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NEA Urges Heightened Vigilance As Dengue Cases Spike

01 Jun 2019

Cases are expected to rise further as we enter the peak dengue season

Singapore, 1 June 2019 – In the week ending 25 May 2019, there were 379 reported cases of dengue, 70 cases more than in the previous week. The number of weekly reported dengue cases have been on an upward trend, and have more than tripled in the past nine weeks. We have not seen such a high weekly number since March 2016. The number of cases of dengue haemorrhagic fever (DHF) are also at a high of 32 cases. We are currently in the peak dengue season and expect the cases to rise further. 

2     As of 25 May 2019, there have been a total of 3,918 reported cases this year. This is more than three times the 1,058 cases we had in the same period last year. The upward trend in the number of dengue cases observed island-wide comes after two years of low dengue cases. The current upward trend coincides with the start of the warmer months from June to October, where we usually experience a higher number of dengue cases.    
 
Chart of DF Cases (2016-2019)_2
Figure 1. Number of dengue cases from 2016 to 2019

3     The Aedes aegypti mosquito population in the community is persistently high and this increases the risk of transmission of the dengue virus. The gravitrap surveillance system deployed by NEA has shown a 25 per cent increase in the Aedes aegypti mosquito population in April 2019, compared to the month before. The data on mosquitoes caught in these traps has been used to guide NEA’s inspection efforts to focus on areas with high Aedes mosquito populations, thus enabling more efficient deployment of limited manpower resources. NEA is also exploring innovative solutions such as Wolbachia technology, to complement NEA’s existing mosquito control efforts and suppress the urban Aedes aegypti mosquito population (refer to Annex A for more information on the deployment of Gravitraps, as well as other tools and technology NEA utilises to improve dengue control). 


4     Between January to March this year, about 60% of the breeding habitats detected have been found in residential premises and the numbers of such breeding in homes remains high. As we are in the traditional dengue peak season, community action is urgently needed to bring down the Aedes mosquito population, and prevent more people from being infected with the dengue virus. NEA urges all members of the public and stakeholders to take immediate action to eradicate potential mosquito breeding habitats and step up housekeeping measures in their respective premises.  We urge all residents living in dengue cluster areas to cooperate with NEA officers and facilitate their checks and indoor spraying of their homes.

 Concerted efforts to stem dengue transmission

5     Following the national dengue campaign launch on 7 April this year, 81 divisions across Singapore have organised more than 440 dengue prevention events and activities. Mayors, Grassroots Advisers, Community Leaders and Dengue Prevention Volunteers (DPVs) have visited residents to share dengue prevention tips, including how to identify potential mosquito breeding habitats. To heighten the public’s awareness and vigilance against mosquito breeding and dengue, particularly in the dengue clusters, NEA has been and will continue to work with our stakeholders to carry out community events and house visits in the next few weeks to remind residents to practise the 5-step Mozzie Wipeout. 

6     NEA, together with the various agencies and other stakeholders represented in the Inter-Agency Dengue Task Force (IADTF), including Town Councils, have stepped up checks leading up to the traditional peak dengue season to remove potential mosquito breeding habitats in our public areas and housing estates. From January to March 2019, NEA conducted about 224,000 inspections, including about 1,800 inspections carried out at construction sites. NEA uncovered about 2,900 instances of mosquito breeding habitats. As at March 2019 , more than 600 households were fined for mosquito breeding. About 70 Notices to Attend Court and seven Stop Work Orders were issued to construction sites. Three court prosecutions were also made against contractors for repeat offences. To safeguard public health, NEA will not hesitate to take enforcement actions against anyone found to have created conditions favourable for the propagation or harbouring of vectors.

Community-led efforts are a key pillar 

7     With a short breeding cycle of seven days, keeping the mosquito population in check requires the joint effort of every individual and stakeholder in the community to eradicate mosquito breeding habitats. Community-led efforts also play a key role in protecting our neighbourhoods from dengue and for tackling the problem collectively, whether preventing mosquitoes from breeding at home or at common spaces. 

8     To protect ourselves, all of us need to play our part in removing stagnant water from our environment, so as to deprive the mosquitoes of their breeding habitats. Inverting pails and plant pot plates and changing water in vases regularly are simple steps that everyone can take to prevent mosquitoes from establishing a foothold in our neighbourhoods. Those infected with dengue should protect themselves from mosquito bites by applying repellent regularly, and those showing symptoms suggestive of dengue should see their GPs early to be diagnosed.

9     We encourage everyone to be an advocate and remind his family members and neighbours to join in the collective effort to help stop the dengue transmission cycle by doing the 5-step Mozzie Wipeout. All of us, including residents, contractors, and business owners, have a part to play in preventing dengue. The latest updates on the dengue situation can be found on the NEA website, stop Dengue Now Facebook page, and myENV app.


1 Provisional figures as at end May 2019.  

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For more information, please contact us at 1800-CALL NEA (1800-2255 632) or submit your enquiries electronically via the Online Feedback Form or myENV mobile application.



Annex A

Leveraging Science and Technology to Stem Dengue Transmission

NEA regularly explores new tools and technologies to improve dengue control in Singapore. 

Drones Deployment

  • To overcome the limitations faced by our officers in inspecting roof gutters, NEA has been deploying drones for the surveillance of roof gutters since 2016, to detect the presence of stagnant water that may lead to mosquito breeding. Where necessary, Bti larvicide is dispensed to destroy any mosquito breeding found in roof gutters with stagnant water.

Artificial Intelligence (AI)

  • NEA’s Environmental Health Institute (EHI) worked with a group of researchers from NUS’ Saw Swee Hock School of Public Health, to develop an AI agent to forecast dengue incidence up to four months ahead, by learning the seasonal patterns of dengue cases over the last decade.
  • By providing advanced warnings of impending outbreaks, the AI agent can assist NEA to optimise our response. This could include measures such as: mobilising additional officers and community volunteers, intensifying removal of mosquitp breedinghabitats, and providing advice to the public on what the community can do to suppress the mosquito population in their neighbourhoods.
  • As more data sources are integrated, the AI agent will potentially be able to predict and localise outbreaks in specific areas of Singapore, by analysing mosquito breeding data and proactively suggesting additional vector control and spot-checking schedules.

Gravitrap Surveillance

  • The Gravitrap, developed by NEA’s EHI is designed to attract and trap female Aedes mosquitoes that are looking for sites to lay their eggs. To enhance surveillance efforts, about 50,000 Gravitraps have been deployed islandwide. This in-house developed Gravitrap is one of the first oviiposition traps deployed in the world, and remains cost-effective when compared to other currently available commercial traps. NEA will extend its surveillance programme and progressively deploy Gravitraps to landed estate premises in 2019.
  • Female mosquitoes attempting to lay their eggs in these containers will be captured and thus prevented from subsequently biting other people. The Gravitrap also traps and prevents the emergence of any mosquitoes from eggs that are laid in the trap. Gravitraps, when distributed across an area, help to monitor the Aedes mosquito population in the vicinity.
  • Knowing which Gravitraps are capturing these mosquitoes helps NEA to prioritise its resources, by directing officers to search for and destroy mosquito breeding habitats at locations with higher Aedes mosquito populations.

Smart Gravitrap

  • In collaboration with a local start-up company, Orinno Technology Pte. Ltd. (OTPL), NEA’s EHI has developed a Smart Gravitrap prototype which will enable remote data collection and analysis. The Smart Gravitrap is currently under development, and may enhance the way NEA officers collect data on the mosquito population in future, thus leading to more effective Aedes surveillance and better dengue control.
  • An assembly of sensors installed in the Smart Gravitrap is triggered when an insect enters the trap. It then captures the signature of signals generated by the flight of the insect and sends the information to a back-end server, which hosts an identification algorithm and database of signatures unique to different species of mosquitoes. The signatures are also unique to the genders of each species of mosquito. The artificial intelligence is thus able to identify the insect that has been trapped by the Smart Gravitrap.

Project Wolbachia – Singapore

  • NEA has embarked on Project Wolbachia – Singapore, using male Wolbachia-carrying Aedes aegypti mosquitoes to further suppress the urban Aedes aegypti mosquito population in the community. When male Wolbachia-Aedes aegypti mosquitoes mate with female Aedes aegypti without Wolbachia, their resulting eggs do not hatch. The novel method was developed to complement existing dengue control strategies in Singapore.

Aedes Mosquito Population Suppression Achieved in Phase 1 and 2 Field Studies

Phase 1 Field Study

  • In the Phase 1 field study, a 50% suppression of the urban Aedes aegypti mosquito population was obtained. At sites where the male Wolbachia-Aedes mosquitoes were released, much fewer Aedes aegypti adult mosquitoes were found. At these sites, half of the collected Aedes aegypti mosquito eggs did not hatch, providing strong indication that the released Wolbachia-Aedes males had successfully competed with the urban Aedes males and mated with some of the urban Aedes aegypti females.

     

    Impact of male Wolbachia-Aedes

    Fig. 1. Phase 1: Infographic showing the impact of male Wolbachia-Aedes mosquitoes on the urban Aedes aegypti mosquito population at the study sites

    Phase 2 Field Study

  • In the Phase 2 field study, an 80 per cent and 70 per cent suppression of the urban Aedes aegypti mosquito population was obtained at the Nee Soon East and Tampines West study sites respectively. The expanded areas of the release sites, and the high floor releases of male Wolbachia-Aedes mosquitoes (in addition to ground floor releases), had led to a better outcome. The results show that a larger release site yields better results, and community efforts to remove mosquito breeding habitats will enhance the effectiveness of the technology.

     

    Impact of male Wolbachia-Aedes on urban Aedes aegypt

    Fig. 2. Phase 2: Infographic showing the impact of male Wolbachia-Aedes mosquitoes on the urban Aedes aegypti mosquito population at the study sites

    Phase 3 Field Study

  •  NEA has commenced the Phase 3 Field Study in February 2019, which aims to determine if suppression of the urban Aedes aegypti mosquito population can be sustained in larger areas. The Nee Soon East and Tampines West study sites will be expanded by between 1.6 to 2.2 times, compared to the Phase 2 field study areas. In the long-term, this will require strategies which reduce the number of male Wolbachia-Aedes mosquitoes being released in an area, to make the technology more sustainable.

    Innovations for Mosquito Production Solutions 
  • Mosquito rearing is laborious and time-consuming, with very little technological support, despite advances in engineering and artificial intelligence solutions in other fields. NEA’s EHI and Orinno Technology Pte. Ltd. (OTPL), a local start-up company, have thus come together to develop various process modules and novel devices that have helped to improve the production efficiency and quality of the Wolbachia-Aedes mosquitoes required for field releases.
  • Thus far, the larvae counter has yielded successful results, and has shortened the time required to fill a tray of water with 4,000 larvae from two hours to less than three minutes. This has effectively enhanced the mass production and sorting of male mosquitoes required for the Project Wolbachia field study in Singapore. Using a similar engineering concept, another innovation currently being used in mosquito production is the pupae counter – an automated device that can accurately count and dispense the desired number of male Wolbachia-Aedes pupae into each release container.
  • Other devices under development include: an automated feeding system, a pupae separator, and an adult mosquito sex sorter. These devices will not only help to save manpower and costs, but will also ensure the consistency and quality of the male mosquitoes produced and released.
  • The most recent innovation is the mosquito launcher – a lightweight and portable release device, designed to efficiently and systematically store, transfer and release male Wolbachia-Aedes mosquitoes at Singapore’s high-rise residential blocks.
  • As a result of these creative solutions, five intellectual property patents have been filed for these novel devices. The devices have received interest from other international programmes that are also producing male mosquitoes for suppression of the mosquito populations in their communities.

Devices Developed/ Being Developed

S/N

Innovation

Brief Description

1

Larvae counter

 

  • Larvae purification and concentration system based on light and micro-fluid control
  • 40 times faster than manual counting methods

2

Pupae counting and dispensing module[1]

  • Pupae purification and concentration system based on light and fluid control
  • 15 times faster than manual counting methods

3

Automated feeding system

  • Multi-layer larvae feeder, designed to automatically deliver a fixed amount of feed into multiple mosquito larval rearing trays simultaneously

4

Pupae separator (embodiment)

  • Incorporates high speed image processing to analyse pupae size profile in mass, and automated separation (without human involvement) of male and female pupae using a robotic arm

5

Adult mosquito sex sorter

  • Adult female and male mosquito separator based on bio-signatures

6

Mosquito launcher

 

  • Mosquito release mechanism, which combines knowledge in mosquito behaviour with microelectronics and mechanical engineering
  • Lightweight and portable, allowing field operators to carry more mosquitoes in a single trip, thus reducing release duration and making the whole release process more efficient

 

-End-

 


[1] The pupae counting and dispensing module follows the same concept as the larvae counter, hence no patent was filed for this innovation.