Update on Investigation into Group B Streptococcus Cases

           The Ministry of Health (MOH) has been working with the Agri-Food & Veterinary Authority of Singapore (AVA) and the National Environment Agency (NEA) to investigate the recent uptrend in the number of Group B Streptococcus (GBS) cases. From 1 Jan to 30 Jun 2015, we have received reports of 238 cases from public hospitals. This compares with an average of 150 cases per year in the past 4 years. More than half the cases were over the age of 55, similar to previous years.

2          GBS is a common bacterium found in the human gut and urinary tract of about 15% to 30% of adults without causing disease. However, GBS may occasionally cause infections of the skin, joints, heart and brain. The risk factors for GBS infection include underlying chronic or co-morbid conditions, such as diabetes. GBS can also be found in fish, but this does not pose an issue if the fish is well cooked before consumption.

3          While there is no proven link between eating raw fish and serious GBS disease in humans to date, government agencies have been studying the possible causes, including the possible link to raw fish consumption. AVA and NEA have been conducting field investigations at various locations, including sources and distribution chains. On MOH’s part, it has asked all hospitals to submit their case listings of patients with GBS infections for this year, as part of its investigation.

4          Based on the preliminary findings of the on-going investigations, some samples of raw fish (Song fish, also known as Asian Bighead Carp; and Toman fish, also known as Snakehead fish) were tested and found to have traces of GBS. Concurrently, interim analysis of MOH’s investigation on a limited number of identified cases also found an association between the consumption of raw fish and GBS infections, although more cases will need to be studied for a more definite conclusion. Hence, NEA will be advising licensed foodshop and foodstall holders to temporarily stop the sales of raw fish dishes using the above two types of fish as a precautionary measure. NEA will also remind stall holders to adhere to high standards of personal hygiene and adopt proper food handling practices to prevent cross contamination and bacterial growth.

5          In the meantime while investigations are on-going, vulnerable groups of people, especially young children, pregnant women or the elderly, or people with chronic illness such as diabetes, should exercise caution by avoiding raw ready-to-eat food (e.g. raw oysters, sashimi, etc).

6          Further investigations are underway, and we will provide an update once our investigations have been concluded. 

MINISTRY OF HEALTH

NATIONAL ENVIRONMENT AGENCY

AGRI-FOOD & VETERINARY AUTHORITY OF SINGAPORE 

24 JULY 2015