The report below details 6 cases imported to Singapore with special emphasis on airlines and potential transmission. However, the ironic part of the article below is the 29F who died after returning to Singapore on March 26 from Beijing. This traveler is almost certainly the Singaporean who flew to Beijing from Hong Kong on March 15 on CA-112. Over 20 passengers developed SARS on that flight including one from Singapore who subsequently died. Thus, although there was no documented transmission of SARS in Singapore from this patient, the index case on Flight 112 (who almost certainly contracted SARS from his niece who was at Prince of Wales Hospital in Hong Kong) did transmit SARS to HCWs in Beijing, the stewardesses transmitted SARS to relatives and HCWs in Hohhot, and Taiwanese travelers transmitted SARS to at least one relative (an 8 year).
-----Original Message-----
From: Niman, Henry L.
Sent: Thu 10/9/2003 9:54 AM
To: SARS News
Cc:
Subject: SARS NG Experience of Severe Acute Respiratory Syndrome in Singapore: Importation of Cases, and Defense Strategies at the Airport
bcdecker.com
ORIGINAL ARTICLES
Experience of Severe Acute Respiratory Syndrome in Singapore: Importation of Cases, and Defense Strategies at the Airport
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Annelies Wilder-Smith, Kee Tai Goh and Nicholas I Paton
Annelies Wilder-Smith, MD, MIH, PhD and Nicholas I Paton, MD: Department of Infectious Diseases, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore; Kee Tai Goh, MD: Ministry of Health, Singapore.
ABSTRACT
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Background: The importation of SARS was responsible for the outbreaks in Singapore, Hong Kong, Vietnam and Canada at a time when this new disease had not been identified. We report the incidence and impact of cases of SARS imported to Singapore between 25 February and 31 May 2003, and describe national measures to prevent further importation.
Methods: Information on imported cases of SARS and measures taken at entry points to Singapore was retrieved from the Ministry of Health and the Civil Aviation Authority of Singapore.
Results: Of the 6 imported cases, which all occurred before screening measures were implemented at the airport, only the first resulted in extensive secondary transmission. Of 442,973 air passengers screened after measures were implemented, 136 were sent to a designated hospital for further SARS screening; none was diagnosed as having SARS.
Conclusions: The SARS outbreak in Singapore can be traced to the first imported case. The absence of transmission from the other imported cases was probably a result of relatively prompt identification and isolation of cases, together with a low potential for transmission. New imported SARS cases therefore need not lead to major outbreaks if systems are in place to identify and isolate them early. Screening at entry points is costly, has a low yield and is not sufficient in itself, but may be justified in light of the major economic, social and international impact which even a single imported SARS case may have. |
