Singapore Prepares for Flu Pandemic

29 Jun 2005

The World Health Organization (WHO) has expressed concern over the possibility of the avian influenza epidemics in Asia evolving into a human influenza pandemic. The H5N1 subtype of influenza A is now endemic in the region and outbreaks continue to occur in poultry in Cambodia, Indonesia, Thailand and Vietnam. Sporadic human cases of H5N1, directly linked to bird flu, continue to be reported.

WHO has stated that to date, there is no evidence of efficient human-to-human transmission of H5N1 influenza. However, WHO is concerned that if new, virulent strains of influenza become as infectious as current seasonal human influenza strains, a human influenza pandemic could ensue. There is a need, therefore, for Singapore to raise our level of preparedness for a influenza pandemic outbreak.

Since Feb 2004, Singapore has established tight surveillance and control over our local poultry population. As such, it is less likely for a local human case of H5N1 to be from direct contact with infected local poultry but rather for the infection to be present in Singapore through imported human cases within days to weeks after it emerges in the region.

INFLUENZA (PANDEMIC) CONTINGENCY PLAN

Being aware of the threat of pandemic influenza is one of the key steps in improving our readiness. In a multi-agency effort, MOH has developed a contingency plan to enable us to respond swiftly and put in place public health measures to protect the health of all Singaporeans. The plan aims to achieve these three outcomes:

1. Maintain essential services in Singapore to limit social and economic disruption.

2. Provide treatment to identified influenza cases.

3. Reduce the spread of influenza in Singapore

Every effort will be made to ensure adequate healthcare services (e.g. adequate hospital beds and medicines), especially for high-risk groups (e.g. the elderly and young children). Some of the key public health measures are already in place. These include:

1. Disease surveillance capability.

2. Maintenance of essential services to the community (e.g. healthcare, power and water supply).

3. Stockpiling of anti-viral drugs sufficient to treat all cases with flu-like symptoms.

4. Infection control measures within the healthcare institutions, workplaces and the community.

5. Rapid implementation of border control measures to detect imported cases early, if required.

In the event of a pandemic, our various response measures would be calibrated depending on the alert level. The details are elaborated in the Contingency Plan.

The public also has an important role to play. They can help prevent the spread of flu through the maintenance of good personal hygiene and being socially responsible in their behaviour, e.g. by not going to work or school when ill.

VACCINATION & STOCKPILING

From previous influenza pandemics, we know that a pandemic usually spreads in two or more waves. A second wave may occur within 9 months of the initial outbreak. The duration of each pandemic wave is estimated to be up to 6 weeks.

The most effective control measure is to immunize the entire population against the new viral strains. However, development of pandemic influenza vaccine could take about 4 to 6 months. When vaccines are eventually developed, the supply would be limited initially, and therefore priorities for vaccinations will need to be established.

Currently, there are no vaccines available against a pandemic virus strain although research is underway to develop a vaccine against the H5N1 influenza virus. To address this problem, the Ministry of Health is currently exploring collaborations with vaccine producing companies to develop these vaccines and to ensure that we receive our supplies for the population at the earliest opportunity.

Oseltamivir or Tamiflu, a neuraminidase inhibitor, is currently the drug used for the treatment of Influenza A infections. This drug is in high demand world-wide and in short supply. Like many other countries, we have started to stockpile the drug.

The Contingency Plan will be reviewed periodically to incorporate new developments e.g. new vaccines as these become available. For more details, please refer to the MOH Website on the influenza pandemic plan and FAQs on Influenza and the FAQs on Avian Influenza.

As Influenza is highly virulent and spreads easily from person to person in confined space, each of us can play an important part in limiting its spread by practicing good personal hygiene and exercising responsible social behavior.