Thursday, April 30, 2009

Singapore raises swine flu pandemic alert from yellow to orange

SINGAPORE: Singapore raises its pandemic alert from yellow to orange on Thursday even though there are no human cases of Mexican swine flu in Singapore.

The Health Ministry (MOH) said it is upgrading its Disease Outbreak Response System Alert as there is a real possibility that such cases may surface in Singapore and the country must be prepared at all fronts to delay its spread here for as long as possible.

Health Minister Khaw Boon Wan said Singapore is preparing for the need to move the alert level to red. The World Health Organisation (WHO) has moved to raise the pandemic alert phase for the Mexican swine flu outbreaks from Phase 4 to Phase 5.

The change indicates that there is human-to-human spread of the virus into at least two countries in one region.

In Singapore, its hospitals have already enhanced their infection control measures. For example, healthcare workers are already donning full personal protective equipment, especially in high-risk areas such as the emergency department and intensive care unit.

To reduce risk of exposure, triaging of patients has also been introduced at emergency departments, polyclinics and outpatient clinics. Elective admissions have also been reduced to increase hospital capacity.

Under the orange alert state, infection control measures will be further stepped up. Temperature screening and screening for flu-like symptoms for visitors to clinical care areas would be implemented, while hospital staff are required to don personal protection equipment in all areas with patient contact.

The number of visitors would also be restricted to one visitor per patient. This will help facilitate contact tracing and reduce unnecessary risk exposure in the hospitals.

MOH statement said those with a travel history to Mexico over the past seven days will be quarantined for seven days on their return to Singapore and undergo phone surveillance for symptoms for Mexican swine flu.

Those who develop symptoms will be referred to the Communicable Disease Centre (CDC) for a thorough assessment. A dedicated ambulance service (993) has been activated to convey such patients to CDC.

Should evidence arise that other countries besides Mexico are exporting cases, the MOH will also consider imposing similar conditions for travellers returning from those areas.

The statement added that members of the public who are returning from other affected areas like New York, California, Kansas and Texas in the United States and the state of Nova Scotia in Canada are advised to stay at home for seven days upon return and check themselves for symptoms for Mexican swine flu.

They should practise social distancing and refrain from joining mass gatherings such as going to the cinemas, shopping malls or supermarkets.

Those who develop respiratory illness with fever of more than 38 degrees Celsius within seven days after their return should put on a surgical mask, call 993 for an ambulance. They should also disclose their travel histories to their doctors.

MOH is encouraging schools, workplaces and places of mass gathering to conduct temperature checks routinely. Those with a higher-than-normal temperature should be advised to seek treatment immediately.

Recording of all information of all visitors, including the date and time of visit, personal particulars and contact number of visitors, is recommended. This will facilitate contact tracing when the need arises.

Although there are no human cases of Mexican swine flu in Singapore, there have been 22 cases in total referred for further medical assessment. Of these, 19 cases have been tested negative for Influenza A.

Two tested positive for usual circulating seasonal strains of Influenza A and one is pending laboratory investigations.

As for travelling to Mexico, MOH said members of the public are strongly advised to postpone or avoid non-essential travel to Mexico and 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 – washing hands frequently with soap and water, especially after contact with respiratory secretions.

Those who are unwell with respiratory illness should stay at home and wear a surgical mask if possible. The ministry added that it is monitoring the situation closely and will update the public should there be any new developments.

For more information on Mexican swine flu, members of the public can access MOH's website at or call its hotline at 1800-333 9999.

- CNA/so

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