Fourth H1N1-related death

A FOURTH patient has died in Singapore after developing complications from Influenza A (H1N1).

The 42-year-old Chinese Singaporean woman died of pneumonia, with H1N1 as a contributing factor, said the Ministry of Health yesterday.

She went to Changi General Hospital's (CGH) emergency department last Saturday after having had a fever, a cough, a sore throat and shortness of breath for five days. She was moved to intensive care that day but died yesterday morning.

Earlier, the ministry had said she had thyroid disease and hypertension, but it has since clarified that she suffered only from the former.

At her wake in Sengkang last night, her husband said her thyroid condition had been under control for two years, and she had not needed medication.

'She was in fine health. That's why it is a total surprise,' the man, who declined to be named, said.

Before she was warded last week, the woman, who had a 12-year-old son, had seen doctors thrice in five days to treat flu-like symptoms, including a fever.

She went to a general practitioner's clinic on July 14. The next day, she sought a second opinion at another clinic.

Last Saturday, she visited the second clinic again. This time, the doctor told her she might have a lung infection and advised her to go to the hospital.

She was nursing a fever of 38.6 deg C at the time, said her 51- year-old brother-in-law, who drove her to CGH.

He said that sometime after 11pm that day, she was 'still conscious and could still talk'. 'She could even pick up the phone to call her husband and call us.'

But just a few hours later, her situation suddenly worsened. She was wheeled into intensive care the next day.

The woman was described as a doting mother who liked to help others.

Singapore's four H1N1-related deaths have occurred within the space of a week.

The first came last Saturday, when a 49-year-old man who had multiple health problems such as diabetes, hypertension and high cholesterol died.

On Wednesday, two others died - a 13-year-old boy with epilepsy and a 55-year-old man with motor neuron disease.

When asked if these deaths in such a short span were cause for alarm, the Health Ministry noted that 600 people a year die from seasonal flu in Singapore.

Experience elsewhere has shown that fatalities will rise as more people get infected, and Singaporeans should be mentally prepared to see a similar pattern here, the ministry said.

It added: 'Our best chance to reduce the adverse effects of the pandemic is to continue to be socially responsible to reduce the disease transmission and seek early medical treatment if unwell.'

Dr Leong Hoe Nam, a consultant infectious disease physician at the Singapore General Hospital, said tens of thousands in Singapore could be infected by now.

Four deaths out of so many infections would be a relatively small proportion, he added. He warned that the number of infections had yet to peak, so the number of deaths could rise.

Meanwhile, two people in their 20s with no known risk factors have fallen critically ill after testing positive for the virus. They are the first seriously ill patients who do not fall into the high-risk category of those with underlying illnesses, who are pregnant or who have low immunity.

Both are in intensive care, with low levels of oxygen in their blood.

One is a 24-year-old Indian Singaporean man who sought treatment at Tan Tock Seng Hospital's emergency department on Thursday. He had a cough, headache and fever.

The other is a 28-year-old female Indian national who went to CGH after having had a fever, a cough and shortness of breath for four days. She is currently on a ventilator to help her breathe.

Laboratory tests for both later confirmed they had H1N1.

Of the 94 H1NI patients now in hospital, five are critically ill.

Health Minister Khaw Boon Wan told Parliament on Monday that H1N1 cases are likely to peak over the next two weeks before tailing off.

His ministry has advised those with underlying conditions and who show flu symptoms to seek treatment early, rather than wait till their conditions worsen.