SARS: More Patients Recovering And Discharged

31 Mar 2003

Situation Update

One death due to SARS has been reported today. The patient had travelled to Sarawak with her family from 15 March to 18 March 03 and had developed fever when she returned to Singapore on 18 March.

She presented at NUH Emergency Department on 24 March with features of pneumonia. At that time, the medical staff were unable to obtain from the relatives a history of contact with a patient with SARS and she had also not travelled to an affected areas. She was too unwell to be transferred to TTSH. Nevertheless, in line with MOH guidelines, she was treated as a potentially infectious patient and was warded in an isolation room. NUH staff took all the necessary infection control precautions after her admission and the patient was isolated throughout her admission. She was also not allowed any visitors. She was transferred to the ICU on 24 March 03, where she was received intensive treatment under isolation.

On 30 March, one of her relatives gave the history that the NUH patient had visited a non-SARS patient in a ward in TTSH on 12 Mar 03. A patient in this ward was later found to have SARS. As the NUH patient herself was very sick, it was not possible to ascertain who she had come into contact with. Despite intensive treatment, her condition worsened and she passed away today. As a precautionary measure, this patient is being considered as a case of SARS. Contact tracing is being carried out.

Apart from this case, there were no new cases of SARS reported. As at 31 March 03, a total of 92 people with SARS have been reported to the Ministry of Health. The total number of people who have recovered from SARS and have been discharged from hospital is 41. The remaining 47 patients are hospitalised.

To date, there have been no SARS cases that are linked to the fourth and fifth imported cases. The cases in Singapore are still traced to the first three people who travelled to Hong Kong and contracted SARS. The number of infected children still remains at 3. There is no change in the number of persons on the suspect list.

There are 13 patients who are in serious condition, including the fourth imported case.

Another five passengers located

Following yesterday's press statement, we have been able to locate another 5 passengers. They are all well and quarantine orders are being served to them. In total, 45 of the 48 passengers (excluding the case) have now been identified. The names of the remaining 3 passengers who we have still been unable to locate are:

(a)Chen Hai Yun

(b)Ho Kee Siong

(c)Wang Ying

However, NEA will continue to try to trace them based on information received from SIR as well as information received through the hotline. The Ministry urges these persons or anyone who knows their whereabouts to call 91788389 with the information.

Case of death on board the cargo ship, Kota Hasil from Hong Kong

MOH was notified of a case of an Indonesian crewman who developed high fever on 23 Mar while on board a cargo ship sailing between Taiwan and Hong Kong, and who passed away on 28 Mar while the ship was enroute to Singapore. The ship arrived in Singapore on 29 Mar 03 and was anchored in a quarantine area. Two doctors from Singapore boarded the vessel and examined the crew members. Although the history of the illness was not completely typical of SARS, the doctors took all the necessary infection control precautions. All crew members were assessed to be well but have not been allowed to come ashore. The body has been taken to the Centre for Forensic Medicine. The ship is scheduled to depart Singapore tonight after it has completed its cargo operations.

Precautionary measures

Singapore has taken extra precautionary measures, beyond WHO's recommended control measures, to ensure that the spread is contained. These include isolating all suspected and SARS patients in TTSH, enhanced infection control measures for hospital staff and instituting home quarantine measures for those who have come into contact with people diagnosed with SARS.

To minimise the import of SARS cases, Singapore has also tightened screening measures for incoming flights into Changi Airport from affected areas as identified by WHO. These include the issuing of health advisory cards and the checking of visibly unwell passengers by nurses. Those who have fever will be sent to TTSH for assessment. As a first line of defence, any visibly unwell passenger from affected areas will be asked to obtain a doctor's certification before they are allowed to board the flight to Singapore.

The key strategy is to identify suspect cases once they show symptoms of the disease and isolate them to prevent transmission to more people. The closure of schools is to allay the concerns of parents. We will step up efforts to help the public understand the nature of SARS and how they could help us in our efforts to minimise the risk of community spread.

We believe that if everyone exercises social responsibility, we can tackle the SARS outbreak here calmly, without too many disruptions to our normal routines. We urge everyone to help us in our efforts by taking these simple precautions:

- Heed our travel advisory and avoid travelling to Hong Kong, Hanoi and Guangdong province in China for the time being, unless absolutely necessary.

- If you have travelled to these places, be vigilant and seek immediate medical attention if you have fever (more than 38 degree celsius) and respiratory symptoms including cough, shortness of breath or breathing difficulty. Do not fly if you develop such symptoms.

- If you think that you have been exposed to persons diagnosed with SARS, and later develop a fever, do not go to work. See a doctor immediately.

- If you are unwell, avoid crowded places.