SINGAPORE — The Ministry of Health (MOH) on Friday (24 January) confirmed Singapore’s second and third cases of a novel coronavirus which originated in Wuhan, China.
One of the two new cases is the 37-year-old son of the first case, a 66-year-old Chinese tourist from Wuhan. The son is currently warded at Singapore General Hospital (SGH).
The other confirmed case is a 53-year-old female Chinese national who is a resident of Wuhan. She is currently warded at the National Centre for Infectious Diseases (NCID) and in stable condition. The ministry had announced on Thursday that she tested preliminary positive.
All three confirmed cases are imported.
The announcement - on the eve of Chinese New Year, a major holiday in Singapore - comes as authorities around the world stepped up measures to curb the outbreak originating from the Chinese city of Wuhan, which has left 26 dead and afflicted over 880.
Details of female patient
During a media briefing at the Health Ministry on Friday (24 January), officials revealed that the woman arrived in Singapore on Scoot TR121 from Wuhan at 5.30am on 21 January. She had one companion.
She reportedly did not have a fever during the flight but developed fever, cough and chills in the afternoon.
She sought medical attention at Raffles Hospital on 22 January and was conveyed to the Tan Tock Seng Hospital (TTSH) emergency department by ambulance. She arrived at 8pm and was immediately isolated. The MOH was notified that she was a suspect case at 3am on 23 January and she subsequently tested positive for the novel coronavirus at midnight.
The woman stayed at J8 Hotel in the Jalan Besar area and had visited the Orchard area, Marina Bay Sands and Gardens by the Bay via public transport. Contact tracing is ongoing, inclusive of the passengers on the plane.
At the briefing, health officials added that they have since expanded the definition of a suspect case and as such, more suspect cases have been notified. Director of Medical Services-designate Kenneth Mak noted, “We have been on heightened surveillance even before the first case was diagnosed. (The) fine tuning of our responses continues on a regular basis.”
Currently, the definition of a suspect case is someone who has pneumonia and travel history to China within 14 days before the onset of symptoms, or someone with acute respiratory infection and had been to any hospital in China, within 14 days before onset of symptoms.
Out of 44 suspect cases – ranging in age between one and 78 – that have been identified, the MOH said that 13 have been ruled out, including the one year old. With three cases confirmed, this means that there are currently 28 suspected cases. Asked for a breakdown of the nationalities of these suspect cases and how many are Singaporeans, health officials promised to get back to the journalists present.
But Director (Communicable Diseases) Vernon Lee noted, “We don’t manage them based on their nationality (but on) their symptoms.”
All but two of the suspect cases, the ministry said, have travelled to China recently. The two who did not travel to China recently were close contacts of the first confirmed case.
The ministry added that more imported cases can be expected. However, A/P Mak cautioned against making “definitive statements” about the virus. “Globally, internationally, we still remain at a very early phase. (We) still do not have a good, proper understanding of the nature of the disease.
He stressed, “At this time, in Singapore, there is no evidence of community spread.”
All three confirmed cases are in stable condition, which means that they are not critically ill and are maintaining their vital signs.
While noting that Singapore has a “multi-layered defence” against the disease, such as enhanced border controls, Permanent Secretary Ng How Yue (Health Development) urged Singaporeans to play their part by exercising social responsibility. “If you are feeling unwell, avoid crowded areas, wear a surgical mask when you go out.”
A/P Vernon Lee added, “(This is a) social etiquette that we want to encourage everyone to adopt as a good baseline practice.”
The strain belongs to the same family of coronaviruses as Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people globally during a 2002-2003 outbreak and also started in China.
Chinese authorities confirmed that the virus is transmissible between humans and said it is adapting and mutating. A total of 881 people in China have been infected by the strain, including 549 cases in Hubei province alone.
At least 19 cases have been confirmed outside of mainland China, including in Singapore, the US, South Korea, Japan, Thailand, Hong Kong, Taiwan, Macau and Vietnam.
Patients suffering from the new strain may exhibit fever and symptoms of lower respiratory illness – such as coughing or difficulty in breathing – as well as pneumonia-like symptoms like a runny nose, sore throat and headache.
However, at least five who died from it have not displayed symptoms of fever according to details released by China’s National Health Commission, potentially complicating global efforts to check for infected travellers as they arrive at airports and other travel hubs.
This means that temperature screening, the most common measure being used at transport links and airports to check travellers, may not identify some infected people.
The MOH has urged members of the public to monitor their health closely for two weeks upon their return to Singapore and seek medical attention promptly if they feel unwell.
Those who develop fever or exhibit symptoms such as cough and runny nose should wear a mask and call the clinic ahead of their visit.
The ministry also advised travellers and members of the public to adopt the following precautions at all times:
Avoid contact with live animals including poultry and birds, and consumption of raw and undercooked meats.
Avoid close contact with people who are unwell or showing symptoms of illness.
Observe good personal hygiene.
Practise frequent hand washing with soap (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing).
Wear a mask if you have respiratory symptoms such as a cough or runny nose.
Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately.
Seek medical attention promptly if you are feeling unwell and inform your doctor about your travel history.
Screening in Singapore
Temperature screening has been implemented at Woodlands and Tuas Checkpoints since noon on Friday (24 January).
In a statement, Singapore’s Immigration & Checkpoints Authority (ICA) said “this is in response to the novel coronavirus pneumonia development in Wuhan and exported cases to other cities and countries”. The ICA also anticipates an increase in travel volume in the lead up to the Chinese New Year holiday period.
Travellers arriving at the land checkpoints will have to undergo temperature screening conducted by on-site healthcare assistants. Suspect cases will be referred to hospitals for further assessment.
Here’s how it will be done for people travelling on the different modes of transport:
By bus: Travellers will be screened at the alighting bus concourse or bus hall before immigration counters. Bus drivers will be screened at the security check area.
By train: Travellers will be screened at the alighting platform before entering the train hall for immigration clearance.
By car: Travellers are required to wind down their car windows for temperature screening at the security check area before immigration counters.
By motorcycle: Travellers are required to remove their helmets for temperature screening at the security check area after immigration counters.
By lorry: Travellers will be screened at the cargo platforms or immigration counters.
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