1 As at 27 April 09, there are reportedly 18 confirmed cases of human swine influenza A (H1N1 viruses) in Mexico, 20 in the United States (New York City, California, Texas, Kansas and Ohio), and 6 in Canada (Nova Scotia and British Columbia). There are also reports of suspected human cases in a number of countries such as New Zealand, Scotland, Israel, Spain, Brazil and Columbia. The World Health Organisation (WHO) has declared that the outbreak of the new strain of human swine influenza in Mexico and the US constitute a Public Health Emergency of International Concern (PHEIC), and has recommended that countries intensify its surveillance and precautionary measures. The US has also declared a public health emergency to deal with the emerging human swine influenza. These reports raise concerns about a global human-to-human spread of a novel influenza virus.
Situation in Singapore
2 As of 27 April 09, there are no cases of human swine flu in Singapore. There are two cases referred to CDC for further assessment. One of them is an American from California picked up for higher-than-normal temperature by thermal screening at Changi Airport. The other is a local resident who had a travel history to the United States and flu-like symptoms, who presented himself at the polyclinic and was referred to the CDC. Preliminary tests for Influenza A for both were negative.
3 MOH is monitoring the situation closely and will update the public should there be any new developments.
Precautionary Measures implemented
4 All healthcare institutions in Singapore have stepped up their infectious disease control measures to handle cases turning up at their hospitals. As a good practice, some hospitals have advised their staff at critical areas such as the Emergency Departments (EDs) and Intensive Care Units to don full Personal Protective Equipment (PPE).
5 There is a system of triage in the EDs where symptomatic patients with a travel history to affected areas, or contact with such persons, will be isolated within the hospitals. At the outpatient setting, for example, at GPs, polyclinics and TCM clinics, there is also a system where such cases will be referred to TTSH ED for further assessment.
6 As part of national level measures, the Civil Aviation Authority of Singapore (CAAS) implemented precautionary measures at Singapore Changi Airport yesterday night. Thermal scanners have been deployed at the Arrival Halls to measure the temperature of passengers just before they undergo immigration checks. These precautionary checks are non-intrusive and have no impact on the time needed by passengers to clear the various airport processes. Flights in and out of Changi Airport are continuing as normal. Passengers with a higher-than-normal temperature will undergo a more thorough medical assessment. If the doctor-on-duty ascertains the passenger requires further testing, the passenger will be conveyed to the CDC.
Advice from MOH
7 Members of the public are advised to postpone or avoid non-essential travel to Mexico. In the event that travel to Mexico is unavoidable, the public is advised to take precautionary measures such as avoiding crowded areas, coming into contact with sick persons and maintaining high standards of personal hygiene at all times.
8 Members of the public are also advised to seek immediate medical attention if they develop symptoms of swine flu within seven days of travel to California, Texas, Kansas, New York City and Ohio in USA or to Mexico. They should also disclose their travel histories to their doctors.
9 Locally, the ministry would like to advise hospital visitors to limit or postpone their trips to the hospitals where possible. The public should also 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). Those who are sick with respiratory illnesses should avoid crowded areas and wear masks if possible.
MINISTRY OF HEALTH
CIVIL AVIATION AUTHORITY OF SINGAPORE