Sudden spike in complaints triggered alarm: Doctors

SINGAPORE — The three doctors at Sims Drive Medical Clinic who raised the alarm that led to the discovery of the first locally-transmitted Zika cases said they first sensed something amiss in the second week of this month.

Dr Tan May Yen was the first to flag the sudden spike in complaints of fever, rashes and joint pain. At its peak, there was an “unusually high” number of about 10 such cases a day, compared to between zero and three cases normally, said her co-worker Dr Lim Chien Chuan on Monday (Aug 29).

What stumped them was how the patients who agreed to be tested for dengue, chikungunya, measles and rubella were cleared of these conditions, even after repeated tests.

The possibility of them contracting Zika was not raised, as most of these patients — a bulk of whom are foreign workers who worked at a construction sites in the vicinity — had not travelled to countries with ongoing Zika outbreaks. “Most of them had very mild symptoms ... But we were seeing more than (the) usual (number of cases) and all with the same symptoms ... (We were) not sure about (whether it could be) Zika as most of the cases did not exhibit the relevant travel history,” said Dr Lim.

Dr Tan, Dr Lim and a third colleague, Dr Chi Wei Ming, started discussing the diagnoses of cases each of them handled, and decided to bring the matter up to the Ministry of Health (MOH) on Aug 22.

After some tracing, 41 confirmed patients have been found in the Aljunied Crescent-Sims Drive area, as of noon Sunday. Of the 41 Zika cases, 34 patients have fully recovered. Seven still have symptoms and are recovering at Tan Tock Seng Hospital, the MOH said. Thirty-six of the patients are foreign workers working at a construction site on 60 Sims Drive.

As of noon on Monday, five patients who visited Sims Drive Medical Clinic — two women and three men — were sent to the CDC for further tests.

When the MOH confirmed on Saturday that their patients had Zika, the doctors at Sims Drive Medical Clinic felt torn. While their puzzle had been solved, it meant there were now locally-transmitted Zika cases.

“On one hand, we know what is wrong with these patients. But on the flipside, it means Zika is now in the community, so everybody has to put in efforts and (take) the necessary steps to control the symptoms,” said Dr Chi.