On Feb. 4, the Ministry of Health (MOH) confirmed four new cases of the Wuhan virus that were spread by local transmission.

The venue where the virus was transmitted among the three cases is Yong Thai Hang, a Chinese health products shop in Lavender. 

https://mothership.sg/2020/02/wuhan-virus-local-spread/?fbclid=IwAR0rAqPBT8MTyZZ_UeNVjRyXLcE-K1NqKYPA6demAszXBI6EROeko6j1I4A

The shop often sees busloads of Chinese tourists, according to the residents Mothership spoke to.

The four people affected are:

• Two shopkeepers at Yong Thai Hang
• A domestic helper, who works for one of the shopkeeper
• A tour guide who brought the tour group around

Three of these cases can be traced to contact with recent travellers from Guangxi, China, of whom two are infected.

MOH has released a timeline of the tourists' whereabouts, as follows:

Jan. 22:

Arrival of tour group from China.

Jan. 23:

Visited Yong Thai Heng, among other places.

These other places are not listed.

Jan. 24 - 26:

Tour group went to Malaysia.

Jan. 27:

Tour Group re-entered via Woodlands at 3am.

They departed Singapore via Changi T1 at 6am. 

Jan. 28, 31

Implementation of  travel restrictions for travellers with travel history in Hubei and rest of mainland China.

And here's the timeline for the four infected individuals in Singapore.

Shopkeeper 1

Jan. 29:

Developed sore throat and fever and visited a General Practitioner clinic (GP).

Jan. 30:

Visited Tan Tock Seng Hospital’s (TTSH) emergency department, but was discharged when chest x-rays came back negative for pneumonia.

Jan.31 - Feb.2:

Stayed at her home in Jalan Bukit Merah.

Feb. 3:

Went to SGH and was confirmed on the same night.

Shopkeeper 2

Jan. 25:

Developed symptoms and went to National Centre for Infectious Disease (NCID).

Classified as suspect case and isolated.

Feb.3:

Went to NCID and was immediately isolated.

Feb. 4:

Test results confirmed Shopkeeper 2 as infected on the morning of Feb. 4.

Domestic helper of Shopkeeper 1

Feb. 2:

Reported onset of symptoms. 

Feb. 3:

Admitted to SGH emergency department.

Feb. 4:

Test results on the afternoon of Feb. 4 confirmed that she was infected.

Tour guide

Feb. 3:

Went to NCID (asymptomatic), where she was immediately isolated.

Feb. 4:

Test results confirmed her as infected on the afternoon of Feb. 4.

Transmitted through droplets

According to MOH, this new cluster of cases constitutes “limited local transmission”, and there is as yet no evidence of widespread sustained community transmission.

Current evidence suggests that the likely modes of transmission at this point are mainly through contact with droplets from infected individuals.

This can happen either directly or indirectly through hands that have come into contact with the droplets.

These four cases were identified as a result of enhanced surveillance at local hospitals.

Contact tracing

The MOH has commenced contact tracing to identify individuals who had close contact with these cases to prevent further spread.

Individuals should keep high levels of personal hygiene and wash their hands often.

They should also refrain from touching their faces with their hands.

However, MOH warns that Singapore could still see extensive community spread despite the community's best efforts.

Should it come to that, the ministry will consider measures to reduce human to human interactions.

This includes cancelling mass gatherings, suspending schools, paring down non-essential care services, as well as introducing further infection control and monitoring measures.

Related article:

Top image via Andrew Koay