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Situation Update
Today, 2 more patients have been discharged, bringing the total number of patients who have recovered from SARS to 149. 28 patients remained hospitalised, of whom 13 are in intensive care.
There is 1 new probable case reported today who had her onset of illness on 22 April. She is a 74-year old woman who was admitted to the same ward in NUH as the 64-year old vegetable seller who was admitted to NUH on 8 April 03, transferred to TTSH on 9 April 03 and died on 12 April 03. The 74-year old woman was admitted to NUH on 1 April 03. She had multiple chronic medical problems and developed a fever on 22 April 03. She was subsequently transferred to TTSH. She developed lung changes on chest-ray and her clinical samples tested positive for coronavirus.
The latest date of onset of a probable case is on 27 April 03. So far, there have been no cases reported with dates of onset later than 27 April 03.
There is 1 death today from SARS. He was the 27-year old son of the 64- year old vegetable seller who died on 12 April 03. He became unwell on 8 April 03 and was admitted to TTSH on 10 April 03. He has been in serious condition in intensive care since 20 April 03.
A previously unlinked SARS case now linked to the SGH cluster
We have established the source of infection for a case that was previously unlinked. This case is a 52 year old lady who was earlier reported on 19 April 03. Investigations have revealed that she had come into contact with a 63 year old female porter belonging to the SGH Ward 57/58 cluster of infections, who subsequently was diagnosed to have probable SARS on 14 April 03. It is believed that the porter was unwell at the time she met the 52 year old lady. The 52 year old lady had not previously been identified as a contact of the porter.
Changes to the case-definition for SARS
The World Health Organisation has on 1 May 03 revised the case definitions for the global surveillance of SARS. Cases of suspect and probable SARS will continue to be based on the clinical features and epidemiological data (history of travel to a SARS-affected area or close contact with a SARS patient in the preceding 10 days) but will now be supplemented by laboratory tests for the SARS coronavirus. WHO has noted that at present, there is no validated, widely and consistently available test for infection with the SARS coronavirus. However, definition of a probable case would now include a suspect case of SARS that has positive laboratory tests for SARS coronavirus, under conditions drawn up by WHO.
The Ministry will from today, adopt the new WHO case definitions for suspect and probable SARS. In patients where the initial clinical presentation and contact history is not sufficient to classify a patient as a suspect or probable case, such cases will be listed under a new category "observation for SARS", until the evolution of the clinical picture and the results of laboratory investigations clarify their status. As these may take several days, contact tracing and the issuance of home quarantine orders, where necessary, will continue to be carried out for such cases.
Survival of SARS Virus
The laboratory findings on the survival of SARS virus reported by WHO are on experiments performed using specimens from SARS patients. The experiments indicated for how long the SARS virus can survive in various places and under different conditions. However, the dose of virus necessary for transmission and the significance of these findings in relation to the infectiousness of the disease have not been established. WHO has also emphasized that the primary mode of transmission is through droplets that spray out when an infected person sneezes or cough, and through close contact. To date, this remains the main mode of transmission in Singapore. Hence, it is important that all of us observe good hygiene practices such as covering our mouths and nose with tissue paper when we cough or sneeze, and washing our hands frequently.
New Suspect Patients
There are 4 patients who were admitted as new suspect cases today. Of these, 3 had a history of travelling to a SARS-affected area and 1 is a family contact of a probable case.
Quarantine Figures*
#Discharged patients under home quarantine: 584
Contacts under home quarantine: 368
Total under home quarantine orders: 952
*Quarantine cases refer to those who are required to stay at home for precautionary reasons as they may have had contact with a SARS patient. These are healthy individuals.
# This is an added precautionary measure for discharged SARS patients as well as those with co-morbidities.
Summary of SARS cases
A summary of the SARS cases to date:
Discharged: 149
Hospitalised: 28 (including 13 in intensive care)
Deaths: 27*
Total No. of Probable Cases: 204
Total No. of Suspect Cases: 12
*includes 1 who died from non-SARS cause
Telephone survey of frontline healthcare workers
As part of its programme to help ensure that frontline healthcare workers are prepared for SARS, MOH will be conducting a telephone survey of all GP clinics, specialist clinics, dental clinics, as well as TCM clinics . The aim of the telephone survey is to assess the level of knowledge on infection control measures in these clinics. The survey will be starting tomorrow, Tue 6 May.
Travel advisory
MOH urges the public to heed the World Health Organisation (WHO)'s advice to postpone travel to Hong Kong, Guangdong, Beijing and Shanxi until another time. We would also like to advise the public to avoid travel to other SARS affected areas - Taiwan, Toronto and Mongolia, unless absolutely necessary.