MOH investigates keratoconjunctivitis cases in rugby players

       The Ministry of Health (MOH) was informed by the Centre for Health Protection, Hong Kong on 18 May 2012 that a group of students who came to Singapore to play in a rugby tournament between 20-22 April 2012 at Turf City had subsequently developed symptoms of keratoconjunctivitis after returning to Hong Kong.

2.     MOH’s investigations have so far confirmed two cases of keratoconjunctivitis caused by microsporidia, a spore-forming unicellular parasite found in the soil, in a 10-year old boy who resides in Singapore and a 12-year old boy who resides in Malaysia. Both boys had played in the tournament.

3.     MOH is working closely with the tournament’s organiser and the participating clubs to ascertain how many players had developed eye infection after the tournament. The tournament involved around 1,600 players from 16 rugby clubs. As at 24 May 2012, the number of affected cases reported by clubs in the following countries/areas are as follows:

•     Singapore: 80-90 cases

•     Hong Kong: 33 cases

•     Malaysia: 14 cases

•     Australia: 13 cases

4.     The affected cases are aged between 5 and 17 years.

5.     MOH is currently in contact with the health authorities in these countries.

6.     Cases of eye infection with microsporidia have been known to occur in Singapore. Infection can occur when mud enters the eye during sporting activities in muddy fields. This can cause keratoconjunctivitis, which may cause eye pain, redness or blurry vision as early as 2 days and as late as 21 days after exposure. Microsporidia keratoconjunctivitis is generally mild and can be treated with antibiotic eyedrops. The infection cannot be transmitted from person to person.

7.     In Singapore, this condition is well known and has been reported by our Ophthalmologists. In 2009, a group of Ophthalmologists from Singapore National Eye Centre, Dept of Ophthalmology NUS and Changi General Hospital reported a large series of 124 patients who had confirmed microsporidial keratitis infection of the eyes in an international scientific journal (Ophthalmology). Last year, ophthalmologists from Tan Tock Seng Hospital and Singapore National Eye Centre reported a series of 22 cases in the Open Ophthalmology Journal. In all these cases there was a strong correlation to soil exposure (e.g. in the second series more than 75% reported prior contamination with soil or mud).

8.     While investigations are ongoing, MOH would like to advise the public to avoid using Turf City pitches for rugby when it is rainy or muddy. Members of the public who engage in sports that involve contact with soil or mud should maintain good personal hygiene. People are advised to wash their faces if they come into contact with mud, and use different towels for the face and body after engaging in such sports. MOH would like to advise members of the public to seek early medical consultation should they experience similar symptoms such as itchy and painful red eyes with discharge occurring from two days up to three weeks after engaging in sports that involve contact with soil or mud.