Update On SARS - 17 Apr

17 Apr 2003

Situation Update

As at 17 April 2003, 4 additional SAR patient has been discharged, bringing the total number of patients who have recovered from SARS to 95. 61 SARS patients remain hospitalised.

There are 4 additional SARS cases reported today. Two of them were linked to the SGH cluster. One of them is an inpatient of Ward 57 who had been transferred to TTSH for observation on 7 April, while the other is a visitor. The third case is a patient who was in the same ward as a SARS patient in NUH before this patient was diagnosed as SARS on 9 April 03. As a precaution the six other patients who were warded in the same cubicle as the SARS patient were transferred to isolation rooms in NUH for observation on 9 April 2003 The third case reported today is one of them. He developed fever on 14 April 2003 and was transferred to TTSH on the same day. As of today, the other five patients remain well.

The fourth case is a 53 year old Chinese man who developed fever, body aches and diarrhoea on the evening of 9 April 03 when he was home. He works as a taxi driver. On 10 April 03, he consulted a GP after working from 6 am to 9 am. He remained at home for the rest of that day and the next. On 12 April 03, he consulted a GP again. As he was still unwell, he was admitted to TTSH that afternoon. Apart from the 3 hours on 10 April 03, he did not work on 11 and 12 April 03. On 14 April 03, his chest x-ray showed changes and he was diagnosed as atypical pneumonia. He was not classified as SARS as there was no history of contact. However, as a precaution, home quarantine orders where issued to 10 of his close contacts. So far they are all well except for his 54 years old wife who was admitted on 15 April for fever. Today, laboratory samples taken from the patient were positive for coronavirus. In view of this finding, he has been classified as a probable SARS case and his wife as a suspect SARS. They are both in stable condition. He gives a history of ferrying passengers to hospitals. He does not ply the airport route. Investigations to determine the source of infection are still on going.

Update on Jurong Shipyard

A 47 year old Malaysian who lived and worked in Singapore travelled to Pontian, Johore from 24 to 30 March 03 to attend his father's funeral. He returned to Singapore on 31 March 03. He was a welder in Jurong Shipyard and returned to work from 1 to 7 April 03, excluding 2 April as it was his day off. On 8 April 03 he stayed at home and did not work as he was feeling unwell. He consulted a GP on 9 April for fever, cough and breathlessness. He did not return to work from 8 to 12 April 03. He was admitted to Alexandra Hospital on 12 April 03. On admission his chext x-ray showed evidence of pnuemonia. As his condition was serious, he was intubated and later transferred on the same day to TTSH Intensive Care. He died on 13 April 03. As a precautionary measure, home quarantine orders were served to 13 of his contacts.

Laboratory investigations have revealed that he had an infection of the blood caused by a bacteria, Streptococcus pneumoniae. So far, post mortem samples of the lung, spleen, intestine and lymph nodes are negative for coronavirus. Further post-mortem test results are still pending.

Deceased child

So far, the preliminary laboratory investigations for the child who died of acute respiratory distress syndrome at KKH on 15 April 03 are negative for coronavirus. Further post-mortem test results are still pending.

Additional Measures in SGH campus

Additional measures have been implemented in SGH campus. Any existing inpatients in SGH who develop fever and/or respiratory symptoms, and those on steroids and other immunosuppressive therapies are being isolated.

As a precautionary measure, SGH will only discharge patients when they are free of fever for 72 hours. From today, patients who have chronic co-morbid conditions, such as chronic lung conditions, diabetes, heart failure, chronic liver or kidney disease, chronic rheumatological or autoimmune disorders, malignancies, or those who are on immunosuppressive drugs such as steroids, will be placed on home quarantine orders (HQO) for 10 days. They are required to monitor their temperature twice a day and if they have fever or are unwell, they have been asked to call the hotline provided immediately. During this period, these patients will be called daily to ensure that they are well. Should they be unwell, they would be re-called to SGH for evaluation. These patients are instructed not to use the public transport but to call MOH (9-178-8477 or 9-178-8478) for dedicated ambulance service.

For other patients discharged from SGH who do not have any concomittant chronic diseases, they can go home if certified fit for discharge by their doctors. SGH will however maintain telephone surveillance on them for 2 weeks.

With effect from tomorrow, SGH campus institutions will restrict visitors to 1 per patient per day. Apart from temperature screening and recording of their particulars, visitors would be provided with surgical masks and advised to avoid contact with other patients and their things. This same arrangement will also be applied to other public hospitals as well.

Health screening for incoming air and sea passengers

Between 4 pm yesterday to 4 pm today, there were 15 passengers from affected areas who required further screening by the nurses at the airport. A male passenger from Guangdong was admitted for observation at TTSH. Between 4 pm yesterday to 4 pm today, there were no passengers who required further screening by the nurses at the ferry terminals.

Summary of SARS cases

Below is the summary of the SARS cases to date:

Discharged: 95

Hospitalised: 61 (including 17 in intensive care)

Deaths: 13 + 2 (pending post mortem findings)

Total: 171

Suspected: 80 (including 8 children below 18)

Under home quarantine orders: 467

Updated Travel advisory

MOH urges the public to heed World Health Organisation (WHO)'s advice to postpone travel to Hong Kong and Guangdong until another time. We would also like to advise the public to avoid travel to other SARS affected areas - Beijing, Shanxi, Hanoi and Toronto, unless absolutely necessary.