Singapore's Dengue Haemorrhagic Fever Control Programme - Essay Example

? Dengue in Singapore Dengue in Singapore Dengue fever consists of a mosquito-borne ailment, which is caused by the four dengue virus stereotypes, 1,2,3,4. Up to date estimates show that over 100 million individuals are infected annually and it has been a threat to over half of the world’s population in the different countries that dengue fever is evidenced. Continuity, over half a million children are infected and develop the dengue hemorrhagic fever which is highly severe and detrimental. As such, dengue has been a significant cause of heavy societal and economic erosion with lives lost in countries such as Sri Lanka, Brazil, Mexico and Malaysia. However, Singapore, where the serotype 2 of the dengue mosquito is highly present, has been on the steadfast path in curbing the dengue fever. Through the initiative by the National Environmental Agency(NEA), remarkable steps have been made. However, it has come under a heavy price through their various initiatives. Furthermore, the prospects of Sanofi Pasteur’s vaccine and oxitec’s genetically modified mosquitoes have presented better options in fighting dengue fever in Singapore. Thus this paper will examine the National environment agency’s initiatives, Sanofi vaccine and oxitec’s genetically modified mosquitoes and make resolutions on which option best suits Singapore. National Environmental Agency initiatives (NEA) Fong, (2012) asserts that since the formation of the national environmental agency in 2002, the main goal has been fighting dengue fever through environmental sustainability. Issuing of recycle bins, setting up of better and cleaner sanitary facilities, inculcating the culture of rain water tapping and environmental cleanliness, NEA has been on the steadfast path in ensuring that mosquitoes in Singapore do not have breeding grounds within both the dengue cluster regions and the densely populated areas. As such, NEA has incorporated the 3P strategy which entails partnerships among people, private and public spheres (Lim & Hong, 2009). As such, the agency trains and guides various voluntary individuals in skills and aptitude in instilling both preventive and vector control measures to the public. Furthermore, the agency is steadfast in the provision of information inform of pamphlets, talk shows and so forth in the dengue cluster regions in Singapore. On the other hand the agency has inculcated the vector control program which is aimed at chemically eradicating mosquitoes and larvae (Fong, 2012). Spraying of the breeding grounds with chemicals and issuing the masses with insecticides aimed at reducing the populations have been the strategy incorporated. However, despite their noble vector control and environmental sustainability measures, NEA has been faced by the following setbacks; Inadequate financial resources in handling both its vector control and environmental sustainability strategy Lack of appropriate dengue vector control tools Improper tools in surveillance and immediate response Mosquitoes developing insecticide resistance However, despite the aforesaid challenges, NEA affirms that continued support both from the public and private sectors is bound to ensure stable financial resources. Additionally, the agency has begun incorporating biological control agents in eradicating mosquitoes with their larvae coupled with rotation of insecticides to mitigate resistance (Fong, 2012). Oxitec’s genetically modified mosquitoes A UK Biotechnology company, Oxitec has been on the steadfast path in engineering mosquitoes purposely aimed at eradication or control of the population of the insects (Novartis, 2006). Furthermore the company has already released millions of genetically modified mosquitoes in Brazil with smaller numbers being released in the Cayman Islands. Continuously, the company aims at conducting further experimental releases inn Panama, India, Sri Lanka and the Florida Keys. Moreover, the company has a patented technique in the process of genetically modifying insects, which is known as RIDL (release of insects carrying dominant lethal genetic system). Fong, (2012), states that all the company’s Field experiments have involved the OX513A strain of Aedes aegypti mosquito. The aforesaid strain of male mosquitoes are released into the environment and intended to mate with the female mosquitoes which reproduce either sterile offspring or larvae which die while still young. However, with such a noble and remarkable technological breakthrough, many of the pundits are raising probable aspects in terms of the success or failure of the genetically modified mosquitoes in Singapore. Among the issues posing as obstacles in the incorporation of Oxitec’s technology in Singapore include; The results of population suppression experiments in Brazil and Cayman have not been released to the public. Hence not proving whether larvae deaths or sterility has been successful The prospect of partial suppression is an aspect of concern mainly when it comes to dengue endemic regions Sterile Insect Technique has been used priory with agricultural pests and become successful but has failed with other insect species since there is disparity in behavior and life histories among insects. Unavailability of clear and fruitful experiments conducted on mosquitoes is an aspect of concern Lastly, the sterile insect technique (SIT) may be complicated especially in Singapore due to the “density dependent” effect. The size of mosquito population is dependent on both the reproduction and competition for food. As such, a reduction in reproductive fitness may not have a significant effect on the population of mosquitoes. However, Oxitec argues that their RIDL mosquitoes are much fitter and can compete effectively in mating with the wild female. Additionally, the company asserts that their GM larvae survive to late larvae stage hence meaning that they will compete for food thus having a significant impact on mosquito population. However, despite the two reasons put forth, the prospect of unavailable data and proof may impede Singapore’s incorporation of Oxitec’s GM mosquitoes. Sanofi vaccine Turgeon, (2013), states that in the medical world there is no specific cure or treatment for the dengue fever. Thus, vaccination forms a hotbed as the only efficient means in the war against dengue fever. Most importantly, Sanofi Pasteur is a world renowned leader on vaccines. Further the company has taken up the challenge in the provision of the pioneer dengue vaccine. Turgeon, (2013) further asserts that the company has researched for over 60 years since 1944 in a bid to create the vaccine for dengue. In 1944, the company made the first isolation and identification of serotype 1 and 2 of the dengue mosquito (Turgeon, 2013). The following year saw the development of a live attenuated vaccine for serotype 1 by Sanofi Pasteur (Chan, 1985). Continuously, the company isolated and identified serotype 3 and 4 in 1956 which was a major step for the company. Turgeon, (2013), further states that the most fundamental success was the development of a tetravalent live attenuated vaccine for DEN 1, 2, 3, and 4 in mid 1970s (Turgeon, 2013). From then on, the company has maintained long term commitments in the development and trial of the vaccines mainly in Thailand whereby in 2007, the vaccine showed remarkable success in their phase II trials. In Phase II, 4000 children aged between 4 to 11 from Ratchaburi province Thailand were subjected to a vaccination schedule that ran for 6 months (Ruzek & Singh, 2013). Continuously, the results showed a 95% efficacy level which was highly impressive through in a low sample of population (Ruzek & Singh, 2013). As at 2010 October, the company had entered into the phase III vaccine clinical study aimed at a bigger sample of population of 31000 children from 10 countries in Asia and Latin America (Ruzek & Singh, 2013). Thus, Turgeon, 2013) asserts that with the continued growth and success in research and trials, Sanofi Pasteur vaccines have shown remarkable prospects for success. Furthermore, in a joint collaboration between WHO and the countries that are high cluster regions of Dengue, financial setback will not be a major problem (Ruzek & Singh, 2013). Further, the government of Singapore plans to roll out subsidized vaccines once the Sanofi vaccine is given the green light (Ruzek & Singh, 2013). Conclusion From the above analysis of the three options that Singapore has in their fight against dengue fever, the Sanofi Pasteur vaccine stands out as the right path to take. The company has shown tremendous success in its research and trials of its vaccine throughout their various phases. Further, the prospect of people in Singapore being vaccinated is a better play as opposed to the unpredictable results of Oxitec’s GM mosquitoes. Nonetheless, vaccine should be incorporated with NEA’s environmental sustainability initiatives for further preventive measures and success in eradicating the dengue menace. References Chan, K. L. (1985). Singapore's dengue haemorrhagic fever control programme: a case study on the successful control of aedes aegypti and aedes albopictus using mainly environmental measures as a part of integrated vector control. Singapore: Southeast Asian Medical Information Center. Fong, I. W. (2012). Challenges in infectious diseases. New Jersey: Springer. Lim, C., & Hong, J. (2009). 13th international conference on biomedical engineering: Icbme 2008, 3-6 december 2008, singapore. New York: Springer. Meunier, Y. (2010). Tropical diseases. London: Oxford University Press. Novartis. (2006). New treatment strategies for dengue and other flaviviral diseases. New York: John Wiley & sons. Roberto Tapia-Conyer, Jorge F. Mendez-Galvan & Hector Gallardo-Rincon, 2009, The growing burden of dengue in Latin America, Journal of Clinical Virology, vol 46, p56-89. Ruzek, D., & Singh, S. (2013). Viral hemorrhagic fevers. Chicago: CRC Press. Turgeon, M. (2013). Immunology & serology in laboratory medicine5: Immunology & serology in laboratory medicine. Paris: Elsevier Health Sciences. Read More