Zika outbreak - News analysis

Just how worried should Singapore be about the Zika outbreak?

Disease is mild for most, but could be tragic for some parents

Singapore's strong and sweeping reaction to the advent of Zika has taken some by surprise.

After all, the authorities have been saying for some time that it is inevitable Zika would come to Singapore and eventually become endemic, like dengue has here.

This is because it is spread by the Aedes mosquito which breeds easily in Singapore, and the vast majority who get infected by Zika show no symptoms but can be infectious. This makes it difficult to put a lid on the spread of the disease.

Yet officials from the Health Ministry and National Environment Agency, ministers, MPs and grassroots leaders have been out in force ever since it became known that local transmission of Zika has taken place here.

Is Singapore overreacting?

Reaction on the ground has been polarised. Some are clearly worried, sending mosquito repellents and patches flying off the shelves.

Others, however, see it as a storm in a teacup, since the illness is essentially mild for the vast majority of people. It cannot be compared with the outbreak of severe acute respiratory syndrome, or Sars, more than a decade ago, which was killing people.

Four in five people infected with Zika do not get sick at all. This disease affects primarily pregnant women, whose babies are at the greatest risk. Those who argue that Zika matters little to the majority are essentially correct, though in rare cases it could cause the Guillain-Barre disease, where muscles weaken rapidly. It could take years to recover from this debilitating disease, and not all do.

But consider this. More than 28,000 Singaporeans and permanent residents are pregnant at any one time. These numbers are not small. If Zika was rife in the community, many could get infected over their nine months of pregnancy.

Associate Professor Arijit Biswas, head of obstetrics and gynaecology at National University Hospital, said between 1 and 10 per cent of pregnant women infected with Zika have babies with birth defects, including brain damage. The wide range stems from these figures coming from different studies.

Singapore had close to 38,000 local births last year. This means hundreds of babies could be affected each year if the virus takes strong root.

Yes, women can check on the growth of the foetus and abort if there are obvious signs the baby is severely affected. This is possible if the discovery is made when the pregnancy is less than 24 weeks old - the legal limit for abortions.

Not only would this scenario put a dent in Singapore's efforts to increase the number of babies born here, but it would also be a tragedy to all the families concerned.

A major birth defect associated with Zika is microcephaly, or an extremely small head. If the mother carries a child with this condition to term, it has only a 15 per cent chance of growing up normal.

But 85 per cent would suffer from varying levels of mental and physical retardation. Most will not live long, but might need a lot of care while alive.

So getting Zika could mean absolutely nothing, or it could have really tragic consequences.

In the light of this, going all out to try to stamp out the spread of the infection here is the correct thing to do, even if in the long run, it will be a tough battle to win.

If Singapore succeeds in containing the current outbreak, it means the rest of the country can stay Zika-free for a while more.

The longer Singapore can delay the spread of Zika, the greater the chances of a vaccine that will protect people, especially young couples planning to have a child, from getting Zika. But commercial vaccines are still some years away.

Anyone who thinks there is too much fuss about eradicating mosquitoes is being selfish. Anyone who allows mosquitoes to breed through carelessness or laziness must live with the possibility that this could cost a child his life.

There can be no let-up in the war against mosquito-borne diseases, including dengue which has infected more than 11,000 people and killed seven this year.

But this war cannot be won unless everyone does his part.



If you have questions on Zika, e-mail us at askST@sph.com.sg.

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A version of this article appeared in the print edition of The Straits Times on August 31, 2016, with the headline Just how worried should Singapore be about the Zika outbreak? . Subscribe