Update On SARS - 19 Apr

19 Apr 2003

Situation Update

As at 19 April 2003, 3 additional SARS patients have been discharged, bringing the total number of patients who have recovered from SARS to 100. 61 SARS patients remain hospitalised. There are 5 additional SARS cases reported today. They are:-

i. 21 year-old female nurse of NUH Ward 64 who was a contact of a SARS patient. The SARS patient was admitted to NUH on 8 April, transferred to TTSH on 9 April and died on 12 April

ii. 37-year old male inpatient of SGH Ward 58

iii. 52-year old housewife

iv. 54-year old male who drives a taxi

v. 45-year old male who works at Pasir Panjang Wholesale Center

The 3rd case is a 52-year old housewife who became unwell while at home on 9 April. She consulted a GP on 14 April, was seen at Mount Alvernia A&E on 17 April and referred to TTSH. She was diagnosed probable SARS today. Investigations are underway to determine the source of infection.

The 4th case, a 54-year old male taxi driver, who routinely ferried an elderly couple in his taxi more than 10 days ago at 1 am from Choa Chu Kang Avenue 4 to Pasir Panjang Wholesale Market. He became unwell on 14 April. He was admitted to TTSH on 18 April. His reported movements from 14-18 April are as follows:

~ 14 April - went to see GP

~ 15-17 April - stayed at home

~ 18 April - went to SGH and was transferred to TTSH.

From the pick-up and drop-off location, it is highly likely that the couple he ferried on 5 April included the brother of the "index" patient of the SGH Ward 7&58 cluster. The brother was accompanied by his wife. The brother with his wife live at Choa Chu Kang Avenue 4 and worked at the Pasir Panjang Wholesale Market. He was admitted to NUH on 8 April 2003 with diagnosis of heart failure, transferred to TTSH on the same day and died on 12 April. The brother?s wife became ill on 8 April and was admitted to TTSH on 10 April. She was diagnosed a probable SARS on 15 April.

The 5th case, a 45-year old male who works at the Pasir Panjang Wholesale Center, became unwell on 8 April. It is likely that he was infected at his workplace as the brother of the "index" patient of the SGH Ward 57&58 cluster works at the Pasir Panjang Wholesale Market. The reported movements of the 5th case are as follows:-

8 April - went to work at 6 am by own transport and returned home at

9 am

9 April - visited GP (Koh's T& T Clinic) at around 830 am and then stayed at home

10 April - stayed at home

11 April - visited the same GP at about 830 am and then stayed at home

12 April - went to Hougang Polyclinic for a blood test. He wore a mask at the polyclinic. Visited same GP. Walked to Chinese Sinseh in the evening

13 April - stayed at home

14 April - visited Chinese Sinseh at Pu Ji Chinese Medical Hall at 11 am

15 April - visited Chinese Sinseh at Everspring Acupuncture at 6 pm

16 April - went to CGH and was transferred to TTSH

Contact tracing is underway.

A 72 year old male who works at the Pasir Panjang Wholesale Market became unwell on 18 April and was admitted to TTSH on 19 April as a suspect SARS.

If you have been to Pasir Panjang Wholesale Market on the following days and you have fever or symptoms of muscle ache, cough or difficulty in breathing, please call the Hotline: 91788477/91788478 and we will despatch an ambulance for you.

5 April 03 from 1 am to 11 am

7 April 03 from 7 am to 9 am

8 April 03 from 6 am to 9 am.

Pasir Panjang Wholesale Market will be closed as from 10.30 pm for a period of 3 days in the first instance.

To prevent community spread of SARS

The Prime Minister appealed to all Singaporeans to fully play their part in Total Defence against SARS. He said that we need to defend along three fronts. First, to prevent travellers from bringing the infection into Singapore. Second, to prevent infection in the hospitals. Third, to prevent community spread, for example by people under quarantine who break their quarantine.

To prevent community spread of SARS, we need everyone's cooperation and help to win this battle. Until we have a reliable and validated diagnostic kit that is easily available, we have two main weapons:

(a) Onset of fever and other symptoms like cough, muscle aches and chills. When you have a fever, see a doctor. If the doctor gives you a MC, stay at home, do not go to work, do not go to school. Do not doctor-hop. This will limit the spread.

(b) Contact history.

Be truthful about your contact history. If you have travelled to SARS affected countries, if you have contact with someone suspected to have SARS, if you have visited TTSH, SGH or other hospitals in the last two weeks and may be exposed to SARS, be extra alert. If you have fever or other symptoms of SARS, call the Hotline: 91788477/91788478 and we will despatch an ambulance for you.

For the rest of Singaporeans, we need to be extra vigilant over the next two weeks to make sure that community spread does not take root. Contact tracing is not 100% fool-proof. So over the next two weeks, anyone with fever or shows other symptoms of SARS should see their doctor and if they are unwell, they should stay at home.

Health screening for incoming air and sea passengers

Between 4 pm yesterday to 4 pm today, there were 8 passengers that were screened and only 1 was referred to TTSH. Between 4 pm yesterday to 4 pm today, there were no passengers who required further screening by the nurses at the ferry terminals.

Summary of SARS cases

A summary of the SARS cases to date:

Discharged: 100

Hospitalised: 61

Deaths: 14 + 2 (pending further post mortem test results)

Total: 177

Suspected: 77 (including 5 children below 18)

Under home quarantine orders: 387

Travel advisory

MOH urges the public to heed World Health Organisation (WHO)'s advice to postpone travel to Hong Kong and Guangdong until another time. We would also like to advise the public to avoid travel to other SARS affected areas - Beijing, Shanxi, Hanoi and Toronto, unless absolutely necessary.