Overreaction may deter others from seeking early treatment

We read with great concern a comment made by Ms Ruth Kua of the Little Greenhouse childcare centre on her initial plan to end the contract of the teacher who was diagnosed with tuberculosis ("Pre-schoolers screened for TB at Bt Batok centre"; last Thursday).

The deputy chief operations officer of the centre had said: "The job involves a lot of contact with very young children who have low immunity. What if she has a relapse?"

Tuberculosis is a global infectious disease, afflicting nearly 10 million people worldwide in 2014, according to the World Health Organisation.

Singapore has an excellent Tuberculosis Control Unit, which offers free treatment and directly observed therapy, with very high rates of completion of treatment and very low rates of relapse.

Most patients with TB are considered not infectious after two weeks of treatment, by all international guidelines.

It is completely reasonable for parents to feel anxious in this circumstance. The centre official could have reassured them by providing them with accurate information about TB, which can be easily obtained from the Ministry of Health website.

The correct response has been taken by the Tuberculosis Control Unit in this case, with contact tracing, assessment of risk of exposure and management of latent infection.

In the latest Ministry of Health report, there were 1,591 cases of TB among Singapore residents in 2014.

The correct approach is early diagnosis and treatment of patients with TB, and contact tracing and treatment of latent infection in exposed high-risk contacts.

This strategy has been effective in reducing TB rates in Singapore from very high levels a few decades ago.

All persons infected with TB should be treated with compassion and dignity, and be provided with the best medical care.

Equally important is continued social and moral support from the patient's family, colleagues and our society.

Any overreaction and discrimination may result in reluctance of others in similar situations to seek early and appropriate medical treatment, which will undermine efforts to control the disease.

David Lye Chien Boon (Associate Professor)
President
Society of Infectious Disease
(Singapore)

Brenda Ang Sze Peng (Associate Professor)
Chair, Chapter of Infectious Disease
Physicians
College of Physicians
Academy of Medicine, Singapore

Ling Moi Lin (Dr)
President
Infection Control Association
(Singapore)

A version of this article appeared in the print edition of The Straits Times on August 29, 2016, with the headline 'Overreaction may deter others from seeking early treatment'. Print Edition | Subscribe