Pre-schoolers screened for TB due to teacher’s contract of the infectious disease

One of the preschool teacher of Little Greenhouse pre-school at Bukit Batok Street 31, was confirmed to have contracted active tuberculosis (TB). As a result, the students and the staffs of the school are obliged to take the screening to make sure that they are not infected.

104 children and 20 staffs of the school all had been screened, the Ministry of Health (MOH) said in its statement on 24 August. The children below 5 years old had a skin test and chest X-ray, while those above 5 years old were given blood tests.

The teacher who was infected with the disease had called school in sick on Thursday (18 August). Ms Ruth Kua, deputy chief operating officer of Global EduHub, the pre-school’s parent company, said she did not show any signs of being infected by the disease before.

Ms Kua said that MOH had called them on Friday (19 August) to tell them about the health condition of the teacher, as she did not update her condition to the school. MOH stated that teacher is now undergoing treatment.

The teacher was granted medical leave for two weeks and she remains on contract with the school till next June. “The teacher needs her own rest and has an MC (medical certificate). The school has to honour it. We did not terminate her, as that would mean that she did not perform her job well as a teacher,” said Ms Kua.

As the school received the news, it began sanitising the premises last Saturday. Ms Kua also asked Early Childhood Development Agency on the need to temporarily close the school, however, the Agency said that there was no need at all to do such thing. “But we have to monitor the situation closely and to see what’s the next step,” she added.

TB is an infectious disease due to Mycobacterium tuberculosis bacterium that usually affects the lungs. It is the second greatest killer due to a single infectious agent worldwide, and in 2012, 1.3 million people died from the disease, with 8.6 million falling ill.

The MOH said that only a very small proportion of TB cases occur in children and last year, only 0.6 per cent of TB cases among Singapore residents occurred in those aged below 15.

TB is contagious, but it is not easy to catch. It is an airborne pathogen, meaning that the bacteria that cause TB can spread through the air from person to person. The chances of catching TB from someone you live or work with are much higher than from a stranger. Most people with active TB who have received appropriate treatment for at least two weeks are no longer contagious.

While latent TB is symptomless, the symptoms of active TB include the following:

• Coughing, sometimes with mucus or blood.
• Chills.
• Fatigue.
• Fever.
• Loss of weight.
• Loss of appetite.
• Night sweats.

Tuberculosis usually affects the lungs, but can also affect other parts of the body. When TB occurs outside of the lungs, the symptoms can vary accordingly. Without treatment, TB can spread to other parts of the body through the bloodstream:

• TB infecting the bones can lead to spinal pain and joint destruction.
• TB infecting the brain can cause meningitis.
• TB infecting the liver and kidneys can impair their waste filtration functions and lead to blood in the urine.
• TB infecting the heart can impair the heart's ability to pump blood, resulting in a condition called cardiac tamponade that can be fatal.

Earlier on June 16, MOH held a press conference and revealed that there were 6 cases of multi-drug-resistant tuberculosis (MDRTB) emerged from Ang Mo Kio Block 203, and the first case were found back in 2012. In its reply to a parliament question about the incident, was not able to provide any update to the reason of how the Ang Mo Kio tuberculosis (TB) cluster occured.

In a 2014 report by TodayOnline, it was reported that a group of researchers from National University of Singapore found that the proportion of TB cases involving non-residents increased from 25.5 per cent in 1995 to 28.9 per cent in 2004 and 47.7 per cent in 2011.

“An increasing trend of non-resident TB cases contributing to the overall proportion of TB cases over the years could suggest that mass immigration from high TB incidence countries is increasingly contributing to the burden of TB in recent years in Singapore,” noted the study, which cited India and China as some of the countries of origin of these non-residents.

But while non-resident TB cases contributed to the overall TB rates here, the researchers did not find a direct link between the increase in the foreign population and the risk of TB among local residents.

One of the researchers noted that foreign workers entering Singapore are already undergoing stricter checks for TB, with their X-rays sent to the STEP registry.