SARS: One Probable Case

18 May 2003

Probable Case

A patient who has been admitted to Tan Tock Seng Hospital (TTSH) since 11 May 2003 has been diagnosed to have probable SARS today.

The patient became unwell on 5 May 2003 and was admitted to TTSH on 11 May 2003. On admission to TTSH, his chest X-ray showed early changes of pneumonia. He had a history of travel to Malaysia on 18 April, 1 May and 5 May 2003. He did not have any known contact with SARS cases in Singapore. He was managed as a case of atypical pneumonia and started on antibiotics. Contact tracing was initiated and home quarantine orders were issued to his close contacts. His temperature became lower and samples sent for PCR testing for coronavirus were negative on 11 and 12 May 2003.

His condition deteriorated and he was transferred to intensive care on 13 May 2003 and intubated on 15 May 2003. Repeat samples were taken for PCR testing for coronavirus on 16 May. The result obtained on the night of 17 May 2003 was positive. In line with the World Health Organisation (WHO) guidelines, the test was repeated on this sample on 18 May 2003 and the result is positive. Two of the additional samples taken on 18 May 2003 were positive using a different PCR test kit. A blood test was also positive for antibodies to SARS on 18 May 2003.

The patient's movements from the 5 to 11 May 2003 are as follows:

5 May 2003

He went to work in the morning.

At 6.00 pm, he drove to Carrefour in Johore Bahru to meet up with a friend. He suddenly felt feverish and developed a cough. He returned to Singapore at 9.00 pm.

At 9.30 pm, he went to see his General Practitioner (GP) at Bukit Gombak and was given medical leave for 3 days.

6 May 2003

He stayed at home

7 May 2003

At 10.15 am, he went to see the same GP as he had developed diarrhoea as well.

8 May 2003

At 9.00 am, he went to see the same GP.

9 May 2003

He went to work from 8.00 - 9.30 am but was told by his employer to return home as he was unwell.

At 11.30 am, he went to see the same GP.

10 May 2003

He stayed home.

11 May 2003

At 11.30 am, he went to see the same GP. At 12 noon, he was sent to TTSH by ambulance.

MOH has been calling up, by telephone, the persons on the contact list for the patient. So far, three quarters of them have been reached and have reported that they are well. Nurses will be sent down to screen all these contacts in their homes.

In addition, the Ministry has decided to put out a public appeal for contacts of the patient. The patient is Mr. Lee Chong Kian, a 39-year-old man who works as a Quantity Surveyor at two sites, one at Bukit Gombak near the Gombak MRT Station and another at Bedok North near to Block 78.

Anyone who was in close contact with Mr Lee during the period from 5 May to 11 May 2003 is to contact MOH at 1800-333-9999 (8.00 am - 11 pm). If you were in close contact with Mr Lee during this period and are unwell, the Ministry advises you to call 993 immediately for the MOH Special Ambulance, which will send you to TTSH for an assessment.

The Ministry has forwarded information of this case to the Malaysian health authorities.

Situation Update

3 patients were discharged today, bringing the number of patients who have recovered from SARS to 160, with 17 patients still hospitalised and 7 of them in intensive care.

Suspect Cases

There were no new suspect cases admitted today.

New Observation Cases

There were 2 admissions today for observation of fever. One is a 32-year-old traveller and the other is a 23-year-old Indian national whose contact history is unclear at this point in time.

Quarantine Figures*

The quarantine figures are as follows:

#Discharged patients under home quarantine = 459

Contacts under home quarantine = 10

Total under home quarantine orders = 469

*Quarantine cases refer to those who are required to stay at home for precautionary reasons as they may have had contact with a SARS patient. These are healthy individuals.

# This is an added precautionary measure for discharged SARS patients as well as those with co-morbidities.

Summary of SARS Cases

A summary of SARS cases is as follows:

Discharged: 160

Hospitalised: 17 (including 7 in ICU)

Deaths: 28

Probable cases: 206*

Suspect cases: 2

Observation cases: 4

*includes 1 case who died from non-SARs causes

Travel Advisory

MOH urges the public to heed WHO's advice to postpone travel to Beijing, Hong Kong, Hebei, Inner Mongolia, Guangdong, Shanxi, Tianjin and Taipei until another time.