Tuesday, July 28, 2009

New Vaccine that combines Chickenpox with Measles

Our clinic has started stocking the MMRV vaccine which is used for your child's second year vaccinations.

MMRV stands for Measles, Mumps, Rubella and Varicella (Chickenpox). In the 2nd year of life, kids are required to take the MMR vaccine as a compulsory vaccine. The Chickenpox vaccine is optional, but many parents are choosing to vaccinate their children against this infectious disease because of the risk of scarring and severe disease

With the MMRV vaccine, you can now reduce these two jabs to one. Normally, we would advise children to take the Chicken pox vaccine at 12 mths and MMR at 15 mths. With this new vaccine, both are combined into one jab and can be given from 12 mths onwards. So this is very convenient for our busy parents. The price of our second year package which includes the MMR, Chickenpox and 5-in-One vaccines remain unchanged at $210 if you choose to use the new MMRV vaccine.

The MMR and Chickenpox vaccines are still available separately.

Read my article on why you should vaccinate your child against chickenpox here.
Listen to me discuss the importance of chickenpox on 938live here.

Wednesday, July 15, 2009

The Flu Vaccine is in Stock

Thanks for all who were patiently waiting for the current Season Flu vaccine to come in. We are pleased to announce that we managed to obtain a batch of the Flu vaccine. Stocks are limited, so please call in to reserve the vaccines for your family.

The H1N1 vaccine will not be available at least till the end of the year. So in the meantime, it is important to vaccinate your family against the flu. In particular, the elderly, pregnant moms in their third trimester, kids with asthma or respiratory problems and people with chronic diseases should have their Flu vaccines done.

Please note that if you are going overseas, you need to take your flu shots at least 3 weeks before departure. A lot of patients have the mistaken idea that it should be done as close to the date of departure as possible. The body needs time to develop immunity after vaccination, just like yeast needs time to rise. So you need to wait at least 2-3 hours for the dough to rise. Similarly, you need 3 weeks for the body to develop immunity after any vaccination.

Sunday, July 12, 2009

H1N1 update: The latest from MOH

With the prevelence of the H1N1 in so many countries. WHO has stopped publishing the table of affected countries. So that means that the H1N1 is everywhere now. In Singapore, H1N1 is now estimated to comprise 28% of all cases of influenza like illness in the community. As such please note the following:

1. Contact tracing and Quarantine Orders are generally no longer required. So it is no longer necessary to send people to Pasir Ris.

2. Diagnostic tests to confirm H1N1 is only required for severe cases. So even if the Dr suspects you have H1N1, you are no longer required to have a lab test to confirm.

3. Pregnant women and persons who are immunosuppressed will have to be treated under new guidelines which stress social distancing and specialist treatment.

4. We will continue to take your temperature when you come to the clinic and ask those who have fever and flu symptoms to wear a mask and sit outside the clinic. This is necessary to avoid spreading the virus.

In a nutshell, H1N1 is amongst us and its almost like how we treat the normal flu except for a few special precautions.

Friday, July 10, 2009

H1N1 update: Protect your family! Vaccinate against Pneumococcal and Flu!

As from today, they have stopped taking temperatures at the checkpoints because the H1N1 virus is now considered endemic ie it is prevalent within our society. There is no point in trying to prevent the virus from getting into Singapore since it is already spreading around within the country.

So, what can you do to protect yourself and your family?

The most important thing is of course to take the necessary precautions. Basic things like avoiding crowded places, eating healthy foods like lots of fruits and vegetables and doing regular excercise will go a long way to keep your immune system in it's peak condition.

In addition, there are some vaccines which you might want to give your loved ones.

The first one is quite obvious and that is the Flu Vaccine. Many patients have asked me why they should take the Flu Vaccine even though it does not specifically protect against H1N1. Well, the way I see it, if you happen to get the seasonal flu now, the symptoms are exactly the same as the H1N1 flu and it might still result in home quarantine for a week. At the moment, it is not compulsory to send every suspect case of H1N1 to TTSH anymore. So if you have Flu-like symptoms and it is not serious, then you will be simply sent home with 1 week MC. So as you can see, even having the seasonal flu is going to mean a lot of disruption to your life.

The second and perhaps not so obvious is the Pneumococcal vaccine. Recent studies have looked at the real cause of death in the Flu pandemic of 1918 and the evidence is that many of the deaths were caused not by the Flu virus itself but by secondary infection caused by Bacteria like Pneumoccocus.

What happens is that the Flu Virus enters the body and damages the lung tissue. This is like "tilling the soil", making it very easy for Bacteria to then infect the tissues. Pneumococcus is the major cause of Pneumonia and in many cases, the Flu Virus creates the condition where it is very easy for Pneumococcus to come in and cause a full blown pneumonia and eventually death.

So another thing you can do for your family is to vaccinate them against Pneumococcal disease. There are currently two such vaccines in the market. One is specifically for children from birth to 9 years of age. Kids, especially babies are most susceptible to this Bacteria which often cause really devastating disease and death. The good news is that this is preventable. In fact, in 42 countries around the world including US, UK and Australia, the pneumococcal vaccine is already administered to babies as part of the National Immunization Program. However, in Singapore, it is still an optional vaccine.

It is important to realise that by vaccinating your kids, you are in fact reducing the chances of the bacteria circulating within your family circle so the chances of the elderly getting the bacteria is reduced.

For elderly folks, there is also a pneumoccocal vaccine which can be administered to prevent pneumonia. This vaccine is in fact recommended by MOH for those 65 and above. One vaccination will last for 5 years.

We got good news. Although Flu Vaccines are short in supply, we just managed to get another lot in. So if you are wanting to vaccinate your family, you should come soon to the clinic. The pneumococcal vaccines for both kids and the elderly are also available.

Wednesday, July 01, 2009

H1NI update: New measures to manage the outbreak

When the WHO declared the H1N1 a pandemic on 11 June 2009, Singapore adopted a containment strategy in order to prevent new cases from being imported into Singapore. This is what we are all experiencing now with strict procedures to identify passengers coming in from overseas and sending them on an extended holiday in Pasir Ris.

However, despite the measures that have been put in place, the H1N1 still managed to spread within our community. Since there is no point in trying to contain the spread anymore, Singapore will soon move into the "mitigation" phase. This essentially means that since the virus is already among us, we will try to minimise the number of people getting the disease and the number of deaths.

We are not yet in the "mitigation" phase. But when that happens, what that will mean for you is that when you come to the clinic. Our doctor will examine you and if you show symptoms consistent with H1N1, then you will be given one week MC to recover at home. You will no longer be required to be taken by ambulance to Pasir Ris and we will do blood tests only in severely ill patients. Tamiflu will only be given to severely ill patients.

Currently we are in the "Transition" phase. That means that when you come to the clinic, our staff will separate those patients with influenza like illness. You will be given a mask and asked to sit outside the clinic. This is essential to prevent cross infection. Patients suspected to have H1N1 infection will be issued MC for 7 days to recover at home. High risk patients like pregnant women, immuno-suppressed persons and renal dialysis patients will be referred to see their specialists.

So when you visit the clinic, please be socially responsible and ask for a mask if you are coughing and please let our staff know if you have flu like symptoms. If you have a fever, we will require you to be seated outside as a measure to prevent cross infection.