Ebola

8 September 2014

Question No. 175

Mr Alex Yam Ziming
MP for Chua Chu Kang GRC

Question

To ask the Minister for Health with regard to the Ebola outbreak in West Africa and the spread through flights from the region (a) what contingency plans does the Ministry have in place to deal with such virulent conditions coming into Singapore; and (b) how prepared is our healthcare system to deal with any potential outbreak of contagious diseases.

Question No. 185

Mrs Lina Chiam
Non-Constituency MP

Question

To ask the Minister for Health (a) whether there is a necessity to detect and keep vigilant for any early signs of an Ebola outbreak from incoming and outgoing passengers travelling by air, sea or land; and (b) what are the contingency plans for such an outbreak of the virulent disease.

Question No. 187

Mr Christopher de Souza
MP for Holland-Bukit Timah GRC

Question

To ask the Minister for Health (a) what preventive measures and precautions has the Ministry been taking to prevent an outbreak of the Ebola virus in Singapore given Singapore's position as a key aviation hub in the region; (b) what is the Ministry's response and treatment plan should a person who has contracted the Ebola virus enter Singapore; and (c) what medical assistance will be provided to the person who has contracted the Ebola virus.

Answer

Ebola Outbreak Situation in Africa and Risk Assessment

1        The ongoing Ebola outbreak is limited to the African region of Guinea, Liberia, Sierra Leone, Nigeria and Senegal, where an isolated imported case has been reported. A separate Ebola outbreak has also been confirmed in a remote region in the Democratic Republic of Congo (DRC), which is not related to the outbreak in West Africa. Our current assessment is that the risk of Ebola spreading to Singapore is low due to the limited travel connectivity between Singapore and Africa.  Prior to the Ebola outbreak, the number of travellers from these countries arriving in Singapore is small, with an average of about 30 travellers a month collectively from Guinea, Liberia and Sierra Leone and between 200 to 300 travellers a month from Nigeria. Since WHO declared the Ebola outbreak in West Africa as a Public Health Emergency of International Concern on 8 August 2014, many airlines have stopped flying to Guinea, Liberia, Sierra Leone, the three countries with widespread active community transmission. The numbers of travellers from these countries to Singapore are even fewer now.  In addition, transmission of Ebola requires direct contact with the blood and/or fluids of an infected person. It does not spread through the air like influenza. Nevertheless, while the risk is low, we cannot rule out the possibility of an imported case to Singapore.

2        Hence, we have put in place measures to reduce the risk of infection to Singaporeans who travel to or are residing in affected countries, ensure early detection of cases and prevent spread in the event that we have an imported case of Ebola in Singapore. 

Contingency Measures for Ebola Virus Disease

I. Measures to Minimise the Risk of Infection to Singaporeans Travelling to or Residing in Affected Countries

3        The Ministry of Health (MOH) has advised Singaporeans against non-essential travel to the affected countries in Africa. For those who need to travel there, we have advised them on the precautionary measures to take, such as frequent hand washing and avoiding direct contact with blood and secretions or other body fluids of dead persons or animals. This information is available on the MOH website. In addition, Health Advisory Posters are also displayed at our Changi Airport Departure Halls. We have also worked with the Ministry of Foreign Affairs and International Enterprise Singapore to disseminate this information through their networks. 

II. Measures to Ensure Early Detection

4        MOH has worked with the Civil Aviation Authority of Singapore (CAAS), Changi Airport Group (CAG), Maritime and Ports Authority (MPA) and the Immigration & Checkpoints Authority (ICA) to display health advisory posters at all air, land and sea checkpoints, and to distribute Health Advisory Notices (HANs) at our immigration counters to inbound nationals and travellers from Guinea, Liberia, Sierra Leone, and Nigeria. These passengers are advised to seek medical attention early if they develop symptoms within 21 days of arrival and to inform their doctor of their travel history. Contingency plans are in place at Changi Airport to manage passengers with signs of EVD. Such passengers will be isolated and transferred using a Portable Medical Isolation Unit (PMIU) to Tan Tock Seng Hospital (TTSH) for further management.  MOH will also extend these measures to Senegal and the DRC to ensure early detection of suspect cases.  

5        Healthcare workers are a key line of defence. Medical clinics and hospitals have been alerted, through professional circulars, to exercise vigilance and ensure early detection of possible suspect Ebola cases.  Laboratories have also been advised of the testing procedures for Ebola.

III. Measures to Prevent Spread in the Event of an Imported Case

6        Management of suspect Ebola cases will be centralised in Tan Tock Seng Hospital (TTSH), at a dedicated facility at the Communicable Diseases Centre 2 (CDC 2). All suspect cases will be triaged at the emergency departments, and as a precaution, isolated from other patients to minimise any risk of transmission. A case that has been admitted in another hospital will continue to be managed there to minimise risk of infection during transfer. All hospitals have put in place procedures for strict infection control measures when managing a suspect or confirmed case of Ebola. In the event of a confirmed case of Ebola in Singapore, MOH will carry out contact tracing and all close contacts of the confirmed case will be quarantined for 21 days from the time of last exposure.

IV. Medical Management

7        As there are no proven anti-viral drug treatments or vaccines yet available, a patient with Ebola will be given intensive supportive treatment. Healthcare workers attending to the patient will use appropriate Personal Protective Equipment (PPE) in addition to the strict infection control measures that have been put in place.

8        Our healthcare system will continue to remain alert and prepared to manage any potential outbreaks of infectious diseases in Singapore and our hospitals have dedicated response plans, which include plans to ramp-up resources and re-deploy staff to respond to disease outbreak situations. They have also carried out regular exercise to familiarise our healthcare workers with the contingency response plans.