No human swine flu in Singapore but docs told to be on lookout

Lau Joon-Nie, Channel NewsAsia 26 Apr 09;

SINGAPORE: The Ministry of Health (MOH) says there are currently no known cases of human swine flu in Singapore.

However, it has alerted all local doctors and healthcare institutions to be vigilant for any suspect cases during this period.

While there are currently no travel restrictions or quarantine advised by the World Health Organisation (WHO) for swine flu, MOH has advised those travelling to Mexico, Southern California and Texas to take precautions such as avoiding crowded places, people with flu symptoms and washing one's hands regularly.

Anyone developing swine flu symptoms within a week of travelling to these places should seek immediate medical attention.

In its list of frequently asked questions, MOH says swine flu spreads to humans mainly through contact with infected pigs, but limited human-to-human transmission can also occur in the same way seasonal flu occurs in people.

The symptoms are similar to regular human seasonal influenza - high fever in the early stages followed by cough, sore throat, runny nose and sometimes breathlessness a few days later.

MOH says it maintains a comprehensive, well-established disease surveillance system for early detection of human cases with novel influenzas such as swine flu.

If the situation warrants, MOH will step up public health measures such as quarantine of contacts, issue public health advisories and work with other government agencies to screen visitors at border checkpoints.

It also has an influenza pandemic preparedness plan.

The MOH adds that there is currently no evidence to suggest that swine flu can be transmitted to humans from eating pork or pork products that have been thoroughly cooked. - CNA

New flu virus kills 68 in Mexico
Health officials act to prevent pandemic; eight also infected by the swine virus in US
Straits Times 26 Apr 09;

Mexico City - A new strain of flu that has killed as many as 68 people in Mexico has had health officials scrambling to avert a possible global outbreak.

As the Mexican government axed public events and shut schools, libraries and cinemas, World Health Organisation (WHO) experts were dispatched to Mexico.

More than 1,000 people there, and eight in the United States, are suspected to be down with that strain of flu.

WHO director-general Margaret Chan warned yesterday that the new multi-strain swine flu virus had 'pandemic potential'.

'A new virus is responsible,' she said after an emergency meeting of flu experts in Geneva. 'It is a serious situation which needs to be closely followed.'

Separately a US health official warned that it may be too late to contain the new virus.

'It is clear that this is widespread. And that is why we have let you know that we cannot contain the spread of this virus,' Dr Anne Schuchat of the US Centres for Disease Control and Prevention (CDC) told reporters.

Dr Chan said it was too early to say whether a pandemic - defined as a global infectious disease outbreak for which there is no immunity - will actually occur.

But the UN agency has advised countries worldwide to look out for similar outbreaks following the discovery of related strains on both sides of the US-Mexico border.

Scores have died in Mexico from severe pneumonia after infection. At least 24 new suspected cases reported yesterday in Mexico City, a city of 20 million people.

Tests on some of the victims found that they had contracted a new version of the A/H1N1 flu virus, which is a combination of bird, pig and human viruses.

'It has pandemic potential because it is infecting people,' said Dr Chan. 'However, we cannot say on the basis of currently available laboratory, epidemiological, and clinical evidence whether or not it will indeed cause a pandemic.'

As the new strain was still poorly understood and the situation evolving quickly, it was too soon to announce any travel advisories or to advise drugmakers to switch to producing a new vaccine, she told a teleconference.

The CDC said some of the samples from Mexican patients were a genetic match of the strain seen in eight people in California and Texas, who later recovered.

In New York City, health officials were looking into what had sickened scores of students who fell ill with flu-like symptoms.

The French government said suspected cases are likely to occur in the coming days because of global air travel.

Most of the dead were young healthy adults. That alarms health officials because seasonal flus cause most of their deaths among infants and elderly people, but pandemic influenza - like the 1918 Spanish flu which killed millions - often strikes young, healthy people the hardest.

Influenza can spread quickly when a new strain emerges because no one has natural immunity.

Yesterday was the first time Dr Chan has convened such a crisis panel since the procedure was created almost two years ago.

An official source said yesterday the panel is expected to declare the outbreak 'a public health emergency of international concern'. With that, the WHO would have to decide next on measures such as travel advisories, trade restrictions and border closures.

The panel is also likely to ratchet up the WHO's six-phase flu pandemic alert level. It is now set at Phase 3 - meaning there is no or very limited risk of a new virus spreading from human to human.

US health officials are urging anyone with a fever, cough, sore throat, shortness of breath or muscle and joint pain to seek medical attention.

The WHO stands ready with antivirals to combat the outbreaks in Mexico. But the authorities have a sizeable supply of Tamiflu, which has proved effective against the new virus, the UN agency said.

Mr William Schaffner, a US flu expert, said the new strain is the biggest threat of a pandemic since the emergence of the H5N1 strain, which has killed millions of birds and hundreds of people.

AP, Reuters, AFP

No cases of deadly flu in Singapore
Straits Times 26 Apr 09;

There are currently no known cases of human swine flu in Singapore but the Health Ministry is not taking any chances.

In a statement yesterday, the ministry said it has informed all medical practitioners and health-care institutions of the outbreak in the United States and Mexico, and alerted them to be vigilant for any suspect cases during this period.

The ministry is monitoring the situation closely and will update the public should there be developments.

Members of the public should seek immediate medical attention if they develop symptoms of swine flu within seven days of travel to California or Texas in the US, or to Mexico, the statement said.

The public is also advised to maintain high standards of personal hygiene, such as washing hands frequently with soap and water, especially after contact with respiratory secretions such as from sneezes and coughs.

Those who are sick with respiratory illnesses should avoid crowded areas and wear masks if possible.

The Agri-Food & Veterinary Authority of Singapore (AVA) also issued a statement yesterday to say that the US Centres for Disease Control and Prevention has said that there is no danger of contracting the flu virus from eating pork products.

It added that cooking pork will kill the swine flu virus as it does with other bacteria and viruses.

Singapore imports about 10 per cent of its pork - all frozen - from the US. Since the beginning of this year, Singapore has imported about 2,500 tonnes of frozen pork from the US. There are no imports of pork from Mexico.

The AVA said it is monitoring the situation in the US and is in contact with the authorities there.

Asian countries on alert for swine flu
Straits Times 26 Apr 09;

Checks done on people arriving from Mexico and the US; Import of pork also under watch
Tokyo - Some Asian nations enforced checks yesterday on passengers and pork products from Mexico amid fears that its deadly outbreak of swine flu might spread to a continent that has battled hard to contain bird flu.

Malaysian Health Minister Liow Tiong Lai said medical practitioners had been told to report cases of atypical pneumonia if their patients had visited Mexico, California or Texas after April 17.

At Tokyo's Narita airport - among the world's busiest with more than 96,000 people using it daily - officials installed a device at the arrival gate for flights from Mexico to measure the temperatures of passengers.

'We are increasing health surveillance following the outbreak of swine flu,' said Mr Akira Yukitoki, an official at the airport's quarantine station.

He said more than 160 passengers arriving from Mexico yesterday were screened by the thermographic machine.

No one complained of fever or severe coughing.

The airport also plans to put up special signs for passengers going to Mexico, urging them to 'wear masks, wash hands and gargle,' Mr Yukitoki said.

In the Philippines, passengers with fevers who have been to Mexico may be quarantined in government hospitals, said Health Secretary Francisco Duque III.

The government was also tightening monitoring at all ports to prevent the entry of any hogs or pork from Mexico and the US.

The health authorities in Thailand and Hong Kong said they were closely monitoring the situation.

The swine flu virus, which the World Health Organisation (WHO) says appears to be able to spread from human to human, has killed scores of people in Mexico and infected eight in California and Texas.

Asia has grappled in recent years with the H5N1 bird flu virus. Nearly 45 per cent of the 257 global bird flu deaths since 2003 have occurred in Indonesia, according to WHO data.

A vaccine for the strain has been available since 2007.

However, no vaccine specifically protects against swine flu and it is unclear as to how much protection current human flu vaccines might offer.

While little can be done to prevent an outbreak from spreading, health experts say common sense measures can help individuals protect themselves.

No. 1 is hand-washing, they say.

'Cover your cough or your sneeze, wash your hands frequently,' Dr Richard Besser, acting director of the US Centres for Disease Control and Prevention told reporters in a telephone briefing yesterday.

'Social distancing' is another tactic, he said.

'If you have the flu, then you shouldn't be getting on the bus or getting on the plane and travelling.'

Flu experts have also long advised against trying to stockpile personal supplies of antivirals, which must be taken within 48 hours of the first symptoms to do any good.

AP, Reuters

Additional reporting by Carolyn Hong

Flu facts
The Health Ministry (MOH) yesterday released information on swine flu.
Straits Times 26 Apr 09;

What is swine flu?

It is a respiratory disease affecting pigs that is caused by type A influenza virus. Most outbreaks occur during the late fall and winter months, similar to influenza outbreaks in humans.

Does it affect humans?

Swine flu viruses very rarely affect humans. However, sporadic human infections with swine flu have occurred. These cases commonly occur in people with direct exposure to pigs.

How does it spread to humans?

It spreads to humans mainly through contact with infected pigs.

Can people catch swine flu from eating pork?

There is currently no evidence to suggest that swine flu can be transmitted to humans from eating pork or pork products that have been thoroughly cooked.

What are the symptoms?

The symptoms of swine flu are similar to the symptoms of regular influenza. An early symptom is high fever, and this is followed by cough, sore throat, runny nose, and sometimes breathlessness a few days later.

How can the infections be diagnosed?

A respiratory specimen would be collected within the first four to five days of illness, when the infected person is most likely to be shedding the virus. However, some, especially children, may shed the virus for 10 days or longer.

What medications are available to treat the infection?

There are four different antiviral drugs that are licensed for use in Singapore: amantadine, rimantadine, oseltamivir and zanamivir.

While most swine flu viruses have been susceptible to all four drugs, the most recent swine flu viruses isolated from humans are resistant to amantadine and rimantadine. At this time, the US CDC recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and/or prevention of infection with swine flu viruses.

What is MOH doing to ensure that the disease is not transmitted here?

A medical alert has been sent out to all medical practitioners and health-care institutions to update them on the outbreak of swine flu in the United States and Mexico.

When the situation warrants, MOH will step up public health measures, such as quarantine of contacts, issuing public health advisories, and working with other government agencies to screen visitors at Singapore's border checkpoints. MOH also has an influenza pandemic preparedness plan in the event of a pandemic situation.

Is it safe to visit countries with cases of swine flu and will I be quarantined when I return? What travel precautions should I take?

There are currently no travel restrictions or quarantine advised by the World Health Organisation. If you intend to travel to areas which have cases of swine flu, you should:

- Avoid contact with persons with symptoms of influenza

- Avoid crowded areas

- Observe good personal and environmental hygiene

- Maintain good body resistance

What should I do if I suspect I have swine flu after returning to Singapore?

You should consult your doctor immediately and inform the doctor that you had recently travelled to areas which have cases of swine flu.

What should I do if I fall ill overseas?

You should consult a doctor as soon as possible and refrain from travelling until you are certified fit by the doctor.

Does influenza vaccination help in preventing swine flu?

There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine is unlikely to protect against H1N1 swine flu viruses.

Is it safe to come into contact with live pigs in nature reserves and the wildlife reserves?

So far, there are no known cases of swine flu in Singapore. However, proper hygiene practices, such as washing of hands after contact with animals, including pigs, should be maintained.