The Ministry of Health (MOH) notes with concern the surge in the number of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) cases confirmed in South Korea and continued news of reported breaches in containment and quarantine measures there. As an additional precautionary measure for the early detection of MERS-CoV cases from the country, we will commence temperature screening at air checkpoints for passengers arriving from South Korea starting from today at 1900 hours. Health Advisories will also be distributed to travellers arriving by air from South Korea from today. [See “Factsheet” for more information].
2 Temperature screening at air checkpoints has been in place since 18 May 2014 for passengers arriving from the Middle East. Health Advisories are also distributed at our border checkpoints for travellers coming from and going to the Middle East.
3 Temperature screening may not pick up all imported cases due to the long incubation period (up to 14 days) of MERS-CoV, and the presence of mild and asymptomatic cases. Our hospitals and doctors therefore remain vigilant for cases with relevant travel history that may not have symptoms when arriving in Singapore, but have since developed symptoms when they consult the doctors. Such cases have not been known to transmit disease during the time when they have no symptoms.
4 All our hospitals stand ready to screen and isolate any suspect cases. Patients with clinical signs/symptoms of pneumonia or severe respiratory infection with breathlessness, and travel history to the Middle East and South Korea in the two weeks before onset, will be evaluated to exclude MERS-CoV infection. In addition, persons with a fever and respiratory illness of any severity who had visited a healthcare facility while travelling in the Middle East or South Korea will also be similarly evaluated.
5 To date, there is no case of MERS-CoV in Singapore but the possibility of an imported case here cannot be ruled out given today’s globalised travel patterns. However, even if there is an imported case, the risk of an outbreak in our community remains low as sustained human-to-human transmission of the virus has not been reported.
Health Advisory
6 The World Health Organization (WHO) does not recommend the application of any travel or trade restriction to areas affected by MERS-CoV. However, to reduce the risk of exposure to MERS-CoV, we advise Singaporeans and other residents travelling to affected areas to maintain their vigilance and adopt the following health precautions when overseas:
- Observe good personal hygiene at all times;
- Practise frequent hand washing (e.g. before handling food or eating, after going to toilet, or when hands are soiled);
- You may consider wearing a surgical mask in crowded places and avoid close contact with persons suffering from acute respiratory infections (e.g. someone who is coughing);
- Avoid contact with camels and other live farm or wild animals, including not visiting camel farms. If contact has been made, thoroughly wash hands with soap.
- Adopt good food safety and hygiene practices and avoid consuming unpasteurised milk, undercooked meats, raw fruits and vegetables (unless they have been peeled), or unsafe water.
- Avoid visiting healthcare institutions in the Middle East and South Korea, unless it is necessary to do so.
7 On their return from a MERS-CoV affected area, Singaporeans and other residents should monitor their health closely for two weeks. Singaporeans and other residents need not self-quarantine themselves upon their return if they have no symptoms of illness. However, they should wear a surgical mask and seek medical attention promptly if they become unwell with fever and cough and if they had recent travel history (within two weeks) to any areas reporting human cases of MERS-CoV. They should inform the doctor of the areas that they had travelled to. Truthful declaration of travel history is important. They may also be isolated for observation and further investigations, which may take up to 48 hours.
8 As the situation is evolving, MOH will provide updates should there be any further measures implemented according to our public health risk assessments. Singaporeans and other residents should refer to MOH’s webpage on MERS-CoV for the latest health advisory.
MINISTRY OF HEALTH
9 JUNE 2015
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FACTSHEET
Procedure for handling passengers with fever identified through temperature screening
Passengers with fever detected at the temperature screening stations will be referred to a designated area for further clinical assessment. A medical practitioner will then recheck the passenger’s temperature manually, ask about his/her travel history or any history of contact with a confirmed case of MERS-CoV, and look for evidence of lung infection or severe respiratory infection with breathlessness. These are the criteria for suspect cases of MERS-CoV.
2 If the passenger fulfils these criteria, he/she will be referred to Tan Tock Seng Hospital (or KK Women’s and Children’s Hospital in the case of children under 16 years of age) for further evaluation, testing and clinical follow up.
3 If the passenger does not fulfil the criteria for suspect cases of MERS-CoV, he/she will be given a surgical mask and health advisory, and will be placed on phone surveillance until his/her symptoms resolve. If his/her condition worsens while he/she is on phone surveillance, he/she will be advised to seek medical attention promptly.