MOH seeks measures to curb spread of infectious diseases

A lady walking past Tan Tock Seng Hospital's Communicable Disease Centre, where  a patient repeatedly absconded from while being treated for tuberculosis.
A lady walking past Tan Tock Seng Hospital's Communicable Disease Centre, where a patient repeatedly absconded from while being treated for tuberculosis. ST PHOTO: KELVIN LIM

The Ministry of Health (MOH) wants more powers to curb the spread of infectious diseases here, including stopping individuals who break quarantine from leaving the country, and turning back visitors with a high risk of yellow fever without first offering vaccination.

Instead of tracking cases, carriers of infectious diseases or contacts in person, the ministry also wants to be able to carry out surveillance remotely, such as through phone calls and video-conferencing.

MOH, which is seeking public feedback on these changes, said yesterday that as Singapore is a major global trade and travel hub, it is imperative for the country to remain vigilant against new and emerging infectious diseases such as avian influenza, Ebola and the Middle East respiratory syndrome.

In coming up with the amendments to the Infectious Diseases Act, MOH said it looked at recent public health threats, including last year's death of a Bangladeshi worker here due to the respiratory disease diphtheria, and the yellow fever outbreak in Brazil, which has affected more than 400 and killed more than 100 since last July.

A key proposal is to stop high-risk individuals who break isolation or movement restriction orders from leaving the country and to isolate them. This will better reduce the risk of transmissions, compared with the current practice of arresting them.

There are an average of about two such cases a year, said MOH, citing the example of a patient who repeatedly absconded from the Communicable Disease Centre in 2014 while being treated for tuberculosis. The patient was eventually arrested and charged.

There will also be a more calibrated approach in restricting the movement of cases or carriers. Those who pose a lower risk of transmission may be allowed to visit certain places without strict home quarantine, and to continue working instead of facing a blanket stop-work order.

Currently, non-citizens from yellow fever-affected countries entering Singapore will have to be vaccinated against yellow fever. Otherwise, they will be subjected to vaccination, isolation or surveillance here.

MOH wants to have the discretionary powers to return unvaccinated non-citizens from yellow fever-affected countries to their place of embarkation without first offering vaccination, isolation or surveillance, saying that this is in line with international practice.

Yellow fever, an acute viral disease transmitted by mosquitoes, can be fatal and is found mainly in Africa and Central and South America. There have not been any cases here.

Experts said the proposed changes are timely. "Modern surveillance using calls or video calls would allow more potential contacts to be screened than a traditional in-person examination," said Associate Professor Alex Cook, vice-dean (research) of the National University of Singapore's Saw Swee Hock School of Public Health.

Senior consultant Dale Fisher of the National University Hospital's Division of Infectious Diseases said a risk-calibrated surveillance approach is not only more convenient, but also likely less stressful for the individual.

The public consultation exercise will run until Aug 7.

Further information can be found on www.reach.gov.sg and www.moh.gov.sg/ida2018

A version of this article appeared in the print edition of The Straits Times on June 27, 2018, with the headline 'MOH seeks measures to curb spread of infectious diseases'. Print Edition | Subscribe