VZCZCXRO3808
RR RUEHAST RUEHCHI RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
RUEHPOD RUEHSL RUEHTM RUEHTRO
DE RUEHGP #0581/01 1700948
ZNR UUUUU ZZH
R 190948Z JUN 09
FM AMEMBASSY SINGAPORE
TO RUEHC/SECSTATE WASHDC 6851
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUSICWP/COMLOG WESTPAC
RUEAUSA/DEPT OF HHS WASHDC
RHMFIUU/DEPT OF HOMELAND SECURITY WASHINGTON DC
RHMCSUU/FAA NATIONAL HQ WASHINGTON DC

UNCLAS SECTION 01 OF 02 SINGAPORE 000581 
 
SENSITIVE 
SIPDIS 
 
STATE FOR OES/IHB 
DHHS FOR OGHA 
EAP/MTS - MCOPPOLA 
BANGKOK FOR REO HOWARD 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU EAGR CASC ETRD ECON SN
 
SUBJECT: SINGAPORE: 77 H1N1 CASES -- COMMUNITY SPREAD STARTING 
 
REF: A) SINGAPORE 495; B) SINGAPORE 445 
 
¶1. (SBU) SUMMARY:  As of June 18, there have been 77 cases of H1N1 
influenza confirmed in Singapore.  Almost all were "imported" cases 
involving people with recent travel to affected countries.  However, 
a Malaysian permanent resident may be the first case of H1N1 
influenza contracted by community transmission in Singapore.  The 
GOS has indicated that once community spread is confirmed, the 
government might move away from its current stringent containment 
measures to a mitigation strategy.  At the same time, however, the 
press has reported that students could be asked to study from home 
if the outbreak worsens.  The CDA met with MFA Americas Director Ng 
Teck Hean and urged that, as Singapore adjusts its approach to the 
new situation, the GOS take into account American interests, 
including: the interests of American travelers to Singapore; 
American businesses that depend on travelers to the United States 
from Singapore; and of U.S. Government agencies whose work with 
Singapore counterparts requires official travel to the United States 
by Singapore officials, some of whom have canceled such trips 
because of H1N1 concerns.  End Summary. 
 
77 H1N1 Cases; Evidence of Community Spread 
------------------------------------------- 
 
¶2.  (U) The Ministry of Health (MOH) has confirmed 77 cases of H1N1 
influenza in Singapore since the virus first appeared here on May 26 
(Ref A).  To date, almost all cases were people with recent travel 
to affected areas, including the United States, Canada, Australia 
and the Philippines, though one case was a close contact of an 
imported case.  However, MOH believes that a Malaysian permanent 
resident may be the first case of community-spread infection in 
Singapore.  The 26-year old man developed H1N1 symptoms shortly 
after departing Singapore and arriving for a short visit in Kuala 
Lumpur.  He had no other travel to affected areas. 
 
¶3.  (SBU) Press reports and information on the MOH website regarding 
the man's case are not conclusive but indicate that he probably 
contracted the virus in Singapore and not during his travel to 
Malaysia.  Only about twelve hours passed between his departure from 
Singapore and the appearance in Malaysia of flu symptoms, too 
quickly for H1N1 to have been contracted in Malaysia. 
 
Qgapore Maintains Strict Containment Measures 
--------------------------------------------- -- 
 
¶4.  (SBU) Singapore remains fixated on containing the virus even as 
MOH has acknowledged that community spread is inevitable.  The 
Ministry of Education said that there is currently no need to close 
schools, but the Ministry is prepared to initiate home-based 
learning if the H1N1 outbreak worsens.  Several schools have 
Internet-based teaching plans to administer lessons and collect 
assignments.  Various businesses continue to conduct thermal 
scanning and question visitors about recent travel to countries with 
widespread H1N1 infection.  The GOS continues to trace and 
quarantine people seated in close proximity to confirmed cases on 
flights arriving in Singapore.  (Note:  At least 250 quarantine 
orders have been issued to date.  A total of 44 Americans have been 
quarantined at home or in GOS-provided housing.  Two American 
citizens with confirmed H1N1 have been quarantined at local 
hospitals.  End note.)  The GOS has expanded its advisories against 
unnecessary travel to include 13 countries, and health screening for 
arrivals at border checkpoints remains in effect. 
 
Move from Containment to Mitigation Possible 
-------------------------------------------- 
 
¶5.  (SBU) Minister of Health KHAW Boon Wan stated publicly that the 
GOS will relax its stringent containment measures and move to a 
mitigation strategy when sustained community transmission of the 
virus has been confirmed.  Contacts at the Regional Emerging 
Diseases Intervention (REDI) Center suggested that MOH may announce 
a shift in policy imminently, but no specific timeline has been made 
public. 
 
CDA Urges MFA to Factor in American Interests 
--------------------------------------------- 
 
¶6.  (SBU) The CDA, in a June 18 meeting with Ng Teck Hean, Director 
for the MFA Americas Directorate, urged the GOS to factor in 
 
SINGAPORE 00000581  002 OF 002 
 
 
American interests as Singapore adjusts its approach to the new 
situation.  The CDA noted that some American travelers to Singapore 
who have been quarantined have expressed concern about the heat, 
insects, and poor living conditions in GOS-provided quarantine 
facilities.  U.S. businesses such as air carriers that depend on 
Singaporeans traveling to the United States believe that 
Singaporeans are deferring such trips because of H1N1 fears.  Some 
GOS agencies, including the police, have canceled official visits to 
the United States with little advance notice, citing H1N1 concerns. 
This has caused problems for the USG agencies who helped arrange the 
trips and set up the U.S. programs, he noted. 
 
¶7.  (SBU) Ng said the GOS will take such concerns into 
consideration.  He noted that there is no official prohibition 
against GOS travel to the United States and the public travel 
advisories are recommendations only.  The decision on whether or not 
to travel rests with the individual.  The CDA pointed out that the 
nuances of such advisories may be lost on some members of the public 
who postpone or cancel travel because they fear being quarantined 
whether or not they actually contracted the virus. 
 
SHIELDS