Update on tuberculosis screening at MindChamps Preschool @ East Coast and Maplebear Toa Payoh

1.        Early results of the tuberculosis (TB) screening exercise conducted by the Communicable Diseases Agency (CDA) at MindChamps PreSchool @ East Coast and MapleBear Toa Payoh on 13 and 15 August, respectively, have found that none of the children have screened positive for active or latent TB to date. One staff member who worked at MindChamps PreSchool @ East Coast has been clinically diagnosed with active TB disease. She is a household contact of the case notified to CDA on 15 July, and there is currently no evidence of spread within the preschools.

 2.        Following the detection of a TB case involving a preschool teacher who had previously taught at both preschools, CDA had initiated screening for the person’s close contacts. In total, 115 contacts were identified across both preschools. Of these, 93 individuals were screened onsite, and 21 have scheduled appointments at the National TB Screening Centre (NTBSC), while one person was screened at a private laboratory. Among the 93 individuals who were screened onsite, 80 persons (86%) tested negative for TB. No children have tested positive to date.

3.        Eight individuals, comprising six children and two staff, had indeterminate results from the onsite screening. This means that the results are inconclusive, and the likelihood of TB infection cannot be determined. This is not uncommon in young children as their immune responses are less mature. Those with indeterminate results require repeat testing for a more accurate assessment. The four individuals with indeterminate results from MindChamps PreSchool @ East Coast will undergo a repeat test between 19 and 27 August at NTBSC. The other four individuals from MapleBear Toa Payoh will undergo their repeat test during the second round of screening at the preschool, which is scheduled on 15 September 2025, 10 weeks after the last date of exposure, to pick up latent infections that may not be detectable in the earlier screening.

4.        Among those who were screened onsite, four staff tested positive on their blood test, which most likely means that they have latent TB infection since they have no symptoms. People with latent TB do not have symptoms and cannot spread TB to others. As a precaution, the staff have been referred to the NTBSC for further evaluation to rule out active TB disease. Once active TB disease is excluded, they will be offered preventive treatment to reduce the risk of developing active TB in the future.

5.        One individual who worked at MindChamps PreSchool @ East Coast was clinically diagnosed with active TB disease on 18 August, pending laboratory confirmation. She is a household contact of the individual notified to CDA on 15 July. The exposure is more likely to have occurred in the household, and there is currently no evidence of spread within MindChamps PreSchool @ East Coast. The individual is currently asymptomatic and is on medical leave. She has commenced TB treatment and will be non-infectious after completing two weeks of treatment.

6.        As a precautionary measure, CDA has commenced contact tracing ahead of laboratory confirmation. CDA has reached out to the preschool to initiate contact tracing to identify staff and students with close and prolonged contact with the individual to offer TB screening at the NTBSC.

7.        Staff and parents of children who were screened on 13 and 15 August have been informed of their screening results and follow-up appointments have been arranged at NTBSC as needed.

8.        CDA continues to monitor the situation closely and is working closely with both preschools to address staff and parent concerns. Parents and staff will continue to be updated through the preschools, and information sheets on TB, screening and treatment have been provided to them. For any other queries, parents of the affected preschools can reach out to the CDA’s National TB Programme (NTBP) Duty Officer at 9836 1082 or email: ntbp@cda.gov.sg.

9.        More information on TB can be found in the Annex. 

COMMUNICABLE DISEASES AGENCY

Annex

TB Screening and Treatment in Singapore

1.        TB is curable and the spread of TB is preventable. Once CDA is notified of a TB case, it will promptly initiate contact tracing and ensure that any exposed contacts who have symptoms of active TB disease are referred immediately for medical assessment. This is to ensure early detection and treatment, and to curtail the spread of TB.

2.        Contact tracing involves gathering information about contacts who are most at risk, such as those with close and prolonged contact with the diagnosed person (e.g. household members), followed by the next group of individuals who spend the next most significant amount of time with the diagnosed person (e.g. workplaces).

3.        Contact screening is then arranged to ensure that those at risk of latent TB infection are tested and receive appropriate treatment. As of July 2024, TB screening has been made mandatory for identified contacts. This involves blood tests to detect antibody response to the infection, which can be up to 10 weeks after exposure. Close contacts may also be offered preventive treatment. People with latent TB do not have symptoms and cannot spread TB to others. They may continue with normal activities unless advised otherwise.

4.        Persons diagnosed with active TB disease will be started on treatment immediately and placed on medical leave. Once treatment starts, the person rapidly becomes non-infectious and will no longer spread the bacteria. There would be no risk of further exposure to close contacts.