Update on Influenza A (H1N1-2009)[1]

 

            As of 3 May 09, there are no human cases of Influenza A (H1N1-2009) in Singapore. Our Disease Outbreak Response System Alert status remains at ORANGE and precautionary measures are in full swing to forestall the spread of the virus to Singapore for as long as possible.

 

Situational Update of Cases

 

2.         As of 3 May 2009, there have been 506 confirmed cases of Influenza A (H1N1-2009) reported in Mexico (with 19 deaths), 160 in the United States (with 1 death), 70 in Canada, 13 in Spain, 15 in United Kingdom, 6 in Germany, 4 in New Zealand, 3 in Israel, 1 in Austria, 1 in the Netherlands, 1 in Denmark, 1 in Switzerland, 2 in France, 1 in Ireland and 1 in Costa Rica. Hong Kong and South Korea have each reported 1 confirmed case. The case in Hong Kong is a Mexican citizen who travelled to Hong Kong, while the case in South Korea was a South Korean who had travelled to Mexico. Both patients have been isolated and there has been no reported community spread in South Korea or Hong Kong to date.

 

3.         In Singapore, we had two additional cases for investigations today. Of the 27 cases investigated thus far, 23 cases have tested negative for Influenza A, 3 cases tested positive for the usual circulating seasonal strains of Influenza A, and one is pending laboratory investigations.

 

4.         So far, a total of five persons (3 Singaporeans and 2 foreigners) who have been to Mexico in the last seven days were put on voluntary phone surveillance.  Of these, one Singaporean has completed the seven-day phone surveillance and is well.  One other Singaporean was reported to have flu-like symptoms today and was admitted to CDC this morning. Laboratory investigations are however negative for influenza A.  The others are doing well.

 

Extension of Temperature Screening to Land Checkpoints

 

5.         Thermal scanning has been deployed at the airports and sea checkpoints, and is instituted at the land checkpoints today.

 

6.         Temperature checks at the checkpoints may not pick up all infected cases as travelers may be asymptomatic in the early stages of the infection. However, it enables us to take precautionary measures and reduce the risk to Singapore.

 

Home Quarantine Order (HQO)

 

7.         The Home Quarantine Order is issued under the Infectious Diseases Act to contacts and suspected contacts of the Influenza A (H1N1-2009) virus, with the aim of limiting the spread of Influenza A (H1N1) in the community. It can be issued to any person who is a known or suspected close contact of a probable or confirmed case of Influenza A (H1N1-2009), as well as persons who arrived in Singapore within 7 days after having departed from Mexico.  Travellers entering Singapore with a travel history to Mexico over the past seven days will be  quarantined for seven days when they enter Singapore from when they were last in Mexico. Travellers who are unable to be quarantined at their own residential homes, or are without a residential home in Singapore, will be quarantined in alternative housing such as government chalets, i.e., the Aloha Chalets located at Loyang.

 

8.         The HQO will come into effect from Monday (0001 hours from 4 May 09). Immigration officers will ask passengers for their travel history and issue HQO to travellers who have been to Mexico in the past 7 days. Specially arranged transport will bring them home or to designated quarantine centre. While under HQO, the person  must stay at home  throughout the quarantine period, monitor their  temperature twice daily and check for flu-like symptoms. Eventhough these people are well, they are encouraged to  minimise contact with other family members and practice good personal hygiene.

 

9          Persons under home quarantine who develop symptoms will be referred to the CDC for a thorough assessment. A dedicated ambulance service (993) is in place to convey them to TTSH Emergency Department. The public is urged to call this number  only if they have a travel history to affected areas. Any person guilty of breaking the HQO shall be liable to a maximum fine of $10,000, or imprisonment of six months, or both. In the case of a second or subsequent offence, the person will be liable to a maximum fine of $20,000, or imprisonment of 12 months, or both. For those who have not travelled to affected areas but are unwell, they should put on a surgical mask and see their family doctors.

 

10.       For travellers who are returning from other areas with evidence of community transmission of Influenza A (H1N1-2009) (i.e., the United States and the state of Nova Scotia in Canada), MOH advises them to stay at home for seven days and check themselves for symptoms of flu-like illness. They should refrain from joining mass gatherings, e.g., going to the cinemas, shopping malls, supermarkets, etc. Those who develop respiratory illness with fever (temperature > 38 deg C) within seven days after their return should put on a surgical mask and call 993 for an ambulance. They should also disclose their travel histories to their doctors.

 

11.       MOH is also requesting all Singaporeans and travellers who stayed at the Metropark Hotel Wanchai in Hong Kong on 30 April 2009 and who have since returned to Singapore to call  MOH’s hotline at 1800-333 9999 (8.30am to 9.00pm. This will enable MOH to advise them on monitoring their own health in light of the confirmed case in Hong Kong.  

 

Advice from MOH

 

12.       Members of the public are strongly advised to postpone or avoid non-essential travel to Mexico and affected areas. In the event that travel is unavoidable, the public is advised to take precautionary measures such as avoiding crowded areas and maintaining high standards of personal hygiene at all times.

 

13.       MOH advises the public to maintain high standards of personal hygiene, such as washing hands frequently with soap and water, especially after contact with respiratory secretions (e.g., after sneezing and coughing). Those who are unwell with respiratory illness should stay at home and wear a surgical mask if possible.

 

14.       MOH is monitoring the situation closely and will update the public should there be any new developments. For more information on Influenza A (H1N1-2009), please access MOH’s website at www.moh.gov.sg, call our hotline at 1800-333 9999, or visit www.flu.gov.sg.

 

 

MINISTRY OF HEALTH

MINISTRY OF HOME AFFAIRS