Friday, June 26, 2009

H1N1 at Singapore

Experts warn that outbreak is only at an early stage

A SCIENTIFIC committee tasked with examining data on H1N1 flu patients here is agreed on one thing: Things are going to get much worse.

And going by the latest numbers released last night, Singapore's H1N1 curve is heading up rapidly, with 95 new patients, the highest number so far. This brings the total to 315.

Nightspot Butter Factory had 10 more staff and patrons down with the flu, making it the biggest cluster of infections, with 21 cases so far. The Health Ministry said last night it had yet to complete investigating how 48 of the 95 new cases caught the bug.

The sharp increase appears to confirm the conclusions of the team headed by the Health Ministry's director of medical services K. Satku that Singapore is 'past the tipping point'.

Signs are that the flu season, which should have been tapering off around this time of year, will return with a vengeance. And over recent days, more flu cases have been of the H1N1 variety.

This happened in the United States too. Its flu season should have ended, except for H1N1 fuelling a drastic spike in the number of flu patients, now in the thousands, with deaths occurring regularly.

Doctors on the panel yesterday made it clear that Singapore was not over-reacting in its response to the pandemic, even though H1N1 has proven mild so far.

The big question now is, what happens when the numbers surge? Said Dr Lim Poh Lian, a senior consultant at the Communicable Disease Centre (CDC): 'When the numbers go into the thousands, we will see people coming down sick, who might need ventilator support and who might die.'

A reason for caution: Doctors and scientists have had only two months to examine the nature of H1N1, and while the Genome Institute of Singapore found that it has mutated only slightly, there is no telling how much it will change. Said Dr Lyn James, the ministry's director of communicable diseases: 'It is wiser not to underestimate the virus, because we are still in the early stages of the outbreak.'

Doctors have so far only examined about 200 patients, mainly young and healthy travellers. Once H1N1 circulates freely, it will also infect the elderly, pregnant women and others with various health problems. Said Prof Satku: 'We must remember that we have vulnerable individuals who have a higher risk of flu complications.

'Let's look after them too, by ensuring that we do not inadvertently expose them to infection.'

CDC head Dr Leo Yee Sin said she is worried because the population mix is different from the H1N1 patients seen so far.

'I worry about how it will affect this group of older folks and immuno-compromised patients,' she said.