Three Cases Reported But No Link To Outbreak Of Atypical Pneumonia Established Yet

13 Mar 2003

The World Health Organisation (WHO) has on 12 March 03 issued a global alert about outbreaks of cases of a severe form of pneumonia in Hong Kong, Vietnam and Guangdong province in China.

In Vietnam, the outbreak began when a traveller was hospitalised on 26 February 03 for the treatment of severe and acute breathing difficulties of unknown origin. He had become sick shortly after arrival in Hanoi from Shanghai and Hong Kong. Following his admission to the hospital, about 20 hospital staff became sick with similar symptoms. Some of these staff are recovering but some remain critically ill.

In Hong Kong, an outbreak of respiratory illness has been reported on 11 March 03 in the Prince of Wales Hospital. More than 20 hospital staff were admitted for observation after they developed fever. Some of these staff, also developed pneumonia. Their conditions are stable.

In February 03, it was reported that about 300 cases of atypical pneumonia, with 5 deaths, had occurred in Guangdong province in China.

The signs and symptoms of the disease include initial flu-like illness (rapid onset of high fever followed by muscle aches, headache and sore throat). In some cases, they developed pneumonia progressing to difficulty in breathing.

The outbreaks in Hong Kong and Hanoi appear to be confined to the hospital environment. No link has so far been made between the outbreaks of pneumonia in Hong Kong and Hanoi and the earlier outbreak of 'bird-flu' A(H5N1) in Hong Kong in February this year. Investigations into the cause of the outbreaks are currently being carried out by the WHO.

The Ministry of Health is closely monitoring the situation. We had been notified of three persons who had travelled to Hong Kong at the end of February and who were admitted to hospital for pneumonia after they returned to Singapore. Two of them have recovered and been discharged from hospital. The remaining case is recovering in hospital. Investigations suggest a viral origin, however no causative organism has been identified. We have conducted contact tracing and given advice to the contacts of these cases to seek medical attention early should they become ill. The hospital staff attending to these cases were advised to take the necessary infection control precautions. None of the hospital staff attending to these patients have reported ill. So far, we have not established that these cases are related to the outbreak in Hong Kong and Hanoi.

Our surveillance has shown that there has not been any increase in the number of cases of acute respiratory infections. As a precautionary measure, we are advising all medical practitioners to be vigilant and to be on the look out for similar cases.

The Ministry advises you to build up your body's resistance to illnesses by having a proper diet with adequate exercise and rest. If you have returned from recent travel overseas, in particular to Hong Kong, Hanoi and Guangdong province in China, you are advised to seek medical attention early if you experience flu-like symptoms.