One dengue-safety measure that the Singapore government has not yet implemented is vaccination management of the Dengue virus.
The Dengvaxia vaccine has been approved in countries such as Mexico, Brazil, El Salvador and the Philippines. Some people worry however, that the vaccine may not be that effective in Singapore as it appears to work better in areas where more people have been already infected with Dengue.
The Dengvaxia vaccine helps to boost the immune system response to people who have already encountered the disease. The immune system of a previously infected individual remembers the dengue virus and responds accordingly the next time they become infected.
The need to simultaneously protect against multiple strains of the dengue virus makes creating an effective dengue vaccine increasingly difficult as more research is needed. A person infected by dengue gains immunity only against the strain that infected him or her, secondary infection by another strain that they have no immunity against can lead to a much more serious illness. Professor Leo Yee Sin, director of the Institute of Infectious Diseases has observed that most of the seniors who have died of dengue in Singapore had secondary infections.
At time of publication experts have identified five strains of dengue, three of which have been found in Singapore. The fifth strain was discovered in 2007 during a dengue epidemic in Sarawak, Malaysia and only positively identified in 2013 and so far confined only to Sarawak.
The Dengvaxia vaccine protects against all strains except the Sarawak strain. At time of publication the World Health Organization has not yet approved the vaccine to be used on individuals below the age of nine or above the age of 45.
Duke-NUS Medical School's Prof Duane Gubler said the length of immunity offered by the new vaccine and its ability to provide continued protection to people as they grow older is not yet known and could take years to determine. Even so, the former director of research policy and cooperation of the World Health Organization suggests Singapore implement the Dengvaxia vaccine as quickly as possible.
The Health Sciences Authority of Singapore is currently evaluating the vaccine. Epidemiologists and modellers are predicting the effectiveness of the vaccine in Singapore and will make a decision on whether or not to introduce the vaccine by October 2016.
A version of this article appeared in the print edition of The Straits Times on June 02, 2016, with the headline "Should Singapore Bring In Vaccine"
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