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Late disclosure because there “were no signs of acute hep C cases”: MOH

The reason why it took several months for the news of the Hepatitis C outbreak to be made public was because there were no signs that the incidents were of acute viral Hepatitis C.

This was the explanation given by the Ministry of Health (MOH) on Wednesday, when responding to questions which are being raised by the public since the outbreak at the renal ward of the Singapore General Hospital (SGH) was reported in the media.

According to the Infectious Diseases Act (IDA), incidents of acute viral hepatitis C must be reported to the ministry within 72 hours, unlike chronic cases which need not be reported.

According to the definition by the United States Department of Health and Human Services:

Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from infection with the Hepatitis C virus (HCV), which is spread primarily through contact with the blood of an infected person. Hepatitis C can be either “acute” or “chronic.”

Acute Hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute infection leads to chronic infection.

Chronic Hepatitis C virus infection is a long-term illness that occurs when the Hepatitis C virus remains in a person’s body. Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.

“As it can be difficult to detect such asymptomatic hepatitis C based on blood tests alone, doctors generally look for a link to an event of relevant exposure, such as current intravenous drug use or a needle-stick injury,” a spokesman for the MOH told the media on Wednesday.

The first eight infections apparently occurred in April to May, with the other 14 taking place later, the last of which was in September.

The confirmation that some of the cases were indeed acute hepatitis C came later, and the MOH was informed only in “late August” of the cluster of infection.

External verification of SGH’s phylogenetic analysts was completed around 7 September and found that 21 of the 22 cases were indeed related.

The news was made public in October.

The outbreak of the hepatitis C virus is believed to have been due to a lapse in the use of multi-dose medication vials.