Influenza- Monthly Update- Dec 2003 2003

04 Dec 2003

Influenza in temperate countries

In recent weeks, temperate countries in the Northern hemisphere (e.g. the United States of America, the United Kingdom, Spain, France and Belgium) have reported increased influenza activity.

The most common strain of influenza virus isolated in Europe and the United States is the influenza A Fujian variant.

Situation in Singapore

The average weekly attendances of acute respiratory infections at the polyclinics in October 2003 were about 16% more than that in September 2003. The attendances in November 2003 decreased by about 10% compared to the month before. The circulating influenza virus strain in Singapore is the Influenza A Moscow strain. The Fujian strain has to date not been isolated in Singapore. MOH will continue to monitor the situation closely.

Ministry's Advice

The Ministry of Health would like to advise travelers, both adults and children 6 months and older, going to temperate countries in the Northern Hemisphere to protect themselves against the disease with influenza vaccination. The vaccination should be taken at least 1 to 2 weeks prior to departure as it takes time for the vaccination to take effect. (Children younger than 9 years old will require 2 vaccinations about 4 weeks apart; the second vaccination should be taken at least 1 week prior to departure.) Influenza vaccination is available at the travel clinics in Tan Tock Seng Hospital, National University Hospital, Kandang Kerbau Women's and Children's Hospital and Changi General Hospital, polyclinics and General Practitioners.

The current influenza vaccine composition will give good protection against the Moscow strain. It may not fully protect against the Fujian strain, but will offer some protection. Immunized persons may still come down with some symptoms if they are exposed and infected by the Fujian strain, but the severity and duration of the disease will be lessened.

Persons who are at higher risk of developing complications from influenza are also advised to get themselves vaccinated against influenza. A list of persons who may be at higher risk of developing complications from influenza is listed as Annex A. The public should consult their family doctor for further advice on influenza vaccination.

To avoid catching influenza, members of the public, particularly children and the elderly, are advised to avoid visiting crowded places. People can combat influenza by building up their body resistance by having a proper diet with adequate exercise and rest. People who develop influenza-like symptoms should consult their family doctors promptly. Strenuous physical activities like running and jogging should be avoided during the illness until complete recovery.

Persons who develop symptoms of acute respiratory infection are advised not to go to work or school and avoid crowded places to minimize the transmission of the infection to others. They should seek medical attention promptly.

Ministry of Health

4 Dec 2003

RISK FACTORS FOR COMPLICATIONS FROM INFLUENZA INFECTION*

1. Persons aged 65 years and older;

2. Residents of nursing homes and other chronic care facilities;

3. Adults and children who have chronic disorders of the lungs or heart, including asthma;

4. Adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes mellitus), kidney or blood disorders, or lowered immunity caused by medications or by the Human Immunodeficiency Virus (HIV);

5. Children and teenagers aged 6 months to 18 years who are receiving long-term aspirin therapy;

6. Women who are in the second or third trimester of pregnancy.

* Adapted from recommendations made by the US CDC Advisory Committee on Immunization Practices