Patients may be sent home instead of being isolated

The practice of isolating suspected Zika patients until they are given the all-clear is being reviewed, and they may be sent home to rest instead.

Currently, suspected patients are isolated at the Communicable Disease Centre as they await their test results. Those found to be Zika-positive are isolated in hospitals.

Read also: 57 foreign nationals test positive for Zika in Singapore

The Ministry of Health (MOH) is considering letting suspected patients rest at home while their blood and urine samples are tested, and sending confirmed cases home to rest, said Senior Minister of State for Health Amy Khor yesterday.

This comes as Zika cases here continue to rise, with another 27 detected by noon yesterday. This brings the total number of locally transmitted Zika cases here to 242.

Of the new cases, 25 are from the initial Aljunied Crescent/Sims Drive/Kallang Way/Paya Lebar Way cluster, while one is from a potential new cluster in Joo Seng Road where a previous case was found.

The last of the new cases has no known links to any cluster. MOH did not say where this case was found.

Yesterday, Dr Khor, who is also Senior Minister of State for the Environment and Water Resources, said: "We are reviewing the practice of isolating Zika-positive patients who are actually clinically well and do not need to be hospitalised."

"In fact, they could be sent home to recuperate but take necessary precautions like applying repellent so they don't get bitten by mosquitoes which will then transmit the disease," added Dr Khor, the MP for Hong Kah North, on the sidelines of an event in her constituency.

In the past week, doctors have observed that Zika-positive patients admitted to hospitals are generally well and have very mild symptoms, and are discharged one to two days after testing negative for the virus.

Also, four in five Zika-infected people do not show any symptoms of the virus, said Dr Khor.

This means that there are people in the community who are infected but do not know that they are, so isolating just those who have tested positive may not be effective.

Dr Khor added that such an approach will be in line with the ministry's protocol for dengue, where those who test positive for it are not warded in hospitals unless their condition is serious.

When asked if Zika is here to stay, she said: "We do expect that we will continue to have Zika virus cases over time, just like dengue."

Infectious diseases specialist Leong Hoe Nam agreed that isolation may not be key in fighting Zika.

"It appears that the Zika virus stays in a patient's blood for three to five days, considerably shorter than dengue's five to seven days," he said.

So by the time an infected person sees the doctor and does the test - which has a turnaround time of two days - the virus may be gone already, which makes isolating the patient pointless.

Preventing mosquitoes from breeding is still key, said Dr Khor, amid continuing community efforts to spread the message to residents yesterday in areas such as Yew Tee and Siglap.

The National Environment Agency (NEA) said that as of last Saturday, it has destroyed 62 breeding habitats in the Aljunied cluster and 39 breeding habitats in the Bedok North Avenue cluster.

NEA will continue with its mosquito control and outreach efforts in those areas, as well as in the potential Joo Seng Road cluster.

This article was first published on September 5, 2016.
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