On high bird flu alert, MOH plans ahead
By Tan Hui Leng, TODAY | Posted: 09 July 2007 0702 hrs
The public focus may be on dengue now, but the Ministry of Health (MOH) is not letting down its guard against the next big infectious disease threat — bird flu.
Although Singapore remains in the safe green zone, with zero infections, the MOH said it is on "high alert" for a possible bird flu outbreak here. Said MOH's director of communicable diseases, Dr Lyn James: "We are on the high alert because the World Health Organization and the United States Centers for Disease Control and Prevention have warned us that we have the right environment.
"(The world's population) has no immunity to H5N1; we will be a totally naive population, we will be totally susceptible to it," she told Today.
And with the possibility of a bird flu pandemic looming ever larger each day, the MOH will be proposing amendments to the Infectious Diseases Act by the year's end.
If passed into law, these will give the ministry more authority to swiftly close down public places — such as schools and cinemas — with a directive should a health crisis erupt. "It will put in place the legal framework to allow us to put a control on these kind of activities," said Dr James, the point person in charge of the bird flu pandemic action plan.
"We managed to close Pasir Panjang market (during the Sars crisis) but we want to do it in a more efficient way and in a more speedy manner, without going through so many layers."
This reflects the high priority the MOH is placing on a possible human flu pandemic caused by the deadly H5N1 virus that is already endemic to chickens in the region.
Since 2003, there have been 317 human infections reported in 12 countries, and 191 people have died. Just last month, the deadly H5N1 strain of bird flu was detected among chickens in a village on the outskirts of Kuala Lumpur. Since then, all poultry and eggs from the state have been banned from Singapore.
"The virus can mutate or combine with other human flu viruses at any time ... we don't know when that will happen. That's when you'll get a flu pandemic in the human population," said Dr James.
Pandemic plans here are based on the premise that bird flu will be imported. Comprehensive hospital, laboratory and community surveillance systems are in place to monitor acute respiratory infections and track suspect cases.
From January until the end of last month, the MOH received 37 notifications of bird flu — all false alarms. The 37 patients, who had flu-like symptoms after travelling to bird-flu affected countries, were hospitalised but tested negative for the disease.
Currently, the alert code for a human pandemic is green in Singapore. To take it to the next step — a yellow alert — there would have to be inefficient human-to-human transmissions of influenza caused by a novel virus, requiring close and sustained contact to an index case.
Should that happen, other measures such as travel health alerts and the dispensing of Tamiflu to healthcare workers will kick in.
To educate the public, the MOH, the Ministry of Home Affairs and the Ministry of Information, Communication and the Arts have put up an exhibition at the National Library. More than 15,000 visitors have viewed the exhibition, which runs until July 22.
"Once a pandemic starts, there is no way to prevent it from coming to Singapore because it'll just spread all over the world," said Dr James. "So, our premise is really to reduce, to mitigate the consequences."
- TODAY/so
If there is a suspected bird flu human case...
1. Patient is sent to Tan Tock Seng Hospital, lab tests ordered
2. MOH notified, contacts hospital for patient's medical, travel history, whether patient has had direct contact with chickens
3. MOH does risk assessment
4. If lab tests are positive for avian influenza, MOH will implement necessary public health actions including contact tracing, quarantine and preventive medical treatment
On high bird flu alert, MOH plans ahead 
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