SINGAPORE: More than 80 children have been screened for tuberculosis as of Wednesday (Dec 9) and none of them were found to have active tuberculosis, according to the National University Hospital. This comes after the hospital asked 178 children to be tested, after discovering that a nurse working in a paediatric ward had been diagnosed with lung tuberculosis.
According to an update from NUH, more than 120 patients - who stayed at NUH's ward 47 since July - have been contacted thus far.
A total of 131 children of the 178 included in the recall are under the age of two, and were cared for by the nurse. The 178 also includes 34 children who had received a transplanted organ, and are on immunosuppression drugs.
Channel NewsAsia understands that a child who stayed at the affected ward has been diagnosed with latent tuberculosis, which is not contagious. A caller to Mediacorp's hotline said his baby had stayed in the affected ward between Aug 23 and Sep 5 this year. The child has undergone screening, and results revealed that he has latent TB.
The caller said his child has been prescribed medication and is recuperating at home.
When asked, NUH said it is aware of the case.
NURSE MAY NOT BE ACTUAL SOURCE OF INFECTION: EXPERT
Dr Leong Hoe Nam, Infectious Diseases Physician from Rophi Clinic at Mount Elizabeth Hospital said it is difficult to ascertain if the nurse was the actual source of the infection.
"It is extremely difficult to find the source of this latent tuberculosis, simply because TB is endemic in Singapore," said Dr Leong.
"The person whom you had lunch with, the person who looked after you as a child minder or a person who plays every day at the field - any one of them could have passed you tuberculosis. Similarly, if you look at the nurse, she could have picked it up at work or picked it up from anybody else," he said.
Dr Leong added that DNA finger-printing would be the only way to find out whether the nurse was the one who passed tuberculosis on to the affected child.
"To be really exact on whether the nurse passed it on to the child, you will need to isolate the tuberculosis from the nurse - which may be difficult. You may also have to isolate it from the child, which is going to be extremely difficult. Between the two, you need to do DNA finger-printing, and it is technically impossible," said Dr Leong. "It is practically impossible because it is latent TB, which means the germ is sleeping and you have very, very small quantities."
WHAT IS LATENT TB?
NUH said cases of latent tuberculosis can be effectively treated to prevent them from progressing to active tuberculosis.
"Current treatment options reduce the risk of developing active TB by more than 90 per cent," NUH said.
According to the Health Ministry's website, individuals with latent tuberculosis infection do not have symptoms and are not infectious. They cannot spread the tuberculosis germs to other people. Tuberculosis disease develops in about 10 per cent of those infected with latent tuberculosis.
Dr Leong explained that tuberculosis can be briefly classified into either latent or active.
"Latent - in other words - means sleeping. Let's say I have been exposed to tuberculosis; I breathe it in and it goes into my lungs. My body tries to 'wall it off' and contain it. If I am able to wall it off and contain it, it goes into a sleeping mode, and that's latent. But if I can't, then it will break out of the wall and then stop proliferating and start growing. In that case it becomes active tuberculosis," he said.
"(Tuberculosis) is in essence, a sleeping bacteria. So it is easy, because you can kill it off with one or two drug regimens, for about six months, and the bacteria can die with a very high success rate. If the person has TB, the immunity of the person will determine the risk of the TB coming out," Dr Leong added.
The doctor also said there is at most a four per cent chance of a relapse even after treatment, and should the person's immune system weaken. "TB masks itself very well, to the extent that a person may have active lung TB and not show any signs at all, and sometimes only an X-ray will show TB."
NUH said treatment given will not protect one from acquiring a new infection in the future, as TB occurs in the general community.
- CNA/dl
This news late liao, was out in media 2 to 3 days ago.