Cold / Flu ?

SYMPTOM COLD FLU

High Fever
Fever Uncommon
(often >39°C)
Headache Uncommon Common
General aches & pains Slight Common
Fatigue, weakness Mild Common
Prostration No Common
Runny , stuffed nose Common Slight
Sneezing Common Common
Mild to Moderate, Mild, pharyngitis
Chest discomfort
hacking cough common
Sinus congestion,
Complications Severe
earache
 INFLUENZA
A severe disease
Highly contagious
Respiratory infection
Incubation : 1 to 3 days Influenza infection is
not just a common cold
Fever & weakness : at least
3 to 5 days
Complications :
viral pneumonia
bacterial pneumonia
nonpulmonary
complications...
 When am I contagious? How long
will I be ill?
Generally, people with seasonal influenza
are contagious at least one day before
they show symptoms and while they have
symptoms. Symptoms usually last about
seven days. People typically suffer flu
symptoms for 5 – 10 days.
 How can I prevent passing the flu on to
others?
 Cover your nose and mouth if you cough /
sneeze, with the inside of your elbow, not your
hands.
• Stay home when you are ill.
• Avoid close contact with others (hugging,
kissing) and do not share eating utensils.
• Frequently disinfect shared household objects
like faucets and doorknobs.
• Wash your hands frequently, and advise others
to do the same.
 Why are annual flu vaccinations
important?

Influenza can be a serious disease,

especially when complications such as
pneumonia occur.
Vaccination is the primary way to prevent flu
and related conditions in people over 6
months old.
What is the influenza vaccination? Must I
have one each year?

A new influenza vaccine is developed each

year to protect people against the virus
that seems most likely to circulate in their
hemisphere during the flu season. Since
the formula changes each year, you must
be vaccinated annually.
 When should I get vaccinated?

In Malaysia / S’pore , the seasonal influenza

pattern mimics the southern hemisphere.
It is best to vaccinate before the start of the
influenza season (which starts in June or
July).
Hence the best time to vaccinate is in April or
May.
 Seasonal Occurrence of
Influenza
Southern hemisphere Tropical Northern hemisphere

J F M A M J J A S O N D

Summary of influenza activity and occurrence in different climates

Reichelderfer PS, Kendal AP, Shortridge KF, Hampson A. and al. Influenza surveillance in the pacific basin.
In: Current topics in medical virology 1988:412-38
 Who should have an annual influenza
vaccine?

Everyone should consider vaccination, if it is in ample supply. It is

especially important for the following
people, as they are most likely to suffer serious complications from flu:
• Children between 6 months and 23 months old
• Adults over 65 years old
• People of any age who have chronic medical conditions
• Children with underlying medical conditions or who are on chronic
aspirin therapy
• Residents of communal living spaces, such as nursing homes
• People who have regular contact with anyone listed above
(caregivers, medical staff, etc)
 Who should NOT have a flu shot?

• People who are allergic to eggs or who

have had an allergic reaction to flu
vaccines in the past
• Children younger than 6 month of age
• People who have a moderate or high fever
(wait until fever subsides to get
vaccinated)
 What are the possible side effects?

The most common side effect of the

vaccine is soreness and redness at the
injection site. Less commonly, patients
may develop a low grade fever or muscle
aches after vaccination.
Serious side effects, like allergic reactions,
are rare.
 Annual Impact of
Influenza Disease in
Singapore*
 Highly contagious respiratory illness
 630,000 cases of influenza infection
 520,000 sick visits
 315,000 days of sick absence from work
 4200 hospitalizations for pneumonia and influenza
resulting in 1450 deaths in persons ≥ 65 years old

*Ng TP et al. National University of Singapore; Ann Acad Med Singapore. 2002
Mar;31(2):182-8.
 What about avian flu?

Seasonal flu vaccination will NOT protect you from avian

flu. Nevertheless, you should have a flu
shot in order to:
• Prevent annual influenza, which can be a serious disease
in its own right
• Avoid becoming a ‘mixing vessel’ for avian and human
flu. If a person has both diseases at the same time, the
two flu viruses could intermingle and create a new flu
strain that can cause a worldwide epidemic (pandemic)
and infect millions of people.
 How is avian flu spread?

Influenza is typically passed between people

through droplets coughed or sneezed by
an infected person. Healthy people either
inhale the virus or pick it up by touching
contaminated surfaces, then their
nose/eyes/mouth – thus introducing the
virus into their own systems.
The "Spanish flu" pandemic of 1918 killed over 20
million people worldwide. Above: Two Red Cross
nurses tend to a patient at a Red Cross emergency
ambulance station in Washington, D.C., during the
outbreak.
 Current
 WHO – Phase 3

 MOH – Color Code Green

 Singapore’s
Flu Pandemic Plan

新加坡 的大 流感应 变计
划
 Singapore’s Pandemic Planning
Assumptions
新加坡 的大流感 应变计划的 假定
 Two or more waves in same year or in
successive flu seasons
在同一 年或连续几 个流感季 节发生两波 或
更多波 的疫情。
 Second wave may occur 3-9 mths later;
may be more serious than first (seen in
1918)
第二波 疫情可能在 三至九个 月后发生； 可
能比第 一波疫情更 严重（如 1918 年的情况
 Singapore’s Pandemic Planning
Assumptions
新加坡 的大流感 应变计划的 假定
 Each wave lasts about 6 weeks
每一波疫情持续 约六周 。
 About 1 million infections in 1st Wave

第一波约有一百 万人受到感 染。
 Components of Plan
计划 的内容
 Surveillance.

监管
 Response & Impact Mitigation.

应对之策，缓解 冲击
 Vaccinate population.

为全民注射流感 疫苗
 Surveillance 监管
 Detect importation, occurrence as early as possible.
尽早测 出病毒 的入 侵或发 生。

 External surveillance 对外监 管


International Health Orgns 国际卫 生组织 (WHO,
CDC, FAO etc)

Country Health Authorities 国家 卫生部 门

 Internal surveillance 内部 监管

Focus on hospitals 集中在 医院
• Atypical pneumonias 非典 型肺炎
• Unexplained deaths + respiratory illness 死因 不明
+ 呼吸 道疾病
 Response & Impact Mitigation
应对之策与缓 解冲击
 Desired Outcomes 理想的结果

Minimise disruption to economy and
society
减轻对经济和社会的破坏
 Maintain essential services
维持基本的服务

Reduce morbidity and mortality
减少发病率和死亡率
 Vaccinate Population
全民 注射 流感疫苗
 Obtain vaccines as soon as possible.

尽早取得 流感疫苗。
 Vaccinate entire population.

为全民注射 流感疫苗。
 Designated vaccination centres.

注射 流感疫苗 的指定地点。
 Pandemic Response Plan
大流感的应对 之策
Colour-coded Risk Management approach
以颜色 为信 号的 危机管 理方 法
Green – animal disease [WHO 1,2,3]
绿色 – 动物疾病 [ 世卫 1,2,3]
Yellow - inefficient human-to-human
transmission, small cluster [WHO 4]
黄色 –人传 人尚 不 普遍 , 一小撮 病例 [ 世卫 4]
 Orange – larger cluster, more efficient H to H
transmission, but still limited [WHO 5]
橙色 –更多 集体 病例： 普遍 出现 人传人 ，但传 播
范围有 限 [ 世卫 5]
 Pandemic Response Plan
大流感的应对 之策

Red – pandemic; widespread infection
[WHO 6]
红色 –大流感 ; 大范围的传染 [ 世卫 6]

Black - high mortality, morbidity

黑色 – 高死亡率、 发病率
 Pandemic Plan – Key Points
大流 感 计划 – 重点
 Enough anti-virals to treat all who have flu.
足够 的抗 病毒药物 治疗感染 了流感 的人 。
 Will get enough vaccine for everyone.
将会 为全 民预备足 够的疫苗 。
 Healthcare system will be organised to deliver care
effectively.
安排 卫生 医疗制度 以能提供 有效的 服务 。
 Government will ensure things continue to run.
政府 会确 保一切继 续运作。
 Personal hygiene and socially responsible behaviour are
crucial to prevent spread.
注意 个人 卫生和采 取负责任 的社会 行为 对预防 传播 非常重
要。
 Conclusion 结论

 Maintain close surveillance of avian flu

situation
继续 密切监管禽 流感的最新 状况
 Singapore has an operational pandemic
plan ready
准备就绪新加坡 的大流感应 变计划
www.flu.gov.sg
www.moh.gov.sg