Posts Tagged ‘Influenza A(H1N1) virus’

Preparing for 2nd flu wave

August 11, 2009
Aug 11, 2009
Preparing for 2nd flu wave <!–10 min–>

Health workers wear face masks as precaution against the influenza A H1N1 virus, which has spread to 168 countries, at an El Salvador, Central America hospital in July. — PHOTO: REUTERS

WASHINGTON – THE US and other countries in the Northern Hemisphere are bracing themselves for a second wave of Influenza A (H1N1) infections that could strike millions of people and contribute to the hospitalisation and deaths of thousands, including many children and young adults.

While flu viruses are notoriously capricious, making any firm predictions impossible, a second wave could hit the Northern Hemisphere within weeks and lead to major disruptions in schools, workplaces and hospitals, according to US and international health officials.

Since emerging last spring in Mexico, the H1N1 virus has spread to 168 countries at least, causing over 162,000 confirmed cases and playing a role in at least 1,154 deaths, including 436 in the US. As the first flu pandemic in 41 years spread through the Southern Hemisphere’s winter recently, scientists have been closely monitoring the virus for clues to how much of a threat it might pose this autumn.

So far, no signs have emerged that the microbe has mutated into a more dangerous form. Most people who get infected seem to experience relatively mild illness.

Still, in the Southern Hemisphere, which experiences winter during the Northern Hemisphere’s summer, the virus caused a more intense and somewhat earlier flu season in some places.

Its appearance in countries such as South Africa and India, both of which have just recorded their first deaths, is raising concern that the pandemic could be devastating if it begins to sicken large numbers of people in places with fewer resources.

Meanwhile, concern about a second wave has prompted a flurry of activity by federal, state and local officials in the United States.

Many experts suspect the second wave could be more severe than an average flu season, which hospitalises an estimated 200,000 Americans and contributes to 36,000 deaths. Because the virus is new, most people have no immunity against it.

The number of cases could increase rapidly as soon as schools begin to reopen in the next few weeks and could accelerate further as cooler, drier temperatures return, possibly peaking in October.

That is much earlier than the usual flu season, and it could create confusion. People could start getting sick with the H1N1 flu before a vaccine is widely available and nonetheless be urged to get vaccinated against the regular seasonal flu, which will be available first.



H1N1 FLU PANDEMIC: All on planet at risk

July 28, 2009

July 28, 2009
All on planet at risk <!–10 min–>

The total number of people infected with H1N1 flu is not known, and countries are no longer testing and reporting each individual case of a person falling ill — ST PHOTO: DESMOND WEE

GENEVA – THERE may be no escape from H1N1 pandemic flu, which according to the latest World Health Organisation figures has spread to the most remote parts of the planet including popular island getaways.

In a snapshot published on Monday, the WHO said more than 20 countries and overseas territories had had their first lab-confirmed cases of the new virus, widely known as swine flu.

These include holiday destinations such as the Seychelles, Turks and Caicos, St Kitts and Nevis, Netherlands Antilles, Belize and France’s Reunion Island, as well as isolated spots such as Tonga and American Samoa in the Pacific and the Solomon Islands in the Indian Ocean.

H1N1 flu, which is a genetic mix of human, bird and swine viruses, has also found its way to Bhutan in the Himalayas and Andorra, an independent state tucked between Spain and France.

Conflict-ridden Afghanistan and Sudan have also had their first confirmed infections in recent days.

The emergence of the never-before-seen virus in Mexico and the United States and its fast international spread caused the WHO to declare in June that a pandemic was under way. The UN agency has said it is impossible to stop it from circulating, and is monitoring it closely for signs of mutation or combination with other flu viruses.

While most patients have had mild flu-like symptoms, such as fever and vomiting, pregnant women and people with diabetes and other diseases have been vulnerable to more serious effects. An estimated 816 people have died from infection to date, according to the WHO’s latest tally.

The total number of people infected with H1N1 flu is not known, and countries are no longer testing and reporting each individual case of a person falling ill. The WHO has said more emphasis should be placed on preventing infection and treating the most serious cases to avoid unnecessary death.

Drugmakers Roche, Gilead Sciences and GlaxoSmithKline have benefitted from a worldwide rush to secure supplies of their antiviral drugs to fight the spreading flu. Vaccine makers including Sanofi-Aventis, Novartis NOVN.VX, Baxter and Solvay are also working on H1N1 shots that could be given alongside seasonal flu jabs. — REUTERS

5th H1N1 death in S’pore

July 27, 2009
July 27, 2009
5th H1N1 death in S’pore <!–10 min–>

By Judith Tan
It is believed that Ms Kuan died of pneumonia, with H1N1 as a contributing factor. — PHOTO: AFP

A FIFTH patient in Singapore has died after developing complications from Influenza A (H1N1).Ms Kuan Lay Kim, 34, died early Monday morning at the Singapore General Hospital (SGH).

Ms Kuan, who was suffering from acute myeloid leukaemia (AML), was admitted to the hospital on July 17 after coughing for two days and tested positive for H1N1.

She was transferred to the ICU on July 19 for closer monitoring as her need for oxygen increased.

It is believed that Ms Kuan died of pneumonia, with H1N1 as a contributing factor.

The five H1N1-related deaths here have occurred within 10 days.

The first victim – a 49-year-old man who had multiple health problems including diabetes, hypertension and high cholesterol – died on July 18.

Two others died last Wednesday. They were a 13-year-old boy with epilepsy and a 55-year-old man with motor neuron disease.

The fourth fatality was a 42-year-old Chinese Singaporean woman, who suffered from had thyroid disease.

She died of pneumonia last Friday morning.

School tells all Pri 5 students to stay home after many fall sick

July 26, 2009

Flu Watch
School tells all Pri 5 students to stay home after many fall sick
No known H1N1 cases, but pupils asked to use e-learning system instead
THE entire Primary 5 cohort at Si Ling Primary School was asked to stay home yesterday.
26 July 2009

THE entire Primary 5 cohort at Si Ling Primary School was asked to stay home yesterday.

And they won’t be going to school on Monday either.

A Si Ling Primary School spokesman told The New Paper that ‘about six pupils’ in each of its 11 classes have taken medical leave since early this week, some for ‘influenza-like illnesses’.

Si Ling has kicked in its home-based learning management system for the two days ‘to continue with teaching and learning.’

First since outbreak

It is understood to be the first school to shut down an entire level since the outbreak of the Influenza A(H1N1) virus.

Earlier, Westwood Secondary and Presbyterian High School had remained closed for another week after the June holidays because of the flu bug.

Si Ling said that it had no H1N1 case reported. But not all flu patients here are tested for H1N1 because the bug has already spread into the community.

One of the Primary 5 students who fell ill, Mary (not her real name), told The New Paper that she and four classmates realised they had a fever at the end of Monday. Mary was given three days’ MC after seeing a doctor.

She was not tested for H1N1.

Mary’s mother 37, a preschool teacher, said: ‘The teacher told me on Tuesday that only 18 out of 41 students had come for class that day. The teacher also said that she’d come down with a fever.’

On Wednesday and Thursday, the school conducted its immunisation exercise for Primary 5 pupils.

Some students developed a fever after the immunisation.

Associate Professor Daniel Goh, Senior Consultant at University Children’s Medical Institute, National University Hospital, said that the ‘Diptheria and Tetanus vaccine booster’ given to Primary 5 students can cause a fever a day or two after.

About three to 25 per cent of those given the vaccine report getting a fever after that, he said.

But he added that the fever is usually mild, lasting only a day or two, and nothing to be worried about. It usually does not come with other flu symptoms.

‘The absence of flu symptoms (like runny nose or cough),’ he said, ‘distinguishes it from H1N1 infection.’

Parents informed

On Wednesday, the school called parents to inform them that their children need not go to school on Friday and Monday.

The school kicked in its learning management programme, which was already in place for those on MC, from yesterday.

For those who have fallen ill, it has been a trying time. The past few days, said Mary, have been ‘miserable.’

‘All I do is stay at home and watch TV or sleep,’ she said.

‘I feel tired all the time.’

Worried about infecting her 8-month-old baby brother, she confined herself to her bedroom.

Whenever she left her room for the toilet, or to take her medicine, she had to put on her mask.

Said Mary’s mother: ‘We were scared that it might be H1N1, and her baby brother is only eight months old.’

Yesterday was the first time the students were learning from home.

Some found it confusing at first.

The Primary 5 students logged on yesterday morning to attempt a series of multiple-choice quizzes for each subject, English, Maths, Science and Mother Tongue.

Mary said: ‘At first we couldn’t find some of the subjects in the e-learning system. One of my classmates called me for help.’

But in the end, she said, they managed to finish the quizzes without a glitch.

The Si Ling spokesman noted that the school had also given hard copies of the questions to the few who could not log on to the system from home.

The spokesman said that the school will ‘continue to be vigilant and remind our students to practise good personal hygiene and social responsibility to see a doctor and rest at home when they are unwell.’

– Han Yongming, newsroom intern.

Ministry: Test for H1N1 only if…

SCHOOLS will continue to remain vigilant to slow the spread of the H1N1 virus, said a spokesman for the Education Ministry.

The spokesman said MOH has revised its approach in tracking H1N1 cases, testing suspected cases only when there is a clinical indication (e.g. severely ill patients).

For patients with influenza-like illness who do not require hospitalisation and are not likely to be tested for H1N1, doctors will issue medical certificates (MC) of up to seven days for staff and students above 12years old, and up to 10 days for children aged 12 years and below.

If a significant number of students in a class are issued MCs due to influenza-like illnesses, the school will consider taking precautionary measures, such as segregating the class into groups or temporarily suspending lessons. The students will be provided with home-based learning lessons or attend make-up lessons when they return to school.

Schools screen students, staff and visitors for fever and flu-like symptoms.

They will continue to keep their premises clean and educate students to maintain high standards of personal hygiene and exercise social responsibility.

Schools also adopt the necessary precautionary measures for mass activities.

H1N1 case at Coral Primary

CORAL Primary’s principal Eric Leong told The New Paper that a Primary 5 student tested positive for the H1N1 virus on Wednesday.

Mr Leong said the student was fine when he came to school on Monday, but saw a doctor on Tuesday after he started coughing.

The boy is now recovering at home.

The school is in touch with his family. Staff and students in his class who were in close contact with him will be staying home for seven days. Some have seen a doctor and have been given MCs.

No one else tested positive for H1N1, said the school.

Affected students can log on to the school’s e-learning system from home.

The school’s system allows for teachers to stay in touch with and monitor those at home. As for the other Primary 5 students, said Mr Leong, it’s class as usual in school.

‘Do I need to be dying before I get screened for H1NI and receive Tamiflu?’

July 26, 2009
‘Do I need to be dying before I get screened for H1NI and receive Tamiflu?’


STOMPer J went to a two clinics when he was suffering from a high fever, body ache, runny nose, cough, diarrhea and breathing difficulties, only to be issued with Panadol and some cold tablets.

The STOMPer had just returned from the UK after a month there.

He recounted in an email sent to STOMP today (July 25):

“I went to two clinics. One was in Hougang and the other in Sengkang.

“I just came back from UK after a month there and I was having a high fever of 39 to 41 degrees, body ache, runny nose, cough, diarrhea and a feeling of lacking oxygen.

“Both clinics I went to only issued me with Paracetamol and some cold tablets.

“The reason I went to two is because the first clinic does not screen for H1N1 despite being PPC ready and does not issue Tamiflu.

“The second clinic cited the same thing. When I checked with the second clinic, I was told that the screening kit and Tamiflu had run out and was told that he is confident that all clinics are out of stock.

“Only Tan Tock Seng Hospital has the kits and Tamiflu but in limited quantity and because of this, they will not entertain walk-in patients.

“This is despite the fact that I told the doctors that I have a history of asthma. Only those who are having a persistent fever for more than 10 days or those who are dying are allowed to go to TTSH.

“I went to TTSH and if confirm that that is the case and they would not entertain me at all.
“1) Is the Government ready for such pandemic? It seems that our stocks are running low.

“2) Do I need to be dying to go for a screening and get the Tamiflu?

“3) I have been feeling out of breathe most of the time and is much worse at night but when I went to the clinic again, I was told to wait for 10 days before he can refer me to TTSH. Is that ethical?

“4) I am having a fever for the past four days and I still have to wait for another six days before I can be screened for H1N1. Isn’t that too late? I have past history of asthma and H1N1 seems to affect those with existing condition.

“This is as good as waiting for death. No wonder the death rate for H1N1 is going up in Singapore.

“5) With the reputation of so-called world class healthcare, I wonder which countries was Singapore compared with.

“I am utterly disappointed with our healthcare system as it seems like people need to be dying in order to get some attention from the doctors who are keeping the medicine.”

H1N1 FLU PANDEMIC: 2 more H1N1 deaths

July 23, 2009
July 22, 2009
2 more H1N1 deaths <!–10 min–>

By Jessica Jaganathan
A second H1N1 patient in Singapore – a 13-year-old boy – has died from complications. –ST PHOTO: DESMOND WEE

TWO more H1N1 patients with underlying conditions died on Wednesday, bringing the number of deaths in Singapore to three in less than a week.

One of them is a 13-year-old boy, who suffered from epilepsy. He died from prolonged seizures in which H1N1 was a contributing factor, said a Ministry of Health statement.

He was admitted to National University Hospital on Sunday after coming down with a fever and cough. His heart and respiratory functions stopped at the hospital’s emergency department and he was later transferred to the paediatric intensive care unit.

The other victim is a 55-year-old who suffered from motor neuron disease and had been in the intensive care unit since last Saturday. He died from severe pneumonia with advanced motor neuron disease and H1N1.

The man sought medical treatment at CGH’s Emergency Department last Saturday after two days of fever and breathlessness. He suffered cardiac arrest at the Emergency Department on Saturday and was admitted to the hospital’s ICU. Laboratory tests confirmed that he was infected with H1N1.

The first H1N1-related death was a 49-year-old man with heart problems. He died at the CGH last Saturday. The Health Ministry said the man, who had multiple health problems, died of a heart attack contributed by severe pneumonia and the H1N1 infection.

Prior to the flu virus infection, he was already suffering from diabetes, hypertension and high cholesterol.

MOH said another H1N1 patient is in critical condition at Tan Tock Seng Hospital. The 42-year-old female foreigner, with a history of hypertension and who is overweight, sought treatment at TTSH’s Emergency Department on Wednesday, after suffering from shortness of breath for three days.

She was found to have low oxygen saturation and low blood pressure. She was tested positive for H1N1 and is currently on a ventilator.

An earlier patient, a 42-year-old woman with co-morbidities (hypertension, thyroid disease) who was admitted to CGH’s ICU last Saturday, remains in critical condition.

Over at the Mount Elizabeth’s ICU, a 46-year-old female foreigner with hypertension and kidney disease on dialysis and infected with H1N1, is currently in stable condition.

$10m for H1N1 research

July 23, 2009
July 22, 2009
$10m for H1N1 research <!–10 min–>

By Grace Chua
The research will include projects on public-health issues such as the spread of infection, and on clinical issues such as the rate of complications in various groups of people, said Health Minister Khaw Boon Wan (left) on Wednesday night. –ST PHOTO: STEPHANIE YEOW

THE Ministry of Health is setting aside $10 million for research into H1N1 influenza so that Singapore can be more prepared for a second wave of outbreak.

The research will include projects on public-health issues such as the spread of infection, and on clinical issues such as the rate of complications in various groups of people, said Health Minister Khaw Boon Wan on Wednesday night.

‘We are still at war with the virus…While the rest of Singapore can return to life as normal, the scientific and medical community still has much to do,’ said Mr Khaw, speaking at the National Medical Excellence Awards ceremony at Chijmes to honour doctors and medical researchers who have made significant contributions to clinical work, medical researchers and academic medicine.

Earlier this week, Mr Khaw said in Parliament that the number of H1N1 infections here will peak in the next two weeks before starting to decline, as is happening in New York City. But a second wave of infections is expected when winter returns to the northern hemisphere later this year.

So far, the Ministry of Health has received 45 proposals for H1N1-related projects from local hospitals and research institutes. The proposals are under review. Grants from the $10 million kitty will be awarded by September and will fund the work for one to three years, the ministry said.

Warning Singapore is not out of the wood from the H1N1 spread, Mr Khaw said laboratories here continue to work round the clock, in partnership with GPs and polyclinics to sample flu patients for the virus.

‘This is to track the spread of the virus through the community and to look for any significant genetic changes in the months to come. Our scientists continue their studies of the strain to spot any mutation of the viruses, looking for clusters of disease, with the aim of quickly recognising changes in the viruses, and to be able to deal with the problem as fast as it occurs,’ said Mr Khaw.

Mr Khaw said the H1N1 pandemic is a good illustration of why Singapore must invest in science and research.

‘It is not simply for prestige, to profile our scientific capabilities. It can actually make a critical difference to our life and death,’ he emphasied. ‘The first wave of H1N1 will eventually run its course. But there will be new waves. And it is not just H1N1. H5N1 remains out there among the chickens and the ducks? We must continue to invest in research, to try to stay ahead of the virus, if not, not too far behind the curve.’

He called for strong collaboration between clinicians and scientists to fight ‘a common enemy’. ‘Given Singapore’s limited resources, it does not make sense to make duplicates of everything. We have to learn to complement each other’s capabilities,’ said Mr Khaw.

H1N1 FLU PANDEMIC: No underlying conditions

July 16, 2009
July 16, 2009
No underlying conditions <!–10 min–>

The latest cases bring the number of people critically ill with H1N1 in Singapore to three. — PHOTO: AP

IN A first here, a person with no underlying conditions has been taken seriously ill with Influenza A (H1N1). The victim is a 22-year-old woman who is six months’ pregnant. She developed pneumonia and tested positive for H1N1 at a private hospital.

She was admitted to KK Women’s and Children’s Hospital (KKH) on Monday. A day later, she was transferred to the hospital’s intensive care unit (ICU) for closer monitoring as her need for oxygen increased.

Pregnant women are considered high-risk and should consult their specialist if they have flu-like symptoms. If complications develop, they should call an ambulance immediately.

In this case, the mother-to-be was sent to the hospital’s ICU because her condition had deteriorated. She is one of two women who are critically ill with the virus, the Ministry of Health said on Wednesday.

The other is a 45-year-old with a slew of medical conditions: Diabetes, hypertension, high cholesterol and peripheral vascular disease, which develops when the arteries which supply blood to the legs become blocked.

She was also on immunosuppressants as she had undergone a kidney transplant in 2006.

She went to the Singapore General Hospital’s emergency department on July4 after vomiting and suffering from diarrhoea for two days, and was admitted. But her condition worsened, and she was transferred to the ICU on Sunday.

Laboratory tests later confirmed that she was infected with H1N1.

The latest cases bring the number of people critically ill with H1N1 in Singapore to three. The third is a 51-year-old man who was admitted to Changi General Hospital’s ICU last Thursday.

His condition is now stable, but he remains in the ICU.

H1N1 FLU PANDEMIC: Vaccine available to all

July 15, 2009

July 15, 2009
Vaccine available to all <!–10 min–>

The H1N1 vaccine – given possible side effects – will be offered to people on ‘a voluntary basis’. — PHOTO: REUTERS

WITH pharmaceutical companies across the globe racing to develop a vaccine for Influenza A (H1N1), it is only a matter of time before Singapore has a guard against it. When such a vaccine becomes available, it will be sold at general practitioner clinics and be available to the public here.

The Ministry of Health (MOH) said this in an e-mail response to a Straits Times query on its vaccination plan.

This strategy is similar to existing arrangements for other vaccinations, including the seasonal flu jab.

The ministry added that the H1N1 vaccine – given possible side effects – will be offered to people on ‘a voluntary basis’. This means anyone who wants the vaccine will be able to approach their doctor for it, when it becomes available.

In 1976, a vaccine rushed into distribution against a different type of swine flu in the United States caused high rates of Guillain-Barre syndrome, a rare and potentially paralysing neurological disorder.

This time, key considerations in procuring the pandemic vaccine will be safety and efficacy, which can be determined only after full clinical trials are done, said an MOH spokesman. With the situation still evolving, the effectiveness of the vaccine, should a more virulent H1N1 strain virus appear, remains uncertain.

When asked about costs, she added: ‘Those who wish to be vaccinated, after considering their risk profile and understanding the possible side effects of any vaccination, will have to pay for it.’ But patients who have difficulty paying for the drug will be given the necessary assistance, she said.

The ministry’s response reiterates Health Minister Khaw Boon Wan’s position earlier when he said that Singapore would order enough H1N1 vaccine for the entire population.

‘We will secure adequate supply of H1N1 vaccine for our people,’ he said at a press conference last month.

The MOH is currently evaluating submissions from three tenderers from its recent open tender exercise to supply a vaccine, but did not reveal more details.


School blindly follows H1N1 rule during dismissal, leaves parents in rain, kids in chaos

July 12, 2009
School blindly follows H1N1 rule during dismissal, leaves parents in rain, kids in chaos

The rule is to have only one school gate open during dismissal time, but instead of helping to control H1N1, STOMPer Lawrence thinks it is doing more harm than good.

He says that because of this ruling, parents, grandparents and maids waiting to fetch the kids from school yesterday (July 10) were caught in the rain, in danger of being knocked down by cars and more susceptible to the spread of H1N1 virus because they were gathered so close to one another for some time.

Lawrence told STOMP in an email yesterday (July 10):

“It has been raining for the past half an hour and it is 1pm at the moment, morning session has just been released.

“There used to be 3 gates open for students to exit the school but has been limited to only one: one way in and one way out, due to the procedures for H1N1.

“You can see that the only gate out of the school has been blocked by parents and grandparents, including domestic helpers with their umbrellas covering each others.

“Cars line up on both side of the road while passing vehicles slowed down to get across. I am standing from a distance, avoiding going close to anyone as I am having an irritating throat and a bad headache.”

He said apparently there was a muffled announcement saying that another gate was open, yet the security rudely refused to let people in, even shouting to one man to “get out of here!”

The guard also tried to prevent the STOMPer from going to the second gate to find his kids.

Lawrence said:

“At 1.20pm, my boy managed to locate me even while he was blocked by parents and umbrellas, but he was

separated from his sister who was at the first gate.

“I instructed him to get his sister here and he replied, ‘We are not allowed to go there’ and I thought: red tape! He paused and continued ‘I’ll try’.

“Given the chaotic situation, he must have squeezed through somehow and after waiting in the rain for couple of minutes, both my kids appeared and we are out of the H1N1 Jam.

“For the grannies’ sake, please allow the poor kids out of the school in an orderly manner.

“A heavy downpour like this can happen any time in a tropical country like ours.

“You can plan for H1N1 but what is a plan if there is no control? By the way, I believe that not all granny can understand English.

“The jokes out of this scenario are:

“1. We have good teachers and they follow the Law closely.

“2. The security guard was like the guard in the Singapore show ‘follow the law’ unfortunately, a very rude one indeed.

“3. They could use a better speaker or at least have better management.

“4. If there was any infected H1N1 person, he or she would be transmitting the virus among the crowd and in turn, transmit to the students.

“It was raining heavily, it was crowded with people, wet and damp, best place for virus to multiply and spread.

“5. I could see one teacher with a mask on his face but not even covering his mouth giving instructions but I doubt most parents could understand him, I definitely couldn’t hear a thing.”