Singapore’s ZIKA outbreak & precautions for runners: Comments by Running Doctor Derek Li

Update: 4 September 2016

New research of the Zika virus in two patients from the first cluster in the Eastern part of Singapore has found that the virus in not from Brazil, as originally thought. It is likely to have evolved from the South East Asian region. And so the linkage of Microcephaly with new born babies whose mother contracted the virus when she was pregnant is now less definite. With this, it is lesser of a risk for the babies to develop Microsephaly or to be born with abnormally small heads.


The Zika virus has well and truly hit Singapore. Since last week, the number of cases here has quickly risen to 215 as of today – Saturday 3 September.

Spread primarily through the bite of the Aedes mosquito, the Zika virus has been spreading rather quickly around the globe, from Brazil and Latin America now to many parts of Asia and Africa.

And according to the World Health Organisation, the current number of Zika cases in Singapore constitutes a health emergency for Singaporeans.

Doctor Derek Li (left) shares more about Zika and how this impacts runners.

Doctor Derek Li (left) shares more about Zika and how this impacts runners.


So what is Zika and what should you know about it? Said Dr Derek Li, 34, a General Practitioner who is commonly known as one of Singapore’s ‘Running Doctors’, “Zika is characterised by fever and rash, plus joint aches or conjunctivitis (red eyes). If you have other symptoms together with the fever – such as flu or stomachache, then it’s unlikely to be Zika.”

The Zika virus however, is not as serious a threat as dengue generally is, added the doctor.

He said “But then again, a lot of people may be infected with Zika and not exhibit the telltale signs. And the average time for recovery is about three to five days.”


Continued Dr Li, “Zika also tends not to be life threatening so by comparison, dengue is a lot more dangerous. The main danger of Zika remains the threat to pregnant women in the form of microcephaly as far as we know for now.”

The main danger of Zika is to pregnant women. [Photo sourced from Bonbon]

Pregnant women who are infected by the Zika virus may give birth to babies with Microcephaly.
[Photo sourced from Bonbon/FreeStockPhotos]

Microcephaly is a congenital condition associated with incomplete brain development and abnormal smallness of the head in unborn babies.

Added Dr Li, “But then again, there is a lot that we still do not know about Zika and even the scientific research is very conflicting. We do know that Zika can cause microcephaly in unborn babies and may even cause stillbirth but the how and why are still unknown.”

So the current recommendation then, is for infected women to wait some time – before they try for a baby.

Explained the doctor, “Infected women should avoid pregnancy within EIGHT WEEKS of Zika infection, but that is the extent of what we are fairly certain of at this time. Recently there were some studies showing a possible link between Zika infection and dementia, but that remains to be fully corroborated by others.”

Many may know that the Zika virus spreads primarily through the bite of the Aedes mosquito, but Dr Li pointed out that it can also be found in the breastmilk of infected mothers too.

The doctor added “But it is not clear if that poses any threat to a breastfeeding baby. The Zika virus can also be found in the sperm and ova of infected adults so foetuses can be affected this way.”


For runners in particular, Dr Li feels that that no special precautions really need to be taken.

Runners do not really need to take precautions about Zika, says Dr Li.

Runners do not really need to take special precautions about Zika, says Dr Li.

He added, “We should bear in mind that Zika and Dengue spread in the same way, so there is really no need to change what you are doing unless you are planning for a baby. Running in general though, does increase your risk of mosquito bites, only if you run in areas that are prone to mosquito infestation, I suppose. That would include places like the Macritchie and Bukit Timah trails, though they are not currently recognised as Zika or Dengue hotspots.”

The reason is because according to Dr Li, there is typically less ventilation in the trails.

He explained “So in theory the chances of getting bitten are higher due to the stillness of the air. I would recommend choosing areas with the potential for more wind to run in, such as coastal park roads and avoid trails altogether if possible. Or ensure adequate clothing plus the usage of mosquito repellants if running in the trails.”

Some of the confirmed Zika clusters in Singapore, include the Aljunied Crescent, Sims Drive, Paya Lebar Way, Kallang Way and Bedok North areas.

Dr Li also added that mosquitoes tend to be most active at nights. Said the doctor, “This is something to bear in mind when you are running. They are also attracted to body heat and the carbon dioxide signature from our breathing. It may be helpful to have more body coverage through clothing like arm sleeves and use insect repellant around the neck, forearms and legs.”


In choosing mosquito repellents, Dr Li does not recommend a specific brand though. He said “I don’t know of any one brand that is better than the others. The ones you can find off the shelf in pharmacies are all deemed safe and effective, even for pregnant women.”

Doctor Li does not have a specific brand of mozzie repellant. [Photo by CDC/PHPPO/DPDE/CAB/PhotoServices acquired from Public Health Image Library]

Doctor Li does not have a specific brand of mozzie repellent for Singaporeans to use.
[Photo by CDC/PHPPO/DPDE/CAB/PhotoServices acquired from Public Health Image Library]

He added, “But personally I have found the SAF (Singapore Armed Forces) insect repellents which are sold in the “Army Market” off Beach Road to be exceptionally good.”

And due to the “kiasu” nature of many Singaporeans though, most pharmacies are unfortunately low on stock, or sold out of mosquito repellent products now. Said Dr Li, “If that’s the case, I’m told that lemon grass works, but I have no idea if that is actually true.”

For example I have checked my neighbourhood Watsons store and the mosquito repellent shelves have all now been emptied.

Empty shelves at Watson's.

Empty mosquito repellent shelves are common at pharmacies since the Zika outbreak.

Added the doctor, “But then again, first and foremost, we should be mindful of leaving stagnant water around that serve as breeding ground for mosquitoes. Overall these are things that we should all have been doing for years, and the Zika outbreak is a reminder of how important those little preventive measures are.”

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