Infectious Diseases and Singapore: Past, Present and Future
By Li Yang Hsu and Vincent Pang
()
About this ebook
Singapore is a young nation at the crossroads of Asia and consistently faces the threat of infectious diseases. The infectious disease threats have changed with the times—it began with malaria, cholera and plague during the earliest days of the Straits Settlements; to vaccine-preventable diseases such as polio and smallpox; and now modern scourges including HIV, SARS, pandemic influenza, and antibiotic-resistant bacteria that threaten a return to the pre-antibiotic era.
Yet what is common is that the people and governments of Singapore have relentlessly worked together to overcome these diseases. Singapore has accomplished much in the arena of infectious diseases, but the lessons from our experiences and the personal stories from those who have worked to control infectious diseases are not well known.
The collected stories and records in this volume will remind us how far the nation has progressed, how we have contributed to global and regional health and how hard-won is the protection from infectious diseases that we take for granted today.
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Infectious Diseases and Singapore - Li Yang Hsu
INFECTIOUS DISEASES AND SINGAPORE
PAST, PRESENT AND FUTURE
Authors
Hsu Li Yang & Vincent Pang Junxiong
Editors
David Lye Chien Boon & Paul Anantharajah Tambyah
SIDS-LOGO.jpgText © Hsu Li Yang and Vincent Pang Junxiong, 2015
Photographs © Hsu Li Yang, Society of Infectious Diseases (Singapore) and CTV Productions, Ngee Ann Polytechnic, 2015
Society of Infectious Diseases (Singapore)
Communicable Disease Centre
Moulmein Road
Singapore 308433
http://sg50id.sg/
Designed by Veronica Teo
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical or other means, now known or hereafter invented, including photocopying or recording, or in any information storage or retrieval system, without permission from the publisher.
With the support of
SG50_logo_50px.jpgNational Library Board, Singapore Cataloguing-in-Publication Data
Names: Hsu, Li Yang, 1972- | Pang, Vincent Junxiong, 1982- | Lye, David Chien Boon, editor. |
Tambyah, Paul, editor. | Society of Infectious Diseases (Singapore)
Title: Infectious diseases and Singapore : past, present and future / authors, Hsu Li Yang,
Vincent Pang Junxiong ; editors, David Lye Chien Boon, Paul Anantharajah Tambyah.
Description: Singapore : Society of Infectious Diseases (Singapore), 2015. | Includes bibliographical references.
Identifiers: OCN 927896329 | ISBN 978-981-09-8291-1 (e-book) | ISBN 978-981-09-7705-4 (hardcover)
Subjects: LCSH: Communicable diseases--Singapore. | Communicable diseases—Singapore--History.
Classification: LCC RA643.7.S55 | DDC 362.1969095957--dc23
Printed in Singapore
TABLE OF CONTENTS
Foreword
1. Introduction
2. Clean Water, Hygiene and Waste Disposal
3. Tuberculosis
4. Vaccines:
a. Poliomyelitis
b. Hepatitis B
c. Pneumococcus
5. Modern Epidemics
a. SARS
b. HIV
c. Dengue
6. Infectious Diseases as a Medical Specialty
7. Clinical Microbiology and the Laboratory
8. Future Infectious Diseases Threats to Singapore
9. Conclusion
Acknowledgements
Additional Reading
Glossary
References
About the Authors
FOREWORD
This is a truly remarkable and fascinating book charting the history and impact of infectious diseases on Singapore and the great contribution the country has made and continues to make to the national and global prevention, control and treatment of these infections. It has been put together by an outstanding group of dedicated clinicians committed to learning the lessons of history and applying those lessons to the challenges and opportunities of the 21st century. It is true in medicine as in every other walk of life that those who do not learn from history are doomed to repeat it
. So often over the last fifty years many learned individuals have argued that infectious diseases have been defeated. These predictions have all proved wrong, and will always prove to be wrong, infectious diseases may change, but they will always be with us. The terrifying rise of drug-resistant infections, the on-going pandemic of HIV, the devastating epidemics of Nipah, SARS, Bird Flu and most recently Ebola and the continued challenge of tuberculosis, influenza and dengue remind us just how vulnerable we remain to endemic pathogens and to the emergence of new infections. With globalization, faster and greater movement of people, trade and urbanisation set to continue and expand this century, we will face new challenges. Infectious diseases do not respect borders and no country can control the threat of infections on its own, we are all inter-dependent and that should force us to work in partnership with our immediate neighbours and with the broader global community to ensure that we all remain safe. What happens today in Freetown, in London, or Riyadh, Jakarta, New York, or Shanghai may affect Singapore tomorrow, and vice versa. It is only by continuing to invest in people, in research and in public health and clinical infrastructure and by working with colleagues in the region and globally can we hope to prevent and control the threat posed by infectious diseases.
I am also thrilled and honoured to read and contribute to this superb book because of my own very personal connection to Singapore in the past and I hope in the future. I was born at the ‘old’ Changi Hospital, Netheravon Road and my first memories are of Singapore in the early and mid 1960s, when the shops on Orchard Road ended at Tangs with only rice fields beyond, of house-boats permanently berthed along the Singapore River, no skyscrapers, of Change Alley, and amazing holidays at Fairwinds Hotel in Port Dixon. But also sad family memories of a friend of my parents being in an ‘iron lung’ and subsequently dying of polio in 1962 and I being one of the children to benefit from Singapore’s remarkable and brave decision to start nationwide polio vaccination that lead to the eradication of the infection from the island as documented so well in this book. Singapore has remained very close to my heart and I am honoured to have had so many wonderful colleagues and friends there throughout my eighteen years living and working in Ho Chi Minh City, Viet Nam (1995-2013) and now through my work with the Singapore Government as a member of the Singapore Biomedical Sciences International Advisory Council.
Singapore is truly world leading in many areas of infectious diseases, it has a fabulous human resource talent base, extremely high quality young graduates and mid-career and senior health professionals. As this book so superbly demonstrates Singapore must continue to invest in research, clinical and public health to address the on-going challenge of infectious disease, which remain endemic in the region. It also has a unique opportunity to provide a leadership role to counter the threat of epidemic infections of importance to Singapore, to the region and globally and thereby keep the citizens of Singapore, the region and the world safe.
C0058569.jpgProf Jeremy Farrar
FRCP, OBE, FRS, FMedSci
Director, Wellcome Trust
Professor of Tropical Medicine, University of Oxford
1. INTRODUCTION
Infectious diseases, according to the World Health Organization (WHO), are caused by pathogenic microorganisms such as bacteria, viruses, parasites, or fungi; they can spread from one person—directly or indirectly—to another.[1] The history of the world is inextricably tied with infectious diseases and humanity’s attempts at overcoming them. Singapore—a small island country in Southeast Asia—is no different. Our country’s modern history started with the arrival of Sir Stamford Raffles and the establishment of a British East India Company trading post on the island in 1819. Throughout the major events of the past, including the days of the Straits Settlements, the Japanese occupation during Second World War, independence in 1965, and the years of nation building afterwards, the people of Singapore have struggled against infectious diseases.
The infectious diseases that most affected the people of Singapore prior and immediately post-independence were those that are associated with poor hygiene and crowding. These included diarrhoeal diseases such as cholera; transmissible diseases such as typhoid fever and tuberculosis; and the vaccine-preventable diseases of childhood such as smallpox, polio and measles. Other infectious diseases that were prevalent in the region such as plague and malaria were also present in Singapore during that period.
Image1-Singapore-CollyerQuay2.jpgPostcard reproduction. 1900’s view along Collyer Quay, looking north towards Johnston’s Pier, with the Exchange Building standing out at the far end. (Credit: courtesy of the National Archives of Singapore)
Image2-St_Johns_Island.jpg