Lifting of Home Quarantine Order (HQO) on recent travellers to Mexico

16 May 2009

Since 4 May 09, all persons with a travel history to Mexico over the past seven days were issued a home quarantine order (HQO), which required them to be quarantined for seven days when they enter Singapore. This precautionary measure was implemented to limit the risk of the H1N1 virus entering Singapore.

Review of Current Situation

2 We have reviewed the imposition of the HQO in light of new information on the Influenza A (H1N1) outbreak situation.

3 Based on the latest case numbers reported by the Mexican health authorities, i.e. 64 deaths out of 2,656 confirmed cases (as of 14 May 09), the case fatality rate (CFR) was 2.4%   This is high.  However, an authoritative study from the WHO Rapid Pandemic Assessment Collaboration published in “Science” (a leading scientific journal) on 11 May 09 suggests that the estimated CFR is lower, at 0.4% (with a range of 0.3% to 1.5%).   The study felt that the apparently high reported CFR was due to large number of undiagnosed and hence unreported infected cases.  At 0.4%, the Mexican CFR would be closer to the CFR as reported elsewhere. 

4 Further more, the outbreak in Mexico appears to be cooling off with a fall in the number of new confirmed cases. The number of exported cases from Mexico has also fallen significantly.

5 Based on the above review, HQO for travellers to Singapore with a recent Mexican travel history will be lifted with effect from 16 May 09.

Other Containment Measures Remain 

(I) Contact tracing and HQO for close contacts of confirmed cases

6 Notwithstanding the above, MOH has a contact tracing system in place, and under the Infectious Diseases Act, HQO will still be issued to any person who is a known or suspected close contact of a probable or confirmed case of Influenza A (H1N1-2009).

(II) Active border screening to facilitate early detection and management

7 We will continue with temperature screening for passengers entering Singapore at all checkpoints (land, sea and air).  All passengers passing through or entering Singapore are given Health Alert Notices on board their flights, advising them to monitor their own health if they have been to affected areas and to seek medical attention immediately if they are not well. 

8 In addition, travellers entering Singapore from affected areas who have fever and/or respiratory symptoms will also be asked to identify themselves so that they can be further screened for H1N1. These measures will help us to screen and pick up any suspected cases early and enable prompt containment and medical management if necessary.  

MINISTRY OF HEALTH