PRECAUTIONARY TUBERCULOSIS SCREENING FOR RESIDENTS OF 2 JALAN BUKIT MERAH

         The Ministry of Health (MOH) will offer voluntary Tuberculosis (TB) screening to current and former residents of Block 2 Jalan Bukit Merah, as well as stallholders, shop owners and their employees at that location. This is a precautionary measure following the detection of a cluster of seven individuals diagnosed with TB¹ residing in seven different units at the block. The screening will be conducted free of charge and will take place from 27 to 31 May 2022.  

2.             Residents, stallholders, shop owners and employees of Block 2 Jalan Bukit Merah are strongly encouraged to participate in the TB screening. For the convenience of residents, mobile teams will go to their home to carry out the screening. A screening station located at the Queenstown Hock San Zone Residents’ Committee (RC) Centre at Block 3 Jalan Bukit Merah will also be set up for those working at the shops and stalls, as well as to cater to residents whose homes are not suitable for screening. Former residents and subtenants who had resided in the block from October 2020 will be contacted via phone call in June 2022 and offered screening at the TB Control Unit  (TBCU). Former residents who had lived in the block from October 2020 and wish to be screened, may also call the TBCU Contact Clinic appointment hotline at 6258 4430.

3.             The risk of transmission to persons who are not close contacts of a TB case is very low. Screening is thus not necessary for individuals who had occasionally visited the block or vicinity.

4.             Staff from the National Centre for Infectious Diseases (NCID), with support from the People’s Association, will be conducting visits to all units at the affected block from 21 to 23 May 2022 to engage residents, as well as shop and stall owners and employees, and encourage them to participate in the screening. While screening is not compulsory, MOH strongly encourages residents to be screened to determine if they have TB disease or infection (which is non-infectious). Persons with positive screening results will be offered appropriate advice and follow-up. Those with TB disease will be treated immediately while those with TB infection will be given appointments at the TBCU and offered treatment to minimise their risk of developing TB disease in the future.

Identification of TB Cluster

5.             MOH was notified on 2 March 2022 of seven TB cases involving residents of Block 2 Jalan Bukit Merah, who were diagnosed between February 2021 and March 2022. All seven individuals live in different units of Block 2 Jalan Bukit Merah. The cases were immediately started on treatment following diagnosis. Amongst them, two have completed treatment, three are currently undergoing treatment while two are deceased from causes not due to TB. As individuals diagnosed with TB will rapidly become non-infectious once treatment starts, the cases are not an ongoing public health risk.

6.             In line with MOH’s TB prevention strategy, the National TB Programme had initiated contact investigations for each of the seven cases shortly after they were notified. Close contacts of the cases were identified and contacted for screening. Investigations for each of the seven cases at the time of their diagnosis did not identify each other as close contacts.

7.             Genetic analysis and links, established in April 2022, revealed that all seven cases have similar genetic make-up. This suggests that these cases are linked by spread from one or more common sources. Investigations into the cases did not reveal any common links, other than that they live in the same block. The cases did not know or interact with one another, or congregate at the same common areas, and had also not identified each other as close contacts. Therefore, as a precaution, we are offering screening for those in the block to diagnose any TB cases that may be present for early treatment.

Health Advisory

8.             The symptoms of TB disease include persistent cough that lasts 3 weeks or longer, low-grade fever, night sweats, fatigue, weight loss and chest pain. TB is typically spread through close and prolonged contact with an infectious individual, and not by contact with items or surfaces touched by a person with TB. Therefore, persons who are contacted and screened following the detection of a TB individual typically comprise family members, close workplace colleagues and acquaintances from common social activities with close and regular interaction. This approach is recommended by the World Health Organization (WHO) and is practised in Singapore. Please refer to the Annex for details of TB.

9.              TB is endemic in Singapore. TB infection is not uncommon in our population, as TB had been prevalent in Singapore until the 1970s and older Singaporeans could have been exposed to TB and acquired TB infection when they were younger. Persons with TB infection do not experience symptoms of TB and are not infectious.

10.          TB is curable and the spread of TB is preventable. Early detection and prompt treatment of cases remain important in helping those infected and rendering them non-infectious. For individuals diagnosed with TB disease, adherence to treatment is important.

MINISTRY OF HEALTH

21 MAY 2022

[1] TB can be cured with anti-TB drugs. Treatment of TB disease, which is sensitive to first-line anti-TB drugs, usually involves a combination of different drugs, taken for six to nine months.