EPIDEMICS (Preventive measures)

Mr Noris Ong Chin Guan asked the Minister for Health (a) what are the precautionary measures taken by his Ministry to prevent the spread of epidemics, such as the influenza outbreak, to our much-travelled and much-visited Singaporeans, and (b) whether steps are being put into place to ensure that an adequate supply of vaccinations is always available in hospitals.

Mr Lim Hng Kiang: Sir, the Ministry of Health has a comprehensive and well established surveillance system to monitor and detect epidemics, including influenza outbreaks. This enables the Ministry to take the appropriate preventive and control measures, including giving health advice to the public on precautionary measures, when necessary.

Influenza is a self-limiting illness and patients usually recover within a week. In temperate countries, when epidemics occur during the cold winter season, the elderly as well as children and adults with chronic medical conditions such as heart and lung diseases, are at higher risk of having serious complications. They are therefore advised to have annual influenza vaccinations as a preventive measure. However, in tropical countries like Singapore where influenza occurs throughout the year, influenza vaccination is generally not introduced on a routine basis.

There is currently no recommendation from international health agencies, such as the World Health Organisation, for countries to restrict travellers and visitors from outbreak areas. The Ministry, however, has advised travellers, especially older adults, going to countries with influenza epidemics, to protect themselves with influenza vaccination.

Influenza vaccination is available at Tan Tock Seng Hospital, Changi General Hospital and many other private clinics. While it is difficult to anticipate the demand for vaccination, over the years, the hospitals have maintained a sufficient supply of vaccine to meet the demand. The recent increase in local demand for vaccination due to the influenza epidemic in the West is unprecedented. This, coupled with the world-wide shortage of influenza vaccines, has led to a temporary shortage in Singapore as well. However, the hospitals have put in the orders for new vaccination doses, and 1,000 doses of such vaccines arrived last week. Another 3,000 doses will arrive this week. So, the shortage is overcome.

Dr Lily Neo: Sir, will the Minister consider a more pro-active approach regarding giving information to our public whenever the Ministry detects an imminent epidemic, especially to inform the susceptibles to go for either vaccination or even immunicable injection?

Mr Lim Hng Kiang: Basically, the system has two components. One is whether there is an epidemic in Singapore, and we have a tracking system where we look at the attendances in the hospitals, polyclinics and the private clinics, to see whether an epidemic is imminent or is already here. If there is, then, of course, we put out an advisory to advise the Singapore public.

The second component is, of course, overseas epidemic, and it only affects Singaporeans if they travel to that area. For this, we also put up advisories as and when necessary if the epidemic is of a very severe nature in the countries that Singaporeans are likely to travel to, and then advise Singaporeans to take vaccinations if they are travelling to such areas.

Mr Noris Ong Chin Guan (Nominated Member): Sir, could the Minister clarify whether there are any statistics available as to the loss to the economy in terms of workers taking leave during a flu epidemic?

Mr Lim Hng Kiang: We love to do many, many studies. We will do this if it makes any sense or it gives us the numbers to do something about it. In Singapore, colds and flus happen throughout the year. To some extent, our population builds up some immunity. When there is a very bad outbreak, we take precautions. We send out advisories to advise Singaporeans to avoid crowded places, etc.

As to how useful it is to know how much is lost to the economy, I think that leaves to be seen.

Mr Chiam See Tong: Sir, I would like to follow up on the question by Dr Lily Neo. I refer to the more specific issue of the recent flu epidemic which occurred in America and, I believe, also in Europe. Did our health authorities know about this flu epidemic that happened in America and Europe and, if so, did they take any steps to prevent the flu coming to Singapore?

Mr Lim Hng Kiang: First of all, I do not take it upon myself to find out when an epidemic occurs in the US or Europe before the Health Ministers there. We keep track with all the various agencies around the world and it is part of professional cooperation that we keep each other informed where epidemics are imminent. Similarly, my Ministry keeps in touch with its counterparts around the world. So, when an epidemic has broken out or is imminent, it is professional practice to keep each other informed. And our job is to let Singaporeans know and we send out the advice so that those who are travelling to such countries could take the precaution of being vaccinated.

The transmission of such epidemics, particularly flu epidemics, from temperate countries like the US to Singapore is limited, unless we have huge numbers travelling there and coming back to spread the flu around Singapore. For this particular epidemic, for example, we have not seen the transference of the epidemic to Singapore, but we will continue to take precautions and if the numbers do build up in Singapore, then we will advise the public accordingly.

Mr Chiam See Tong: Sir, I would like to ask the Minister what advisory has the Singapore health authorities given to its citizens, because I recently travelled to America and I went straight into this flu epidemic in America. I came back and I suffered that flu for one month. I did not receive any advisory.

Mr Lim Hng Kiang: I will send a doctor to take a look at the Member! Is he cured? If he is not, he should not come to this crowded place.