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SINGAPORE: Clinical evidence shows that the H1N1 situation in Singapore is past the tipping point.
And the island state could move into a full mitigation phase as early as next week as flu cases spike, according to the National Scientific Committee which was tasked to study local cases and make recommendations for treatment guidelines.
In a span of just six days, confirmed H1N1 cases made up 5 per cent of total flu cases in Singapore. That means community transmission is spreading and the entire population is susceptible.
The magic number is 15 - once 15 per cent of flu cases here are H1N1 positive, Singapore will go into a full mitigation phase where the focus will be on treating those who are ill instead of isolating them.
The National Scientific Committee believes this will happen within the next one to two weeks.
Professor K Satku, director of medical services, Ministry of Health, said: "Over the last one week, we have been consistently picking up samples of H1N1 from individuals who have had no travel history, who have been living in Singapore, no contacts (with H1N1 cases) and this figure has been gradually creeping up.
"This persistence of these samples and the increasing numbers certainly clearly indicate to us this virus is now in the community."
The somewhat reassuring news is that genome studies by the Singapore Genome Institute show that the H1N1 virus here has not mutated.
The National Scientific Committee said there are two similar strains of the H1N1 bug circulating in Singapore and they are the same strains as those circulating around the world.
In addition, most of the cases here are relatively mild and Tamiflu has proven effective in treatment. What worries medical experts is the fact that the virus is hitting young, seemingly healthy individuals.
One in two H1N1 patients in Singapore is below 20 years old. Over at the KK Women's and Children's Hospital (KKH), the average age of H1N1 patients is 10 years.
82 patients have been admitted to KKH since June 2. Seventy of them are children and 12 are adults, who are caregivers. Of these, two patients exhibited complications such as pneumonia and exacerbation of asthma. KKH said the patients have since recovered.
There have been varying accounts on the mortality rate of H1N1. Some medical experts have put it at double that of seasonal flu. Hence, death occurs in about two in every 1,000 patients.
But one thing is for sure - there is a time lag between infection and death.
Professor Satku said: "It's too early to say that everything is going to be fine. As has happened in countries like the US, when you start having large number of cases, you're bound to encounter some fatalities. In the US with 30,000 cases, they have had more than 100 deaths."
Moving forward, the National Scientific Committee will continue to track the virus' behaviour in Singapore.
Experts say how individuals conduct themselves will have an impact on how the flu pandemic pans out in Singapore.
So the emphasis is really in social responsibility - practice good personal hygiene and isolate yourself if you are sick so that you do not inadvertently infect vulnerable groups in the community.
- CNA/ir
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