Update on Influenza A (H1N1-2009) (6 May)

06 May 2009

 Our Disease Outbreak Response System Alert (DORSCON) status is currently at Orange. However, we are preparing for a progressive step-down of the alert status to Yellow. The new strain of Influenza A (H1N1 2009) seems milder than originally feared and appears to be more like seasonal flu. However as the situation is still evolving, we would need to constantly review and adjust our responses, and be prepared to deal with changing threat.

Transition to DORSCON Yellow

2 If the situation maintains status quo, we will progressively transit to DORSCON Yellow by Monday, 11 May 2009.

3 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. However, we can lift temperature screening requirements and screening for flu-like symptoms and travel history at work places, schools, buildings and events. At healthcare institutions, the current tighter restrictions will continue to be in place for the time being, especially in high risk areas such as A & E and ICU. Please refer to Annexs on the specific measures under Orange, transition period and Yellow.

4  Meanwhile, Singaporeans are reminded to maintain high standards of personal hygiene. This means covering your nose and mouth with a tissue when you sneeze or cough, and wash 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 avoid crowded places (including trains, buses, offices) when you are unwell and put on a  surgical mask and see a doctor if you have flu symptoms.

Situational Update of Cases

5 As of 6 May 09, 21 countries have officially reported a total of 1,490 cases of influenza A (H1N1-2009) infection. In Singapore, there are still no human cases of Influenza A (H1N1-2009). The World Health Organization (WHO) has cautioned nations not to let our guard down as there may be a second more severe wave of infection.

6 As of 6 May 2009, there have been 822 confirmed cases of Influenza A (H1N1-2009) reported in Mexico (with 29 deaths), 403 in the United States (with 2 deaths), 140 in Canada, 57 in Spain, 27 in United Kingdom, 9 in Germany, 6 in New Zealand, 4 in Israel, 1 in Austria, 1 in the Netherlands, 1 in Denmark, 1 in Portugal, 2 in El Salvador, 1 in Switzerland, 4 in France, 1 in Ireland, 5 in Italy, 1 in Costa Rica, 1 in Columbia, 1 in Hong Kong and 2 in the Republic of Korea. The second case in Korea had no travel history to Mexico (but had close contact with the first case in Korea who had travelled to Mexico), making this the first case of reported human-to-human transmission in Asia.

7 In Singapore, we had no additional case for investigations today (as of 1400hrs). Of the 29 cases investigated thus far, 25 cases have tested negative for Influenza A, and 4 tested positive for the usual circulating seasonal flu strains.

Home Quarantine Order (HQO)

8   As at 1400 hrs on 6 May, a total of 12 HQOs have been issued. 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. To date, 6 were issued to foreign residents and 6 were issued to Singaporeans. 2 foreign residents will end their Home Quarantine Order at 2359h tonight.

9 While under HQO, the person must stay at home throughout the quarantine period, monitor their temperature twice daily and check for flu-like symptoms. They should minimise contact with other family members and practise good personal hygiene. 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.

10 Travellers who are returning from other areas with evidence of community transmission of Influenza A (H1N1-2009) (i.e., the US and Canada) should monitor their temperature daily and check themselves for symptoms of flu-like illness. They can continue with their normal routines if they are well. 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

Advice from MOH

11 Members of the public are strongly 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.

12 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

6 May 2009