Public hospitals explain their infection control measures

Public hospitals have issued details of their infection control procedures, such as minimising the use of multi-dose vials and tracking infections in high-risk wards.

This comes in the wake of a hepatitis C outbreak at the Singapore General Hospital (SGH), which has seen 22 people diagnosed with the disease.

Tan Tock Seng Hospital (TTSH) said that although it uses around 700 types of injectable drugs, only 13 make use of multi-dose vials - small bottles that contain more than one dose of medication.

Eight types are shared between patients, while the rest are used to give multiple doses to the same patient, medical board chairman Thomas Lew said yesterday.

"Out of 700, there are 13 types of drugs for which there are no alternatives based on our current manufactured supply, and we take very stringent measures when we use these drugs," Prof Lew said.

He added that these drugs are usually not commonly administered and not available in single doses.

"We are reviewing the issue to ensure that if there are really no alternatives, then our use of multi-dose vials is consistent with best practices," he said.

The National University Hospital said that it has not observed any unusual trends of hepatitis C infections among its kidney patients.

"Our renal patients are routinely investigated for any symptomatic liver disease or abnormal liver function blood test results," the hospital said in a statement yesterday.

It added that when the Health Ministry's independent review committee publishes its findings, it will review existing practices and work with the ministry to make any recommended changes.

Changi General Hospital (CGH) carries out surveillance of infections across the hospital, as well as more targeted tracking of specific infections in high-risk units. In the event of an outbreak, its protocol includes identifying cases, searching for the causes, and implementing control and preventive measures.

"Hospital management and MOH are informed as soon as practically possible and regular updates are provided as the situation evolves," said Dr Tan Thean Yen, chairman of the hospital's infection control committee.

"The timeline to inform depends on factors such as the complexity of the infection as this affects the assessment of whether this is an outbreak or normal variation."

Speaking to reporters at SGH yesterday, medical board chairman Fong Kok Yong said that strict measures have been taken to make sure that hepatitis C - a blood-borne virus - will not infect anyone new.

"I have to say that we are not perfect - no system is perfect. There will always be the risk of some lapses and gaps," he said. "We are fully cooperating with the independent review committee."

As of last night, SGH had contacted 646 out of 678 patients who were admitted to wards 64A and 67 from January to June this year. Those diagnosed with hepatitis C had been admitted to these wards.

Some 186 patients have been screened for hepatitis C and will be notified when their results are ready in a week. Some 202 out of 273 hospital staff have also been screened.

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