Members of the public should exercise caution when consuming ready-to-eat (RTE) raw fish, the Ministry of Health (MOH) and Singapore Food Agency (SFA) warned in a joint press release on Sunday (30 Aug).
This comes after a recent spike in the number of Group B Streptococcus (GBS) cases, leading to the authorities to launch an investigation.
Recent Spike In GBS Bacterial Infections
50 GBS cases were reported from public hospitals in July, twice the average monthly figure of 25 GBS cases per month from January to June 2020.
According to authorities, further laboratory investigations showed that 18 of the cases reported in July were of the GBS Type III ST283, a more infectious strain.
In comparison, there was only an average of four cases per month from April to June 2020.
The profile of these patients is reportedly similar to those infected by the same highly infectious bacteria strain in a 2015 outbreak caused by consuming raw freshwater fish. It led to blood poisoning in over 160 people, who suffered fever, joint infection and meningitis.
While GBS is a common bacterium that is commonly found in the gut and urinary tract of about 15 to 30 per cent of adults without causing disease, it may occasionally cause invasive infections of the skin, joints, heart and brain.
Image source: iStock
Other symptoms include fever, chills and low alertness, according to the United States Centers for Disease Control and Prevention, which could be easily misdiagnosed as a COVID-19 infection or dengue fever.
Most GBS infections are said to be treatable with antibiotics.
According to the authorities, the majority of the cases with GBS Type III ST283 were those aged 65 and above, and most have since been discharged and have recovered from the infection.
However, it is said that one case has passed away due to an unrelated cause.
“MOH and SFA are currently collecting information on the affected individuals’ food history and conducting field investigations at various locations, to determine possible sources of GBS in these cases,” MOH and SFA stated.
Between May 2019 and August 2020, SFA did a routine sampling and testing of fish samples for GBS but did not detect the presence of ST283.
In addition, inspections conducted by SFA showed that none of the food stalls visited by recent cases sold any RTE raw fish dishes.
Certain Groups More Vulnerable to GBS Infections
The ministry said that GBS infections have previously been associated with the consumption of raw freshwater fish, and that raw food is likely to contain more bacteria as compared to well-cooked food.
It emphasised that members of the public who choose to consume RTE raw fish must be aware of the risks involved.
Image source: iStock
While cooking raw food well is still the most effective way to kill bacteria, according to the ministry, there are certain groups that are more susceptible to GBS infections.
“As a general precaution, vulnerable groups of people, especially young children, pregnant women, elderly persons, or people with chronic illness such as diabetes, may be more susceptible and should exercise caution by avoiding the consumption of raw food,” it stated.
CBS is a common cause of severe infection in newborns, according to the CDC. However, giving antibiotics to women who are at increased risk during labour is effective at preventing GBS disease in newborns.
Individuals can also reduce their risk of infection by:
- Thoroughly cooking food
- Washing hands and kitchen utensils such as knives and cutting boards thoroughly before handling food
- Using separate sets of knives and cutting board for raw and cooked food
And perhaps, when we think of all-time favourites such as sushi and sashimi, to Poké (a salad with seasoned raw fish and vegetables) and even the yu sheng that we toss during Chinese New Year, proper handling and consumption should be of priority.
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