​She says 46-year-old who died from disease likely sought treatment late.

The 46-year-old man who died from dengue had likely sought treatment late and was already very ill when he did so, said the executive director of Singapore's National Centre for Infectious Diseases.

Professor Leo Yee Sin told The Straits Times yesterday that adults and young adults in good health and without pre-existing conditions are typically able to fight through the infection.

But, she added, early diagnosis, early treatment and close monitoring are key in combating dengue.

As of July 20, nine people in Singapore, including the 46-year-old, have died from dengue this year.

The other eight victims were all above the age of 60.

Prof Leo said that although dengue can affect people of all ages, those between the ages of 12 and 60 usually have "no issue" fighting the disease.

In Singapore, it is the elderly – those around the age of 60 and above – who are at higher risk of dying from dengue.

There are two main reasons. First, symptoms of dengue tend to be less severe in older individuals, making it harder to detect. For instance, while a 30-year-old may have sudden high fever and intense body aches, a 70-year-old may have only a mild fever and mild body aches.

But despite this, the disease will take its toll on the elderly patient as it places a lot of strain on the body, she said. This can lead to multi-organ failure and death.

The elderly also tend to have more pre-existing clinical illnesses, and dengue will complicate the management of these.

For example, a dengue patient taking pills for high blood pressure will need to monitor his blood pressure as dengue will naturally lower it. As a result, he may need to adjust the medication dosage. If the patient fails to do so or is unaware that he has dengue, his blood pressure may drop dangerously low.

Prof Leo said those who are around the age of 12 or younger are also at risk of plasma leakage if they are infected with dengue a second time. In this case, fluid and proteins leak out of blood vessels, causing a drop in blood pressure, which can lead to death.

Those who are least at risk of dying from dengue are young adults and adults, aged between 12 and 60, who have not been infected with dengue before.

Although they tend to experience worse manifestations of the symptoms of dengue – a sudden onset of fever for two to seven days, a severe headache with pain behind the eyes, joint and muscle pain, skin rashes, nausea and vomiting, and mild bleeding – the disease is usually mildest for them.

Prof Leo warned, however, that there is a "critical period" for intervention.

Around the fifth day of a dengue infection, a patient's body will undergo a lot of unstable and rapid changes which are difficult to recover from. This is why early detection, treatment and monitoring are important, she said, adding that those with fever or muscle aches should consult a doctor as there are tests that can be done to detect dengue fever.

She added that the fatality rate of dengue in Singapore is "very, very low" – just nine out of 8,020 cases, but noted that the death of the 46-year-old highlighted the importance of educating the public about early intervention.

ST spoke to 20 residents living in Woodlands Drive 50, the last known address of the 46-yearold victim.

"It is worrying, and we are in a dengue red zone, so I do what I can at home to prevent mosquitoes from coming in," said 67-year-old housewife Pang Choo Kwee.

A banner on the street said the area has seen some 60 dengue cases. Disposable plastic bowls containing stale water were seen around several blocks, with one having cat food mixed with the water.

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Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction.