Infectious Diseases in 2016 (Singapore)
Naturally, this is biased by what I know and has been reported. But here is what I feel are the significant events in 2016.
These are the most easily recalled and form the biggest group of infectious disease events by far. The major outbreaks this year include:
- Rotavirus gastroenteritis at Pek Kio Market affecting at least 180 persons, mostly adults. The actual source was presumably never uncovered, but the outbreak abated after a massive clean up at the hawker centre. I remember being rather bemused that the causative agent was rotavirus, having previously associated this with childhood gastroenteritis.
- Multidrug-resistant tuberculosis occurring rather unusually among local residents living in a high-rise Housing and Development Board (HDB) block in Ang Mo Kio. Technically, the outbreak occurred over 4 years (TB is a slow disease), but was only discovered this year, resulting in mass (voluntary) screening of the block’s residents in June.
- Zika virus erupting as a massive outbreak in August, having spread undetected among construction workers and residents living nearby the Sims Urban Oasis construction site for weeks. The origin of the virus was Asia, and I recall thinking that we had been caught out again, having focused our efforts at detecting Zika importation primarily from South America.
Then there are the notifiable diseases where the number of cases shot up this year relative to previous years, although no major outbreak was reported. The two diseases that were particularly eye-catching were:
- Hand foot and mouth disease – 41,636 cases as of 24th December; 27,846 cases by the same week last year.
- Measles – 134 cases as of 24th December as opposed to just 42 last year. This did in fact make it into the news in May and June.
Lastly, there were the outbreaks that did not happen. There has still been no case of MERS-CoV diagnosed to date – 119 suspect cases were tested this year to date. Experts had predicted that dengue cases could exceed 30,000 this year, but there have “only” been 13,027 diagnosed to date.
Transmissible colistin/polymyxin-resistance gene mcr-1 – which probably spread as a consequence of the antibiotic being used in animals and was first described in November last year – was found in human Enterobacteriaceae from at least 3 hospitals in Singapore. The findings from SGH and NUH have been published (the SGH paper is behind a paywall). On its own, this gene is not particularly important, but it provides one of the final pieces that help generate complete antibiotic resistance in Enterobacteriaceae if it continues to spread successfully.
Following the UN General Assembly high-level meeting on antimicrobial resistance in September, Singapore has committed to developing a national action plan on antimicrobial resistance as well, hopefully by next year.
Pre-exposure prophylaxis (PrEP) is now being offered to prevent HIV in both public and private sector clinics.
[…] hospital epidemics with multidrug-resistant bacteria, etc. but nothing on the scale of Zika and multidrug-resistant TB in 2016, or Group B Streptococcus and hepatitis C in Singapore General Hospital (SGH) in […]