MOH to set up taskforce to better manage infectious disease outbreaks

SINGAPORE — In the wake of shortcomings identified by the independent review committee tasked to look into the hepatitis C outbreak in two wards of the Singapore General Hospital (SGH) earlier this year, both the hospital and the Ministry of Health (MOH) announced several measures they would undertake to improve infection control and response to outbreaks.

A taskforce led by Minister of State for Health Chee Hong Tat will be set up by the MOH to improve the national healthcare system’s ability to detect and respond to infectious disease outbreaks in hospitals and the community. 

The Communicable Diseases Division of the MOH is now responsible for overseeing surveillance of all infectious diseases. It will also centralise all notifications and analyses of infectious disease data, the MOH said. This will strengthen capability of detecting potential outbreaks here.

All healthcare institutions have also been reminded to notify all acute infections of the hepatitis C virus to the ministry, even though laboratories will separately inform MOH of their test results.

The hepatitis C outbreak in two wards of SGH between April and August affected 25 patients and led to over 1,000 being called for tests. It exposed a gap within MOH: There was no designated division with the responsibility and capability to deal with an unusual hospital-associated infection such as hepatitis C.

The review committee, led by infectious diseases expert Leo Yee Sin of Tan Tock Seng Hospital, had recommended improvements in how hospital-associated infections are monitored and responded to at the national level, and the designation of a single team in MOH to do surveillance and identify and investigate potential outbreaks. The ministry should also ensure enough expertise to facilitate investigations of outbreaks.

As for SGH, the committee recommended that it review its standard operating procedures and practices on infection control and reduce the risk of environmental contamination by adequate cleaning and disinfection.

For instance, intravenous medications should be prepared in “clean” areas free of items potentially contaminated with blood or body fluids. Items used during invasive procedures should not be brought into “clean” areas, the committee said.

The hospital could use fluorescent dyes to ensure equipment and room surfaces have been adequately cleaned, the committee said.

It should also keep to standard procedures for infection control, as laid out by the United States Centers of Disease Control and Prevention. Supervision of hospital staff to ensure compliance should also be beefed up, said the committee. Staff should consistently practise hand hygiene, for example.

SGH will work closely with SingHealth’s infection control audit taskforce to do cross-institution audits to reinforce standards of infection control, said SGH CEO Ang Chong Lye. 

It will implement a plan for corrective measures as recommended by the committee, said SGH medical board chairman Fong Kok Yong. It will also put a more robust alert and escalation system in place with clear definition of roles and individual accountability, he said.

The hospital has met with all affected patients and their families to provide “full support”, and Health Minister Gan Kim Yong said today (Dec 8) that compensation would be part of the process, which will take its due course.