Dengue fever in Singapore - symptoms, insurance and treatment costs

It seems to be mozzie season - according to reports, there were a total of over 2,000 cases of dengue fever in Singapore in the first quarter of 2019. And of those, there were 3 deaths. That's 3X of 2018's 600 cases and 1 death.

At the end of last month, there were 500 people who got diagnosed with dengue fever in a week, the highest weekly number in more than 3 years.

Because dengue fever (and other viruses like zika and chikungunya) is transmitted by the Aedes mosquito that's native to tropical regions, the disease is a much bigger threat in Southeast Asian countries like Singapore.

DENGUE FEVER SYMPTOMS

• Fever for 2 to 7 days
• Severe headache with pain behind the eyes
• Joint and muscle pains
• Nausea and vomiting
• Rashes
• Nose and/or gum bleeding and/or easy bruising of the skin

(Taken from Health Hub, by Ministry of Health, Singapore.)

As you would've noticed, the signs and symptoms of dengue fever are actually very similar to that of the regular flu. The biggest tell-tale signs are the last two, which are rashes and bruising/bleeding from the gums and/or nose.

Dengue causes your platelet count to drop, and because platelets are what helps your blood to clot, the biggest tell-tale sign is bleeding from the gums and/or nose.

If all of a sudden, you're also getting bruises from light knocks and bumps, you should also seek medical attention.

Dengue haemorrhagic fever (or dengue shock syndrome) is a severe form of dengue fever which can cause complications resulting in more widespread bleeding, low blood pressure or shock, and even death.

DENGUE HAEMORRAGIC FEVER SYMPTOMS

• Stomach pain and/or tenderness
• Severe vomiting (>3 times in 24 hours)
• Bleeding from nose or gums
• Vomiting blood
• Blood in stool
• Feeling tired, restless or irritable

(Taken from the Centres for Disease Control and Prevention, US)

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NEA DENGUE FEVER CLUSTERS IN SIGNAPORE (RED ALERT ZONES)

Under NEA's Dengue Community Alert System, residential zones in Singapore and colour-coded to show dengue clusters. Green is the safest, yellow is moderate and red is high alert.

It is determined based on how many cases have onset in the past 14 days.

• Red - 10 or more
• Yellow - less than 10
• Green - 0 cases

At the time of writing, the following areas are red zones: Woodlands, Chai Chee, Bedok Reservoir, Guillemard, Geylang, Yio Chu Kang, Upper Thomson, Defu & Hougang.

For more specific information (including street names and blocks), please check the official NEA updates.

NEA HOTLINE

And if you want to "bao tou" your neighbour for breeding mosquitoes… I mean, if you have any enquiries and feedback related to dengue and mosquitoes, here are the relevant hotlines:

Ministry of Health (MOH) hotline 1800 225 4122

National Environment Agency (NEA) hotline 1800 9 336483

DENGUE FEVER TREATMENT & COSTS

If you suspect dengue, you should seek medical attention immediately. The dengue fever symptoms usually last longer than the typical flu. For instance, the fever is typically quite persistent, lasting up to a week.

Most times, cases of dengue fever are relatively mild. These are usually diagnosed by general practitioners at family clinics. Excluding medication and tests, regular consultation fees should cost you between $20 to $55 (recommended guidelines by the Singapore Medical Association).

You may also go to a polyclinic. For adult Singapore citizens, consultation fees are $13.20 after subsidy. If you go to A&E (at a government hospital), you can expect to pay around $120.

Your doctor will examine and advise you, and if dengue is suspected, a blood test will be done to confirm it. They will look at your platelet count - for reference, normal levels are around 150k to 450k per ml.

Most times, you can take a long MC and with enough rest and hydration, recover from the viruses on your own. There is no cure or "treatment" per se.

However, if your platelet count drops too low (under 80k per ml), you may be hospitalised and kept under observation. Bed rest is to lower the risks of you injuring yourself, causing excessive bleeding.

CAN YOU DIE FROM DENGUE?

Most people recover from dengue fever, but yes, you can die from dengue. The fatal types of dengue are dengue haemorrhagic fever and dengue shock syndrome, which usually develop 3 to 7 days after mild symptoms of dengue.

Dengue haemorrhagic fever is marked by severe abdominal pain, persistent vomiting, sudden change in temperature, irritation and/or mental confusion. Symptoms of dengue shock syndrome includes restlessness, cold and clammy skin, and narrowing of pulse pressure.

Seek immediate attention if you or your loved ones are experiencing such symptoms.

DENGUE FEVER VACCINE (DENGVAXIA)

Currently, there is only one dengue vaccine in Singapore, Dengvaxia. However, it is quite controversial and most clinics do not carry it.

I could not find the prices because all the clinics I called up (like the polyclinic, One Doctors and Raffles Medical) do not have it.

Although still listed on the Health Sciences Authority (HSA) Singapore's website, it may very well be unavailable locally. I don't blame the clinics though - even I think the drug sounds a little dodgy.

Dengvaxia is developed by French pharmaceutical company Sanofi Pasteur, and was first licensed and approved for use in Singapore in Dec 2015.

Since then, the HSA and Sanofi have confirmed that "there is a postulated risk of a higher incidence of severe dengue following vaccination in individuals who do not have previous dengue infection".

That means that if you've never had dengue fever before, if you take the vaccine and then fall ill, there is a higher chance it will be a more severe infection.

The vaccine is suitable for individuals aged 12 to 45 years only, and if you're interested, please check with your preferred clinic and/or doctor.

DENGUE FEVER INSURANCE

Yup, there's actually such a thing as dengue fever insurance. Currently, there's only one in Singapore - TM Protect MosBite by Tokio Marine. It's a yearly personal accident plan with a 100 per cent benefit payout for dengue fever (and other mosquito-transmitted viruses).

There are 2 plans:

• TM Protect MosBite Plan A ($59 yearly, $3,000 insured)
• TM Protect MosBite Plan A ($39 yearly, $1,500 insured)

The premiums are fixed and anyone can get insured. This seems more lenient than Etiqa's old plan, MozGuard. It's no longer available, but back then when it was introduced in 2017, the premiums varied depending on how serious the dengue cluster is at the zone of your residential address. So if you red zone then "good game" liao.

However, dengue-specific coverage may be an overkill for most. If you've never been the kind to read the fine print, it may surprise you that most personal accident insurance plans actually already cover dengue fever (and other mosquito-transmitted viruses). Here are some providers to consider:

• NTUC
• AIA
• FWD
• Aviva
• Prudential

MEASURES TO PREVENT DENGUE FEVER

Of course, as all our wise parents say, prevention is always better than cure. Treatment for dengue is rarely that expensive (unless hospitalisation is required), but there is literally no cure for it, and waiting it out can be very uncomfortable.

Here are some tips to prevent mosquitoes from breeding in your home, as well as some helpful information about dengue in general.

• Remember to apply insect repellent if you're going to cluster areas, and avoid risky areas during dawn and dusk (that's when they bite the most).
• Aedes mosquitoes are easily identified by the black and white stripes on this body and legs.
• Check and remove stagnant water in your home. Make sure to check under flowerpots and roof gutters.

For more, please check NEA's official mozzie wipeout guide.

This article was first published in MoneySmart.