SINGAPORE: SIX DEATHS AND H1N1 CASES PASS EPIDEMIC LEVEL

UNCLAS SECTION 01 OF 02 SINGAPORE 000730 SENSITIVE SIPDIS STATE FOR OES/IHB DHHS FOR OGHA EAP/MTS - MCOPPOLA BANGKOK FOR REO HOWARD E.O. 12958: N/A TAGS: TBIO KFLU CASC ECON SN SUBJECT: SINGAPORE: SIX DEATHS AND H1N1 CASES PASS EPIDEMIC LEVEL REF: A) SINGAPORE 518; B) SINGAPORE 676 ¶1. (SBU) SUMMARY: Six people have died as a result of H1N1 influenza infection, although each was complicated by preexisting health conditions or obesity. The Ministry of HEALTH (MOH) reported that the number of respiratory infections believed to be H1N1 has surpassed epidemic levels and MOH has predicted that this wave of the outbreak should reach its peak before mid-August. Western health experts view the current wave of cases in Singapore as typical of past influenza epidemics but have questioned some of MOH's numbers and warn that there could be another more serious wave of cases during the Northern Hemisphere flu season, which typically begins in November. Singapore has deactivated the three quarantine centers that were used to house suspected H1N1 cases when the GOS was actively seeking to contain the spread of H1N1. MOH continues to encourage the public to seek early treatment, particularly for people in high-risk groups, such as pregnant women and the obese. End Summary. Six H1N1-Related Deaths to Date -------------- ¶2. (U) Six people have died of H1N1 influenza infection complicated by preexisting medical conditions or obesity. The latest death, reported August 2, was a 29-year-old woman who reportedly died of pneumonia and renal failure as a result of a prolonged H1N1 infection. The woman was obese but did not have any other known medical conditions. She checked into a local hospital for care four days after first expressing flu-like symptoms and died approximately one week later. Other H1N1-related deaths involved patients with underlying conditions such as epilepsy, hypertension, high cholesterol, or cancer that was in remission. Number of H1N1 Cases Surpasses Epidemic Levels -------------- ¶3. (SBU) The Ministry of HEALTH (MOH) reported at the end of July that numbers of upper respiratory tract infections passed the epidemic threshold of 16,665 cases a week, illustrating the effect the presence of H1N1 has had on the local community. MOH stated that as of July 20, sample surveys indicated that 53 percent of flu-like illnesses were H1N1, but a more recent press report quoted MOH officials saying that H1N1 currently accounts for 90 percent of flu cases in Singapore. The current wave of flu-like cases in Singapore has followed a pattern similar to past influenza epidemics and demonstrated the rapid spread of a new virus within a previously unexposed community, Dr. Rod Hoff, Executive Director of the Regional Emerging Diseases Intervention (REDI) Center told Econoff. A contact at the Program on Emerging Infectious Disease at the Duke-National University of Singapore Graduate Medical School noted that Singapore appears to be in the midst of a major epidemic. However, he indicated that different GOS officials have told him varying estimates for the total number of H1N1 cases, making it difficult to ascertain the full extent of the outbreak. (Note: MOH no longer publicly reports individual confirmed cases of H1N1. End Note.) ¶4. (U) MOH has predicted that the current wave of H1N1 cases should peak before mid-August. HEALTH officials are preparing for another substantial wave of cases to emerge during the Northern Hemisphere flu season, which typically begins in November. How the coming flu season will manifest in Singapore remains to be seen, Dr. Hoff said. As a major transit hub close to the equator, Singapore may be uniquely exposed to the effects of both Southern and Northern Hemisphere flu seasons as people travel through Singapore. MOH Deactivates Quarantine Centers, Urges Vigilance -------------- -------------- ¶5. (SBU) On July 31 MOH deactivated the three guesthouse facilities used as quarantine centers when the GOS was actively seeking to contain the spread of H1N1 to Singapore (Ref A). Press reports indicated that at least 281 people were quarantined at the three facilities over the course of the containment period. The last American citizen known to be quarantined was released at the end of June (Ref B). ¶6. (U) MOH continues to urge the public to be vigilant about seeking treatment early and reducing the spread of the disease. MOH SINGAPORE 00000730 002 OF 002 is particularly focused on high-risk groups, such as pregnant women, people with underlying conditions like hypertension, and the obese. In most cases, the people who died from H1N1-related complications went to the hospital after a few days of symptoms, so MOH has encouraged at-risk groups to seek treatment as soon as they show flu-like symptoms. MOH recently mailed out public notices in English, Chinese and Malay that provided guidance on precautionary measures like thorough hand washing and how to properly fit and wear a surgical mask if feeling unwell. SHIELDS