SINGAPORE,. Infants admitted this month to the KK Women’s and Children’s Hospital (KKH) and National University Hospital (NUH) may have consumed a bacteria-tainted batch of Dumex infant formula, said the Singapore Ministry of Health (MOH) last night.
The Cronobacter sakazakii bacteria was found in samples of a batch of Dumex Mamil Gold Infant Milk Formula – Step 1 (850g), the Singapore Agri-Food and Veterinary Authority announced on Monday.
While Cronobacter infections are rare, they can be fatal when associated with serious infections such as meningitis in infants.
The infants who may have received the implicated milk formula are less than six months old and were admitted to KKH and NUH between Aug 1 and 20. Both hospitals are contacting their parents and caregivers, although the exact number who may be affected is not yet known.
No other public hospital is affected. Private players Mount Alvernia Hospital and the hospitals under Parkway Pantai, such as Mount Elizabeth Novena, are also not affected. TODAY has sent queries to Thomson Medical Centre.
The MOH was informed yesterday that infant formula from the implicated batch had been used at the two public hospitals.
It has advised all public and private paediatrics hospitals to cease the use of the implicated product, and to notify the ministry of suspected cases. “We are closely monitoring the situation,” said an MOH spokesperson.
No case of Cronobacter infection associated with consumption of formula milk has been reported to the MOH this year.
Parents and caregivers of infants who have consumed the affected batch of formula (batch number 09117R1, expiry date 11 Sept 2019) should seek immediate medical treatment if their infant becomes unwell, said MOH.
Infants with Cronobacter infection may show symptoms such as fever, crying, poor feeding or lethargy, and some may also develop seizures. The incubation period ranges from four to nine days, but could be up to 21 days.
Cronobacter infection can be treated with antibiotics.
Dr Leong Hoe Nam, an infectious diseases specialist at Mount Elizabeth Novena Specialist Centre, said younger children are at risk due to their lower levels of immunity.
Antibiotics used to treat blood and brain infections, such as ceftriaxone, can be used to treat Cronobacter infection, he added. Ceftriaxone, for instance, is not considered a strong antibiotic for infants and would typically need to be consumed for about 14 days.
Most infants who have consumed the affected batch of milk powder should be able to overcome the infection, given the generally good immunity of infants here, said Dr Leong.
There have, however, been a small number of cases overseas that developed a resistance to the antibiotics used to treat such bacterial infection, he said.
Anxious parents have posted numerous comments and questions on Dumex Singapore’s Facebook page since the news of the recall.
An affected parent who only wanted to be known as Mrs Koh told TODAY that she took her 2.5-month-old son to the pediatrician yesterday morning after reading about it on the news.
The 29-year-old service quality specialist said her son, who started taking the Dumex formula four weeks ago, had finished two tins from the implicated batch.
“He is currently alright, but we will continue to monitor… (The) doctor said as long as there are no existing symptoms, there should not be any issues,” she said.
Mrs Koh said she initially chose Dumex because she had heard of many mothers feeding it to their infants and trusted the brand. “But I have lost trust in their products and have switched to others. I will not be using Dumex again,” she added.
Mrs Koh was also frustrated by what she called vague and “template replies” from the company to her comments on its Facebook page, but managed to sort out refunds after calling its hotline.
Another parent, sales manager Stephen Yang, 32, also rushed his three-month-old daughter to her paediatrician, who told him that Cronobacter infection has been very rare in the past decade.
Yang’s daughter started on the milk formula three weeks ago.
The doctor advised him to monitor his daughter and return if any symptoms appear. Yang said he was “very disappointed” by the incident and would stop using Dumex’s products.
Dumex said all formula from the affected batch, which involved 4,200 tins, have been taken off the shelves. “Since January 2018, the majority of the batch has been sold, islandwide, and consumed without reports of any incident. All remaining tins were completely removed from shelves as soon as AVA informed us of their findings,” a spokesperson said.
Dumex is currently investigating the issue on a “high priority basis.”
The company said it has stringent processes and conducts rigorous tests that are of international standards. This includes tests before the product is shipped out of the factory to Singapore.
Customers who may have purchased the affected batch are advised not to consume it and are encouraged to call 1800 265 3188 for an exchange.
Advice from MOH on minimising risk of Cronobacter infection:
Wash hands with soap and water before handling items, such as milk bottles and food, that will come
into contact with the infant’s mouth. Hand should also be washed after using the toilet or changing of diapers.
Properly sanitise items meant for baby feeding with hot water and soap or commercial sterilisers (follow manufacturer’s instruction).
Prepare powdered infant formula in a clean environment, and ensure the cleanliness of infant formula containers, lids and scoops.
Give infants only freshly prepared infant formula – using hot water to prepare infant formula can kill
Cronobacter sakazakii and other bacteria in the formula. Boil water and allow to cool to no less than
70°C before pouring into a clean and sterilised feeding bottle. To achieve this temperature, the water should be left for no more than 30 minutes after boiling.
Use the prepared formula milk within two hours of preparation. If the infant does not finish the entire bottle of milk, discard the content.
If the prepared formula milk is not to be used right away, refrigerate it immediately and use it within 24 hours.
When unsure if the milk prepared is fresh, discard it.