Screening for residents of Ang Mo Kio block after 6 TB cases found

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Screening for residents of Ang Mo Kio block after 6 TB cases found

Mobile TB screening stations being set up at the void deck of Block 203, Ang Mo Kio Avenue 3, last night. MOH is providing voluntary free screening for residents from today until Sunday as a precautionary measure, to pick up any undiagnosed or latent TB infections.ST PHOTO: ALPHONSUS CHERN

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Six neighbours have same drug-resistant strain of the disease over four-year period

Linette Lai

linettel@sph.com.sg

The residents of a block of flats in Ang Mo Kio Avenue 3 are being urged to undergo screening for tuberculosis (TB), after six of their neighbours were diagnosed with the same drug-resistant strain of the disease over a four-year period.

Last night, grassroots volunteers, officers from the Ministry of Health (MOH) and Ang Mo Kio GRC MP Koh Poh Koon knocked on the doors of the 160 units of Block 203 to inform residents of the situation, which MOH described as "highly unusual".

Three of the six TB patients lived in the same unit but the other three were from different households. All four households said they did not know and had not interacted with one another.

 

This stumped investigating doctors as TB is typically spread through "close and prolonged contact", said Associate Professor Benjamin Ong, director of medical services at MOH.

 

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Even among members of the same household, transmission could take days or weeks to occur.

 

 

"It is unusual for TB to be spread by casual, brief exposure," Prof Ong told reporters yesterday. The ministry has been unable to find out how the same strain of TB could have spread among the six.

The cluster came to light when a sharp-eyed doctor at Tan Tock Seng Hospital's TB Control Unit noticed that a patient diagnosed with multi-drug resistant TB lived in the same block as earlier cases and alerted the ministry.

The first patient was diagnosed with the disease in February 2012. The last was diagnosed last month.

The group comprises five men and one woman aged between their early 20s and 70. They are no longer infectious and cannot spread the disease, said Dr Jeffery Cutter, director of MOH's communicable diseases division.

Three have completed treatment, and the other three are undergoing treatment in hospital.

MP Koh Poh Koon visits resident at Block 203 Ang Mo Kio Ave 3

Screening of their close contacts, such as family members and colleagues, has also been carried out. MOH said, without specifying the number, that some were found to have the latent form of the disease, which cannot be spread.

TB is caused by bacteria that usually attack the lungs. It is spread via droplets in the air when someone with an active infection coughs.

Of those who are infected, only one in 10 will actually develop an active infection. The vast majority have latent infections without symptoms, and will not spread the disease.

Normal TB infections can be completely cured within six to nine months, but the use of antibiotics has led to the rise of drug-resistant strains that are harder to treat.

MOH is providing voluntary free screening for residents at the void deck of the 11-storey block from today until Sunday as a precautionary measure, to pick up any undiagnosed or latent TB infections.

Told of the situation last night, some residents expressed concern while others said they were not worried as they did not interact much with their neighbours.

When approached by reporters, Dr Koh, who is also Minister of State for Trade and Industry and National Development, said he would comment on the issue later.

This letter was distributed to residents at Block 203 Ang Mo Kio Avenue 3. The letter came in four languages and also included information on the free TB screening and FAQs about TB. ST PHOTO: YEO SAM JO

[Guest Guest]

TB is caused by bacteria that usually attack the lungs.

 

It is spread via droplets in the air when someone with an active infection coughs.

[Guest Guest]

http://topdocumentaryfilms.com/rise-superbugs/

 

It's the Indian subcontinent which is proving to be a superbug's perfect petri dish. Antibiotic abuse is rampant there and there's no antibiotic policy. India mass produces antibiotics, sells them cheaply and the drugs are available over the counter without prescription. Waterways and even the soil are contaminated by waste from antibiotic manufacture. On top of poor sanitation and chronic overcrowding, it's fertile ground for antibiotic resistance

 

http://www.dnaindia.com/world/report-tuberculosis-and-superbug-strains-ravaging-europe-who-warns-2069639

 

As many as 1,000 people a day in Europe contract tuberculosis, and slow progress against the disease coupled with rising drug resistance mean the region is unlikely to defeat it until next century, health officials said on Tuesday.

At current rates, the region has little chance of meeting a target to eliminate it by 2050, according to a joint report by the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC). "MDR-TB (multi-drug resistant TB) is still ravaging the European Region, making it the most affected area of the entire world," Zsuzsanna Jakab, the WHO's regional director, said as the report was published.

 

TB is a contagious bacterial lung disease that occurs mainly in areas of poverty and deprivation and spreads via the coughs and sneezes of an infected person. It is hard to treat, requiring months of antibiotic treatment, and drug resistant strains are rapidly gaining a foothold.

 

TB in all its forms killed around 1.5 million people worldwide in 2013 and the WHO warned last year that rates of MDR-TB were "crisis levels". The WHO's European region covers 53 countries with a population of nearly 900 million, of which around 508 million live in the European Union and European Economic Area EU/EEA.

 

 

Tuesday's WHO/ECDC report said the overall trend across the region showed TB rates falling in some high-priority countries, while the disease is fighting back in other low-incidence countries.

 

In the EU/EEA, some 65,000 TB cases were reported in 2013, it said, with 360,000 cases in the whole WHO European region.

"At the current pace of an annual 6 percent decline, the EU/EEA will only be free of tuberculosis in the next century," said Marc Sprenger, director of the Stockholm-based ECDC which monitors disease in Europe.He said that for Europe to reach elimination -- defined as less than one case of TB per 1 million population per year -- by 2050, it would have to cut down cases at least twice as fast. "Our data show a Europe in need of tailored interventions which target each country's settings," Sprenger said.

 

In most countries were TB is relatively uncommon, rates are either stable or going down only very slowly, he said, and the majority of patients are of foreign origin. Countries with larger TB problems, however, also have higher rates of re-infection and report many more cases of multi-drug resistant TB.

Also Read: TB epidemic looms large with Rs 2,000 crore fund cut, erred policy

 

 

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April 25, 2016 12:11 am

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TB superbugs spur need for new vaccine

Amy Kazmin

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Indian patients with multi-drug-resistant TB are running out of treatment options

In December 2011, Zarir Udwadia, a tuberculosis expert in Mumbai, announced that he had diagnosed four patients with a new type of tuberculosis that proved resistant to all known medicines. He called the new form of the disease “totally drug-resistant” TB, and since then, he says, he has seen at least eight more cases in India.

Estimates suggest that India also has around 62,000 cases a year of so-called multi-drug-resistant tuberculosis — a form that cannot be cured by the usual first-line treatments but does respond to other drugs. Dr Udwadia considers that figure to be an underestimate, however

 

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“

We have seen a slow but steady rise in the number of patients with the most dreadfully resistant TB strains,” he says. “Some of them are therapeutically destitute — we literally have no drugs left to treat them.”

The rise of drug-resistant TB in India is one instance of a problem that some scientists warn signifies humanity’s return to the dark ages of medicine. Antibiotics could completely lose their efficacy against drug-resistant superbugs, they say, meaning that now-treatable common infections or simple surgical procedures could once again become life-threatening.

Drug-resistant strains of diseases like TB, gonorrhoea and pneumonia are created when patients fail to complete a full course of prescribed drugs. By cutting short a course of medication once they start to feel better, patients allow the remaining bacteria in their bodies to survive and may build up a resistance to the drug.

Scientists and public health workers are increasingly agreeing that vaccines, which curb excessive antibiotic use by reducing incidence of disease, will be a critical weapon in the fight against superbugs.

“Vaccines prevent infections and so reduce the need for antibiotics,” the UK-led Review on Antimicrobial Resistance argued in a February report. “This is true for vaccines that prevent bacterial infections, and it is also true for vaccines that prevent viral infections, such as the flu, which should not be treated with antibiotics, but often are anyway.”

2.2m

Number of new TB cases India has each year, just under a quarter of the world’s total

Widespread overuse of antibiotics — not just for humans, but also in mass agriculture — has even led to the emergence of a separate bacterial gene for antibiotic resistance. But the impact of an advanced pneumococcal vaccine in South Africa has shown that vaccines can help to curb drug resistance.

In 2009, South Africa began vaccinating children for pneumonia, an infection once treatable by penicillin but that was, at the time, showing growing drug resistance. Not only did the vaccination programme sharply reduce the number of pneumonia cases but it also reduced the proportion of drug-resistant strains of the disease. “Infection rates went down, but resistance went down more,” says Seth Berkley, chief executive of Gavi, the global vaccine alliance.

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Dr Berkley says that in an environment with limited antibiotic use, the bacteria carrying the gene for resistance — an otherwise inefficient extra gene — lose any advantage over bacteria without the gene. This suggests that bacterial populations can evolve away from drug-resistant strains, if antibiotics are used less. “You take away the incentive for bacteria to have resistance if, over time, you get rid of antibiotic usage,” he says

 

India has around 2.2m new TB cases a year — just under a quarter of the world’s estimated 9.6m total, and more than any other country. The only vaccine currently available is BCG — named Bacillus Calmette-Guérin after the French scientists who developed it in 1906 — which can protect small children from severe disease, but has limited effect on adults.

Meanwhile, resistance to existing treatments is growing due to weaknesses in the state healthcare system, and incorrect or unsupervised treatment by private practitioners. Some patients have simply run out of medicines to try. “In this setting — when your therapeutic cupboard is bare, immune modulation may be the only strategy left,” Dr Udwadia says. “Vaccines fall into this category.”

 

Vaccines may be expensive to develop and produce on a large scale, but Dr Berkley believes more investment may be on the horizon. “Gonorrhoea has a huge problem with antimicrobial resistance,” he says. “In the old days, you used penicillin and it was cheap and easy to treat. But with the changes in antimicrobial resistance, vaccines may become more attractive to produce and to pay for.”

Funds are finally trickling into tuberculosis vaccine research, but the investment is still insufficient, according to organisations involved in the research effort, and there are many technical challenges.

 

“A new and effective vaccine to replace the BCG is desperately needed and in my opinion may be the only way to turn the tide against TB,” says Dr Udwadia. “Sadly, it’s proving fiendishly difficult to design a new vaccine. [It’s] at least a decade away.”

 

[dsd]

KNNCCB a lot of people dun cover their mouth when they cough but carry on playing their HP when they are in the trains.

[cutejack]

Agree.some dont know how to take mc n carry their disease to work n spread to others.real KNNCCB.work until they die also no money.

N now this.spore hospital staffs can expect more bonus next year.another chance to earn money.