A sharing by Chang Tou Liang
The event made the headlines some twenty-one years ago now. What an age back! Food poisoning outbreaks crop up so frequently these days that we hardly bat an eyelid anymore. However, there is a cautionary tale in every infectious disease outbreak.
Those who do not learn history are doomed to repeat it.
———- attributed to George Santayana
A Good Day’s Work
It happened in August 2000, on my thirty-fifth birthday. In the morning, I saw a few patients with symptoms of gastroenteritis, which was nothing out of the ordinary. Over lunch, my mother, who was also a doctor at our family practice, remarked that she had seen several similar cases as well. Then one of the clinic assistants complained of diarrhea too.
It all seemed rather odd.
My immediate response was to get the staff to draw up a list of patients attending for diarrhea from that morning and also the preceding days, while I continued seeing patients in the afternoon. Still more cases of diarrhea were seen.
When the list came came out, I was startled. There were at least twenty names, and the patients all had something in common. They either lived in the condominium apartments above Bukit Timah Plaza where our clinic was located, worked in the shopping centre at the Plaza, or both. Was there an outbreak in the community, or was it confined to our building? Was this food poisoning or water poisoning? The spread of the patients suggested that it was more of the latter situation, on both counts.
How does one even report one’s suspicions? Fortunately, I had some old friends to rely on. Long ago, when I served in the Preventive Medicine branch of the Medical Core Headquarters, I had become acquainted with officials from the Ministry of the Environment’s Quarantine and Epidemiology Department. A quick telephone call related my suspicions, and investigations began that very afternoon.
Bukit Timah Plaza is an old building. The source of contamination was traced to the ageing overhead sewage pipes that had leaked into the water tanks built below them. In short, structural and maintenance issues caused the outbreak, rather than outright human error.
Over a hundred and fifty people were affected but thankfully only one was hospitalized. The most seriously affected were the food and beverage outlets, which were out of action until a clean supply of water was assured.
The incident highlighted the need for proper upkeep of older buildings, and also underscored the family physician’s role in keeping a vigilant lookout. It was the high index of suspicion and knowing when and how to raise the alarm that led to a relatively swift conclusion to the saga.
I attended the Three Tenors Concert by the Singapore Symphony Orchestra with my wife and my mother later that evening. All in a day’s work and play for a family of family physicians!
———Dr Chang Tou Liang
Chang Tou Liang is in private practice. He is a husband, father, piano fancier, cat collector, and is also sometimes remembered as the most prolific music reviewer of The Straits Times ever.
The commentary and vignette were reproduced with permission from the book ‘Being Human, Stories from Family Medicine’ edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
