MOH’s response to WHO's declaration of PHEIC

1. The Ministry of Health (MOH) notes that the World Health Organisation’s (WHO) Emergency Committee regarding Ebola Virus Disease (EVD) has ascertained that the Ebola outbreak in West Africa constitutes a Public Health Emergency of International Concern (PHEIC).

2. The WHO also recommends that countries put in place measures, which includes the following:

a. There should be no general ban on international travel or trade; restrictions outlined in these recommendations regarding the travel of EVD cases and contacts should be implemented.

b. States should provide travellers to EVD affected and at-risk areas with relevant information on risks, measures to minimise those risks, and advice for managing a potential exposure.

c. States should be prepared to detect, investigate, and manage Ebola cases; this should include assured access to a qualified diagnostic laboratory for EVD and, where appropriate, the capacity to manage travellers originating from known Ebola-infected areas who arrive at international airports or major land crossing points with unexplained febrile illness.

d. The general public should be provided with accurate and relevant information on the Ebola outbreak and measures to reduce the risk of exposure.

3. These measures are already in place in Singapore, as part of our preparedness plan against EVD.

Raising the awareness and knowledge of travellers about the potential risk of EVD

4. Information on EVD has been provided to the public and potential travellers on MOH’s website, and in its media release issued on 7 Aug. Singaporeans have been advised to avoid non-essential travel to affected areas. Instructions have also been provided on precautions to take if there is a need to travel to affected areas.

Raising the awareness and knowledge of health care providers about the infection

5. All medical practitioners and hospitals have been alerted, through professional circulars, to the EVD situation in West Africa. They are advised to remain vigilant to pick up cases of EVD early amongst patients with compatible symptoms and a travel history to affected areas. MOH has also provided guidance on the criteria for defining suspect EVD cases, and on how to notify MOH of such cases.

Prepare health system response

6. All public hospitals have put in place infection control procedures in the event of an imported EVD case. Processes have also been put in place to send samples for EVD testing at the National Public Health Laboratory’s designated testing facilities. The management of suspect cases of EVD will be centralised in Tan Tock Seng Hospital (TTSH). Suspect cases who are seriously ill will be transported in specially configured ambulances, and all suspect cases will be managed in negative pressure isolation rooms with strict infection control procedures.

7. Contingency plans are also in place at Changi Airport to manage passengers with signs of EVD. Such passengers will be isolated and transferred using a Portable Medical Isolation Unit (PMIU) to TTSH for further management.

Measures beyond WHO recommendations

8. In addition, MOH has taken the following additional precautionary measures in our preparedness against EVD:

a. Border Health measures

b. Contact tracing and Quarantine

Border Health measures

9. MOH has worked with Civil Aviation Authority of Singapore (CAAS), Immigration & Checkpoints Authority (ICA) and Changi Airport Group (CAG) on border health measures. Individual Health Advisory Notices (HANs) have been distributed to nationals from the affected areas at air and land checkpoints, starting from 2pm on 7 August 2014.

10. The HAN advises travellers to consult a doctor early, and inform the doctor of their travel history if they become unwell, with sudden onset of high fever, stomach pains, diarrhoea, vomiting, rash or bleeding, within 3 weeks of being in any of the affected areas in West Africa. Similar advice is provided in Health Advisory posters at land and air checkpoints, which will be progressively put up from this evening (8 Aug).

Contact Tracing and Quarantine 

11. MOH has been ready to conduct contact tracing in the event of a confirmed case of EVD since the beginning of the outbreak in West Africa. All close contacts will be quarantined and monitored for up to 21 days, either in their homes or in the Government Quarantine Facility (GQF) in Pasir Ris.

12. MOH will continue to closely monitor the situation, and continually assess and calibrate its measures.

MINISTRY OF HEALTH

8 AUGUST 2014