Updates

Singapore Implements Heightened Surveillance and Stockpiling, Exercising for H5N1 Readiness

Overview Of Medical Readiness Plan In June last year, the Ministry of Health (MOH) shared and publicised its Influenza Pandemic Readiness and Response Plan. The plan is premised on WHO guidelines. The full details are available on MOH website. The Plan is constantly updated to make sure it stays relevant and responsive to global and local developments. The plan adopts a colour coded risk management approach, with appropriate public health measures to be adopted for each alert level. Hospitals have also worked out their response plans. Physical Infrastructure
  • After SARS, we have upgraded the Communicable Disease Centre (CDC), and all public hospitals to enhance their capacity to deal with infectious patients. Aside from building additional isolation rooms (total of 425 in public hospitals), hospitals also have dedicated workflow for potentially infectious patients.
Surveillance and detection
  • MOH conducts both external and internal surveillance - to assess possible threats overseas and to detect possible avian flu cases within Singapore . Our front liners are experienced.
  • Post-SARS epidemic, surveillance systems are in place at hospitals to detect and report cases of atypical pneumonia, prolonged unexplained fever with poultry contact, and sudden unexplained death with acute respiratory symptoms.
  • Avian influenza made a notifiable disease by MOH since 12 Dec 05. Any suspect case will be reported immediately, and relevant medical assessments and investigations would be carried out.
  • All clinics and hospitals on high alert for possible cases of avian flu. Suspect cases are immediately isolated. Strict infection control measures are also in place. (To cite the recent suspected avian flu case in NUH as an example of the robustness of our surveillance and response system).
  • There is also a national influenza surveillance programme administered by MOH which includes virological surveillance of influenza viruses, community surveillance of acute respiratory infections, veterinary surveillance of poultry and bird populations through AVA, as well as monitoring of regional and global infectious disease incidents.
On stock-piling of anti-virals, Personal Protection Equipment (PPE) etc
  • MOH will stockpile 1.05 million boxes (10 capsules per box) of Tamiflu. This will be used for the prophylaxis forentified essential services personnel and the treatment of flu patients in a pandemic.
  • People should not take Tamiflu indiscriminately as this could result in resistance to the virus. We should not have personal stockpile of Tamiflu.
  • Our current stockpile stands at 680,000 boxes. The entire stock is expected to be built up by Oct-2006.
  • We are also stockpiling 50,000 courses of Relenza for use as a second-line drug.
  • A vaccine producer has been contracted by MOH to manufacture up to 10M doses of pandemic vaccine for our projected population of 5M.
  • Besides having anti-virals as a preventive measure, we have also build up other capacity such as having a stockpile of N95 masks and other PPE items.
Flu Pandemic Exercise
  • The Ministry is currently planning for a 2-day Flu Pandemic Exercise, involving public participation. This will be held in July this year. Prior this, MOH will work with each public and private acute hospitals April/May to review the SOPs of hospitals and exercise their control measures in dealing with suspect cases in their hospitals.
  • The aim of Exercise is:
    • To test our preparedness
    • To practice the key components of Flu Pandemic Readiness and Response plan, and
    • To prepare the public and raise vigilance
  • The Exercise will cover various aspects such as the management of imported avian flu cases and close contacts; healthcare institution’s infection control measures and case management; and contact tracing.
  • It will be comprehensive, involving different points of care delivery in the healthcare system – hospital, polyclinic, selected GPs and a nursing home. Infection control measures will be tested, including visitor registration, temperature screening, and full PPE for HCWs) and case management of H5N1 probable cases.
As part of our community outreach effort, we will also set up a Community Flu Clinic, with participation from the public. The public will be involve in the exercise, simulating patients requesting treatment, and the distribution of anti-virals will be exercised . http://www.flu.gov.sg/