policyholder and an insurer, the policyholder could possibly win. Their opinions were based on legal arguments and English case law.

A check with some of Singapore's largest insurers found that at least one, AIA, has a personal accident policy that does provide hospital income benefit for those hospitalised with dengue fever, but that most policies do not.

'Lawyers having looked at the question think, on balance, dengue would be covered,' said Singapore Insurance Institute (SII) president Stanley Jeremiah. 'But, of course, there is no test case yet in Singapore.' Mr Jeremiah, who is a lawyer, said that whether contracting dengue was covered under a personal accident policy depended on the policy's wording.

'The main issue revolves around the definition of an accident which is usually 'violent, external and visible means',' Mr Jeremiah said. 'But the legal argument is that 'violent' simply means the opposite of 'natural' - so the considered view, is that, yes, (contracting dengue from a mosquito bite) will be covered.'

He said there was English case law dating back to the 19th century which had showed that the definition of 'violent' need not include the use of force.

'There are quite clearly cases that support this view,' he said. 'Based on contracts and law, it would seem the insured would have a valid claim for dengue as falling under accident policies.'
Adeline Chong, a partner at Harry Elias Partnership specialising in insurance law, agreed that being bitten by a mosquito and contracting dengue could be construed as an accident under legal terms.

'I haven't seen a case like this yet, but it would be interesting to see how a local court rules,' she said. 'Off the top of my head, I think that these policies might cover dengue . . . but still, at the end of the day, we have to look at how the underwriters determine their scope of cover.'
A check with some of Singapore's largest insurers reveals that they believe that most personal accident policies do not cover dengue fever.

A spokeswoman for NTUC Income, the largest insurer in Singapore in terms of policyholders, said that dengue fever was covered under the company's infectious disease plan, but not its personal accident policies.

'The personal accident plan under NTUC Income covers a person against death and bodily injury caused by violent accidental external and visible means . . . (but) dengue fever is not covered under the plan,' she said. 'However, we will look at the circumstances leading to the person contracting the dengue fever. Where appropriate, we may make a payment to help a policyholder.'

The company did not indicate if it had ever made a payment on a claim like this, but did say that fewer than 10 claims were made a year.

Aviva declined to comment, while Prudential said that their policies did not cover the disease, although AIA said that one of its personal accident policies did.

'Our personal accident plan, AIA Personal Accident 24-Hour Plan, has a hospital income benefit which is payable when the insured is hospitalised due to an injury or illness, including dengue fever,' a spokeswoman of the company said, adding that the company had paid out for dengue claims recently.

According to the company, in the event that an accident or illness causes a policy holder to be confined in hospital, a daily hospital income benefit will be paid up to the maximum of 500 days, and hospital expenses reimbursed up to a maximum of five times the daily in-hospital income or $300, whichever is less, for the same illness or injury.

However, Mr Jeremiah said that a hospital income benefit was a 'given', as it would be payable to anyone who was hospitalised, regardless of why.

He added that if a person were to die from dengue fever, it would be covered by most life insurance policies, but it was unlikely to be covered under critical-illness policies.

'I think this issue is not something that insurers have thought about,' he said. 'But as far as the insured party is concerned, he clearly will view it as an accident, while the insurers are unlikely to do so.'

© Copyright Singapore Press Holdings 2005. Co. Regn. No. 198402868E Privacy policy

If quarantined, dengue patients have less than 20% chance of infecting others

2005-10-03T22:20:00.000+08:00

To: Feedback Unit - MCYS
cc: NEA

On Channel News Asia's report of 1 Oct 2005, "Singapore's dengue outbreak has peaked: experts" (http://www.channelnewsasia.com/stories/singaporelocalnews/view/171227/1/.html )... "quarantining dengue patients was not recommended by the panel because symptoms appear 24 to 48 hours after infection. It is therefore possible for mosquitoes to bite the person and spread the disease to others during this period." Presumably, such "symptoms" include fever.

However, in the "The Vicious Circle" pictorial of The Straits Times dated 20 Sept 2005 ("No need to quarantine dengue patients"), it was stated that "He (the infected man) can pass the dengue virus to the female Aedes mosquito only during the period when he has fever, which can last from three to seven days". This contradicts with the experts' opinion that transmission can still occur during the first 24 to 48 hours of pre-symptomatic feverless infection period.

Nevertheless, even assuming most dengue patients have an infection period of about 10 days (including the frist 1 to 2 days of the feverless stage), quarantining them upon the onset of fever will still mean the risk of infecting others (through being bitten by the Aedes mosquitoes which then infect others) is reduced by 80 to 90% (taking into consideration that symptoms may not appear for 24 to 48 hours after infection, as the experts are led to believe - I am however curious to know if this has been medically and scientifically proven to be the case as the experts have themselves admitted a lot of their previous assumptions are no longer valid. I am now very sceptical of what is to be believed unless it is medically and scientifically proven recently to be the case - not based on studies done 50 years ago).

Therefore, if it means decreasing the odds of transmission, it may still be worthwhile to consider the option of quarantine to minimize infection.

Jeff

=============================================================
SINGAPORE : Singapore's dengue outbreak is finally on the decline -- that is the assessment of international experts who are here to review its current anti-dengue measures and to make recommendations. After a record two months of dengue cases, the disease is finally on the decline. This is because the epidemic is coming to the end of its two-month cycle and the peak season is over. The latest outbreak coincided with a global resurgence. But the government's efficiency at controlling the disease probably made the country more vulnerable. Said Dr Paul Reitner, Professor of Entomology at the Pasteur Institute, France, "Singapore really is the outstanding example; throughout the world there is no country in the world that has been so successful in suppressing this virus. So successful, the population born over the last 20 years has a very low herd immunity. In other words many people are susceptible." The panel of local and international experts called for research to guide mosquito control operations. One area that needs studying is where people catch the disease. Said Dr Duane Gubler, director of the Asia-Pacific Institute of Tropical Medicine and Infectious Diseases, "If they are being infected in the home then we need to focus more on finding those mosquitoes. But it's very likely that some of them or many of them are being infected outside of the home." Fogging also needs more research to determine how effective it is in Singapore's urban setting. Said Dr Reiter, "Indoor fogging undoubtedly has an impact, it kills the mosquitoes dead. Outdoor fogging will depend on the obstructions, the air movements so it's really hard to say until you've evaluated." The current search and destroy approach to reduce breeding sites will continue. But with Singapore's low mosquito population, the expert panel recommends using trap and destroy methods as well, such as Ovitraps, which are the perfect size and colour to lure the aedes mosquito. The female mosquito comes in, lays its eggs then flies off again. The eggs are so small they actually slip through a wire mesh into the water below, where they hatch into larvae and eventually turn into mosquitoes. By that time, though, they are too large to escape so are trapped inside. Now the Environmental Health Institute is working on a more advanced model that traps both the mosquito as it lays its eggs, as well as the eggs and the larvae. Quarantining dengue patients was not recommended by the panel because symptoms appear 24 to 48 hours after infection. It is therefore possible for mosquitoes to bite the person and spread the disease to others during this period. The expert panel says public education and community involvement remain the key to controlling dengue, along with efforts by the private sector. Meanwhile, the number of dengue cases dropped slightly between 3pm on Friday and 3pm on Saturday. A total of 74 cases were reported, down from 86 the previous day. This is the third day in a row the numbers have not passed the hundred mark. The weekly total has fallen significantly from 714 cases last week to 541 this week. - CNA /ct

Can NEA publish a weekly listing of cluster sites found breeding mosquitoes?

2005-09-29T22:10:00.000+08:00

In an article in Today (29 Sept 2005 - see below), it was reported that of the 220 mosquito-breeding habitats found over the weekend, some 70% were found in public areas (like scupper drains, discarded recepticles in the open, etc.)

Over the last two weekends when intensive combing for mosquito-breeding sites was done, a total of 329 breeding sites were found. What is more worrying is that some 4,139 potential breeding sites have been found during the these two weekends (Straits Times, 29 Sept - "Shop assistant dies from dengue; third victim this month").

While the decision by the NEA to publish the weekly "Location of Active Clusters" is a step in the right direction, what is equally useful is to include another weekly listing of cluster sites found breeding mosquitoes.

Hopefully, with this new listing, residents will be more vigilant to ensure their areas are regularly maintained. Besides, it can act as a deterrent as I'm sure both residents and town councils will not want their areas to be listed too frequently?

Jeff Ho
www.denguealert.blogspot.com

==============================================================================================
http://www.todayonline.com/articles/75270.asp

Dengue cure's long wait
Tan Hui Lenghuileng@newstoday.com.sg

ALTHOUGH dengue has been around for centuries, most health authorities only allocate resources to it when there are epidemics.
.
Due to this neglect, it would be some time before the world gets a vaccine for dengue, said Professor Paul Herrling, head of corporate research at Novartis International, who is in town with 300 other scientists for the second Asian Regional Dengue Research Network Meeting.
.
"You have to keep in mind the drug discovery or circle is more than 15 years," he said.
.
"So we are very much in the beginning of this process. We might have the first drug to be tested on humans after 2008. And in 2012 or 2013, we might have the first drug for patients in general."
.
One of the labs working on a cure is the Novartis Institute of Tropical Diseases (NITD), which was set up at the Biopolis two years ago. It aims to develop a drug that can stop the replication of the virus in the human body.
.
Prof Herrling said the lack of a suitable animal model for testing makes finding a solution difficult as scientists cannot ascertain the virulence of the dengue strains.
.
But he is confident that a cure can be found as the NITD continues researching into the basics of the dengue virus, which the world knows very little about.
.
Other drug companies are also working on a dengue vaccine, but Prof Herrling said it is anyone's guess if a vaccine would be available in the next six to 10 years as there are four types of dengue.
.
Scientists in the three-day meeting discuss strategies for vaccine and therapeutics for dengue and other diseases transmitted by mosquitoes and ticks.
.
Meanwhile, there were 104 cases of dengue reported between 3pm on Tuesday to 3pm yesterday, a drop from the 157 reported the previous day. There was one fatality yesterday, bringing the number of deaths from dengue this year to 12.
.
The National Environmental Agency yesterday reported that a total of 220 mosquito-breeding habitats were found and destroyed during its second carpet combing operation over the weekend.
.
This represents an average of one breeding site found for every 11 blocks of flats.
.
Half of the habitats were found in scupper drains, pump rooms, joss-paper burners, gully traps, manholes and telecom chamber covers.
.
About a third of the habitats were detected in flowerpot trays, water jars and containers found along common corridors.
.
Another one in five were in discarded receptacles left in the open.

Town Councils should terminate errant contractors for failure to clean up repeatedly

2005-09-28T22:52:00.000+08:00

There have been many calls for tougher enforcement by NEA on errant town councils found breeding mosquitoes.

Is the fact that they have so far been exempted from penalties the reason why despite all the stepped-up efforts by households that the problem not only has not improved but has in fact got worse? Without being subjected to penalties, town councils will not act against their contractors.

Shouldn't town councils terminate their cleaning contracts if they are found to be grossly and recalcitrantly inefficient? Are yardsticks in place to measure their performance?

Town councils, being custodians of the residents' money, should award contracts to companies that can do the job best and at the most competitive price, and if the recent dengue outbreak and the subsequent clean-up efforts is any indication, then these outsourced contractors have failed miserably, even if their price may have been competitive.

Jeff
http://www.denguealert.blogspot.com/

Letter from ex-ENV (predecessor of NEA) health inspector dated 27 Sept calling for NEA to fine town councils that breed mosquitoes

2005-09-27T22:34:00.000+08:00

Extract from Straits Times online forum, 27 Sept 2005: (link
http://straitstimes.asia1.com.sg/forum/story/0,5562,343287,00.html )

Sept 27, 2005

Yes, fine town councils that breed mosquitoes

I AGREE with Health Correspondent Salma Khalik ('Fine way to get town councils to clean up act'; ST, Sept 22) that 'town councils should be fined like any other property owner found breeding mosquitoes'.

I should know how effective this can be. From 1961 to 2001 I was a public health inspector with the then Ministry of the Environment.

Thirty-five years ago, when the late Mr Tan Teck Kim, then Commissioner of Police, was seconded by Minister Mentor Lee Kuan Yew to my ministry to clean up Singapore, I had his support to even serve notice on any government department whose properties were found to be breeding mosquitoes.

On one occasion I found mosquitoes breeding in a neglected part of a government school overgrown with thick vegetation. I served a notice on the then Permanent Secretary of the Ministry of Education at Kay Siang Road.

His secretary asked what my ministry would do if they did not comply with the notice to clear the thick vegetation and remove all discarded articles.

I told her the due process of the law would be applied against her ministry. Within a week, when I checked the site again I found that all vegetation and discarded containers had been cleared.
I was told later that the Education Ministry mobilised more than 20 school servants to do the clearing. News spread far and wide and I had no more problems with schools after that.
The National Environment Agency should take a leaf from my book.

Raymond Lo Wan Mou

Today (26 Sept 2005) - Letter questioning NEA's "selective" enforcement policy in exempting Town Councils from being fined

2005-09-26T22:43:00.000+08:00

The following letter questioning NEA's "selective" enforcement policy in exempting Town Councils from being fined when their areas are found breeding mosquitoes was published in the Today newspaper, 26 Sept 2005:

'Selective' enforcement?

Deterrent penalties should apply to town councils and other government agencies

Letter from Jeffrey Ho Loon Poh

.JUST like Danny Chua ("Fine the town councils as well", Sept 21), I note with concern that town councils are exempted from fines should areas under their care be found to be breeding mosquitoes.

.This may explain why there is widespread breeding of mosquitoes in many of the public areas (drains, scupper drains, et cetera). National Environment Agency (NEA) chief Lee Yuen Hee was even quoted in The Straits Times as saying that town councils "are not fined for breeding mosquitoes and the agency has no plans to change that".

.While the NEA keeps harping on the fact that mosquito breeding mainly occurs inside homes, the recent anti-dengue efforts found that equally numerous, if not more, breeding places are in the public domain — many of which are under the respective town councils' responsibility.

.How then can we hope to succeed in our fight when the law is not equally applied to deter such irresponsible behaviour, when private residences or construction sites face hefty fines if found breeding mosquitoes, while areas under the town councils (and presumably other government agencies, too, such as state land under the Singapore Land Authority or Public Utilities Board premises) are exempt?

.And at the national level, what is of more concern is: What if all the other agencies with enforcement powers (such as the Building and Construction Authority, Health Sciences Authority and the Infocomm Development Authority of Singapore et cetera) practise "selective" enforcement when it comes to their fellow government-linked entities?

Kenny Lim's feedback on "Fine way to get town councils to clean up act"

2005-09-26T12:10:00.000+08:00

Sent by Contributor, Kenny Lim:

Subject: Feedback on Fine way to get town councils to clean up act

To: salma@sph.com.sg

Hi! Salma Khalik,

I fully agreed with your write up. I am trying very hard to get my Town Council and NEA and PUB to be more responsible and efficient in carrying out their duty.

Without policing, they are just as irresponsible as some members of the public. We can't rely on them confidantly.

Have our Government forgotten our sacred PLEDGE to build a democratic society based on justice and equality so as to achieve happiness? Why double standards being practice in giving out fine to offenders?

As a responsible citizen, since May I am giving feedback to clean up my neighbourhood. In the process of getting my neighbourhood clean up my wife was infected with dengue fever. She was hospitalised in 6th September and discharged on 14th September. Her platetelets went down to 3 and almost died. She is now on one month medication and need a lot of rest.

In view of the Dengue Fever Fiasco, I have contacted your counterpart in Straitstimes,Wanbao and Zhaobao to report on the clogged drains and mosquito breeding ground but was told that the Editor are not interested in these kind of news. Eventually Channelnewsasia reported it on 10pm news last night. What a shame to SPH! Since May I have been giving feedback to my Town Council on clogged up manholes and potential breeding ground.Yet in August, the common drain was found to be breeding mosquito.(see pictures on manholes)

Below is NEA reply to my feedback.

"2.Thank you for your feedback. Our records show that our field officers had found mosquito breeding in the drain next to Block 671A Klang Lane on 18 Aug 05.The breeding habitats were eliminated and the Town Council was alerted to clear the drains and spruce up the area."

Since August 19, I have also persistently wrote to National Enviroment Agency on drains that are badly clogged up and are breeding mosquito. I even collected laarvae sample and gave to NEA staff. Nothing was done.(Pictures attached)

The dengue hotline is also a joke. Refer letter attached.

In the process PUB also gave a false report to NEA for the work that they have not carry out properly. See extract of NEA letter to PUB as follows:

"We inspected the closed drain at Rotan Lane.

Contrary to your claim below, we discovered that the stone and the plank have not been cleared and stagnation of water was observed. The turbidity of water in the drain was black and murky and indicate that no flushing had been done. We also found out that the plank is actually a part of the formwork used for the construction of the covered drain. Apparently, the contractor who constructed the drain had failed to remove the formwork."

Why is law not equally applied to Town Councils and government agencies when their areas are found breeding mosquitoes?

2005-09-25T06:04:00.000+08:00

To: Feedback Unit - MCYS
: NEA

cc: Dr Yaacob Ibrahim - Minister for the Environment and Water Resources

Extract of letter published in Straits Times online forum, 23 Sept 2005 by Mr Henry C W Suriya (in Red below or visit link, http://straitstimes.asia1.com.sg/forum/story/0,5562,342368,00.html )
listing problem areas in Singapore's fight against dengue and suggested improvements.

However, one big area seems to have been "glossed over": Town Councils.

Why is there double standard in law enforcement - NEA fines households and construction sites who breed mosquitoes but not areas under Town Councils' management (and other government agencies)? If this anomaly is not addressed, Singapore will never be able to control the breeding of mosquitoes because town councils (who are responsible for a big chunk of the public areas in Singapore) and other government agencies can get away scot-free without punishment when found breeding mosquitoes - NEA should apply the law equally to all, including government agencies like NParks, SLA state land, MOE's schools, PUB, town councils, etc..., not just private residents and corporations whose properties are found breeding mosquitoes.

Town Councils collect conservancy fees from residents (which are quite substantial), and such fees should be used prudently to maintain their areas.

Regards
Jeff
www.denguealert.blogspot.com

=======================================================
Sept 23, 2005
Change mindsets first to lick dengue problem

The Government has expressed concern about the increase in dengue transmission but this has yet to result in efficient control programmes.
There must be a heightened awareness and full public participation in vector control and preventative efforts. This can only be achieved through constant training, health education, community and intersectoral participation.
Every school, polytechnic, university, government and statutory board must form its own dengue prevention groups.
The Dengue Prevention Volunteer Group of Aljunied-Kembangan Zone 2 (RC) was formed in November 1999. Since then, we had met obstacles created by an insipid Residents' Committee administration.
The RC has failed to realign itself to meet the changing needs of its residents. Creativity is viewed as dissent. This makes it difficult for subordinates to contribute ideas or develop plans.
Notice boards can serve as a focal point for the dissemination of information. This, when well displayed, will attract people's attention.
I wrote to the Town Council some time ago requesting one for environmental purposes, especially on dengue.
I thought the common areas under void decks were managed by the Aljunied Town Council but was I mistaken. It told me to contact the Peoples' Association, which is the controlling body. I did just that but to my disappointment, I did not get a reply.
The National Environment Agency was willing to provide us with very artistic and educational materials whenever I needed them. In fact, it has given us solid support in our efforts to spread the dengue awareness message. A great partnership is in place.
Aljunied-Kembangan Zone 2 has more than thirty notice boards, some half empty, others empty. Yet, I had to face such a dilemma. So much for cooperation and coordination!
During one of our Senior Citizens' monthly gatherings, our dengue-prevention group arranged with the NEA to give a talk on dengue awareness.
Officials from the People's Association and the Constituency Office thought it to be a value-added event. An additional $50 was approved for the RC to dispense refreshment. The turnout was more than eighty people.
This was turned down by the RC at the last minute, leaving some residents without refreshments. Even a walkabout with our advisor was aborted at short notice. No reason was given.
It is ironic that money spent for dinner after an MP's walkabout is never questioned. I hope the PA could tell the RC what exactly is the vision and mission of the Residents' Committee.
I imagine a basic ingredient of good leadership is to communicate and motivate. After all, we are just volunteers trying to promote neighbourliness, harmony and cohesiveness among the residents of our zone.
The only consolation our dengue-prevention group has is knowing that Lorong Ah Soo Zone 2 is not listed on the dengue hot spot list.
Our constant surveillance and willingness to engage residents have provided some results. We shall continue to cultivate the best network to garner people's support in making our estate clean, green and dengue-free.
To meet the challenges ahead, the following areas have to be closely monitored:
- Power stations which are locked and fenced up;
- Vacant state land: a horrendous mosquito breeding site;
- Bamboo pole-holders in HDB estates;
- Landscaping: avoid plants with large leaf axils;
- Grass cutters who blow cut grass into drains and clogging them up;
- Vacant HDB flats and private properties: house owners and housing agents must do their part to maintain them;
- Litter;
- Fogging: how competent are the pest control operators? Indiscriminate fogging by untrained personnel endangers the environment and residents.
- Insecticides: resistance in mosquito population;
- Increased movement of human population within and between countries;
- Zones within constituencies: in many instances, a street demarcates them. If one zone is napping, it causes problems for others as mosquitoes are found within 25 metres of their breeding sites.
- Everyone must be able to identify the Aedes mosquitoes, with their black and white stripes on the body and legs.
Unless there is a behavioral change at the individual, household and community levels, the dengue situation may not improve.
The maxim should be 'Detect and destroy - No mosquito, no dengue'.

Henry C W Suriya
DPVG Team Leader
Aljunied-Kembangan Zone 2

Dengue deaths in Singapore so far in 2005: TEN

2005-09-25T06:00:00.000+08:00

Extract from Today newspaper, 23 Sept:

Dengue claims two more

DENGUE has claimed two more victims in Singapore, bringing the total death toll to 10 this year. The two, a 55-year-old woman and a 61-year-old man were patients at the Tan Tock Seng Hospital.

.While the Health Ministry declined to reveal more details, it said in a statement that the latest victims were also suffering from other health problems. The woman had diabetes and chronic renal failure and died from dengue in August.

.The male patient, on the other hand, had liver cirrhosis. He is believed to be the oldest person to die from dengue this year. The youngest was a nine-year-old boy who died early this year.

.It is understood that both died from dengue shock syndrome, the more severe form of the disease.

.Meanwhile, 136 cases of dengue were recorded between 3pm on Wednesday and 3pm on Thursday. That is up slightly from Wednesday's 131.

.The number of hospital admissions of suspected and confirmed cases also nudged up, from Wednesday's 75 to 80 yesterday. – Channel NewsAsia

Did NEA fail in its task to prevent upsurge in dengue cases?

2005-09-23T23:11:00.000+08:00

The following extracted from letter-writer, Lim Boon Hee - Straits Times Online Forum page, 22 Sept 2005:

Sept 22, 2005
Did NEA fail in its task to prevent upsurge in dengue cases?

Between the lines of all the questions and answers in Parliament as well as media coverage of the high profile weekend 'search and destroy' mozzies and 'carpet combing' missions by ministers for breeding sites, the underlying tension of fingering who is ultimately the larger culprit in this dengue epidemic is palpable.

We are told that we have to help ourselves and not depend on the government to stop this outbreak.

We are encouraged to go and tell our neighbours if we find that they are breeding mosquitoes on their grounds.

Can we really do so without causing more Everitt Road-type of neighbourhood vendetta and catfights? Who will tolerate such intrusions in their domestic affairs?

Minister Mah Bow Tan also seems to be pretty convinced that the greater responsibility lies with Singaporeans themselves in the latest dengue scourge.

If, according to the minister, littering is the main contributing factor to mosquito breeding and dengue epidemic, why hasn't enforcement been carried out so that Singapore is not on other countries' lists of dengue hotspots?

Is this also the public's fault for littering and not a blight on the NEA's poor enforcement too?
The other contributory factors brought up include HDB perimeter drains and stagnant water areas because of design flaws. Surely the town councils and HDB must take some of the rap as well?

How can it be that we are almost always reassured that our food or our environment is safe whenever other countries get hit with some environmental hazards, but when something like dengue happens here, it is the people's fault for breeding mosquitoes or their littering rather than the failure of the relevant government bodies in tackling the problem and nipping it in the bud?

I agree that the community must cooperate in fighting dengue but shouldn't we also scrutinise the NEA's role in its failure to prevent or at least curb the present dengue scourge?

Lim Boon Hee

MP Dr Tan Cheng Bock's plea to the government in Parliament on measures to "prevent dengue patients from infecting others"

2005-09-22T23:02:00.000+08:00

The following article extracted from Electric New Paper (21 Sept 2005). Another potential "I told you so" about the government's refusal to hospitalise/quarantine all suspected and confirmed dengue patients.

"My body was covered with tubes and drips
That's why I feel for dengue sufferers, says MP Tan Cheng Bock. He was seriously ill with meningitis in July. Yesterday, he gave hospitals an earful in Parliament for the way they treat people with dengue
HE was speaking as a doctor who had just gone through a life-and-death struggle himself.
By Clarence Chang

21 September 2005

HE was speaking as a doctor who had just gone through a life-and-death struggle himself.
Unknown to many, the affable Dr Tan Cheng Bock, 65, had been struck down by viral meningitis, an infection of the brain, in mid-July.
He was at Singapore General Hospital, his 'whole body covered with tubes and intravenous drips', for two weeks.
He lost close to 7kg, and had to learn to walk properly again before he could return to work at his GP clinic just a fortnight ago.
That was also when public fears about the dengue outbreak reached its peak.
'I remember when I was ill, I couldn't follow so well at first because my head was splitting,' Dr Tan told The New Paper.
'Initially they also thought it was dengue, but it turned out not to be so. So I have special interest in this.'
True to form, the always passionate backbencher made a heartfelt plea in Parliament yesterday for local hospitals to admit, not send home, every dengue-infected patient - even just suspected ones.
His concern: 'You are bringing in a reservoir of infection, who should be in hospitals and sheltered, back into the community... It is a very dangerous practice.'
Most of the Government's measures so far, said the veteran Ayer Rajah MP, is aimed at 'catching the mosquito'.
'But what measures are we taking to prevent dengue patients from infecting others?'
From what he's seen, he told The New Paper, even high-fever patients with a blood platelet count of about 100 are being 'released', although the all-clear should only be given once they regain a healthy level of at least 150.
And these patients, tired and weak, could still be in their five-day 'infectious' period. So one bite from an Aedes mosquito which later bites someone else is all it takes for re-infection to happen.
That's why mindful of the chronic shortage of hospital beds (see report below), Dr Tan wants the inter-ministerial committee on dengue to set aside part of its $30-million budget to build special quarantine units instead, next to the main premises.
Rather than just asking those with symptoms to go home, rest and apply insect repellent, 'I would advocate sheltering, isolating, ring-fencing all these patients'.
In fact, get the 'army chaps' to man the isolation units and doctors to monitor them daily, he added.
An over-reaction? Former patient Ho Lian-Kuang, 22, feels forced quarantine is 'too serious' a measure, and should only be reserved for the 'irresponsible' ones or those who truly need medical attention, like the elderly.
Like many others, Mr Ho, 22, had also been sent home on his first visit to SGH last month, but was admitted the next day after his platelet count dropped to 76.
But overall, he said: 'I'd much rather take my own precautions and spend time with my family at home.'
Dr Tan doesn't think that's a good idea.
Why? Because although he now spends just three hours a day at his clinic, he already sees an average of one dengue patient daily. And with islandwide numbers climbing to over 600 infections a week, the 'reservoir' is growing bigger.
'We send them to hospital. Hospital says no need to admit, go back. But he's still feverish. Next day, he comes back to me. We have to do another blood test. His platelet count falls to 50. Then we send him back to hospital.'
SAYING IT STRAIGHT
Add to this the cost of transport, the inconvenience of getting a loved one to take leave to accompany you, the need to fork out cash at the hospital instead of upfront Medisave payments, and you get the picture, the MP explained.
'I've been in practice for 30-plus years. I've seen dengue as a medical student... Previously, when dengue patients went to hospital, they didn't come out until they were well. So there was no chance of community spread.'
This, coming from a community doctor clearly frustrated at the re-emergence of dengue.
'I hope I haven't frightened people,' Dr Tan said. '(But) I'm just going to say it straight. I'm not going to pretend.
'In fighting any infectious disease, isolation is very important. Any leakage, we must stop it.'
His parting shot to hospitals? If you say you have no choice but to turn away patients because of lack of beds and other resources, you haven't planned enough.
'Let this be a lesson for hospital authorities. Dengue is already a national problem. Lurking around the corner is the Avian flu.'

Decision on isolation units: Leave it to the experts

WILL we soon see the return of isolation units on hospital premises?
Senior Minister of State for Health, Dr Balaji Sadasivan, believes it's a decision best left to the government-appointed panel of experts studying the sudden upsurge.
'We need some science in dealing with this problem,' he said.
So far, the panel has recommended that patients simply 'cover themselves with insect repellent'.
As to whether hospitals should admit all dengue patients, Dr Balaji says he'll defer to the World Health Organisation's 'clinical criteria'.
For now, 'the majority of patients can actually be treated as outpatients,' he said.
Between May and August alone, the percentage of beds taken up by dengue patients had gone up from 0.8 per to 3 per cent at the National University Hospital, and from 2.7 to 6 per cent at Tan Tock Seng Hospital.
Dr Balaji also said there's 'no necessity' for self-quarantine.
'Because this is not an infection that spreads directly from one person to another. So any amount of human contact is safe,' he said.
Likewise, it's safe to go to nature parks even though there are 'large mosquitoes flying around and they're the noisy variety'.
Dr Balaji explained that these are not dengue-carrying Aedes mosquitoes which usually breed in 'urban' areas and in buildings.
Earlier, Environment and Water Resources Minister Yaacob Ibrahim, who heads the inter-ministerial committee on dengue, urged all patients to heed their doctors' advice.
'They can apply mosquito repellent on themselves, wear long-sleeved clothing, sleep under mosquito nets and keep their rooms mosquito-free,' he said.
Last weekend's anti-dengue blitz across four estates, the minister revealed, had uncovered 172 breeding sites, with flower pots and litter making up more than half of the cases.
As of last Saturday, overall dengue infections this year had reached an all-time high of 10,237.

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