Clinical Data of Local Swine Flu Victims

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TTSH releases clinical data of first 50 H1N1 patients in Singapore

By Satish Cheney, Channel NewsAsia
Posted: 24 June 2009 1923 hrs

SINGAPORE: The World Health Organisation uses a temperature benchmark of 37.8 degrees Celsius as one of the factors to determine if someone is a suspect H1N1 case, but experts at the Tan Tock Seng Hospital warn that doctors should not overlook those with low fever as well.

92 per cent of H1N1 patients in Singapore had respiratory infections, but 46 per cent had mild fever of less than 37.8 degrees Celsius when they sought medical treatment.

This is according to Tan Tock Seng Hospital, which released its clinical findings on the first 50 H1N1 patients on Wednesday.

Professor Leo Yee Sin, clinical department head at Tan Tock Seng Hospital, said: “We do come across many patients where the fever may not be very high. It’s important to be able to add several symptoms together that would include fever and respiratory symptoms that would include running nose, cough, sore throat and other clinical symptoms like headache and muscle ache.”

The professor continued to say that it is possible for general practioners to miss out on diagnosing some of their patients as having the H1N1 virus because their symptoms could be very mild.

There is also the possibility that some patients may not show any symptoms at all.

According to the hospital, about 20 per cent of the first 50 H1N1 cases who are on Tamiflu were still infectious on the fifth day of treatment.

Those who started Tamiflu earlier (for example, on the second day instead of the third day of infection) have a shorter infection period.

Currently, there are about 70 confirmed H1N1 patients hospitalised at the Communicable Disease Centre.

One of the bigger concerns for medical authorities now involves the higher risk group – people with asthma, very young children, the elderly and anyone with major underlying medical problems.

The high risk group also includes those with chronic lung disease, heart disease, liver disease, renal disease, immuno-compromised patients such as those on chemotherapy, radiotherapy or patients who are required to be on long-term steroids and pregnant women.

Professor Leo said: “How the disease is going to behave in the high risk population is yet to be seen and to be determined in the local situation.

“However, we know from overseas data and understanding of seasonal influenza, that high risk groups tend to have a higher frequency of complications and they may have adverse outcomes and we may not be surprised that there may be deaths among the risky individuals.”

The hospital said high risk patients may need more medical attention while on antiviral medication.

Another concern is the mutation of the H1N1 virus as it mixes with other types of flu viruses. Professor Leo said this is something the authorities are keeping track of.

The hospital said it will be doing more clinical research to help authorities understand the nature of the disease better. It has urged the public to remain vigilant and not to be complacent.

Professor Leo said Singaporeans must change their mindsets about donning face masks when they are sick and that they should adopt a life-long approach to improve their personal hygiene to ward off flu viruses.

Source: CNA link here.

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Only 25% of Singapore firms ready for Flu Pandemic

By Imelda Saad, Channel NewsAsia
Posted: 24 June 2009 2146 hrs

SINGAPORE: Only one in four companies in Singapore is prepared to deal with a H1N1 flu pandemic, according to a survey of more than 350 companies carried out by the Singapore Business Federation.

While schools have made it compulsory for all staff and students to take a 7-day leave of absence if they return from H1N1-infected countries, a check with businesses showed that this added precautionary measure may not be a practical move for most.

Here’s the problem: smaller companies simply do not have the resources or manpower to implement a business continuity plan, let alone extra measures like what the Education Ministry has instituted.

Even with the leave of absence, students and those working in schools need not necessarily have to be cooped up at home for seven days. They can still go about with their daily activities. The idea is to mitigate the spread of the virus in an area – in this case the schools – where people congregate for a long period of time.

But while students are asked to stay away from schools for a week, the same cannot be said for their parents. That is because companies follow the Health Ministry’s guidelines.

Right now, the advice is for people coming back from infected countries to monitor their health for seven days upon return. They will be quarantined only if they exhibit flu-like symptoms.

The Civil Service, too, takes its lead from the Health Ministry’s travel advisory. Channel NewsAsia understands that the public sector will re-calibrate its human resource policy when Singapore fully moves into the mitigation stage of managing H1N1.

Most companies Channel NewsAsia spoke to have not made a leave of absence compulsory for staff coming back from infected countries, even if they feel well.

Chan Chong Beng, chairman of Goodrich Global, said: “I really don’t think that the SMEs (small and medium enterprises) can afford to implement this self quarantine; we just don’t have the resources to do it.

“It is very different from the schools; the schools can close for seven days, can close for 14 days, there’s another indirect cost but there’s no impact on the cost as compared to SMEs.”

He said a lot of SMEs think “it could never happen to me”. Mr Chan is also the vice-president for communications at the Association of Small and Medium Enterprises (ASME).

But being unprepared is even costlier. Teng Theng Dar, CEO of Singapore Business Federation, said: “You’ll suffer complete disruption of operations when the situation turns bad and your supply chain is affected, your business affected and in the worst case scenario, in the very extreme case, then there’ll be total shutdown of operations.”

Mr Chan of Goodrich Global knows the impact only too well, having witnessed the Hong Kong experience when the first H1N1 case in the territory was discovered.

Goodrich Global, which employs some 170 people, has in place a comprehensive business continuity plan covering everything – from making available healthcare equipment to visitor management to making provisions for a holding area in case a suspected case surfaces within the company’s premises.

For companies which want to take that extra precaution, the Singapore Business Federation has this advice – consider alternative working arrangements from home and perhaps even bearing half of the leave of absence so that employees do not deplete their personal leave.

For example, employees just take 3-and-a-half days off their leave entitlement for a 7-day self-imposed quarantine period.

“The situation whereby an individual cannot work from home, in the case of Singapore, to me, is non-existent because there are many alternative communication devices to keep things going,” said Mr Teng.

He added: “I think the challenge will be the manufacturing sector where you need people on the ground to man the machines and you need qualified persons.”

In this case, measures such as splitting staff into different teams would be prudent to ensure uninterrupted operations.

Mr Teng said: “There are different sectors, different requirements, it’s difficult to give a one-size-fits-all answer. But I think the message is very clear – we have to work as one and have a good understanding and operate on the basis which is supportive and compassionate.”

To engage more companies, the Singapore Business Federation is holding another Business Continuity Seminar on Thursday. It has already organised 10 focus group discussions and three mass sessions, reaching out to some 3,500 participants.

Source: Link here.

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26 new H1N1 cases in Singapore, bringing total to 220

By Channel NewsAsia
Posted: 24 June 2009 2036 hrs

SINGAPORE: Singapore has confirmed another 26 new H1N1 cases, comprising 11 local cases and 15 cases with travel history.

This brings the total number of confirmed cases in Singapore to 220.

The Health Ministry said Wednesday the 11 new local cases comprise two Butter Factory patrons, two who attended a church camp at the Fishermen of Christ Church, two full-time national servicemen at Maju Camp and five unlinked cases.

The five unlinked cases comprise four women and one man – between 18 and 22 years of age.

Of the 15 imported cases, four had a travel history to the Philippines, four to Australia, three to Hong Kong, two to the United States, one to the United Kingdom and one to New Zealand.

Source: Link here.

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Latest update: As of 25 June 2009, the number of confirmed H1N1 patients has reached 320 – another 100 cases within 24 hours.