Singapore Government Press Release

Media Relations Division, Ministry of Information, Communications and the Arts,

MITA Building, 140 Hill Street, 2nd Storey, Singapore 179369

Tel: 6837-9666

One new patient with SARS was admitted since the MOH Press Release yesterday. She is a health care worker who was in contact with a case. As at 17 March 2003, we have a total of 21 patients of SARS. Other than the initial three cases, the additional 18 patients were all close contacts with patients of SARS. Ten are family members and friends, and eight are hospital staff. All the patients are stable, except for two patients who are in a serious condition.

The doctor, his wife and his mother-in-law are being treated in the infectious disease unit of a university hospital in Frankfurt, Germany. The conditions of the doctor and his mother-in law are stable.

The Ministry would like to reiterate that you should seek immediate medical attention if you have:

• Fever (>38⁰C) and respiratory symptoms including cough, shortness of breath or breathing difficulty;

• have travelled to Hong Kong, Hanoi or Guangdong province in China, within 2 weeks of onset of the symptoms; or
• are a close contact of persons diagnosed with SARS. (Close contact means having cared for, having lived with, or having had direct contact with respiratory secretions and body fluids of a person with SARS)

As a precautionary measure, the Ministry strongly advises you to avoid travel to Hong Kong, Hanoi and Guangdong province in China for the time being, unless absolutely necessary.

Ministry of Health

17 March 2003

MOH Hotline for queries : 1800-2254122

Website : www.moh.gov.sg

Suspect and probable cases of SARS are being identified as early as possible so that they can receive treatment and are isolated early.

To do this, we are providing information and general advice to the public on symptoms to look out for and to seek immediate medical attention if they develop such symptoms. It is important that the public understand that they should ONLY suspect that they may have SARS if they have a relevant travel history and/or close contact with a person who has been diagnosed with SARS.

All doctors and hospitals have been notified on the evaluation of such cases through our MedAlert system and circulars. Regular updates are being provided to all doctors and hospitals as more information becomes available.

Early identification of cases is also being done through tracing of contacts of known cases (see below).

All patients with SARS are being treated in isolation rooms in CDC and the other public hospitals.

Tracing of contacts of known cases has been done, and will continue. Contacts with symptoms suggestive of the illness are immediately referred to CDC, TTSH for further evaluation. At CDC, if assessed to be a suspect or probable case, they will be admitted for isolation and observation.Contacts that are well are instructed to go to CDC immediately if they develop fever or cough. NEA officers will call these contacts daily to check on their status.

Besides the measures above to detect cases early, MOH has also advised the public against travelling to Hong Kong, Hanoi and Guangdong province in China unless absolutely necessary.

Travel advisories will be provided to all passengers on inbound flights from the above areas to Singapore. The travel advisories explain the symptoms of SARS and advise passengers who develop these symptoms to seek medical attention immediately.

5. Laboratory investigations Laboratory investigations are ongoing to identify the causative agent for SARS. To date, tests done so far have all been negative.. We are also working closely with the WHO and specimens will also be sent to laboratories in CDC, Atlanta, USA for further investigation.

6. Enhanced Infection control procedures in hospitals Strict infection control procedures are in place around the patients. Only immediate family members of the patients are allowed to visit them. The family members and the hospital staff have to observe enhanced infection control procedures when entering the rooms of, or coming into contact with, the patients. These measures include the wearing of tight fitting facemasks, gowns, gloves and thorough hand washing.

All hospitals implemented measures for the screening of suspect cases of SARS. Suspect cases will be handled separately from the other patients. If the cases are assessed to be probable cases, they will be referred to CDC, TTSH for admission and treatment. If the cases are ill and require more intensive treatment, they will be admitted to the hospital and managed accordingly.

Emergency department staff who come into contact with suspect or probable cases will adopt the enhanced infection control measures.

All acute hospitals in the public sector are prepared to create additional isolation rooms and wards, as a contingency in case the number of cases increase beyond the capacity of CDC, TTSH.

MOH has and will continue to issue daily press statements to update the public on the situation in Singapore. A list of FAQs has also been released to the media and have been put on the MOH website.

MOH has also set up a hotline to handle all general public enquiries at 1800-2254122.

A task force has been set up by MOH to monitor situation very closely and take appropriate action. The taskforce is chaired by Prof Tan Chorh Chuan, Director of Medical Services and includes the relevant experts from MOH, NEA (QED) and hospitals.

 ABOUT SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

WHO reported on 15 March 2003 that it has received reports of more than 150 new suspected cases of an atypical pneumonia for which cause has not yet been determined. WHO has coined the term Severe Acute Respiratory Syndrome (SARS) to refer to this condition.

Reports to date have been received from Canada, China, Hong Kong Special Administrative Region of China, Indonesia, Philippines, Singapore, Thailand, and Viet Nam.

Atypical pneumonia refers to an infection of the lung that is caused by certain organisms such as Mycoplasma, Legionella and Chlamydia. SARS is a type of atypical pneumonia, and the organism causing it has not yet been identified. As more information has become available, WHO has revised the SARS case definitions as follows:

The travel or close contact history are key criteria in suspecting the diagnosis and helps distinguish SARS from other causes of fever and cough such as the common cold or the flu.

From the available information available so far, the disease seems to be spread through close contact (as defined above).

No definite cause identified so far. However, on-going investigations suggest a viral origin.

Largely supportive. At present, patients are being treated empirically with antibiotics and in some cases, anti-viral agents.

 FREQUENTLY ASKED QUESTIONS

SARS is the short form for Severe Acute Respiratory Syndrome. SARS is an atypical pneumonia for which the cause has not yet been determined.What is atypical pneumonia?Atypical pneumonia refers to an infection of the lung that is caused by certain organisms such as Mycoplasma, Legionella and Chlamydia. However, the type of atypical pneumonia that occurred in the persons who had travelled to Hong Kong (SARS) is a new type, and the organism causing it has not yet been identified.

How do I know if I may have SARS?

You may have SARS if high fever (greater than 38(C) and have respiratory symptoms like cough, shortness of breath or difficulty breathing and close contact with a person who has been diagnosed with SARS or a recent history of travel to areas reporting cases of SARS.

The infection can spread to persons who have had close contact with an infected person. Based on information so far, contacts who have been infected in Singapore were family members and friends, and healthcare workers who had come into close contact with the patients, and who had attended to the patients when they were first admitted to the hospital.

SARS, like any other atypical pneumonia, is a serious infection that can potentially lead to death in some cases. So far, the cases in Singapore are stable and no deaths have occurred.

As a precautionary measure, the Ministry of Health advises you to avoid travel to Hong Kong, Hanoi and Guangdong province in China for the time being, unless absolutely necessary. For those who are unable to delay their travel to these places, you are advised to avoid crowded places and to build up your body’s resistance by ensuring that you get adequate rest, proper diet and exercise.

As the cause of the infections is not yet known, there are no specific measures that can be taken. If you are unable to delay your travel plans, you are advised to avoid crowded places and to build up your body’s resistance by ensuring that you get adequate rest, proper diet and exercise.

If you have travelled to Hong Kong, Hanoi and Guangdong province in China in the last two weeks, and developed a sudden onset of high fever (greater than 38(C) and have respiratory symptoms like cough, shortness of breath or difficulty breathing, you are advised to seek medical attention early.Ministry of Health17 March 2003