TB screening measures for foreign domestic workers in place

• The Straits Times (1 December 2018): Why was maid with TB allowed into country

TB screening measures for foreign domestic workers in place
- The Straits Times, 12 December 2018

1. We thank Ms Jaslin Huang for her feedback (“Why was maid with TB allowed into country?”, 1 Dec).
2. Foreign domestic workers (FDWs) are required to undergo a medical examination by a Singapore-registered doctor within two weeks of their arrival in Singapore, before they are issued with work permits.
3. The medical examination screens for four types of infectious disease of public health significance, namely, active TB, HIV, syphilis and malaria, to minimise the risk of local transmission and to check if they are fit for work.
4. Applicants found to have active TB will not be issued with work permits while those found to have lung scarring will be referred to the Tuberculosis Control Unit for further assessment. Active TB screening is repeated two years after a FDW first arrives in Singapore, regardless of any change in employers.
5. Anyone who is free from TB may subsequently contract active TB from another infectious person. This could be the case for Ms Huang’s FDW who did not have active TB when she first entered Singapore. Persons who tested negative for active TB may still carry latent TB germs, but these persons are not infectious.
6. TB is endemic in Singapore, and latent TB infection is not uncommon in our population. In the vast majority of cases, the TB bacteria remains inactive in the body throughout their lives, and they do not spread TB to others.
7. In view of this, we do not routinely screen for latent TB, including for foreigners. Screening for latent TB is however recommended for persons at high risk of developing active TB disease, such as those who were identified to have recent close contacts with an infectious and active TB case as the risk of progressing to active TB is higher in the initial period of infection. 
8. While there are national control measures in place to reduce the risk of TB transmission in Singapore, everyone plays an important role in preventing the spread of TB.
9. Individuals who display symptoms of active TB, such as unexplained prolonged cough of three weeks or more, should seek medication attention early to ensure prompt diagnosis and treatment. 
10. We have contacted Ms Huang and we wish her and her family well.

Why was maid with TB allowed into country?
-The Straits Times, 1 December 2018

1. I hired a maid in July as I needed help with my newborn baby who was due in October.
2. But in October, my maid started to cough persistently. At first, we did not think much of it, but when her cough persisted after two weeks, we took her to a doctor who advised us to have our helper take a chest X-ray if her condition did not improve within a week.
3. Her condition did not and we took her to Tan Tock Seng Hospital, where she was diagnosed with tuberculosis. So, on top of caring for my newborn baby and recuperating, I was saddled with paperwork to admit my maid into the hospital during my confinement period.
4. The TB control unit advised everyone who had come into contact with my maid to undergo a blood test. It turned out, that a few of my family members and I had contracted latent TB. Now even my newborn baby, who is only a month old, has to take medication because of the latent TB in us.
5. Usually, health checks are only mandatory when maids come to Singapore to work. But as mine was a "transfer case", she did not undergo a thorough health check, besides an HIV and pregnancy test every six months.Is the process for the hiring of foreign domestic workers into Singapore too lax?
6. I hope the ministries of Manpower and Health will be able to explain their policy on health checks for maids.