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Pre-schoolers screened for tuberculosis after teacher gets disease

SINGAPORE — About 80 pre-schoolers enrolled at a centre in Bukit Batok have been screened for tuberculosis (TB), after a teacher there was found to have contracted the infectious disease.

Outside the Little Greenhouse pre-school on Bukit Batok Street 31 on Aug 24. Photo: Raj Nadarajan/TODAY

Outside the Little Greenhouse pre-school on Bukit Batok Street 31 on Aug 24. Photo: Raj Nadarajan/TODAY

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SINGAPORE — About 80 pre-schoolers enrolled at a centre in Bukit Batok have been screened for tuberculosis (TB), after a teacher there was found to have contracted the infectious disease.

The teacher, a Chinese national who taught at the Little Greenhouse pre-school on Bukit Batok Street 31, had phoned in sick last Thursday morning. She had shown no signs of being sick in the days prior, said Ms Ruth Kua, deputy chief operating officer of Global EduHub, the pre-school’s parent company.

The teacher, who has active TB, did not update the pre-school on her condition after she was diagnosed, according to Ms Kua. The pre-school, which has 104 students, was only informed of the TB case last Friday, she said.

The Ministry of Health (MOH), in response to queries, said that the ministry and Tan Tock Seng Hospital’s TB Control Unit (TBCU) were notified of the diagnosis last Wednesday, and that the patient is now undergoing treatment.

“TB transmission typically requires close and prolonged contact with an infectious individual. It is not spread by contact with items or surfaces touched by a person with TB,” said a ministry spokesperson. “Persons with active TB disease rapidly become non-infectious once treatment starts. The childcare centre is not required to close.”

TB is endemic in Singapore and can occur in various settings including pre-schools, but it mainly affects older adults, said the spokesperson. The TBCU has started contact tracing for the case and have identified 124 staff and students for screening.

About three-quarters of the students were screened at the school on Wednesday, while five of its staff were screened at TTSH.

In addition to sanitising the premises last Saturday, Ms Kua said the pre-school phoned or messaged parents from Friday to Sunday, asking them to check on their children’s health. “So far, the majority have reported to us that they are OK,” she said.

The teacher, who will be on medical leave for two weeks, remains on contract with the school till next June. “The teacher needs her own rest and has an MC (medical certificate),” said Ms Kua. “The school has to honour it. We did not terminate her, as that would mean that she did not perform her job well as a teacher.”

About five children were taken home by their parents after Wednesday’s screening so they could rest, but Ms Kua described parents’ reaction to date as “very calm”.

Ms Kua also said she had sought advice from the Early Childhood Development Agency on the need to close the centre temporarily, and was told that there was “no need at all”. “But we have to monitor the situation closely and to see what’s the next step,” she added. 

As for why screenings began only on Wednesday, Ms Kua said time was needed to allow the TBCU to do an assessment, and get the parents’ consent to screen their children.

TODAY understands that time was needed for contact tracing before screening began. The MOH said that only a very small proportion of TB cases occur in children and last year, only 0.6 per cent of TB cases among Singapore residents occurred in those aged below 15.

“Those with positive screening test results will be followed up at TBCU for further assessment and treatment if necessary. These cases may not be linked to the staff member with active TB,” the MOH spokesperson said.

Parents TODAY spoke with were shocked and concerned by the news initially, but say they were satisfied with the school’s handling of the matter so far, noting that the school has been prompt in updating them on the situation.

Said warehouse supervisor Muhammad Nurzady, 34: “They don’t keep us in the dark and update us regularly. Even in the past, back when my older children were here and when there were cases of hand, foot and mouth disease, the school has been consistent in keeping us informed.”

Mdm Jasmine Chua, a 40-year-old human resource administrator, was worried when she first heard about the case, but felt more assured after the school’s explanations.

One parent who wanted to be known only as Mrs Tan had kept her son at home as she did not want to take any risks. At the school on Wednesday to speak to staff about the situation, she added that it was good that the school had sanitised the toys and premises.

Mr James Ong, a laboratory manager, did not mind the wait for screenings to begin. As parents, they had to be given sufficient information before giving consent for the screening,
he said. Last year, there were 1,498 new TB cases among Singapore residents, up from the 1,454 cases in 2014.

In June, the authorities revealed that an unusual cluster of six multi-drug-resistant cases had emerged in a housing block in Ang Mo Kio.

In December last year, the National University Hospital had to call in 178 children for tests after a paediatric nurse was diagnosed with pulmonary TB. Five children were found to have latent TB, which is TB in its uninfectious, asymptomatic state.

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