Timeline: Actions taken as SGH hep C outbreak unfolded

SINGAPORE — The first case from the hepatitis C outbreak at SGH was detected on April 17, and news of the incident was made public on Oct 6. How events unfolded: 

April: First case diagnosed

May: Renal doctors noted increase in frequency. More tests to detect the presence of hepatitis C virus carried out. Infection control was reinforced.

June: Infection control team activated. Renal ward stopped use of multi-dose vials. Subsequently, all wards stopped using these vials.

July: Phylogenetic tests carried out for the first time in SGH lab. Tests were done in three batches. Some past hepatitis C positive cases were also tested as control group. The results for the first 21 cases were out between July 6 and Aug 21, and showed evidence that this was a cluster of cases.

August: Internal review done by SGH senior clinicians. The MOH was informed of the cluster in late August.

Sept 3: After reviewing SGH’s report, Associate Prof Benjamin Ong, the MOH’s director of Medical Services, met SGH clinicians to seek further clarifications. He recommended further investigation and verification.

Sept 4: An MOH team visited the renal ward (Wards 64A and 67) for a process walkthrough with SGH.

Sept 7: External analysis by an A*STAR laboratory confirmed SGH’s initial findings that the 21 cases were related.

Sept 9: SGH started hepatitis C screening for all doctors and nurses involved in the direct care of the affected patients. As of Sept 25, 76 staff members have been screened. All were found to be negative for hepatitis C.

Sept 18: Having assessed that the additional investigations requested had largely been completed, Assoc Prof Ong reported the identification of the cluster to Health Minister Gan Kim Yong. Mr Gan asked SGH for a briefing. SGH requested that it take place on Sept 25 to allow SGH sufficient time for investigations to be completed.

Sept 21:  The MOH notified of the 22nd case.

Sept 24: SGH report submitted to MOH.

Sept 25: Mr Gan was given a briefing. He instructed that an independent review committee be set up, and for SGH to make public its preliminary findings.

Oct 6: SGH made public the cluster of infections. The MOH announced the setting up of an independent review committee.

Dec 5: Independent review committee submits its findings to MOH.

Dec 8: Independent review committee's findings made public