6th and 7th Confirmed Cases of Influenza A (H1N1-2009)

Singapore has confirmed its 6th and 7th cases of Influenza A (H1N1-2009). Both of them have relatively mild symptoms and are in stable condition.

2 The 6th case is a 36-year-old Singaporean male who was in Manila on a business trip from 18 - 29 May. He returned to Singapore from Manila on Friday 29 May on Singapore Airlines SQ917 at 1750 hours. He was seated at row 17.  He went home by taxi and remained home for the rest of the day. On 30 May, he went out briefly in the morning and returned home in the afternoon. He developed symptoms in the evening, and stayed home the whole of the next day. On 1 Jun morning, he called a 993 ambulance to take him to TTSH for further assessment. Laboratory results confirmed his infection at 1440 hours on 1 June and he was admitted to CDC.
 
3 The 7th case is a 30-year-old Australian male tourist who had travelled to Chicago from 14 - 21 May, Detroit from 21 - 25 May, and New York from 25 - 30 May.  He developed symptoms on 26 May while he was in New York.  He arrived in Singapore from New York via Frankfurt on SQ25 at 0618 hours on 1 June. He was seated at row 54.  He went straight to Raffles Medical Group clinic at Changi Airport transit area upon arrival, and was sent to TTSH via a 993 ambulance. He was admitted to CDC for further assessment in the late morning. Laboratory results confirmed his infection at 1645 hours on 1 June.

4 MOH is currently reviewing the 6th case. It appears that he was well during the flight which was more than 24 hours before onset of his symptoms. He has informed MOH that a passenger who was seated next to him appeared unwell and was coughing during the flight. MOH is trying to identify the ill passenger to assess his health condition. Contact tracing has been initiated for the close local contacts of the 6th case who will be quarantined and provided with antiviral prophylaxis.

5 MOH has initiated contact tracing of the close contacts of the 7th case. They will be quarantined and provided with antiviral prophylaxis. Based on MOH’s risk assessment, passengers within rows 52 to 56 on SQ25 on 1 Jun who have not been contacted by MOH yet should call the MOH hotline at 1800-333 9999 to enable us to check on their health condition expeditiously. 

National Scientific Committee on Influenza A (H1N1-2009)

6 MOH has formed a National Scientific Committee on Influenza A (H1N1-2009) to review and make recommendations on refining our strategy and control measures to handle the Influenza A (H1N1-2009) situation in Singapore. Chaired by Prof K Satku, Director of Medical Services of MOH, the Committee will undertake a detailed study of local cases, and make recommendations on treatment guidelines.  The Committee will also conduct genomic analysis of the virus and comparison with international data and undertake serial tracking of the virus over time – to look for mutations and assess the potential impact of mutations on clinical disease.

7 These will help to establish scientifically if indeed the virus here remains mild, not unlike seasonal flu in terms of public health impact. We could then adapt our containment measures, which currently involve active contact tracing and hospitalisation of each and every case, to focus on treatment of the at-risk groups and seriously ill cases instead. 

8 The Terms of Reference for the Committee are as follows:

i.  To review the evidence on clinical, scientific and public health aspects of  Influenza A (H1N1-2009) and make recommendations on measures to be  taken to manage this outbreak.

ii.  To propose and review clinical, scientific and public health research studies  on Influenza A (H1N1-2009) for the purposes of controlling the outbreak.

iii.  To provide inputs on any other matters related to Influenza A (H1N1-2009) as  requested by MOH.

9 The Committee consists of the following members:

Clinical:
i) Prof Chee Yam Cheng, Assistant CEO (Clinical), National Healthcare  Group
ii) A/Prof Leo Yee Sin, Clinical Director, Communicable Disease Centre,  Tan Tock Seng Hospital
iii) Dr Lim Poh Lian, Senior Infectious Diseases Consultant, Tan Tock Seng  Hospital

Scientific:
i) Prof John Wong, Dean, NUS Yong Loo Lin School of Medicine, National   University Health System
ii) Prof Edison Liu, Executive Director, Genome Institute of Singapore
iii) A/Prof Raymond Lin, Head, National Public Health Laboratory, MOH
iv) A/Prof Vincent Chow, Department of Microbiology, NUS Yong Loo Lin School  of Medicine, National University Health System

Public Health:
i) A/Prof Chew Suok Kai, Deputy Director of Medical Services, MOH
ii) Dr Lyn James, Director, Communicable Diseases Division, MOH
iii) Dr Derrick Heng, Director, Epidemiology and Disease Control Division,  MOH

10 MOH is monitoring the situation closely and will update the public on 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