GENERAL

1. What is SARS?
SARS is the short form for Severe Acute Respiratory Syndrome. SARS is an atypical pneumonia for which the cause has not yet been determined.

2. What is atypical pneumonia?
Atypical pneumonia refers to an infection of the lung that is caused by certain organisms such as Mycoplasma, Legionella and Chlamydia. However, SARS is a new type of atypical pneumonia, and we are finding out more about it as we gain more experiences.

3. How do I know if I may have SARS?
If you have travelled to Hong Kong, Guangdong Province, Taiwan, Hanoi and Toronto (Canada), or been in contact with a person diagnosed to have SARS over the last two weeks and you now develop a high fever (greater than 38 degree Celsius) you may have developed SARS. Other respiratory symptoms are cough, shortness of breath or difficulty breathing.

The most updated list of affected areas is on the WHO website at www.who.int

4. Is SARS infectious?
The infection can spread to persons who have had close contact with an infected person. Based on evidence so far, persons who have been infected in Singapore were healthcare workers who had attended to the patients when they were first admitted to the hospital, and family members and other close contacts of the patients. Some infected persons are good "hosts" to the virus and can be very infectious. Scientists think the virus is most likely to be a strain of coronavirus not previously known.

5. What does close contact mean?
According to WHO, close contact means:
- having cared for,
- having lived with or
- having had direct contact with respiratory secretions and body fluids of a person with SARS

6. Is SARS dangerous?
SARS, like any other atypical pneumonia, is a serious infection that can lead to death in some cases.

7. Is there any vaccination against SARS?
There is no vaccination against SARS.

8. What are the preventive measures against getting SARS?
Although there are no specific preventive measures against SARS, we encourage the practice of good hygiene like hand washing and covering the mouth and nose when coughing. You can also contribute by heeding MOH's advice to avoid travel to Hong Kong, Guangdong Province, Taiwan, Hanoi and Toronto Canada) for the time being, unless absolutely necessary, and to also seek immediate medical attention if you are sick.

Unless you have the above symptoms AND a similar travel history or personal contact with infected persons, the Ministry urges the public to seek the advice of a GP first and not go to Tan Tock Seng Hospital to avoid bogging down its resources.

9. What is MOH going to do before more people get infected with SARS? Is it too late then?
- Early identification & isolation of symptomatic cases
- Tracing of persons who have had close contact with patients with SARS and requiring them to be quarantined at home.
- Timely information to keep doctors, hospitals and the public updated
- Enhanced infection control measures in hospitals
- Travel advisory to the public
- Health Alert Notice given at the airport to inbound and outbound passengers from and to the affected countries.
- Special precautions for schools

10. Any advice from MOH to companies with front-line customer service employees or the general population on whether they must wear a mask? What sort to buy?
Based on currently available evidence, the infection is spread to persons who have had close contact with SARS patients. Contact with exhaled droplets and bodily secretions from an infected person appears to be important in disease transmission. Persons who have been infected in Singapore were healthcare workers who had attended to the patients when they were first admitted to hospital, and family members and other close contacts of the patients. The possibility of airborne transmission or through objects that become contaminated in the environment is still being investigated.

We strongly advise people who are sick to avoid crowded places and to wear face masks if they do. Otherwise, it is not necessary for the public to routinely use face masks. Separate guidelines have already been issued to healthcare workers, who need to take infection control precautions particularly in areas where they are at risk of exposure to persons who may have SARS, eg A&E Departments and ICUs

11. Where can I call to obtain general info on SARS?
You can call the MOH's hotline (Tel: 1800-2254122) from Mon to Sun at 8.30 am to 11.00pm.

Information /queries regarding schools should be directed to 6872-2220. Queries on childcare centres should be directed to 1800-258-0677.

PUBLIC PLACES

1. I have a colleague who is down with pneumonia and we suspect that he/she has SARS. What shall we do?
Not everyone with pneumonia has SARS. However, you should advise your colleague to go to TTSH for an assessment.

If a person is diagnosed to have SARS, contact tracing will be carried out and those who have been in close contact with the infected person at home or at the work place, etc. will be subjected to Home Quarantine.

All persons confirmed or suspected to have SARS are admitted to CDC/TTSH.

2. Is it safe to use the swimming pools?
So far, there is no evidence that the virus can be transmitted via swimming pools.

3. Will visitors/patients who had been to TTSH/CDC spread the virus to people around them?
So far, evidence suggests that only those who have SARS symptoms can spread the virus to people around them. Contacts of SARS cases are not infectious unless they themselves become unwell with fever. The non-SARS patients warded in TTSH are physically separated from the SARS wards. Transmission is not likely, as TTSH has taken extra precautions for infection control.

4. Can the teachers go to the schools/centre which are closed?
MOE has indicated that this period of school closure is considered vacation time, during which, some teachers can continue to go to schools.

The closure of schools is meant to address the parents' fears, and is not directly related to efforts to stop the spread of SARS. The schools/centres will have to decide on what is required of their employees during this period. We hope that special consideration and/or arrangements can be made for staff members who need to care for their young children during this period.

TRAVEL
1. I have booked a tour to the affected countries. Should I continue with my plans?
As a precautionary measure, the Ministry of Health advises you to avoid travel to Hong Kong, Guangdong Province, Taiwan, Hanoi and Toronto (Canada) for the time being, unless absolutely necessary. For those who are unable to delay their travel to these places, you are advised to avoid crowded places and to build up your body's resistance by ensuring that you get adequate rest, proper diet and exercise.

2. Is it safe to travel to Guangzhou?
Guangzhou is a city in Guangdong province.

3. Are there any preventive injections that I could have or medications that I can take along with me before I continue with my travel plans to the affected countries?
As the cause of the infections is not yet known, there are no specific measures that can be taken. If you are unable to delay your travel plans, you are advised to avoid crowded places and to build up your body's resistance by ensuring that you get adequate rest, proper diet and exercise.

4. I have recently come back from the affected countries. What should I do?
From 18 March 03, Singapore's Ministry of Health has started issuing travel advisories to all passengers on outbound and inbound flights to and from the affected areas. These advisories explain the symptoms of SARS and tell those who have travelled to go to the Emergency Department, TTSH immediately if they develop these symptoms. Visitors who may not be in Singapore when the symptoms develop should see a doctor in their own country. It is very important for you to let your doctor know that you have recently travelled to these places.

Even if a person has travelled to the affected destinations, it does not mean they are infected. They are at risk of the infection and therefore will be advised to see a doctor immediately when they fall ill within 14 days of their travel to such destinations.

5. If a person has visited the affected countries, how long does one wait to know if the person is SARS-free?
If the person does not develop any symptoms of SARS within 10 days following his/her travel to the affected places, it is unlikely that he or she is infected.

6. Will people who have travelled to the affected countries likely to develop SARS?
Persons at risk (with travel history) have been asked to go to the Emergency Department, TTSH to seek medical help if they develop fever. Not all persons who have travelled to those affected countries will get SARS. In fact most will be well.

7. Travel agencies are refusing to let customers postpone their trip to parts of China, although MOH's advisory only applies to Guangdong province. What can I do?
This matter is not under the Ministry?s purview. You may wish to negotiate with your travel agency on such matters.

HOME QUARANTINE ORDER
1. What is the Home Quarantine Order (HQO)?
MOH has invoked the Infectious Diseases Act to isolate all contacts who have been exposed to infected SARS patients. They will be required to stay at home for 10 days and to minimise contact with other people. Those who do not heed the quarantine requirement are liable for prosecution under the Act.

2. Who is affected by it?
Those who have come into close contact with SARS patients.

3. What is the purpose of the HQO?
The HQO is to aid the efforts of the authorities to contain the spread of SARS, as well as to facilitate the monitoring of persons who have been in contact with SARS patients. Persons who develop SARS can then be isolated and treated quickly, and will not have been in contact with many other people during the period they are symptomatic.

4. How will I know if I am affected by the HQO?
Officers from the NEA (National Environment Agency) will visit the person at home to serve the HQO. The order will also clearly indicate the name and NRIC of the person to be quarantined, and the period of the quarantine.

5. Will the quarantine affect everyone in the household?
The HQO will be served to any person who has been in close contact with a person with SARS:

- If the Person served the HQO has school-going children (all levels of schools other that Polytechnic and University) and children attending childcare, playgroups and kindergartens, these children must also be kept at home.

- If the HQO is served on a child, his school-going siblings (all levels of schools other that Polytechnic and University) and siblings attending childcare, playgroups and kindergartens must also be kept at home.

- Other school-going children (all levels of schools other that Polytechnic and University) and children attending childcare, playgroups and kindergartens, who are not related to the contact but who are living in the same house must also be kept at home for the period specified in it.

Other adults in the household who have not been issued the Home Quarantine Order are free to leave the house and carry on with their daily routine.

In cases where the parents feel the need to take care of the quarantined child and his/her siblings, they may wish to approach their employers for leave from work. The Ministry has appealed to the employers to be sympathetic to parents whose child(ren) was/were served with the order.

6. What will happen during the period of quarantine?
During the home quarantine period, NEA and MOH officers will be contacting the person daily as well as conducting spot checks to ensure that the person is present at home.

7. How will my employer/school know that I am under quarantine?
The Ministry is asking all employers whose employees are affected by the home quarantine measure to accept the Home Quarantine Order from MOH to the contacts as medical certificate

If your child is being quarantined, the Home Quarantine Order issued to your child can be used when claiming for child sick leave.

Employees who are served a Home Quarantine Order will be deemed to be on medical leave. The period of absence from work would be treated as paid hospitalisation sick leave, as part of the employee?s hospitalisation leave eligibility under their employment contracts, collective agreements or as per the Employment Act.

Please contact Ministry of Manpower's (MOM) Call Centre at 64385122 for question on employment terms related to hospitalisation sick leave.

8. I received a quarantine order paper for my son/daughter, but three other family members' name appeared on the top right hand corner of the letter (beside MOH's letterhead), so who is/are quarantine? (refer to to Q5)
- Only the person whom the Quarantine Order was served to is quarantined.
- However, if your son/daughter is a school-going child (all levels of schools other that Polytechnic and University) or attending childcare, playgroups and kindergartens, then his school-going siblings (all levels of schools other that Polytechnic and University) and siblings attending childcare, playgroups and kindergartens must also be kept at home.

9. My child has come into contact with the children from the Pats School House and Pei Cai Secondary School. Must she/he be quarantined?
Only children who have come into close contact with a suspected SARS patient are to be quarantined. If your child is to be quarantined, he/she will be served with a HQO.

SARS PATIENTS AT TTSH/CDC
1. Who is paying the hospital bills for those who are warded at TTSH for SARS?
Normal circumstances, where the SARS patients will have to pay for their own hospital bills, will apply. However, if they require financial assistance, they can approach the Medical Social Worker for help.