Private clinic reveals govt circular warning outbreak of typhoid fever in Singapore

Etern Medical Group which operates 4 branches in Sengkang and Punggol published a circular it had received on its Facebook page yesterday (15 Aug).

The circular, apparently from MOH, revealed that there has been an increase in typhoid fever in Singapore recently. As of 13 Aug, MOH has already been notified of 15 cases of typhoid fever locally:

All 15 cases were hospitalised and are reported to be stable. Eleven of these cases have been discharged and MOH said investigations are ongoing.

On its Facebook page, Etern Medical also added that typhoid fever “is active these few weeks”.

“Best test to use are stool specimen or rectal swab. Blood test like Widal test, CRP, basic panel, stool calprotectin are useful to assess severity and to rule out other important conditions like Dengue. Even infants have been diagnosed to have salmonella infection in our clinic also,” it said.

Highest risk for typhoid in South Asia

According to Wikipedia, typhoid fever is caused by bacterium Salmonella. Symptoms usually begin 6 to 30 days after exposure. It is commonly accompanied by weakness, abdominal pain, constipation, headaches, and mild vomiting. Some people develop a skin rash with rose colored spots.

Wikipedia also said that people may carry the bacterium without being affected; however, they are still able to spread the disease to others. It is spread by eating or drinking food or water contaminated with the feces of an infected person.

“Risk factors include poor sanitation and poor hygiene. Those who travel in the developing world are also at risk. Only humans can be infected,” it said.

“Until an individual’s infection is confirmed as cleared, the individual should not prepare food for others. The disease is treated with antibiotics such as azithromycin, fluoroquinolones, or third-generation cephalosporins. Resistance to these antibiotics has been developing, which has made treatment of the disease more difficult.”

And according to US CDC, typhoid is common in developing countries. It is not common in industrialized regions such as “the United States, Canada, western Europe, Australia, and Japan”.

“Travelers to the developing world should consider taking precautions. Travelers to Asia, Africa, and Latin America are especially at risk, and the highest risk for typhoid is in south Asia,” CDC added. “About 22 million cases of typhoid fever and 200,000 related deaths occur worldwide each year.”

Indeed, according to this chart, the highest incidence rate for typhoid occurred in the Indian sub-continent:

So far, on MOH’s website, it did not say anything about the outbreak of typhoid publicly.

It only issued a PR on 8 Aug – Over 880 General Practitioner Clinics Open During National Day and Hari Raya Haji Weekend, and release a speech from Edwin Tong on 2 Aug – Speech by Mr Edwin Tong, Senior Minister of State, Ministry of Law & Ministry of Health, at the Institute of Mental Health (IMH) Nurses’ Day 2019, 2 August 2019.