After contracting diphtheria, a 21-year-old Bangladeshi construction worker in Singapore died on 4 August. This is the first local case of the contagious bacterial disease in 25 years, according to a statement issued on 5 August by the Ministry of Health (MOH).

The last local case was in 1992, while the last imported case was in 1996.

“As he had not travelled out of Singapore recently, he was likely to have been infected in Singapore,” said the statement.

The worker developed fever and swelling of the neck on 30 July and was isolated and hospitalised on 1 August. He died three days later, on Friday. A respiratory sample taken from the patient tested positive for the bacterium causing diphtheria.

The deceased worked in Teban Gardens and lived in a dormitory in Yishun Avenue 7. A total of 48 others who worked directly with or lived close to the worker have been quickly identified for further checks, with two “close contacts” also in isolation wards at Khoo Teck Puat Hospital (KTPH).

Both have developed a sore throat since 3 August. Respiratory samples have also been taken for diphtheria testing, and the results are pending, said the MOH.

“Investigations are ongoing to determine the source of the infection,” assured MOH.

Most Singaporeans are vaccinated against diphtheria

The MOH stressed that the risk of diphtheria spreading locally is low, as Singaporeans have had compulsory vaccinations against it as part of the National Childhood Immunisation Programme since 1962.

Those born before 1962 are also likely to have had mild or childhood infections, and would have developed immunity to the disease, said infectious diseases specialist Dr Leong Hoe Nam.

Vaccination coverage for diphtheria among two-year-olds here is at 96 – 98%, said MOH.

MOH said that there was no pre-requisite for foreigners to have the diphtheria vaccination, as diphtheria is included in the childhood vaccination schedule in most countries.

All 48 contacts – 46 foreigners and two Singaporeans ̶ have since been given preventive medication and a booster diphtheria vaccine. Respiratory samples have been taken for testing as well.

Authorities might review rules on vaccinations for foreign workers

Several workers have expressed their worry. Thai construction worker Nantha Khoei, 47, said, “Our employer has told us about Sars and Zika before, and how to report if we have headaches, body pains and fever. But we don’t know what to do for this disease.”

Dr Leong, who practices at Mount Elizabeth Novena Hospital, remarked that the deceased worker may have been infected by an asymptomatic carrier of the bacteria, where the germ could be carried at the back of one’s throat, or by a person suffering from a mild infection.

“The question is: Is there a circulation of bacteria inside the foreign workers’ dormitories, which we are not aware of?” he asked.

He added that the authorities might have to consider looking into making such vaccinations compulsory for foreign workers as well.

The Health and Manpower ministries have assured that they will review if improvements are needed to better ensure that foreign workers in Singapore are vaccinated against such infectious diseases. MIMS

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