DOCTORS will miss at least one in five H1N1 patients here because their symptoms will be so mild, said an infectious diseases expert on Wednesday.

Polyclinics ready to take in patients WHITE tents are up outside Chua Chu Kang Polyclinic, ready to hold those who think they might have the H1N1 flu. Singapore's 18 polyclinics are already in pandemic mode, segregating patients with flu-like symptoms and providing them with masks while they wait. ... more

Or they could exhibit no symptoms at all, and still pass on the virus. This means Singapore can expect its H1N1 numbers, now at 220, to spike sharply.

Dr Leo Yee Sin, head of the Communicable Disease Centre, gave this gloomy prognosis on Wednesday when she released results of an examination of Singapore's first 50 patients.

The CDC team found that only half had high fevers of 37.8 degrees or more - one of the symptoms the United States uses to identify H1N1 cases.

'If we use this cut-off, then 46 per cent of confirmed cases would not have been picked up,' she said.

Cough was the most common symptom, affecting four in five patients, although only half had sore throats. These are such general symptoms that 'it would be a challenge' for general practitioners (GPs) to identify them as H1N1 patients, she said. Such symptoms are also very similar to those of seasonal flu.

Also, unlike in the United States where many had diarrhoea, only one of the 50 patients here suffered from it.

In fact, Dr Leo said, most of the CDC's 70 or so patients still warded are 'doing very well', with most no longer sick.

For most, the fever receded a day after they started on Tamiflu. But they remain in hospital because their nose and throat swabs show that they still have the virus.

The problem: Doctors do not know if the virus is alive or dead - so they are uncertain if the person is still infectious.

Read the full report in Thursday's edition of The Straits Times.

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