Update on Influenza A (H1N1-2009) (5 May)

05 May 2009

* As of 30 April 2009, WHO refers to the new influenza virus as Influenza A (H1N1-2009)

As of 5 May 09, 21 countries have officially reported a total of 1124 cases of influenza A (H1N1-2009) infection. In Singapore, there are still no human cases of Influenza A (H1N1-2009).  The World Health Organization (WHO) has cautioned nations not to let our guard down as there may be a second more severe wave of infection.

2 Our Disease Outbreak Response System Alert status remains at ORANGE and precautionary measures are in place to forestall the spread of the virus to Singapore for as long as possible. Meanwhile, Singaporeans are reminded to ensure high standard of personal hygiene.

Situational Update of Cases

3 As of 5 May 2009, there have been 590 confirmed cases of Influenza A (H1N1-2009) reported in Mexico (with 25 deaths), 286 in the United States (with 1 death), 140 in Canada, 54 in Spain, 18 in United Kingdom, 8 in Germany, 6 in New Zealand, 4 in Israel, 1 in Austria, 1 in the Netherlands, 1 in Denmark, 1 in Portugal, 2 in El Salvador, 1 in Switzerland, 4 in France, 1 in Ireland, 2 in Italy, 1 in Costa Rica, 1 in Columbia, 1 in Hong Kong and 1 in the Republic of Korea. The case in Hong Kong is a Mexican citizen who travelled to Hong Kong, while the case in the Republic of Korea was a Korean who had travelled to Mexico. Both patients have been isolated and there has been no reported community spread in the Republic of Korea or Hong Kong to date.

4 Seven Singaporeans who have stayed at the same Metropark Hotel as Hong Kong’s index case are currently under quarantine in Hong Kong. They are doing well.

5 In Singapore, we had two additional cases for investigations today. Of the 29 cases investigated thus far, 24 cases have tested negative for Influenza A, 4 tested positive for the usual circulating seasonal strains of Influenza A, and 1 is pending laboratory investigations..

Home Quarantine Order (HQO)

6   As at 1700 hrs on 5 May, a total of 8 HQOs have been issued. Travellers entering Singapore with a travel history to Mexico over the past seven days will be quarantined for seven days when they enter Singapore from when they were last in Mexico. To date, 2 were issued to foreign residents and 6 were issued to Singaporeans.

7 The Home Quarantine Order is issued under the Infectious Diseases Act to contacts and suspected contacts of the Influenza A (H1N1-2009) virus, with the aim of limiting the spread of Influenza A (H1N1) in the community. It can be issued to any person who is a known or suspected close contact of a probable or confirmed case of Influenza A (H1N1-2009), as well as persons who arrived in Singapore within 7 days after having departed from Mexico. Travellers who are unable to be quarantined at their own residential homes, or are without a residential home in Singapore, will be quarantined in alternative housing such as government chalets, i.e., the Aloha Chalets located at Loyang.

8 While under HQO, the person must stay at home throughout the quarantine period, monitor their temperature twice daily and check for flu-like symptoms. They should minimise contact with other family members and practice good personal hygiene. Persons under home quarantine who develop symptoms will be referred to the CDC for a thorough assessment. A dedicated ambulance service (993) is in place to convey them to TTSH Emergency Department. The public is urged to call this number only if they have a travel history to affected areas.

9 Any person guilty of breaking the HQO shall be liable to a maximum fine of $10,000, or imprisonment of six months, or both. In the case of a second or subsequent offence, the person will be liable to a maximum fine of $20,000, or imprisonment of 12 months, or both.  

10 For travellers who are returning from other areas with evidence of community transmission of Influenza A (H1N1-2009) (i.e., the states of California, New York and Texas in the United States, and the Province of Nova Scotia in Canada), MOH advises them to stay at home for seven days, monitor their temperature daily and check themselves for symptoms of flu-like illness. They should refrain from joining mass gatherings, e.g., going to the cinemas, shopping malls, supermarkets, etc. Those who develop respiratory illness with fever (temperature > 38 deg C) within seven days after their return should put on a surgical mask and call 993 for an ambulance. They should also disclose their travel histories to their doctors.

Advice from MOH

11 Members of the public are strongly advised to exercise caution over travel to affected areas. In the event that travel is unavoidable, the public is advised to take precautionary measures such as avoiding crowded areas and maintaining high standards of personal hygiene at all times.

12 MOH advises the public to maintain high standards of personal hygiene, such as washing hands frequently with soap and water, especially after contact with respiratory secretions (e.g., after sneezing and coughing).

13 MOH is monitoring the situation closely and will update the public should there be any new developments. For more information on Influenza A (H1N1-2009), please access MOH’s website at www.moh.gov.sg, call our hotline at 1800-333 9999, or visit www.flu.gov.sg.

MINISTRY OF HEALTH

5 May 2009