The Ministry of Health (MOH) has been in contact with the public health authorities in Hong Kong. We have been informed that Hong Kong is in the middle of the peak flu season which started in mid-February and is expected to last at least till March/April.  It also appears that this year's influenza season resembles that of previous years, except that there is co-circulation of all three subtypes of seasonal influenza, i.e. H1, H3 and B influenza subtypes. On the reported death of three children, there is evidence of influenza infection in at least two of these children, one is an A/H3N2 subtype, and another is an A/H1N1. According to the Hong Kong public health authorities, avian flu (A/H5) and SARS have been ruled out in all of them. We are in close touch with our counterparts in Hong Kong on the on-going investigations into the exact cause of death and possible linkages to influenza.

Impact of Influenza

Worldwide each year, up to 500 million people are infected with influenza and there are up to 500,000 deaths from influenza. Pneumonia is the leading cause of influenza-related deaths. More than 90% of deaths attributed to pneumonia and influenza occur in older persons aged 65 years and above. During an influenza epidemic, everyone is at risk of contracting the disease and everyone with influenza is at risk of developing serious complications. Even otherwise healthy people are at risk; approximately 20% of those who die from influenza during epidemics are previously healthy. The vulnerable groups for influenza complications are older adults aged 65 years and above, persons with underlying health conditions and young children under five years of age.

Situation in Singapore

Our ongoing influenza surveillance in Singapore shows that the number of attendances at emergency departments and hospital admissions for acute respiratory infections and pneumonia have not risen. The percentage of influenza viruses isolated from patients with flu-like illnesses has also not risen and has remained low at the usual 5%.  The predominant circulating strain in Singapore is the A/H3N2 subtype, though we have also detected Type B and A/H1N1 strains. 

Though Singapore's peak for acute respiratory infections extends to March every year, there has also not been any significant upward trend in the weekly attendances for acute respiratory infections (ARIs) in polyclinics (please refer to chart at ANNEX).

Nevertheless, the Ministry and healthcare institutions will continue to remain vigilant.

Health advisory

In healthy individuals, influenza is usually a self-limiting disease. The best ways to stay healthy, especially for those travelling to places experiencing increased influenza activity such as Hong Kong, are to keep a high standard of personal hygiene and to avoid crowded places with poor ventilation.

MOH would like to remind the public on the importance of good hygiene practices such as washing hands thoroughly and often, using a serving spoon when sharing food, not spitting on the floor, covering nose and mouth with a tissue when coughing or sneezing and wearing masks if unwell. Those who have flu-like symptoms (fever and cough with/ without sore throat and runny nose), including those returning from recent travel to places with increased influenza activity, are advised to seek medical help promptly, and to stay away from public places such as the school and workplace until they have fully recovered.

There is no need for Singaporeans to rush to get themselves vaccinated against flu. The Ministry advises that elderly persons aged 65 years or above, young children aged 6 months to 5 years, persons with chronic heart and lung diseases and persons with diabetes or renal diseases, who are at a higher risk of developing complications from influenza, to undergo routine annual flu vaccination. Women in the second or third trimester of pregnancy are also encouraged to be vaccinated.

MINISTRY OF HEALTH