New ways needed to fight infectious diseases

SINGAPORE - The threat of infectious diseases has escalated in recent memory. Infectious agents such as Sars, Nipah, H1N1, H7N9, and now, the Middle East Respiratory Syndrome (Mers) are emerging with disconcerting frequency.

While cases of Mers are largely confined to Saudi Arabia, it appears similar to Sars in many respects but is far more deadly.

Besides these new infectious agents, endemic infectious diseases such as dengue are proving hard to control.

Indeed, the number of dengue cases is now at an all-time high, with more than 11,000 cases so far.

Moreover, this current dengue epidemic has already claimed the lives of three Singaporeans and a foreigner.

The Communicable Disease Centre (CDC) in Tan Tock Seng Hospital was set up more than a century ago and has been at the front line of major infectious disease outbreaks since then.

However, given the severity and scale of some of the recent infectious disease outbreaks, it would be prudent to reconsider how else to boost and deploy Singapore's reserves for dealing with these epidemics.

As it is, an ever-increasing population density as well as more frequent and extensive air travel already conspire to increase the burden of infectious diseases on our nation's health-care infrastructure.

Building up a network of collaborating centres, each with the necessary expertise and facilities for managing disease outbreaks, may be an option.

Decentralising the nation's resources could encourage greater medical specialisation, build deeper capacity and importantly, act to reduce staff fatigue among health-care workers during a prolonged outbreak.

Indeed, as with Sars and Mers, infection among health-care workers is a particular concern as these front-line workers are a significant potential source of new infections.

Staff who are fatigued are more prone to mistakes, which in infectious disease management can have potentially deadly consequences.

On the plus side, Singapore does not have to start from scratch as in the past.

Over the years, the number of infectious disease experts at the CDC, universities and hospitals has increased.

Perhaps it might be an opportune time to reconsider how our nation's infrastructure for handling infectious disease epidemics can be enhanced.

Daniel Ng Peng-Keat (Dr)

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