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18 Apr 2003
Situation Update
As at 18 April 2003, 2 additional SARS patients have been discharged, bringing the total number of patients who have recovered from SARS to 97. 59 SARS patients remain hospitalised.
There is 1 additional SARS case reported today. She is the wife of a probable SARS case who had been previously admitted to TTSH as a suspect case. Her husband had visited the Radiology Department at SGH on 1 Apr 03 and later developed clinical signs consistent with SARS.
Situation Update at SGH
So far, 62 persons are linked to the SGH cluster, comprising 25 SGH staff, 20 inpatients and 17 contacts. 48 are probable cases.
Precautionary measures for SGH Ward 74
SGH had moved all patients who had been through Wards 57 & 58, to TTSH on 6 & 7 April. A patient who was previously in Ward 57 between 26 -28 March, and subsequently transferred to Ward 74 between 28 March - 6 April for neurological management, was also transferred to TTSH on 7 April. In view of this, Ward 74 was placed on close surveillance. On 9 and 10 April, 3 nurses from Ward 74 B2 station (Neurology ward) were noted to have low-grade fever (37.6 degree C). They were given medical leave. Two of them were admitted to our Isolation Ward for observation. All three of them became afebrile after 1 day and were sent home with further medical leave.
On 14 April, one of the medical officers in the Neurology unit also reported sick with a low-grade fever for a day. He was put on medical leave
On 14 April, SGH noted that there were 3 patients in one cubicle in Ward 74 who had fever. However, these were patients had been having fever intermittently for some time, in part due to the nature of their underlying illnesses. As a precaution, we transferred all 6 patients in that cubicle to our Isolation Ward on the same day (14 April). One of these 3 patients was admitted on 27 March with a fever. He was diagnosed with pneumonia on 29 March, treated with antibiotics and improved. However, on 17 April, he became chesty and breathless. On 17 April evening, as a further precaution, a decision was made to transfer all 3 patients to TTSH. They have been classified as Suspect cases.
As a further precaution, the three Ward 74 nurses have also been recalled to be re-evaluated in TTSH today.
SGH will also move all 55 patients of Ward 74 to TTSH starting tonight (17 April). The neurologists at TTSH, who are part of the NNI, will look after these patients. As such, the clinical management of these patients will not be disrupted. Two neurologists have been assigned to handle communication issues with the patients' relatives. One will be stationed at SGH and the other at TTSH to update patients' relatives on the transfer of patients and the management of their medical condition at TTSH. This is to ensure a smooth transfer of patients to TTSH.
SGH's clinical departments have started working on a modular system since 10 April. Each team is mapped to a fixed location (such as a part of a ward, or an outpatient clinic). With this mapping of persons to place, the risk of exposure is reduced. As such, SGH's neurology outpatient service can still continue to function while the inpatient neurology doctors are put on Hospital Enforced Quarantine. Two of the neurologists from the outpatient service team will now be deployed to cover the inpatient area.
As a precaution measure, some 100 staff from this latest development in Ward 74 will be put on Hospital Enforced Quarantine.
Active contact tracing of patients, visitors and staff of Ward 74 is in progress. Visitors to Ward 74 during the period 26 March to date should monitor their temperature. If they have any concerns, they can call Tel: 62223322 for a free health check at SGH Staff Clinic.
These strong precautionary measures are in line with SGH's intention to do everything possible to deal with the SARS outbreak.
Update on Departments of Urology, Radiology and General Surgery
SGH's Urology Department and Department of Radiology's Barium Investigation and Radiology Archive services will reopen for service tomorrow, 19 April. The Department of General Surgery will also reopen for service on Monday, 21 April.
Added Precautions in Public Hospitals
Starting from today, all public hospitals will restrict visitors to 1 per patient per day. This is an added precaution to reduce the risk of the virus spread.
Health screening for incoming air and sea passengers
Between 4 pm yesterday to 4 pm today, there were no passengers from affected areas who required further screening by the nurses at the airport or the ferry terminals.
Summary of SARS cases
A summary of the SARS cases to date:
There was one additional death today bringing the total deaths to 16 (of which 2 are pending further post mortem test results). This was the NUH inpatient who was in contact with a previous NUH SARS case.
Discharged: 97
Hospitalised: 59 (including 17 in intensive care)
Deaths: 14 + 2 (pending further post mortem test results)
Total: 172
Suspected: 80 (including 5 children below 18)
Under home quarantine orders: 444
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.