FLU INFECTIONS

Column No : 668

FLU INFECTIONS: 1.

Mr Steve Chia Kiah Hong asked the Minister for Health (a) whether there has been an increase in flu infections over the last three months and if this is normal for this period of time; and (b) if so, whether this rise in flu infections is caused by any virus closely or remotely related to the H5N1 strain.

The Minister for Health (Mr Khaw Boon Wan): Mr Speaker, Sir, in Singapore , influenza viruses circulate all year round. But over two periods every year, there would normally be an increase in influenza incidence: April to July and November to January. They roughly correspond to the southern winter and northern winter respectively.

Influenza A is the predominant circulating influenza virus here. In the last three months, its incidence peaked in the first week of January 2006, when 5.7% of all patients who presented with Acute Respiratory Infection (ARI) tested positive for Influenza A. This rate of 5.7% is, in fact, lower than the corresponding figure of 17.9% in 2004 or 7.0% in 2005.

So far, H3N2 - this is the Hong Kong flu that caused an epidemic in 1968 - and H1N1, the infamous Spanish flu which caused a major problem for the world in 1918, have been the influenza virus subtypes in circulation. To date, H5N1 has not been identified in Singapore , whether among humans or birds.

Mr Steve Chia Kiah Hong (Non-Constituency Member): Sir, anecdotal evidence from many people I talked to tells me that this is a very strong virus, and people are suffering very badly from the cough. It seems that this is something different. Is there a special medicine for this? Or is it something that normal medicine is able to cure the flu?

Mr Khaw Boon Wan: Sir, I wonder where did Mr Chia get his anecdotes from because, fortunately, there is no H5N1 yet in Singapore. He may have friends in Indonesia or Vietnam, but most of them who got it have died. The symptoms are the usual flu and severe pneumonia with many complications. The fatality rate is high. I think the recorded cases in about seven countries is more than 100. The fatality rate is more than half.

So this is a serious problem. Fortunately, for human beings, the problem remains one that largely affects the animals. There is now a world pandemic. We see it in Germany, Turkey, Africa, among the birds. It remains among the birds. The risk is that one day, the virus will mutate and become much more infectious - spreading from human to human. And that is why all of us have to quickly gear up and we have been doing so, like any other country.

Mr Steve Chia Kiah Hong: Sir, today's Straits Times has an article advising the shut-down of businesses and Government in the event of a pandemic when the virus is able to transfer to humans. Is the Government prepared for such a contingency to shut-down the whole Government, all systems and all companies in the event of such a pandemic? Are we prepared for this? What are the likely consequences of such a shut-down?

Mr Khaw Boon Wan: Sir, preparations take the form of the Flu Pandemic Preparedness Plan which, by now, practically all countries would have it. We have been refining our Plan for a couple of years now, and it is fully published in the website. Like all plans, you can never be fully prepared, because while the risk now is H5N1, when it happens, will it actually be H5N1 or some other virus? Nature has a way to surprise. But there are certain generic principles which we can follow to gear up as much as we can. And we will continue to refine our plan. We have, in fact, discussed it in this House not too many months ago in response to some Members' query.

My own assessment is this. I think our own domestic preparation plan is as good as one can get. But in the last few months, we have devoted our energy to work upstream, on the preventive aspects. And it is possible to prevent it. The world has a window to prevent this disaster from happening, but it requires cooperation from many countries, especially those with large agricultural sectors. That is why we work with our neighbours. In fact, Members would have read and I have spoken about it in this House that we are doing a major project helping Indonesia, working not just between our two countries but involving America and many other countries. In fact, they are right now in town to discuss this pilot project, and I am meeting them tonight.

Mr Speaker: Last supplementary question, Mr Chia.

Mr Steve Chia Kiah Hong: Sir, now that a lot of poultry are affected in many other countries, should citizens make a conscious effort to avoid chickens and ducks in the meantime?

Mr Khaw Boon Wan: Sir, although I eat very little meat, I continue to occasionally eat Kentucky fried chickens. This H5N1 reminds me of the SARS virus. While it is fearsome when it spreads, it is easily killed outside of a host. At a temperature of 60 degrees, I think, the virus is killed. Therefore, if the chicken is properly cooked, eggs are properly boiled, the risk is almost zero. Therefore, when Singaporeans travel overseas, just stay away from chicken farms and wet markets where slaughtering continues. When we stopped the slaughtering of poultry in wet markets 15 years ago, there was a lot of unhappiness coming from housewives. But what an important contribution it has made to our public health. It has reduced significantly this risk.

Mdm Ho Geok Choo (West Coast): Sir, the Minister indicated that at a temperature of 60 degrees or so, it will be very safe. Many eateries are still serving half-boiled eggs. I wonder whether it is good for us to issue an advisory for Singaporeans to avoid half-boiled eggs.

Mr Khaw Boon Wan: Sir, I personally do not think that is necessary because our AVA is very vigilant. Last fortnight when a case cropped up in Malaysia - kampong chickens were infected with H5N1 - they moved at a fast speed to reduce the risk. For the past two years, they have been inspecting farms in Malaysia and making sure that the chicken farms which export to us are properly bio-secured. The risk therefore is very low, as we only import chickens from these areas. In Singapore, a large proportion of our eggs are locally supplied, and AVA has made sure that our farms in Singapore are properly bio-secured. Unless you start smuggling eggs from I do not know where, I think it is quite safe to continue eating your boiled eggs.