A severe case of hemorrhagic fever with renal syndrome in Singapore.

The incidence of human hantavirus infection in Singapore is low. Hitherto, only 2 cases of hemorrhagic fever with renal syndrome (HFRS) have been reported. A third case is reported here of a ragman who had the classical manifestations of HFRS, confirmed by serology. In addition, his condition was complicated by liver dysfunction and neurological disturbance. After a protracted stay, the patient was finally discharged from hospital 5 months after the onset of his severe illness.

Prevalence of varicella-zoster virus infection in Singapore.

The incidence of chickenpox in Singapore has been increasing since 1984. A seroepidemiological survey was conducted in 1989-90 to determine the prevalence of varicella-zoster virus-specific IgG antibody in the healthy population in Singapore aged from 6 months to over 45 years. Overall, 42.8% of 500 samples assayed qualitatively by the ELISA method were positive, with less than one fifth of those aged under 15 years and less than half of the 15-24 year olds possessing antibody to the virus. However, antibody prevalence increased markedly to between 86% and 98% in those over 25 years of age. No significant sex or ethnic difference was noted. The survey confirmed the low herd immunity and the higher susceptibility of the young adult population to varicella infection in a tropical city compared to that of temperate countries.

An epidemic of acute conjunctivitis caused by enterovirus-70 in Singapore in 1980.

The clinical, epidemiological and virological findings of the 1980 epidemic of acute conjunctivitis were described. Enterovirus 70 was isolated from 7 (35%) of 20 eye swabs submitted for virus isolation, and the paired sera of eight patients showed a four-fold or greater rise in neutralising antibody titre to Enterovirus 70. The disease mainly affected children and young adults of all ethnic groups. Most of the cases contracted the infection at home. The mean secondary attack rate was 72.6% and the mean incubation period, four days. The clinical features were similar to the 1970 and 1975 epidemics caused by Coxsackievirus A24. Subconjunctival haemorrhage was observed in 10% of the cases. Most of the cases recovered spontaneously within a week. Transmission of infection within the home was either indirect, probably through fomites contaminated with eye or respiratory discharges of cases, or direct, through intimate person-to-person contact. During outbreaks, health education on simple personal hygiene should be highlighted.