Update On SARS - 23 Apr

23 Apr 2003

Situation Update

As at 23 April 2003, 58 SARS patients remain hospitalised. There are 3 additional SARS cases reported today.

The three additional cases are:

- a 28 year old female staff nurse from NUH who was a contact of the NUH SARS patient admitted to NUH on 8 April, transferred to TTSH on 9 April and died on 12 April,

- a 60 year old woman who is a friend of a probable SARS case, and

- a 68 year old woman; investigations are still underway to determine her source of infection.

There was one SARS death today. He was a 74-year old inpatient of SGH Ward 58.

Update on Pasir Panjang Wholesale Market (PPWM)

There are no new probable cases linked to the Pasir Panjang Wholesale Market. There are 14 suspected SARS cases linked to the market who have been admitted, comprising 8 persons with direct links to the market (1 worker, and 7 visitors) and 6 of their family members. Among the family members are 2 children aged 18 months and 10 years.

Update on Jurong Shipyard workers

A 47-year-old Malaysian who lived and worked in Singapore was admitted to Alexandra Hospital on 12 April 03 for pneumonia and later transferred to intensive care at TTSH where he died on 13 April 03. He had travelled to Pontian, Johore from 24 to 30 March 03 to attend his father's funeral and 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 03 as it was his day off. He did not return to work from 8 to 12 April 03 as he was unwell. Laboratory investigations have revealed that he had an infection of the blood caused by a bacterium, Streptococcus pneumoniae and post mortem samples of the lung, spleen, intestine and lymph nodes were negative for coronavirus. His death has been determined to be non-SARS related.

It was reported that another Malaysian Jurong Shipyard worker, who lived in Johore, was classified by the Malaysian health authorities as an imported SARS case from Singapore. His last day in Singapore was on 25 March 03, and his onset of illness was on 11 April 03. It is therefore unlikely that he was infected in Singapore as this would give an incubation period of 17 days.

Investigations have revealed that the two cases are not linked to each other.

Update on the admissions and discharges (SGH cluster)

The SGH cluster of infection in Ward 57 & 58 could be traced to the Chinese man in his 60s who was previously discharged from TTSH and re-admitted to SGH Ward 57 on 24 Mar and subsequently to Ward 58 on 29 Mar 03. On 5 April 03, a cohort of staff from Ward 57 & 58 were noted to have low-grade fever. As part of the isolate and contain strategy, the decision was made to transfer all inpatients from Wards 57 and 58 to TTSH. At the same time, a team consisting of doctors from the Department of General Surgery, nurses and Allied Health workers moved over to TTSH to continue the care for these patients.

On 14 April 03, it was noted that 3 patients in a cubicle in Ward 74 had fever. As a precautionary measure, the decision was made to transfer all patients from Ward 74 to TTSH. Again doctors and nurses accompanied the patients in the move. So far, none of the patients have become probable cases and the staff remained well. Since the transfer, no new cases have developed in SGH thus far.

A total of 166 healthcare workers, patients, visitors and contacts were admitted to TTSH as a result of the SGH cluster of infections. Of these, 52 are probable, 65 suspects, 45 are under observation. 4 patients are non-SARS.

88 of this cohort have been discharged, leaving 70 still warded. There were 8 deaths of whom 5 had multiple medical illnesses.

Health screening for incoming air and sea passengers

Between 4 pm yesterday and 4 pm today, there were 7 passenger that were screened and 4 were referred to TTSH for further observation. Between 4 pm yesterday and 4 pm today, there was 1 incoming passenger who required further screening by the nurses at the ferry terminals. The passenger was subsequently sent to TTSH for assessment.

Health screening for travellers at the land checkpoints

ICA has begun using thermal imaging cameras to screen incoming and outgoing travellers at the Woodlands and Tuas checkpoints from 8 am this morning. Between 8 am and 4 pm today, 20 passengers at the Woodlands Checkpoint and 4 passengers at the Tuas Checkpoint required further screening by nurses. None were referred to TTSH.

Financial assistance for self-employed workers and assistants at PPWC

The Government would be providing financial assistance for those self-employed and their assistants who worked at the PPWC. These people would be provided up to $700 during the 10-day home quarantine.

Summary of SARS cases

A summary of the SARS cases to date:

Discharged: 114

Hospitalised: 58 (including 18 in intensive care)

Deaths: 15 + 2 (pending further post mortem test results)

Total: 189

Suspected: 95 (including 5 children below 18)

Under home quarantine orders: 2467

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.