The Ministry of Health said in a statement on Tuesday (23 July) that a total of 17 people have been infected with measles recently. Those infected included 14 employees and residents at [email protected] in Hougang and three foreign workers at the S11 Dormitory in Seletar North Link.
“There is currently no evidence of community spread from these cases. Nonetheless, the ministry took precautionary measures to prevent further spread of the disease,” said MOH.
Close contacts of those who have been infected will be vaccinated if they lack proof of past vaccinations or immunity, said the statement. MOH will also be monitory the health of these contracts and isolating all suspected measles cases.
As measles cases around the world are on the rise, MOH urges people to be vigilant as Singapore, being a travel hub, is likely to see more cases. In Singapore, the number of measles cases reported in the first 11 weeks of 2019 was 28 cases, which is more than triple that of the same period in 2018 of only 11 cases.
In the statement it was said, “MOH investigates all notified cases of measles under our surveillance programme, and will continue to monitor the situation closely.
“MOH has alerted general practitioners to be on the lookout for cases of measles, particularly in patients who have recently travelled overseas or who have not been vaccinated, and to notify MOH promptly.”
Of the 14 cases in Hougang, 12 were residents of Mindsville, a home for persons with intellectual disability. Two more were staff. Six of those infected were hospitalised and one has since been discharged while the remaining five are in stable condition.
The first case was reported on June 29. A female resident had developed symptoms and received outpatient treatment on 1 and 5 July. MOH was subsequently notified of this suspected case on 7 July.
A couple of days later tests, the woman was hospitalised and tests confirmed that she measles. However, she was later discharged after it was determined that she was no longer infectious.
In the following month, nine more cases were reported between 19 and 20 July and another four cases on 22 July. MOH said that people who were infected were “promptly isolated and treated”.
MOH noted that it had advised the home on vaccination recommendations for people who had been in close contact with those infected as well as enhanced infection prevention and control measures to be employed at the home.
They were reminded to maintain a high standard of personal hygiene while staff where directed to don gloves and protective equipment when tending to residents who were displaying symptoms. Staff were also directed to keep a close watch on each other and the residents for symptoms of measles.
Additional measures include screening residents for symptoms before they left the home for medical appointments and other activities.
All residents and staff at Mindsville without proof of prior immunity were given the measles, mumps, rubella (MMR) vaccine on 22 July as an added precaution.
As for the three cases of migrant workers with measles at the S11 Dormitory, two are Indians with no recent travel history and one is a Bangladeshi who arrived in Singapore on 27 June.
MOH was notified on 15 July of an Indian worker who had contracted measles, and then again on 16 and 19 July for the other two cases. All these workers were hospitalised and later discharged as they were no longer infectious
Curiously, the three workers lived in different blocks of the dormitory, worked at different sites, and are employed by different companies. The ministry said there have been no links identified among these three cases and that investigations are ongoing.
According to MOH, around 50 roommates and co-workers of the three workers have been identified as of 22 July and the ministry is working with the companies to conduct screening and vaccinations of these close contacts who do not have proof of prior immunity. MOH also advised the companies to closely monitor the health of these people.
In an effort to reduce the risk of further transmission, MOH is offering MMR vaccinations to all residents of the dormitory staying on the same floors are the three men, said the statement.
“The vaccination of all contacts identified is expected to be completed by the end of this week,” it said.
Measles in Singapore
This year (as of 22 July), there have been 116 measles cases report to MOH, 88 were Singaporean residents while the rest were imported from Bangladesh, Dubai, Malaysia, New Zealand, the Philippines, Thailand and Vietnam.
These include eight cases in the Toh Guan Dormitory and Sungei Tengah Lodge in June 2019, with two from Toh Guan and six from Sungei Tengah. MOH updated in their statement that it has since completed vaccination of all close contacts of those eight measles cases and there have not been further cases reported from either dormitory.
No deaths have been reported in any of these cases.
Symptoms of measles
Some of the early symptoms of measles include fever, a runny nose, sore or red eyes, and a cough followed by a rash that spreads over the entire body. The disease is infectious as early as four day before the onset of the rash and up to up four days after it appears.
The viral disease is highly infectious among the those who are not vaccinated. In Singapore, measles vaccination is mandatory for all resident children and adults are also advised to be vaccinated if they have not previously done so.
Measles vaccinations are available at healthcare institutions including polyclinics, private general and paediatric clinics.