By the time the first locally transmitted case of Zika was confirmed last Saturday, the authorities were already tracing past cases of fever in the area.
This allowed them to move swiftly on Zika testing of another 123 people last Saturday, said the Ministry of Health (MOH) and National Environment Agency (NEA) in a joint press conference yesterday.
Most of the results came in on Saturday night. As of noon yesterday, results were pending for five cases.
Said Professor Leo Yee Sin, senior consultant at the Communicable Disease Centre: “The minute the first case was made known – in other words, the blood was detected positive – a lot of investigations had already taken place to find out as much as possible.”
The MOH was first alerted on the evening of Aug 22, when Sims Drive Medical Clinic flagged an unusual increase in cases of fever, rashes and joint pain.
The next day, MOH officials visited the clinic. The cases that the GP had seen were mild. The initial hypothesis was that a mild viral illness was being spread from person to person.
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At that point, Zika was not specifically suspected.
The MOH told the clinic to refer any new cases to the Communicable Diseases Centre (CDC) for testing, and to start tracing past cases.
The MOH also told clinics in the vicinity and supervisors of a nearby construction site at 60, Sims Drive, to report any cases to the ministry.
Last Thursday, as part of tracing, the MOH approached the construction site’s contractor for records of workers who had had fever.
That same day, a 47-year-old Malaysian woman developed a fever, rashes and conjunctivitis. She visited Sims Drive Medical Clinic last Friday, and was referred to the CDC.
The next day, it was confirmed she had Zika.
The MOH jumped into action that day, alerting the NEA and testing another 123 people for Zika, including 118 construction workers. The tests take three to four hours.
The NEA intensified anti-mosquito measures in the area, including inspections, misting and fogging, and increasing the frequency of drain flushing and oiling. These will continue for 14 days, with surveillance for another 21 days afterwards.
The NEA also started outreach efforts in the Aljunied Crescent and Sims Drive area.
Asked about the jump from one case last Saturday to 41 cases announced yesterday, Health Minister Gan Kim Yong noted that part of the reason more cases were discovered was because the MOH went back to past cases to “re-test, relook at the test results” last Saturday.
Of the 41 cases, 36 were found through the MOH’s active testing of potentially infected people.
One reporter also asked him: “So it’s not like you knew about it earlier and were keeping quiet about it?”
Mr Gan said: “No, of course not.”
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How events unfolded
MONDAY, AUG 22
Sims Drive Medical Clinic, having noticed an unusual increase in cases with fever, rashes and joint pains, notifies the Ministry of Health (MOH) in the evening.
TUESDAY
MOH officials visit the clinic and discuss the cases with a doctor there. The initial belief is that there is a cluster of a mild viral illness.
MOH makes arrangements for the clinic to refer new cases to the Communicable Disease Centre (CDC) for testing, and to start tracing past cases.
Nearby clinics and supervisors of a nearby construction site are also told to increase vigilance and report cases to MOH.
THURSDAY
MOH asks the construction site’s contractor for records of workers who had had fevers. Meanwhile, a 47-year-old Malaysian woman working in the coffee shop at Block 45 Sims Drive develops a fever, rashes and conjunctivitis.
FRIDAY
She visits Sims Drive Medical Clinic and is referred to the CDC.
SATURDAY
The woman is confirmed to have Zika. The National Environment Agency (NEA) is notified and starts anti-mosquito measures as well as inspections. NEA also begins outreach efforts to 14 blocks of flats in the Aljunied Crescent and Sims Drive area.
MOH tests another 123 people with Zika-like symptoms, including 118 construction workers.
CDC reports preliminary positives for three of these cases.
YESTERDAY
By noon, 41 of the 124 people tested are found to have Zika. Most of the results came in late on Saturday night. Another 78 tested negative. Test results are pending for the remaining five.
A joint press conference by MOH and NEA is held just before 4pm to announce the findings.
NEA completes outreach efforts in Aljunied Crescent and Sims Drive. It starts similar efforts in the Sembawang Drive residential area, where one of the Zika cases, a 30-year-old Singaporean man, lives.
This article was first published on Aug 29, 2016.
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