Diseases In Urban Areas Research Articles

Survey of spatial distribution of vector-borne disease in neighborhood dogs in southern Brazil

Neighborhood dogs may act as reservoirs and disseminators of vector-borne diseases in urban areas. Accordingly, the aim of this study was to ascertain the health status and the vector-borne pathogens infecting dogs living in public areas with high levels of human movement in the city of Curitiba, southern Brazil. Blood samples from 21 neighborhood dogs that were found in nine of 22 bus stations and two public parks were subjected to a complete blood cell (CBC) count, serum biochemical profiling, a commercial rapid ELISA test and a commercial real-time PCR panel of vector-borne diseases. The CBC count and serum biochemical profiling were within the normal range for dogs and only 1/21 (4.7%) of the dogs was seroreactive for Borrelia burgdorferi sensu stricto. The commercial real-time PCR panel showed that 7/21 (33.3%) of the dogs had Mycoplasma haemocanis infection, 9/21 (42.8%) had ‘Candidatus Mycoplasma haematoparvum’ and 4/21 (19.0%) had both. No statistical association between infected by the agents found here and abnormalities in physical examinations, laboratory tests or ectoparasite presence was found (p > 0.05). In conclusion, neighborhood dogs showed low prevalence of vector-borne diseases and satisfactory wellbeing, and dogs can be used as sentinels for disease exposure.

Costs of chronic obstructive pulmonary disease in urban areas of China: a cross-sectional study in four cities.

PurposeThe economic burden of COPD has not been well studied in China. This study investigated the total costs caused by COPD and the influencing factors for the high economic burden in urban areas of China.Patients and methodsA cross-sectional study was carried out among 678 COPD patients in four cities in China in 2011. The average annual direct medical costs (DMCs), direct nonmedical costs (DNMCs), and indirect costs (ICs) on COPD were measured by median and mean (± standard deviation). Logistic regression model was used to explore factors related to high total costs on COPD.ResultsThe median annual DMCs, DNMCs, and ICs per COPD patient were RMB 5565 Yuan (US$ 862), 0 Yuan (US$ 0), and 0 Yuan (US$ 0), respectively, and the mean annual DMCs, DNMCs, and ICs per COPD patient were RMB 11968 (±22422) Yuan [US$ 1853 (±3472)], 539 (±2092) Yuan [US$ 83 (±324)], and 2087 (±8110) Yuan [US$ 323 (±1256)], respectively. The annual DMCs, DNMCs, and ICs for diagnosed COPD patients were RMB 195.70 billion Yuan (US$ 30.30 billion), 8.78 billion Yuan (US$ 1.36 billion), and 34.10 billion Yuan (US$ 5.28 billion), respectively, in China. Hospitalization accounted for 56.7% of the total costs. High economic burden was significantly related to age, acute exacerbations, and disease severity in COPD patients.ConclusionCOPD posed a heavy economic burden in China. Measures to delay the disease progression and to reduce the risks of acute exacerbation and hospitalization will help substantially lower the costs for COPD care.

Acute exposure to fine particulate matter and cardiovascular hospital emergency room visits in Beijing, China

Fine particulate matter (PM2.5) air pollution outbreaks have recently occurred frequently in China. However, evidence of the associations between short-term exposure to PM2.5 and cardiovascular morbidity is still limited in China. This study aimed to evaluate the associations between PM2.5 and hospital emergency room visits (ERVs) for cardiovascular diseases in urban areas in Beijing. Daily counts of cardiovascular ERVs were collected from ten large general hospitals from Jan 1 to Dec 31, 2013. Air pollution data were obtained from the Beijing Environmental Protection Bureau including 17 monitoring stations. A generalized additive Poisson model was used to examine the associations between PM2.5 and cardiovascular ERVs after controlling for seasonality, day of the week, public holidays, influenza outbreaks, and weather conditions. In total, there were 56,221 cardiovascular ERVs during the study period. The daily mean PM2.5 concentration was 102.1 μg/m3, ranging from 6.7 μg/m3 to 508.5 μg/m3. Per 10 μg/m3 increase in PM2.5 was associated with a 0.14% (95% confidence interval [CI]: 0.01%–0.27%) increase in cardiovascular ERVs at lag3. Cumulative delayed estimates were greatest at lag0–5 (0.30%, 95% CI: 0.09%–0.52%). The estimates of percentage change in daily ERVs per 10 μg/m3 increase in PM2.5 were 0.56% (95%CI: 0.16%–0.95%) for ischemic heart disease (IHD) at lag0–1, 0.81% (95%CI: 0.05%–1.57%) for heart rhythm disturbances (HRD) at lag0–1 and 1.21% (95%CI: 0.27%–2.15%) for heart failure (HF) at lag0, respectively. The effects of PM2.5 on IHD ERVs during high temperature days (>11.01 °C) were significantly higher than that on low temperature days (≤11.01 °C) at lag0, lag0–1, lag0–3 and lag0–5 (P < 0.05). The study suggests that PM2.5 has acute impacts on cardiovascular ERVs in Beijing, especially on IHD, HRD and HF. The effects of PM2.5 on IHD ERVs vary by temperature.

A fully GIS-integrated simulation approach for analyzing the spread of epidemics in urban areas

Human-to-human communicable diseases can be devastating in urban areas where large heterogeneous population groups are living in restricted spaces, causing serious concerns for public health, especially during epidemic outbreaks. Even though Geographic Information Systems (GIS) have been used to study a variety of public health issues in the last decade, their use to study human communicable diseases has been limited to the development of disease clustering, mapping and surveillance systems. These systems don't provide ways to understand and predict the dynamics of diseases spread across an urban region, taking into account the dynamics of human contacts and mobility, which are the main widely recognized mechanisms responsible for diseases' spread. In this paper we address such limits by presenting a GIS-based spatial-temporal simulation approach and software to support public health decision making in the context of communicable diseases in urban areas. The approach fully integrates epidemiological, mobility and GIS-data models at an aggregate population level in order to support spatialized interventions.

Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing, China, in 2013.

BackgroundHeavy fine particulate matter (PM2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing.MethodsDaily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender.ResultsA total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM2.5 concentration was 102.1±73.6 μg/m3. Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM2.5 concentration at lag0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO2, O3, CO and NO2. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM2.5 exposure.ConclusionPM2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM2.5 pollution varied by gender and age.

Exposure of dogs to spotted fever group rickettsiae in urban sites associated with human rickettsioses in Costa Rica

The zoonotic transmission cycles of Rickettsia rickettsii and other spotted fever group (SFG) rickettsiae in Latin America have usually been associated with rural or sylvatic environments, although domestic dogs can be implicated in more populated settings. In this study, exposure of dogs to SFG rickettsiae in the Greater Metropolitan Area of Costa Rica was investigated. Dogs from sites associated with human cases and from dog shelters were evaluated by indirect immunofluorescence assay (IFA) using antigen of SFG rickettsiae. Rickettsia spp. were detected in ectoparasites by polymerase chain reaction (PCR). A total 18.5% (31/168) of dogs associated with human cases and 6.8% (11/161) of dogs in shelters had IgG end titers≥64 to Rickettsia spp. The odds of being seropositive were greater in dogs from areas associated with human cases when compared to shelters (OR: 3.2; 95% C.I: 1.5–5.6). Rhipicephalus sanguineus sensu lato (s. l.) was present in all sites associated with human cases. Rickettsia felis URRWXCal2 and R. felis-like RF2125 were detected in Ctenocephalides felis, and Rickettsia sp. IbR/CRC in Ixodes boliviensis. Results demonstrate that dogs from the main urban center of Costa Rica have been exposed to SFG rickettsiae, especially in areas with known human infection. Both human and animal health sectors must be aware of possible rickettsial diseases in urban areas, where dogs may also serve as sentinels for human infection.

Atmospheric Aerosols: Air Quality and Climate Change Perspectives

Recently, air quality has become a matter of concern of everyone. According to the reports, atmospheric aerosols play very crucial role in air quality. PM10 and PM2.5 aerosols are integral parts of total suspended particulate matter which affect our health. Often air quality has been reported very poor due to violation of National Ambient Air Quality Standard (NAAQS) limits. PM10 and PM2.5 limits are crossed for both residential as well as sensitive sites. This is one of the major reasons of increasing cases of respiratory diseases in urban areas. However, aerosol loadings alone are not the factor for deciding or predicting toxic and harmful effects of aerosols. Chemical composition and size ranges do matter. Aerosol loadings can be due to three major source categories viz. marine, crustal and anthropogenic. Since, marine and crustal content of aerosols are generally non-toxic and hence, degree of toxicity of air needs to be decided on the basis of anthropogenic fraction having metals, PAHs and other harmful content. Apart from air quality and health, atmospheric aerosols play vital role in other atmospheric processes such as cloud formation, radiative transfer and monsoon etc. Though there are several studies reported on different aspects of atmospheric aerosols, but most of the findings are sort of data reporting based on short term observations. Hence, there is need to investigate the atmospheric aerosols in order to demonstrate local and regional phenomenon on the basis of long term datasets.

Economic growth and nutrition transition: an empirical analysis comparing demand elasticities for foods in China and Russia

This study provides empirical evidence on the link between economic growth and nutrition transition in two emerging economies, China and Russia. Both countries have experienced rising average incomes, accompanied by an increasing rate of nutrition-related chronic diseases in recent years. Given the regional heterogeneity between these two countries, we analyze the extent to which income growth as a major driver of nutrition transition has a significant effect on the consumption of different food aggregates and how these effects differ between Chinese and Russian consumers. Our results indicate that with increasing household incomes over time the demand for carbohydrates decreases, while the demand for meat and dairy products, as well as fruits increases. This is a development generally known as nutrition transition. Further, we estimate a Quadratic Almost Ideal Demand System (QUAIDS) for nine different food aggregates for China and Russia. Our results indicate that in both countries all food aggregates have positive expenditure elasticities and are thus normal goods. Moreover, our results indicate that in 2008/2009 meat is still a luxury good in China yet a necessity good in Russia. For 2009, the highest own-price elasticities in China are found for non-meat protein sources and dairy products. Within the meat group, beef, poultry and mutton have the highest price elasticities in China. In Russia, the milk and dairy group, together with the vegetable group, is the most price-elastic food group in 2008. In line with the definition of a nutrition transition, our overall results underscore the finding that income growth in China and Russia tends to increase the demand for animal-based products much stronger than, for example, the demand for carbohydrates. Despite being a positive signal for problems of malnutrition in rural China, this trend of increasing meat consumption might further increase the incidence of chronic diseases in urban areas since there is convincing scientific evidence that increasing meat consumption, especially red and processed meat, is associated with an increased risk of chronic diseases.

Mosquitoes (Diptera: Culicidae) and their relevance as disease vectors in the city of Vienna, Austria.

Mosquitoes (Diptera: Culicidae) are important vectors for a wide range of pathogenic organisms. As large parts of the human population in developed countries live in cities, the occurrence of vector-borne diseases in urban areas is of particular interest for epidemiologists and public health authorities. In this study, we investigated the mosquito occurrence in the city of Vienna, Austria, in order to estimate the risk of transmission of mosquito-borne diseases. Mosquitoes were captured using different sampling techniques at 17 sites in the city of Vienna. Species belonging to the Culex pipiens complex (78.8 %) were most abundant, followed by Coquillettidia richiardii (10.2 %), Anopheles plumbeus (5.4 %), Aedes vexans (3.8 %), and Ochlerotatus sticticus (0.7 %). Individuals of the Cx. pipiens complex were found at 80.2 % of the trap sites, while 58.8 % of the trap sites were positive for Cq. richiardii and Ae. vexans. Oc. sticticus was captured at 35.3 % of the sites, and An. plumbeus only at 23.5 % of the trap sites. Cx. pipiens complex is known to be a potent vector and pathogens like West Nile virus (WNV), Usutu virus (USUV), Tahyna virus (TAHV), Sindbis virus (SINV), Plasmodium sp., and Dirofilaria repens can be transmitted by this species. Cq. richiardii is a known vector species for Batai virus (BATV), SINV, TAHV, and WNV, while Ae. vexans can transmit TAHV, USUV, WNV, and Dirofilaria repens. An. plumbeus and Oc. sticticus seem to play only a minor role in the transmission of vector-borne diseases in Vienna. WNV, which is already wide-spread in Europe, is likely to be the highest threat in Vienna as it can be transmitted by several of the most common species, has already been shown to pose a higher risk in cities, and has the possibility to cause severe illness.

Prevalence and risk factors of fatty liver disease in young and middle‐aged population: One center study in southwestern China

Fatty liver disease has become common hepatic disease not only in western countries but also in developing countries in Asia-Pacific area. Our aim was to determine the prevalence and risk factors of fatty liver disease as well as its correlation with metabolic syndrome in young and middle-aged population. Data were collected from check-up center at the 1st Affiliated Hospital of Chongqing Medical University in 2011. Relationships of fatty liver disease and age, body mass index, and metabolic syndrome were determined. Logistic regression was performed to identify the risk factors for fatty liver disease. Data of 18 676 subjects (mean age 40.55 ± 9.94 ranging from 18 to 59) were analyzed. The prevalence of fatty liver disease was 22.0% and increased along with age, body mass index, and the presence and severity of metabolic syndrome. In logistic regression, living area was significantly associated with fatty liver in total population. Male, overweight and obese, waist-to-height ratio ≥ 0.5, hypertension, hypercholesterolemia, high triglyceride, low high-density lipoprotein cholesterol, and fasting plasma glucose ≥ 7.0 mmol/L were common independent risk factors for fatty liver disease in urban and rural areas. Older age and white blood cell over 5.5 ×10(9) /L were related to fatty liver disease in urban area. Obesity was the most important factors in both areas. Fatty liver disease was prevalent in young and middle-aged population and mainly associated to multiple metabolic disorders.

Prevalence of Risk Factors for Non-Communicable Diseases in the Adult Population of Urban Areas in Kabul City, Afghanistan.

BackgroundNon-Communicable diseases (NCDs) are a major global problem. This study aims to estimate the prevalence of common risk factors for NCDs among the adult population in urban areas of Kabul city, Afghanistan.Methods and MaterialsThis study was conducted from December 2011 through March 2012 and involved a survey of 1169 respondents, aged 40 years and above. Multistage cluster sampling was used for participant selection, followed by random sampling of the participants. The World Health Organization STEPwise approachfor Surveillance (STEPS) was modified and used for this study.ResultsThe overall prevalence of smoking was 5.1% (14.7% men versus 0.3% women) and using mouth snuff was 24.4% in men and 1.3% in women. The prevalence of obesity and hypertension were 19.1% and 45.2 % in men and 37.3% and 46.5% in women. Prevalence of diabetes was 16.1% in men and 12% in women. The overall prevalence of obesity, hypertension and diabetes mellitus was 31.2%, 46% and 13.3%, respectively. On average, subjects consumed 3.37 servings of fruit and 2.96 servings of leafy vegetables per week. Mean walking and sitting hours per week (as proxies for physical activity) were 19.4 and 20.5, respectively. A multivariate model demonstrated that age was a significant risk factor for obesity (OR=1.86), diabetes (OR=2/09) and hypertension (OR=4.1). Obesity was significantly associated with sex (OR=1.65).ConclusionThese results highlight the need for interventions to reduce and prevent risk factors of non-communicable diseases in urban areas of Kabul City, Afghanistan.

Efficacy tests on commercial fungicides against ash dieback in vitro and by trunk injection

Ash dieback, caused by Hymenoscyphus pseudoalbidus Queloz et al. (anamorph Chalara fraxinea Kowalski), has emerged as a critical disease in urban areas and in the forests of many European countries. This study was conducted to evaluate six fungicides for their potential to control the disease. In vitro assays with different concentrations of the products against five different strains of the pathogen, illustrated that thiabendazole, propiconazole and allicin exhibited lower median lethal doses, procloraz completely killed half of the samples at higher concentrations, whereas copper sulphate and potassium phosphite were totally ineffective. Subsequently, the antifungal activities of the best three compounds were investigated in planta against H. pseudoalbidus by trunk injection. The rate of necroses development following artificial inoculation of 24 F. excelsior was significantly slowed down in the growing season by the treatment with thiabendazole and allicin. In the phenological phase and climatic conditions tested, and with the chosen formulation and injection method, propiconazole injections were impracticable. The results of this study, along with some technical suggestions for application in the field, support the idea of using organic and chemical endotherapic products to combat ash dieback symptoms in Fraxinus spp., with the safe and very low impact method of trunk injection.

Prevalence ofDirofilaria immitisamong shelter dogs in Tokyo, Japan, after a decade: comparison of 1999–2001 and 2009–2011

Changes in the seroprevalence of Dirofilaria immitis infection among shelter dogs between a decade ago and the present were evaluated. Serum samples were collected from 200 adult dogs in urban and suburban areas in Tokyo, Japan, during two 2-year periods (April 1999 to March 2001 and April 2009 to March 2011). Sera were tested for the presence of D. immitis antigen using a specific commercialized kit. The seroprevalence of D. immitis infection was 46% in 1999–2001 and 23% in 2009–2011. A decrease was observed in the prevalence of infection between 1999–2001 and 2009–2011; in particular, the prevalence in urban areas decreased significantly compared with that in suburban areas (P < 0.01). There was no significant difference in prevalence between the sexes in each period, but there was a significant difference between mixed-breed and purebred dogs (P < 0.01). The decrease in prevalence of canine heartworm disease in urban areas could be related to better veterinary care.

Leptospirosis in a Japanese urban area: A case report and literature review

Leptospirosis is not a major disease in urban areas of Japan. We describe a 49-year-old man with leptospirosis, who lived in an urban area and had no history of living in endemic area of leptospirosis. As he worked at a fish market infested with rats, he was suspected of having contracted leptospirosis and received antimicrobial agent treatment. Serum and urinary tests confirmed the diagnosis of leptospirosis. Although it took six days from the onset until treatment initiation, the patient improved in response to receiving ceftriaxone for seven days. Analyzing past reports of Japanese patients with leptospirosis who had no history of overseas travel, we identified 90 patients with courses similar to that of our patient, and the period from onset to treatment initiation was about six days on average (described in 46 cases). Health care providers as well as patients need to recognize that even people with no history of being in an endemic area of leptospirosis may still be at risk of developing this disease depending on occupations and activities.

CARDIOVASCULAR DRUG INTERACTION;

Introduction: Cardiovascular drug interaction is the alarming and becoming leading cause of death in the society ofKarachi Pakistan where the prevalence rate of CVS diseases in urban areas is very high. Objective: The aim was to evaluate thecardiovascular interactions in poly prescription in the city of Karachi, Pakistan. Study Design: The methodology adopted for this study iscross sectional study. Material &amp; Methods: In which verbally and signed informed consent prepare which help to limitize the biasness.Results: In this study the determination of the percentage of interactions is about 30%.The gender which is most susceptible forinteraction is females. The Significance or consequences of interaction would measured by minor, moderate and major level. In our studyminor is about 28, moderate is about19 while Major is about 9.The most untoward effects which was seen was bradycardia and the classof drug which lead for interaction is Beat and ACE blockers in the prescribing practice and some severe interaction lead to life threatening.Conclusion: The main result which is concluding for this study is the huge number of interaction which is found in the prescription createslife threatening circumstances. With the proper consultation and time we can minimize the interaction as well as the health scenario canbe improved and the quality of life can be improved.

Development of a Electrically Inspired Low Emission Microcontroller Based Hybrid Vehicle

Problem statement: Recently, influx of research afford is being concentrated in automobile engineering to develop low emission hybrid electric vehicle to reduce the greenhouse gases such as hydro-carbons, carbon monoxide, carbon dioxide, produces from the vehicle. Approach: Hybrid Electric Vehicles (HEVs) powered by electric machines and an Internal Combustion Engine (ICE) are a promising mean of reducing emissions and fuel consumption without compromising vehicle functionality and driving performances. Reduction of emission is a significant issue to save the environment from pollution that cause of many diseases in urban areas is almost entirely due to transport using fossil fuel. Although zero emission transport has not been developed and used practically yet. Results: This study introduce a control mechanism for alternative hybrid electric vehicle combination of electric motor and gasoline engine that reduce the use of fossil fuel without compromising the overall car performance. Conclusion: In this study, a microcontroller based control mechanism of HEV is introduced which consists of battery, voltage indicator, DC motor controller and battery charger.

Metal Emissions and Urban Incident Parkinson Disease: A Community Health Study of Medicare Beneficiaries by Using Geographic Information Systems

Parkinson disease associated with farming and exposure to agricultural chemicals has been reported in numerous studies; little is known about Parkinson disease risk factors for those living in urban areas. The authors investigated the relation between copper, lead, or manganese emissions and Parkinson disease incidence in the urban United States, studying 29 million Medicare beneficiaries in the year 2003. Parkinson disease incidence was determined by using beneficiaries who had not changed residence since 1995. Over 35,000 nonmobile incident Parkinson disease cases, diagnosed by a neurologist, were identified for analysis. Age-, race-, and sex-standardized Parkinson disease incidence was compared between counties with high cumulative industrial release of copper, manganese, or lead (as reported to the Environmental Protection Agency) and counties with no/low reported release of all 3 metals. Parkinson disease incidence (per 100,000) in counties with no/low copper/lead/manganese release was 274.0 (95% confidence interval (CI): 226.8, 353.5). Incidence was greater in counties with high manganese release: 489.4 (95% CI: 368.3, 689.5) (relative risk = 1.78, 95% CI: 1.54, 2.07) and counties with high copper release: 304.2 (95% CI: 276.0, 336.8) (relative risk = 1.1, 95% CI: 0.94, 1.31). Urban Parkinson disease incidence is greater in counties with high reported industrial release of copper or manganese. Environmental exposure to metals may be a risk factor for Parkinson disease in urban areas.

A low-cost approach to measure the burden of vaccine preventable diseases in urban areas

We piloted a low-cost approach to measure the disease burden of Streptococcus pneumoniae, Hib and Salmonella Typhi by leveraging the existing infrastructure of high performing microbiology laboratories at two large paediatric hospitals in Dhaka Bangladesh, and assessing the hospital utilization of the catchment population of these hospitals for different syndromes. S. Typhi was the most common bacterium identified in culture and accounted for an estimated 211 hospitalizations per 100,000 children <5 years of age per year. Meningitis due to S. pneumoniae was the most common cause of mortality accounting for 8.0 deaths per 100,000 children <5 years of age per year. This low-cost approach can provide data to support vaccine introduction and the health impact of newly introduced vaccines.

Brucella canisCausing Infection in an HIV-Infected Patient

From the blood culture of an HIV-positive patient with a febrile syndrome (CD4 count 385 cells/microL and viral load nondetectable), Brucella canis was isolated. The patient was presumptively infected from his dogs, which tested positive, and showed good outcome after the therapy with doxycycline-ciprofloxacin, and the HIV infection would seem not to have been influenced by brucellosis. To our knowledge, no other case of B. canis in the setting of HIV infection has been reported in the literature, and the emerging zoonotic potential of the disease in urban areas should be considered.

Incidence of Chikungunya Fever in Singapore: Implications of Public Health Measures and Transnational Movements of People

In addition to Dengue virus infection, another mosquito-borne viral infection has become a significant health hazard. After the first domestic case of Chikungunya fever was reported in the Republic of Singapore, the outbreak was brought under control in 18 days. Despite the quick and thorough public health measures including intensive vector control, this country known as a developed island state could not stop the subsequent outbreaks as both domestic and imported cases surged. Our in-depth investigation benefiting from field activities recapitulates the governmental interventions to control the re-emerging infectious disease. We discuss potential factors contributing to the subsequently increased cases in Singapore and then review strategies that other governments may consider in controlling vector-borne infectious diseases in urban areas with transnational movements of people.