Risk of Community Spread Rises Significantly in Singapore with Recent Confirmed Cases of Influenza A (H1N1-2009)

16 Jun 2009

Singapore has confirmed two more cases of Influenza A (H1N1-2009), bringing the total number of confirmed cases here to 49. Unlike the earlier imported cases, a number of the recent imported cases have engaged in extensive community activities such as working, shopping and participating in mass activities since their arrival here.  Some have even travelled to Singapore even though they were already unwell prior to departure. This is contrary to MOH's advice that travellers who have been to countries that have been considered by WHO to have sustained community transmission or to be in transition towards community transmission, as well as countries that have been reported to have exported cases (ie. Argentina, Australia, Canada, Chile, Dominican Republic, Japan, Mexico, Panama, Philippines, Spain, Thailand, United Kingdom, United States of America) should immediately call 993 for medical assistance if they feel unwell within seven days of arrival. The WHO has also consistently advised against travel if one is unwell. Such behaviour has considerably increased the difficulty of contact tracing and significantly heightened the risk of community spread here in Singapore.

Details of Confirmed Cases

2. The breakdown of the 49 cases is as follows:

Country of Origin of Travel of Confirmed Cases (as of 16th June 2009)

3. So far, 22 patients have been discharged.  The remaining 27 patients (21st - 28th, 30th - 32nd, 34th - 49th cases) are still in the hospital and their conditions remain stable. 

48th Confirmed Case

4. The 48th case is a 56-year-old German man who works in Singapore as a researcher at Biopolis. He went to Philadelphia, USA on 28 May to attend a conference.  He developed symptoms on 4 June while he was there.  He returned to Singapore on SQ15 via Seoul at 0100 hours on 8 June. He was seated at row 52. He was not picked up by the thermal scanner at the airport as he did not have a fever then.  He took a taxi home from the airport, and stayed at home for the rest of the day.  He went to work from 9 to 12 June. On 11 June evening, he went to a function at the French Ambassador's Residence attended by about 70 persons.  On 13 June, he went to a shopping mall and had social activities at Clarke Quay. On 14 June, he attended a concert and did more shopping. On 15 June, he did not go to work in the morning and called a 993 ambulance to send him to CDC2 around noon time. Laboratory results confirmed his infection at 2140 hours on 15 June.

49th Confirmed Case

5. The 49th case is a 26-year-old Indonesian man who works in Singapore.  He went to Melbourne with friends for a holiday on 5 June.  He developed symptoms on 11 June while he was there. He returned to Singapore together with his companions on SQ228 at 2133 hours on 14 June. He was seated at row 61, and was on the same flight as the 43rd, 44th and 45th cases who were seated at row 43. He was not picked up by the thermal scanner at the airport as he did not have a fever then.  He and his friend took a taxi home from the airport. On 15 June morning, he sought medical attention at a GP clinic, and was given 2 days of medical leave.  Before he took a taxi to TTSH ED, he did some shopping first. Laboratory results confirmed his infection at 2140 hours on 15 June.

Contact Tracing 

6. Contact tracing is ongoing for the two cases. Passengers seated within rows rows 59-63 on SQ228 on 14 June who have not been contacted by MOH yet should call the MOH hotline at 1800-333 9999 to enable us to check on their health condition expeditiously. All close contacts identified will be quarantined and provided with antiviral prophylaxis. No contact tracing will be done for the close contacts on SQ15 on 8 June as the seven day quarantine period from the last day of contact with the 48th case has passed.

MOH Advisory to all travellers

7. For people who are planning to travel, they should check the MOH website for the latest update on the list of countries with confirmed cases of H1N1 (refer to Annex) so that they can make considered decisions on whether to proceed with their travel plans.  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