Care at NUH

Division of Infectious Diseases

2024/10/02

The Division of Infectious Diseases at NUH, established in 2003 by Professor Paul Tambyah, has a rich history marked by significant growth and contributions to the field. Professor Tambyah, after completing his training in Wisconsin, returned to Singapore to become NUH’s first Infectious Diseases (ID) consultant. The Division witnessed a notable expansion with the recruitment of Professor Dale Fisher during the SARS outbreak in March 2003 and later the addition of Dr Louis Chai. Over the past 15 years, the Division has evolved from its original three founders to include 13 consultants, a resident physician and two senior residents. The team is supported by a multidisciplinary group comprising microbiologists, nurses, pharmacists, research assistants, epidemiologists, medical social workers, administrators and other partners. The Division's achievements are reflected in its trainee alumni, clinical contributions, research output and its extensive collaborations and influence both locally and globally. 

Our Team

Head of Division & Senior Consultant 

Senior Consultants 

Consultants 

Associate Consultant 

  • Dr Wu Jiawei Sean  
  • Dr Tham Sai Meng 

Senior Resident Physician 

  • Dr Salada Brenda Mae Alferez 
Our Services

Inpatients

We provide care for patients admitted with a range of community-acquired and healthcare-associated infections, including influenza, tuberculosis, melioidosis and severe dengue, along with other bacterial and viral infections. We manage HIV patients across various stages, from those with late-stage AIDS to well-controlled individuals. All adult general medical patients requiring isolation are managed in our 21-bed negative pressure isolation ward. 

Our two consultation teams work closely with other clinical services in the hospital to treat patients with complex infections. This includes patients in various medical and surgical disciplines, as well as those in liver, kidney and bone marrow transplant units, haematology/oncology and critical care units. 

Outpatients 

Patients referred to our ID specialists are typically seen within a week at the 13b Medicine Clinic in the NUH Medical Centre. In addition, we provide care through various subspecialty clinics, including: 

Outpatient Parenteral Antibiotic Therapy (OPAT)

Established in 2004, OPAT, predominantly nurse-led, handles over 300 new cases annually, providing outpatient antibiotic infusions in the clinic or at home, often via a self-administration system. OPAT manages infections requiring long-term antibiotics and oversees vascular access devices during treatments. We offer comprehensive education to patients and families on managing vascular access devices, antibiotic side effects and infusor pumps. 

Home caregivers are trained to administer intravenous antibiotics using an elastomeric pump, with training available during hospitalisation. Patient education materials (PICC and Infusor) are provided for reference. A 24-hour emergency support hotline is available for patients/caregivers. 

The NUH OPAT Programme, subject to 14 peer-reviewed publications and numerous conference presentations, has also hosted healthcare professionals from Singapore and internationally.  

With most patients needing less than 30 minutes door-to-door time, the programme has a readmission rate of just 2%. In 2016, an international OPAT network was established, with over 200 practitioners across 23 countries. 

For more information on OPAT, please click here

Dengue Outpatient Management (DOM)

The DOM clinic safely manages dengue patients who meet specific criteria without hospital admission, preventing over 500 admissions every year. Services in the DOM clinic include daily monitoring of patients’ conditions, patient education on managing dengue and daily updates on full blood count results. 

For more information on DOM, please click here.  

Travellers' Health and Vaccination Clinic 

Established in 2002, the NUH Travellers’ Health and Vaccination Clinic (THVC) provides comprehensive pre- and post-travel health counselling, along with necessary immunisations and medications for overseas travel. 

In addition to advising on the risks of travel-related infections and diseases, the clinic caters to travellers with special needs, including pregnant women, the elderly and immunocompromised individuals. A broad range of travel immunisations and medications, including those for malaria prevention and treatment of travel-associated diarrhoea, are available. 

The clinic also offers consultations for returning travellers, with screening tests for travel-related infections tailored to exposure history and symptoms. 

Non-travellers requiring routine childhood vaccinations or specific immunisations due to immunocompromised states or high-risk occupations can also receive vaccinations here. 

Types of Vaccinations available: 

  • Hepatitis A 
  • Hepatitis B 
  • Hepatitis A and Hepatitis B combined vaccine 
  • Influenza
  • Japanese Encephalitis (IXIARO and IMOJEV) 
  • Measles, Mumps, Rubella (MMR) 
  • Meningococcal conjugate (ACWY) 
  • Pneumococcal conjugate (PCV13) and polysaccharide (PPSV23)
  • Inactivated polio (EIPV) 
  • Rabies (PCEC)
  • Tetanus, diphtheria, and acellular pertussis (Tdap)  
  • Typhoid Fever (Typhim Vi)  
  • Varicella (Chickenpox) 
  • Yellow Fever 

For more information on NUH THVC, please click here. 

Antimicrobial Stewardship Programme

Initiated in July 2009 as a collaborative project between the Department of Pharmacy and the Division of Infectious Diseases, the Antibiotic Stewardship Programme (ASP) is funded by the Ministry of Health. The programme has expanded to include three full-time pharmacists and three ID consultants and now covers all wards outside of the intensive care units. 

ASP focuses on auditing the use of broad-spectrum antimicrobials to reduce inappropriate usage. 

The ASP team, consisting of doctors and pharmacists, reviews prescriptions of broad-spectrum antimicrobial agents at specific intervals. The primary goals are to curb the emergence of resistant organisms within the hospital, reduce inappropriate antibiotic usage and minimise adverse effects experienced by patients.   

HIV Programme

Established in 2010, the NUH HIV Programme, also known as the Multidisciplinary Infectious Diseases (MID) Programme, aims to better address the needs of Persons Living with HIV/AIDS (PLHIV) at NUH. The programme encompasses inpatient and outpatient clinical care, education and training for healthcare workers, PLHIV and the community, operational and clinical research, community support and advocacy.  

Since its inception, the programme has cared for over 450 PLHIV and trained more than 1,000 healthcare workers through initiatives like the Red Ribbon Ambassadors Programme, the Healthcare Worker HIV Education Series, and the Asia Pacific HIV Practice Course (APHPC). 

The first APHPC was conducted in November 2016. This four-day course, designed to enhance the knowledge and skills of healthcare workers in the HIV sector across Asia Pacific, was repeated in 2017 and was well received by participants from all countries. It will continue regularly in Singapore and in the Region.  

For more information on APHPC, please click here.  

For more information on the HIV programme, please click here.  

Be Prepared (BePrep) Clinic

Launched in October 2016, the BePrep Clinic offers confidential and holistic services specialising in Sexually Transmitted Infections (STIs) and HIV prevention. Led by Dr Dariusz Olszyna, a Senior Consultant at the Division of Infectious Diseases with over 10 years of experience in HIV and infectious diseases, the Clinic provides counselling and testing for STIs and HIV, as well as risk-reduction packages including Post Exposure Prophylaxis (PEP) and Pre Exposure Prophylaxis (PrEP).  

Why is sexual health important?

Regular testing for STIs, including HIV, is vital for personal and partner health. 

Early treatment can reduce infection severity and improve overall health outcomes 

Consulting with healthcare professionals about sexual health can help in protecting oneself and partners effectively 

Services offered: 

  • STI and HIV-risk assessments 
  • STI risk-reduction counselling 
  • STI and HIV screening 
  • STI treatment 
  • Vaccinations 
  • Comprehensive HIV risk-reduction package including PrEP 
  • Direct linkage to HIV care (NUH Multi-Disciplinary Infectious Diseases Clinic) for patients testing positive for HIV  
  • PEP service 
  • HelpLine for support 

Why visit the BePrep Clinic? 

  • Concerns or questions about sexual health 
  • Consideration of PrEP  
  • Need for STI treatment 
  • Symptoms of STIs or HIV 
  • Exposure to an STI or HIV 
  • Seeking safer sex advice or counselling 
  • Discussing protection from STIs and HIV 

For more information about STIs, please visit: NHS 

For more information about HIV, please visit: 
Centers for Disease Control and Prevention 
HIV Programme

HIV Programme

Infection Prevention and Control (IPC)
Established in 2015 from the merger of the Epidemiology and Infection Control teams, the IPC team plays a key role in ensuring the safety of both NUH patients and staff. Since the SARS outbreak in 2003, the team has been focused on managing the threat of emerging pathogens (such as Ebola and MERS) in the region. The team is skilled in managing outbreaks and threats at the hospital level and has developed internationally recognised best practices for infection control training. The team members have contributed to infection prevention activities and trainings locally, in various Asian countries, the Middle East and West Africa. Through numerous interventions, we have seen improved hand hygiene compliance and reduced MRSA colonisation and infection rates throughout the hospital. We continue to publish on various infection prevention successes. 

Infectious Disease Community Pilot Programme (IDCP) 
Initiated in 2015, the IDCP Programme aims to build the capacity of the regional health system, encompassing non-acute hospitals, nursing homes and family medical centres in Western Singapore. Motivated by Singapore’s ageing population and the rise in patients with multi-drug resistant organisms needing ongoing community care, the programme seeks to develop an integrated care model. This model supports, empowers and builds the capacity of community healthcare providers, aiming to improve patient care, reduce healthcare systems costs and lessen the burden on both the hospital system and the patients.  

Infection Prevention and Control (IPC)
Immunocompromised Hosts Programme 
The immunocompromised hosts programme team

The immunocompromised hosts programme, with two dedicated arms, plays a vital role in the clinical management of patients before and after solid organ transplantation, as well as haematology-oncology patients. It offers both inpatient and outpatient consultation and is integral to routine multidisciplinary clinical discussions. 

Key activities include: 
Pre-transplant screening, risk assessment and management of transplant recipients (including PLHIV) and donors.  
Providing timely, regular inputs for patients receiving chemotherapy.  
Establishing and regularly reviewing workflows for: 

Management of febrile neutropenia 
Antimicrobial strategies and surveillance of broad-spectrum antimicrobial usage and pathogen susceptibility 
Surveillance for opportunistic infections, particularly invasive fungal infections  
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Our Research

Dr Louis Chai's Immune Compromised Host research team

The Division of Infectious Diseases Research Programme consolidates the research efforts of all programmes and staff within the Division. Our research themes are diverse and include tuberculosis (TB), influenza, opportunistic infections and immunocompromised hosts, reflecting the Division’s comprehensive and complex research endeavours. Between 2014 and 2016, the Division produced over 176 publications and secured over $75 million in research grants. 

Many of the Division’s clinician scientists contribute to this programme. Notable projects include the Sprint TB Programme led by Professor Nick Paton, with Dr Lawrence Lee, Dr Gail Cross, Dr Catherine Ong and Dr Louis Chai. Additionally, Dr Louis Chai is a part of the Synthetic Biology Summit Research Programme.  

Dr Louis Chai’s team focuses on prevention, prophylaxis, diagnosis and management of opportunistic diseases. Their work involves exploring patient immune responses to fungal pathogens and developing innovative diagnostics and immunotherapies for challenging infections.  

Dr Swaine Chen's team specialises in using genomics to understand of gram-negative pathogenesis and resistance. Their focus is on urinary tract infections caused by E. coli and outbreak analysis. The team is also involved in a strong bacterial genetics program, contributing further to synthetic biology.  

Additionally, Dr Lawrence Lee's team is working on Pharmacokinetic-Pharmacodynamic-Pharmacoeconomic Anti-Infective Research.  

The Division is also active in both investigator-initiated and industry-sponsored clinical trials. A/Prof Sophia Archuleta serves as a Site Principal Investigator for the Singapore Infectious Diseases Clinical Research Network (SCRN), which promotes and coordinates multi-centre clinical infectious disease research in Singapore. Recent trials have involved patients with conditions such as Klebsiella liver abscess, dengue, MRSA and resistant gram-negative infections. 

Our Education
Undergraduate Education Programme 

 

Medical students at MIDC

Our Undergraduate Education Programme in infectious diseases offers a structured approach to educating both local and international medical students. It encompasses student placements, curriculum planning, elective attachments, contribution to textbook development and support for students in examinations. 

Key initiatives include: 
  • A buddy/mentor system where an ID Senior Resident mentors and supports medical students during their rotation
  • Replacing traditional didactic teaching sessions with experiential and interactive tutorials 
  • Scheduling tutorials to maximise ward time
  • Dividing students into three groups (Inpatients, General ID Consults and ICU/Immunocompromised Consults) to broaden their exposure to the Division's work 
  • Postgraduate Education Programme
  • Post-Graduate Education Team
The Infectious Diseases Senior Residency Programme (SRP) at NUH, accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) since 2013, aims to train academically-oriented ID specialists over three years. The programme combines faculty guidance, clinical rotations, mentored research and didactic coursework, focusing on developing professional, attitudinal, cognitive and technical skills for competent and compassionate care.  

Our graduates are well-prepared for infectious diseases practice, clinical research and leadership roles in the ID field. Training opportunities include general infectious diseases, transplant infectious diseases, HIV, travel medicine, microbiology, hospital epidemiology, infection prevention, antibiotic stewardship, and Outpatient Parenteral Antibiotic Therapy (OPAT). The programme offers structured research opportunities and one-year SMC-accredited clinical fellowships in ID and HIV for physicians from the region, being a recognised ID training site for Australia, New Zealand, Brunei, Malaysia and the Philippines. In addition, the programme has developed and implemented diverse training opportunities for allied health and nursing professionals, including the first Singapore Nursing Board-certified ID Advanced Practice Nurse course. 

For more information on the ID SRP, please click here. 
Patient Education
Human Immunodeficiency Virus (HIV)  
Tuberculosis (TB) 
Klebsiella Liver Abscess 
Dengue 
Guide to using 1-hour infusor at home 
Guide to using 24-hour infusor at home 
Outpatient Parenteral Antibiotic Therapy (OPAT)  

Advice for Peripherally Inserted Central Catheter (PICC)  

Travellers’ Health and Vaccination 
Contact Us

MIDC / HIV Clinic 

Operating Hours (Strictly by appointment only) 

  • Mon - Fri: 8.30am to 6.00pm 
  • Weekends & Public Holidays: Closed 

Contact  

To make an appointment :

For MIDC patient related enquiries 

For non-patient related enquiries 

3a Outpatient Procedure Centre/OPAT 

  • BePrep Clinic 
    Operating Hours (Strictly by appointment only) 
    Thurs: 2.00pm to 5.00pm 

  • Contact  
    To make an appointment  
    Phone: (65) 6908 2222 
    Email: [email protected] 

  • For all other enquiries 
    Email: [email protected] 
    Location: within 13b Medicine Clinic 
    For directions, click here. 

NUH Travellers' Health And Vaccination Clinic 

  • Operating Hours (Strictly by appointment only ) 
    Mon, Wed, Thu and Friday: 2pm to 5pm    

  • Contact 
    Phone: (65) 6772 8600 (8.30am to 5.30pm) 
    Email: [email protected] 
    Location: Within 3a Outpatient Procedure Centre/OPAT 
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