At least 21 kidney patients have been infected with hepatitis C at Singapore General Hospital (SGH), with the needles used to inject insulin coming under scrutiny.
Eight of these patients have died, with four deaths linked to the viral infection that affects the liver. Three died of unrelated causes while a question mark still hangs over the last death.
The hospital is confident that the transmission of the virus in its newly renovated Ward 67 has stopped, said its chief executive officer, Professor Ang Chong Lye.
Health Minister Gan Kim Yong said yesterday that he was "deeply concerned" by the infection at SGH, which he was told of at the end of last month. He said: "My thoughts are with the affected patients and their families."
He has set up an independent committee to "provide a critical review of SGH's investigation and findings".
Our first priority is to extend our help and support for our patients, to ensure that their conditions are managed... and also provide support for the family members. And our second priority is to look at how we can strength our precautionary measures and safeguards to ensure that this doesn't happen again.
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This committee, headed by Professor Leo Yee Sin, director of the Institute of Infectious Diseases and Epidemiology, is expected to complete its review in two months.
The first case surfaced on April 17, Professor Fong Kok Yong, chairman of SGH's medical board, told reporters yesterday.
But it was not till mid-May, some five cases later, that liver specialists started suspecting the infection could have occurred in the hospital.
It was not easy to spot a pattern earlier because the hospital sees three to four hepatitis C patients in a month, who often consult different liver experts.
But when it was observed that several of these hepatitis C patients were also kidney failure patients, alarm bells rang, especially since all had been warded at the hospital this year.
Tests then showed that 22 were infected with a virus of the same genotype, indicating that they were from the same source.
The 22 patients, including the possible index case, range in age from 24 years to 70 years, with the majority in their 50s and 60s. The latest case was diagnosed on Sept 18.
SGH set up a review committee but it was not able to ascertain the source, although Prof Fong said the virus was likely spread through multi-dose vials, which it stopped using throughout the hospital by June.
These vials contain more than one dose and one vial is usually shared between two or three patients, said chief nurse Tracy Ayre.
But a new needle has to be used each time the medicine - in this case, most likely insulin - is taken. The needle is then discarded.
Prof Ang yesterday apologised unreservedly to all affected patients and their families.
The hospital will pay for all necessary treatments. So far, two patients have been given newer antiviral medicine that costs $90,000.
Said Prof Ang: "We should and must take responsibility for these patients."
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