First case in TB outbreak also part of older cluster

Man with drug-resistant strain was the first case in Parklane outbreak reported in 2013

The first person found to have drug-resistant tuberculosis in the recently discovered Ang Mo Kio outbreak was also the first to be diagnosed in an older TB cluster, the Ministry of Health (MOH) revealed yesterday.

The man was the index case in that drug-resistant TB outbreak reported in 2013, which was traced to three cybercafes in Parklane shopping mall. In a statement yesterday, an MOH spokesman said the man had been coughing for four months before he was diagnosed in 2012.

However, he defaulted on treatment shortly after his diagnosis.

"Efforts were made by the TB Control Unit and MOH to locate him, but he was not residing at his registered address and was uncontactable for about five weeks," the spokesman said.

When the authorities located him, he was served an order under the Infectious Diseases Act and isolated for treatment at Tan Tock Seng Hospital's Communicable Diseases Centre.

He was discharged to continue his treatment as an outpatient only when he was deemed no longer infectious.

The TB Control Unit also screened the man's close contacts, including users of the cybercafe, as well as two flatmates.

"There is currently no evidence to suggest that there was similar spread to persons outside of the close contacts," said the MOH spokesman.

In the earlier cluster he was involved in, six people were treated for multi-drug-resistant TB after falling ill between February and December 2012.

Five of them had frequented cybercafes at Parklane shopping mall in Selegie, while the last was a family member.

This week, MOH revealed it had identified another cluster of multi-drug-resistant TB cases at Block 203, Ang Mo Kio Avenue 3.

Unlike the previous cluster, however, this was a "highly unusual occurrence" as the four households involved did not know or interact with one another.

Typically, TB requires "close and prolonged" contact between two people to spread.

But one of the six, Mr Effandy Rahmat, told The Straits Times he used to frequent a cybercafe at Parklane four or five times a month, though he has not been back there for years.

"That was when I was 18 - I would spend maybe 12 hours there each time," recalled the 25-year-old. "But my NS (national service) health check-up didn't find any problems."

MOH had screened 147 residents and former residents for TB by 5pm yesterday.

Eleven children were given appointments at the TB Control Unit, as the tests were different.

MOH officers and grassroots volunteers have also reached out to more than three-quarters of the 160 households to inform them of the situation.

One resident who had screening was retiree Hong Zhai Sun, 66, who said: "I thought why not, since it's free. I also want to make sure that my health is good."

• Additional reporting by Clarice Teo

A version of this article appeared in the print edition of The Straits Times on June 18, 2016, with the headline 'First case in TB outbreak also part of older cluster'. Print Edition | Subscribe