How Singapore’s first case of Zika infection was spotted

Dr Leong (left) diagnosed Singapore's first Zika patient 10 days ago but Watten Estate resident Ms Clark says it may be an isolated case.
In Watten Estate - where the first confirmed person from Singapore to contract Zika lives - the National Environment Agency has inspected more than 700 premises. It has destroyed 43 mosquito breeding habitats, 28 of which were found in homes and 15 in common areas. ST PHOTO: MARK CHEONG
In Watten Estate - where the first confirmed person from Singapore to contract Zika lives - the National Environment Agency has inspected more than 700 premises. It has destroyed 43 mosquito breeding habitats, 28 of which were found in homes and 15 i
Dr Leong (above) diagnosed Singapore's first Zika patient 10 days ago but Watten Estate resident Ms Clark says it may be an isolated caseST PHOTO: MARK CHEONG
Dr Leong (left) diagnosed Singapore's first Zika patient 10 days ago but Watten Estate resident Ms Clark says it may be an isolated case.
Dr Leong diagnosed Singapore's first Zika patient 10 days ago but Watten Estate resident Ms Clark (above) says it may be an isolated case.

Symptoms so mild, only patient's Brazil trip led doc to suspect virus

When Singapore's first confirmed Zika patient went for a check-up at Mount Elizabeth Novena Hospital 10 days ago, he almost did not get hospitalised.

According to Dr Leong Hoe Nam, the infectious diseases expert who first diagnosed him, his symptoms were so mild that it was "difficult to justify even getting him admitted".

The 48-year-old permanent resident had a fever, head and muscle aches, and rashes - symptoms easily mistaken for a viral fever.

 

But Dr Leong noticed that his eyes were red, "as if he was suffering from a hangover".

When he heard that the patient had returned from a business trip to Sao Paolo, Brazil, five days ago, alarm bells went off.

Dr Leong asked for a blood sample to be sent to the laboratory for analysis, and for the patient to be admitted to hospital.

When the test came back positive, he recalled thinking, siao liao, siao liao ("here comes madness" in Hokkien). He said: "I'd rather have been made to look like a fool than to have dropped the ball on this one."

The Zika virus is spread by the Aedes mosquito, which also transmits dengue. The virus has been linked to serious birth defects in children whose mothers were infected during the pregnancy.

Dr Leong said when they broke the news to the patient, his wife was "devastated and crying".

He tried to comfort the patient by telling him that his diagnosis could help medical research in Singapore. Because of the previous dearth of Zika-positive samples, existing test kits here are rudimentary.

"I told him that his blood is going to save thousands, and it is more precious than gold right now," Dr Leong said. "He told me he wanted to volunteer to help the people of Singapore in any way he could. "

The patient, who has not been named, was then transferred to the Communicable Diseases Centre in Tan Tock Seng Hospital. He has since made a full recovery and was discharged on Tuesday last week.

In Watten Estate - where the patient lives - the National Environment Agency (NEA) has inspected more than 700 premises. It has destroyed 43 mosquito breeding habitats, 28 of which were found in homes and 15 in common areas.

The NEA and Ministry of Health (MOH) have urged residents to "remain vigilant" as the possibility of a secondary infection in the estate remains until June 23.The incubation period for the Zika virus is typically three to 12 days.

Professor Paul Tambyah, an infectious diseases expert who is secretary-general of the Asia-Pacific Society of Clinical Microbiology and Infection, said: "People might think that they just have a flu-like illness, with a non-specific rash."

He added, however, that the risk that the virus continues to circulate silently in the neighbourhood is low, given heightened public awareness and the NEA's prompt action.

Residents said things are getting back to normal after the Zika scare. Housewife Jemane Ing, 43, said 10 people had attended her boxing class in a park on Thursday. Two days earlier, nobody turned up.

Students studying in schools in the area said they were not concerned about Zika and were still participating in outdoor activities such as physical fitness lessons - albeit with more mosquito repellent on.

National Junior College student Wang Rui Feng, 17, said: "They've been carrying out fumigation and misting the classrooms. I don't think there's a good chance of contracting Zika."

Watten Estate resident Louise Clark, 45, said: "Given the international nature of Singapore, Zika was bound to come in at some point. But, so far, there's been only one, so maybe it was an isolated case."

A version of this article appeared in the print edition of The Sunday Times on May 22, 2016, with the headline 'How S'pore's first case of Zika infection was spotted'. Print Edition | Subscribe