SINGAPORE: 77 H1N1 CASES -- COMMUNITY SPREAD STARTING

UNCLAS SECTION 01 OF 02 SINGAPORE 000581 SENSITIVE SIPDIS STATE FOR OES/IHB DHHS FOR OGHA EAP/MTS - MCOPPOLA BANGKOK FOR REO HOWARD E.O. 12958: N/A TAGS: TBIO KFLU EAGR CASC ETRD ECON SN SUBJECT: SINGAPORE: 77 H1N1 CASES -- COMMUNITY SPREAD STARTING REF: A) SINGAPORE 495; B) SINGAPORE 445 ¶1. (SBU) SUMMARY: As of June 18, there have been 77 cases of H1N1 influenza confirmed in Singapore. Almost all were "imported" cases involving people with recent travel to affected countries. However, a Malaysian permanent resident may be the first case of H1N1 influenza contracted by community transmission in Singapore. The GOS has indicated that once community spread is confirmed, the government might move away from its current stringent containment measures to a mitigation strategy. At the same time, however, the press has reported that students could be asked to study from home if the outbreak worsens. The CDA met with MFA Americas Director Ng Teck Hean and urged that, as Singapore adjusts its approach to the new situation, the GOS take into account American interests, including: the interests of American travelers to Singapore; American businesses that depend on travelers to the United States from Singapore; and of U.S. Government agencies whose work with Singapore counterparts requires official travel to the United States by Singapore officials, some of whom have canceled such trips because of H1N1 concerns. End Summary. 77 H1N1 Cases; Evidence of Community Spread -------------- ¶2. (U) The Ministry of Health (MOH) has confirmed 77 cases of H1N1 influenza in Singapore since the virus first appeared here on May 26 (Ref A). To date, almost all cases were people with recent travel to affected areas, including the United States, Canada, Australia and the Philippines, though one case was a close contact of an imported case. However, MOH believes that a Malaysian permanent resident may be the first case of community-spread infection in Singapore. The 26-year old man developed H1N1 symptoms shortly after departing Singapore and arriving for a short visit in Kuala Lumpur. He had no other travel to affected areas. ¶3. (SBU) Press reports and information on the MOH website regarding the man's case are not conclusive but indicate that he probably contracted the virus in Singapore and not during his travel to Malaysia. Only about twelve hours passed between his departure from Singapore and the appearance in Malaysia of flu symptoms, too quickly for H1N1 to have been contracted in Malaysia. �00A;Qgapore Maintains Strict Containment Measures -------------- -- ¶4. (SBU) Singapore remains fixated on containing the virus even as MOH has acknowledged that community spread is inevitable. The Ministry of Education said that there is currently no need to close schools, but the Ministry is prepared to initiate home-based learning if the H1N1 outbreak worsens. Several schools have Internet-based teaching plans to administer lessons and collect assignments. Various businesses continue to conduct thermal scanning and question visitors about recent travel to countries with widespread H1N1 infection. The GOS continues to trace and quarantine people seated in close proximity to confirmed cases on flights arriving in Singapore. (Note: At least 250 quarantine orders have been issued to date. A total of 44 Americans have been quarantined at home or in GOS-provided housing. Two American citizens with confirmed H1N1 have been quarantined at local hospitals. End note.) The GOS has expanded its advisories against unnecessary travel to include 13 countries, and health screening for arrivals at border checkpoints remains in effect. Move from Containment to Mitigation Possible -------------- ¶5. (SBU) Minister of Health KHAW Boon Wan stated publicly that the GOS will relax its stringent containment measures and move to a mitigation strategy when sustained community transmission of the virus has been confirmed. Contacts at the Regional Emerging Diseases Intervention (REDI) Center suggested that MOH may announce a shift in policy imminently, but no specific timeline has been made public. CDA Urges MFA to Factor in American Interests -------------- ¶6. (SBU) The CDA, in a June 18 meeting with Ng Teck Hean, Director for the MFA Americas Directorate, urged the GOS to factor in SINGAPORE 00000581 002 OF 002 American interests as Singapore adjusts its approach to the new situation. The CDA noted that some American travelers to Singapore who have been quarantined have expressed concern about the heat, insects, and poor living conditions in GOS-provided quarantine facilities. U.S. businesses such as air carriers that depend on Singaporeans traveling to the United States believe that Singaporeans are deferring such trips because of H1N1 fears. Some GOS agencies, including the police, have canceled official visits to the United States with little advance notice, citing H1N1 concerns. This has caused problems for the USG agencies who helped arrange the trips and set up the U.S. programs, he noted. ¶7. (SBU) Ng said the GOS will take such concerns into consideration. He noted that there is no official prohibition against GOS travel to the United States and the public travel advisories are recommendations only. The decision on whether or not to travel rests with the individual. The CDA pointed out that the nuances of such advisories may be lost on some members of the public who postpone or cancel travel because they fear being quarantined whether or not they actually contracted the virus. SHIELDS