Zika: On the ground - News analysis

Everyone needs to stamp out mosquito breeding

Thermal fogging around Blk 50 Sims Drive on Aug 29, 2016. ST PHOTO: LIM YAOHUI

Two pregnant women have been infected with the Zika virus. They are unlikely to be the last.

So it is not surprising that pregnant women around the country, as well as young couples planning to start a family, are greatly concerned.

International data reports that pregnant women who are infected with Zika have a 1 per cent to 13 per cent chance of having a baby suffering from microcephaly, a condition where the baby is born with an exceptionally small head.

Some young couples are seriously thinking of pushing back having a child until Zika is under control here.

Will that happen? Not likely.

Already, the infection has spread beyond the original outbreak area to other parts of Singapore. More cases around the island will probably surface, especially with doctors now on high alert to Zika symptoms.

In backtracking symptomatic cases since the first local transmission was revealed last Saturday, the Ministry of Health found one person who had the viral infection as far back as July.

There could have been more before that but the current tests are not able to pick up the antigen, or the body's defence, against Zika beyond a month.

Given that four in five people infected do not have symptoms, and the fifth would be only mildly sick, the spread of Zika here could have already gone on for months.

Even if it hasn't, and the current outbreak is stopped, it could well return and eventually become endemic, the way dengue has, since the carrier, the Aedes mosquito, is native to the tropics.

And they flourish in our city because people allow mosquitoes to breed in homes, construction sites and public areas within the community.

Until every single person here does his part in stamping out mosquito breeding, mosquito-borne infectious diseases such as Zika, dengue and chikungunya will continue to plague the population.

If just one family living in a block of flats allows mosquitoes to breed, perhaps in a pole holder, in a vase of cut flowers or even in the rim of an upturned pail, it will negate the efforts of families living in all the other flats in the block.

Last year, the National Environment Agency (NEA) found 19,000 mosquito-breeding spots, the majority in homes. It had carried out more than 1.4 million inspections to find them, which means that only a tiny minority were breeding mosquitoes.

This lack of cooperation by a tiny minority resulted in more than 11,000 people here getting dengue last year.

So far this year, more than 11,100 have had dengue, with over 2,000 needing to be hospitalised. Seven have died.

The message is clear: In our fight against dengue, and now against Zika, "almost everyone" stamping out mosquito breeding is just not good enough.

The only way to win the fight is for every single household, construction site and agency in charge of public areas to be continuously vigilant against mosquito breeding.

All that is needed is a little bit of water, the size of a 20-cent coin, for mosquitoes to breed and proliferate. If everyone cooperates, the incidence of Zika, dengue and chikungunya will plummet. Unborn babies would be safe and young couples can happily start their families.

Meanwhile, families of pregnant women should do their own campaigning among their neighbours. This is because the Aedes mosquito generally does not fly very far - often within 50m to 100m of its birth place and rarely farther than 150m.

If people are bitten at home, chances are, the mosquito was bred in their homes, those of their neighbours, or in public areas nearby.

Perhaps the NEA should give priority to clearing out mosquito breeding in areas where pregnant women live. They are the ones at greatest risk during the Zika outbreak.

If everyone cooperates and the number of mosquitoes flying around, and hence the number of infections, is kept low, then the risk to pregnant women and their unborn children could be kept to the very minimum.

If out of a population of five million, only a few hundred, not thousands, of people, get infected, the chances of a pregnant woman becoming infected would be small, especially if she takes care to protect herself against mosquito bites in the mornings and evenings, when the Aedes mosquito is active.

Another thing to bear in mind is that the vast majority - depending on the report, between 87 per cent and 99 per cent - of pregnant women infected with Zika give birth to perfectly normal babies.

Even without Zika, there are risks to pregnancy. But that has never stopped women from wanting children. They should not let Zika stop them either. Don't take the threat lightly, but do not be so scared that it mars the happiness of bearing a child.

It would be great if they can also have the confidence that the rest of the population is solidly behind them, doing their best to stomp out mosquito breeding so they can have a pregnancy free of the additional worry caused by the Zika virus.

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A version of this article appeared in the print edition of The Straits Times on September 02, 2016, with the headline Everyone needs to stamp out mosquito breeding. Subscribe