Update on Influenza A (H1N1-2009) (10 May)

10 May 2009

 Singapore’s Disease Outbreak Response System Alert (DORSCON) status will fully step down from Orange to Yellow on 11 May 2009. The new strain of Influenza A (H1N1 2009) seems milder than originally feared. Though information from Mexico suggests a declining trend, the global situation is still evolving with more cases reported in several countries including in Asia. We need to constantly review and adjust our responses, and be prepared to deal with changing threat. It is critical that we continue to maintain our alertness and surveillance, especially with the coming Southern Hemisphere winter and flu season.

2 While Singapore currently has no cases of Influenza A (H1N1 2009), the virus has proven to be highly contagious. While we have shored up our defences in terms of temperature screening at air, land and sea check points and infection control measures at healthcare institutions, we can expect the virus to eventually affect Singapore as well. 

3 Singaporeans are thus reminded to maintain high standards of personal hygiene. This means covering your nose and mouth with a tissue when you sneeze or cough, and washing your hand frequently with soap and water, especially after contact with respiratory secretions (e.g., after sneezing and coughing). We also need the cooperation of everyone to be socially responsible. This means staying home and avoiding crowded places (including trains, buses, offices), putting on a surgical mask and seeing a doctor if you have flu symptoms. MOH advises those who travelled to affected areas to closely monitor their health and seek treatment as soon as possible should they develop symptoms. 

DORSCON Yellow

4 In Alert Yellow, stringent border controls will still be maintained, with temperature screening at air, land and sea checkpoints. Home Quarantine Orders (HQO) will still apply to persons with a travel history to Mexico in the past seven days.  The aim is to delay the entry of the virus into Singapore for as long as possible.

5 As border controls can’t detect all cases, in particular those that are incubating the disease, healthcare institutions will continue to observe strict infection control measures as they are likely to be among the first point of contact of those who are ill and also in view of the more vulnerable population in healthcare institutions (eg patients who are immuno-compromised, or with multiple co-morbidities). We seek the public’s understanding on the need for temperature screening of all visitors at healthcare institutions and the restriction of hospital visitors to 2 per patient at any one time.  On 11 May 2009, the zoning of transfers of patients from hospitals to nursing homes will be lifted. On 14 May, medical officers and registrars will take up their new clinical postings which were earlier deferred.

Situational Update of Cases

6 According to the World Health Organisation, 29 countries have officially reported 4379 cases of influenza A (H1N1-2009) infection. In Singapore, there are still no human cases of Influenza A (H1N1-2009). However, the World Health Organization (WHO) has cautioned nations not to let their guard down as there may be a second more severe wave of infection.

7 As of 10 May 2009, there have been 1626 confirmed cases of Influenza A (H1N1-2009) reported in Mexico (with 45 deaths), 2254 in the United States (with 2 deaths), 280 in Canada (with 1 death), 8 in Costa Rica (with 1 death), 93 in Spain, 39 in United Kingdom, 11 in Germany, 7 in New Zealand, 1 in Australia, 7 in Israel, 1 in Austria, 3 in the Netherlands, 1 in Denmark, 1 in Sweden, 1 in Portugal, 1 in Poland, 2 in El Salvador, 1 in Switzerland, 12 in France, 1 in Ireland, 9 in Italy, 3 in Panama, 1 in Columbia, 1 in Guatemala, 6 in Brazil, 1 in Argentina, 1 in Hong Kong, 3 in the Republic of Korea, and 4 in Japan.

8 Since 8 May 2009, we had 1 additional case for investigation. Of the 33 cases investigated thus far, 26 cases have tested negative for Influenza A, 6 tested positive for the usual circulating seasonal flu strains, and 1 is pending laboratory investigations.

Home Quarantine Order (HQO)

9 Since 4 May 2009, a total of 15 HQOs have been issued. To date, 7 were issued to foreign residents while 8 were issued to Singaporeans. 10 have successfully completed the HQO. The remaining 5 include 3 foreign residents and 2 Singaporeans.

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Advice from MOH

10 Members of the public are advised to exercise caution over travel to 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. However, if you are unwell with fever and cough but have no travel history to affected areas, please see a doctor and stay at home.

11 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

10 May 2009