September 09, 2003

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The news direct from Singapore's

The news direct from Singapore's Ministry of Health:

A new probable SARS case

The Singapore General Hospital (SGH) has picked up a new
probable SARS case. It appears to be a single, isolated case. The
patient is currently isolated at the Communicable Disease Centre.
Investigations are on-going to establish the source of infection.
His contacts have largely been followed up and all of them are
well. As a precautionary measure, MOH has served HQOs on his
close contacts.

Chronology of event

2 The patient is a 27-year-old Chinese Singaporean post-
doctoral student working on West Nile virus at a microbiology
laboratory in the National University of Singapore (NUS). He also
does some work at the Environment Health Institute (EHI)
laboratory of the National Environment Agency. He last visited
the EHI laboratory on 23 August 03. He has no history of travel
to previously SARS-affected areas and no known contact with SARS
patients.

3 On 26 Aug 03, he went to work at the NUS lab and was well
but he developed fever around midnight. On 27 Aug 03, he
consulted a general practitioner and was given a course of
antibiotics. The fever persisted and he sought treatment at the
SGH A&E on 29 Aug 03. His chest X-ray was normal. He was
diagnosed to have a viral fever and discharged from the A&E. As
he did not feel better, he consulted a Chinese physician on 1 Sep
03. Two days later, on 3 Sep 03, he sought treatment again at the
SGH A&E and was admitted.

4 From the time he became unwell on midnight of 26 Aug 03
till his admission to SGH on 3 Sep 03, he remained at home apart
from his two visits to SGH A&E, the GP and Chinese physician.

5 When he was admitted to the SGH, he complained of fever,
muscle aches and joint pains, but did not have any significant
respiratory symptoms. He developed a dry cough after admission.
Three serial chest X-rays at SGH were all normal. However, on 8
Sep 03, when his PCR and serology test results were returned
positive, the patient was transferred to the CDC for further
management. He remains well.

Diagnosis

6 A repeat of his PCR tests was done in NUH lab today and
was confirmed positive. In view of his positive PCR and serology
results, MOH is treating him as a probable SARS case. Source of
infection

7 Investigations are underway to identify the patient's
source of infection.

Precautionary measures at the laboratories

8 Pending investigation, the two laboratories have suspended
all their research activities. Meanwhile, the staff members of
the laboratories have also been asked to stay at home until the
all-clear is given. No staff member has fever or feels unwell.

Precautionary measures at the SGH

9 Although the patient was isolated throughout his stay in
the SGH and the staff who had contact with him were in protective
gear, the SGH is not taking any chances and has ramped up its
precautionary measures to Orange Alert Level. These include
restrictions to visitation of the affected wards and more
intensive temperature surveillance of staff.

10 Home Quarantine Order

Group Number
Family members of case 8
TCM Sinseh 2
SGH A&E outpatients 8
Visitors 3
Discharged patients 4
Total 25

Conclusion

11 MOH has notified the WHO of the incident and the details
of the case. WHO has informed us that the case does not fulfil
the case definition for SARS as per the new WHO guideline in the
post outbreak period.

12 MOH's assessment is that this case was a low public
health risk as the patient was picked up and isolated early.

posted by Simon on 09.09.03 at 06:23 PM in the




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