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82 New confirmed cases of H1N1 in Singapore (Total 783 cases)

02/07/2009 12:34:00

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Singapore has confirmed 82 new cases (701st cases to 783rd cases)of Influenza A (H1N1-2009) today, bringing the total tally to 783 confirmed cases. Investigations are on-going for the 97 new cases.

Of the 57 cases investigated yesterday, there were 41 local cases and 16 imported cases. Fortunately so far, most cases of Influenza A (H1N1-2009) are mild and self-limiting. To date, 300 patients have fully recovered and the rest are recuperating.

GRADUAL TRANSITION FROM CONTAINMENT TO MITIGATION PHASE

In the initial period of the outbreak, most of cases are imported cases with travel history from affected countries. The outbreak has however since progressed from merely imported cases to local community transmissionAs of 26^th June 2009, MOH’s bio-surveillance programme showed that Influenza A (H1N1-2009) made up 5% of all samples from patients with influenza-like-illness (ILI). With more local transmission cases, MOH are in the process of moving from containment to mitigation. MOH are still trying to slow down the community spread but have concurrently started preparing to manage the disease in a more targeted and risk-stratified manner

In this transition stage, Singapore hospitals have used their clinical discretion to selectively test patients for Influenza A (H1N1-2009) only when required for clinical management (e.g. severely ill patients) and/or in situations where it will be of significant public health importance. Cases that are assessed to be very mild cases are not hospitalised but placed on home quarantine orders.Laboratory testing for Influenza A (H1N1-2009) is not necessary before commencement of treatment. There is therefore no need for GPs to send all suspected cases to hospital for testing.

Pandemic Preparedness Clinics (PPCs) and polyclinics regularly see patients with flu under normal circumstances. They have also been geared up to ensure that they are H1N1 ready through additional training in infection control measures, supply of PPE and Tamiflu. MOH advised Members of the public who develop influenza-like illness (e.g. fever, cough, sore throat, runny nose) can visit the PPC or polyclinic for initial assessment and treatment. Doctors would exercise clinical judgment in prescribing anti-virals (eg Tamiflu) on a case by case basis taking into account patients risk of developing influenza related complications, prevalence of Influenza A (H1N1-2009) in our community and after weighing the risks and benefits of treatment. Depending on the severity of their illness and other risk factors, they may be referred to the hospital for further management. The hospitals will increasingly focus on managing more complex cases.

DETAILS OF NEWLY INVESTIGATED CASES

	Classification	New cases	Total
(1)	LOCAL	41	390
A)	Community clusters
	Riverlife Church	0	10
	Butter Factory	1	43
	Workplace	0	2
	Republic Polytechnic	8	86
	Fishermen of Christ Church	0	13
	Maju Camp	0	23
	NUS Orientation Camp	0	5
	Pulau Tekong Camp	0	8
	Clementi Camp	2	57
	Police Coast Guard (Brani Base)	1	6
	Social (Party)	0	4
	Raffles Institution Boarding	0	4
	Jurong Camp	5	5
B)	Local transmission from imported case.	3	16
C)	Unlinked	21	108
(2)	IMPORTED	16	296
TOTAL		57	686

BREAKDOWN OF TOTAL CONFIRMED CASES (AS AT 1 July)

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Breakdown by source of infection
Countries	Number of cases
Singapore	390
Australia	88
Philippines	75
United States	41
Indonesia	42
Thailand	19
UK	12
Hong Kong	10
Canada