Dengue prevention and 35 years of vector control in Singapore.
After a 15-year period of low incidence, dengue has reemerged in Singapore in the past decade. We identify potential causes of this resurgence. A combination of lowered herd immunity, virus transmission outside the home, an increase in the age of infection, and the adoption of a case-reactive approach to vector control contribute to the increased dengue incidence. Singapore's experience with dengue indicates that prevention efforts may not be sustainable. For renewed success, Singapore needs to return to a vector control program that is based on carefully collected entomologic and epidemiologic data. Singapore's taking on a leadership role in strengthening disease surveillance and control in Southeast Asia may also be useful in reducing virus importation.
Ooi
Eng-Eong
EE
Defense Medical and Environmental Research Institute, DSO National Laboratories, Singapore. oengeong@dso.org.sg
Goh
Kee-Tai
KT
Gubler
Duane J
DJ
D000330:Aedes / Q000821:virology*; D000818:Animals; D003715:Dengue / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D003716:Dengue Virus / Q000254:growth & development* / Q000276:immunology; D004196:Disease Outbreaks / Q000517:prevention & control*; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D006801:Humans; D032521:Immunity, Herd; D007300:Insect Control / Q000379:methods*; D007303:Insect Vectors / Q000821:virology*; D012846:Singapore / Q000453:epidemiology