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HONG KONG (PRC SAR): Epi-Surveillance [Since 7/31/09]: H1N1 2009 and H3 co-circulation.
A spokesman for the Department of Health said there had been 783 newly confirmed cases of human swine influenza (Influenza A H1N1) (HSI) in the 24 hours to 2.30pm today (September 24).
The new cases involve 388 males and 395 females, aged between one month and 85 years.
This brings to 24,681 the total number of HSI cases in Hong Kong.
The spokesman said the total number of HSI cases would be revised according to further laboratory results.
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The Department of Health today (September 24) advised a primary school and two secondary schools to suspend classes for seven days starting tomorrow to stop the possible spread of influenza-like illness (ILI) in the schools.
The advice was made following the outbreaks of ILI in the schools involving 216 students and three staff (see Annex), a spokesman for the department said.
The schools are Farm Road Government Primary School in Kowloon City, Ko Lui Secondary School in Kwun Tong and Pui Kiu Middle School in North Point.
So far, a total of six students in two schools were being infected with human swine influenza. No hospitalisation is required. All of the affected students are in stable condition. The department has visited the schools and advised the staff on infection control measures. The schools are put under medical surveillance.
The spokesman called on parents to pay attention to the health condition of their children, and to remind them to observe good personal and environmental hygiene.
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The following is issued on behalf of the Hospital Authority:
The spokesperson of Queen Mary Hospital (QMH) made the following announcement regarding the death of a critical human swine influenza (HSI) patient today (24 September):
A 84-year-old male patient with chronic obstructive pulmonary disease, hypertension and stroke was transferred to QMH for management of his chronic disease on 2 September 2009. He had fever and pneumonia since 5 September 2009 and positive result of human swine influenza was confirmed on 8 September. He was prescribed with Tamiflu and antibiotics. Positive result of Tuberculosis was confirmed on 17 September 2009. His condition deteriorated later and he was put on ventilation support. His condition continued to deteriorate and he was certified dead at 10:43am today (24 September) due to Tuberculosis .
The case has been reported to HA Head Office and Centre for Health Protection. We would like to express our condolences to the patient's family.
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The following is issued on behalf of the Hospital Authority:
Regarding the services of the eight Designated Flu Clinics (DFCs) and the confirmed human swine influenza patients admitted to public hospitals, the Hospital Authority (HA) spokesman provided the following updates today (24 September):
The Designated Flu Clinics today (as at 5pm) provide treatment to a total of 1,774 patients with flu-like symptoms.
As at 2.30pm today, there were 783 newly confirmed cases of human swine influenza in the past 24 hours.
This brings to 24,681 the total number of confirmed human swine influenza cases in Hong Kong.
Currently, a total of 189 confirmed cases are staying in public hospitals for treatment.
Among them, 171 cases are in stable condition, seven in serious and 11 in critical condition.
The newly confirmed critical case announced today is a 66 year-old male patient with diabetes mellitus, hypertension of Yan Chai Hospital (YCH). He developed upper respiratory symptoms on 21 September 2009. The patient attended the Accident and Emergency Department of YCH and was admitted for medical treatment. His condition deteriorated and was transferred to the Intensive Care Unit on 23 September 2009 (yesterday). He is prescribed with Tamiflu and antibiotics and is on ventilation support. Positive result of HSI was confirmed today (24 September 2009). The hospital is closely monitoring his condition. The patient is now in critical condition.
Furthermore, the confirmed cases announced today included 16 staff members of public hospitals (four male and 12 female, including two doctors, four nurses, two allied health professionals, three clerks and five supporting staff).
So far there were 680 HA staff members being confirmed as human swine influenza.
Among them, 537 have already recovered and returned to work.
The HA spokesman reminded the public that HA has progressively resume service for chronic patients with scheduled appointment at the eight designated flu clinics (DFC). Chronic patients who have been pre-scheduled for follow up at the DFCs should go to the clinics according to their date of original appointment, bringing along the appointment slip and Identity Card.
Other general outpatient services such as episodic disease, injection and wound care will not be resumed at these DFCs for the time being.
Patients with other illnesses are advised to seek medical treatment at other general outpatient clinics in the district or private practitioners.
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The following is issued on behalf of the Hospital Authority:
The Hospital Authority today (September 25) announced a new set of clinical management protocols for treatment and testing of human swine influenza cases with the objective of targeting thosewith a more severe conditionand receiving in-patient care.
The spokesman said patients with influenza-like-illness (ILI) seeking consultation at both Designated Flu Clinics (DFC) and Accident & Emergency (A&E) Departments would be assessed by clinicians to determine the course of treatment, and the need for clinical testing and hospital admission.
Starting next Monday (September 28), DFCs and A&E Departments will conduct laboratory tests for human swine influenza on the following specific groups of patients:
Pregnant women
Children 12 months old or under
Healthcare workers including staff from residential homes
Patients living in institutions without outbreak
Influenza patients with persistent fever (over 38C) or whose condition deteriorates 48 hours after treatment
"Hospital admission and antiviral treatment will be based on clinical assessment.
For other ILI patients, test for human swine influenza is not routine as the testing of influenza infection will not affect the treatment for them."
At the same time, patients who have risk factors and chronic illnesses, and residents of residential institutions presenting with influenza-like-illness will be offered antiviral treatment on presentation with no need for laboratory testing. The Hospital Authority spokesman said public hospitals and clinics would only prescribe symptom control medication to influenza patients with mild condition.
"We would like to appeal to patients with ILI symptoms to consider seeking consultation first with private doctors and clinics amid a continual surge in the attendance in DFCs and A&E Departments in the past few weeks."
In the past four weeks, the average daily attendance of the 15 major A&E Departments increased from 6,354 in the last week of August to 7,086 in the past week, with attendance peaking at 8,391 on Monday (September 21).
"At the same time, there has been an increase in the attendance of patients presenting with Influenza-like Illness in some major A&E Departments,from below 10 percent in the last few months to an average of 20 percent in the past week,"the spokesman said.
In some A&E Departments, more than 30% of the attending patients have presented with ILI symptoms. "If there are accident casualties or a sudden surge in patients seeking consultation, patients with minor ailments will inevitably need to wait longer at the A&E Department. Additional manpower has already been deployed at pressured A&E Departments to address the increasing workload," the spokesman said.
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A spokesman for the Department of Health said there had been 624 newly confirmed cases of human swine influenza (Influenza A H1N1) (HSI) in the 24 hours to 2.30pm today (September 25).
One of the cases was from an elderly home in Kowloon City.
The new cases involve 313 males and 311 females, aged between eight months and 83 years.
This brings to 25,305 the total number of HSI cases in Hong Kong.
The spokesman noted that the total number of HSI cases would be revised according to further laboratory results.
The case in the elderly home involved a 78-year-old man, who was admitted to Queen Elizabeth Hospital today. His current condition is stable.
"The case was associated an influenza outbreak in the elderly home where two other residents were affected. One of the residents was also confirmed to have HSI infection earlier.
"The department will put the staff and residents of the institution under medical surveillance," he said.
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The following is issued on behalf of the Hospital Authority:
The spokesperson of Tuen Mun Hospital (TMH) made the following announcement today (September 25):
Four patients (aged 25 to 34) of a male ward for the mentally handicapped in TMH have presented with fever and flu symptoms since September 21. Viral tests were arranged for them and all were subsequently confirmed with Human Swine Influenza.
They are being treated under isolation and are in stable condition. Infection control measures of the concerned ward have already been stepped up. Admission to and discharge from the ward have been suspended, while restricted visiting policy has been implemented.
Patients' relatives have been informed about the situation.
All other patients and the staff in the ward are under close surveillance.
The cases have been reported to the Hospital Authority Head Office and the Centre for Health Protection for necessary follow up.
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The following is issued on behalf of the Hospital Authority:
Regarding the services of the eight Designated Flu Clinics (DFCs) and the confirmed human swine influenza patients admitted to public hospitals, the Hospital Authority (HA) spokesman provided the following updates today (September 25):
The Designated Flu Clinics today (as at 5pm) provide treatment to a total of 1,592 patients with flu-like symptoms.
As at 2.30pm today, there were 624 newly confirmed cases of human swine influenza in the past 24 hours.
This brings to 25,305 the total number of confirmed human swine influenza cases in Hong Kong.
Currently, a total of 203 confirmed cases are staying in public hospitals for treatment.
Among them, 185 cases are in stable condition, eight in serious and 10 in critical condition.
There are two newly confirmed critical cases announced today, including a 37-year-old female patient with renal failure and beta thalassaemia major in Queen Mary Hospital, and a 51-year-old female patient with history of asthma in Queen Elizabeth Hospital. They were admitted to hospitals on September 21 and 24 due to upper gastrointestinal bleeding and influenza symptoms respectively. The test results for human swine influenza were subsequently confirmed and they were prescribed with Tamiflu and antibiotics and on ventilation support.
Furthermore, the confirmed cases announced today included 28 staff members of public hospitals (seven male and 21 female, including two doctors, 12 nurses, three allied health professionals, five clerks and six supporting staff).
So far there were 708 HA staff members being confirmed as human swine influenza.
Among them, 557 have already recovered and returned to work.
The HA spokesman reminded the public that HA has progressively resumed service for chronic patients with scheduled appointment at the eight DFCs. Chronic patients who have been pre-scheduled for follow up at the DFCs should go to the clinics according to their date of original appointment, bringing along the appointment slip and Identity Card.
Other general outpatient services such as episodic disease, injection and wound care will not be resumed at these DFCs for the time being.
Patients with other illnesses are advised to seek medical treatment at other general outpatient clinics in the district or private practitioners.
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The following is issued on behalf of the Hospital Authority:
Yan Chai Hospital (YCH) spokesperson made the following announcement regarding the death of a human swine influenza (HSI) patient today (September 25):
A 44 year-old female patient with asthma and hyperlipidemia developed respiratory symptoms on September 20, 2009. The patient attended the Department of Accident and Emergency of YCH on September 22, 2009 and was admitted to the Intensive Care Unit on the same day. The patient was prescribed Tamiflu and antibiotics. She required ventilation support and had been in critical condition. Positive result of HSI was confirmed on September 23, 2009. Her condition was further deteriorated and succumbed at 12.38pm today.
The case has been reported to HA Head Office and Centre for Health Protection. YCH has also referred the case to Coroner.
The hospital would like to express its condolences to the patient's family.
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Starting next Monday (September 28), the Centre for Health Protection (CHP) of the Department of Health will adopt a series of surveillance indicators for human swine influenza (HSI) to be reported weekly, a CHP spokesman said today (September 25).
The indicators include the percentage tested positive for HSI among patients in Designated Flu Clinics (DFC), the number of DFC attendances for influenza-like-illness (ILI) and the consultation rates of ILI at sentinel private doctors' clinics.
"Latest laboratory surveillance data reveals that HSI is the predominant influenza virus strain circulating in Hong Kong, representing over 80 percent of all circulating influenza viruses.
"Over 60 percent of patients with ILI attending DFC are tested positive to HSI.
"At this stage of HSI pandemic, the number of laboratory confirmed cases is no longer a useful surveillance indicator," the spokesman said.
World Health Organization recommends that for countries already experiencing community-wide transmission, the focus of surveillance activities may shift to reporting against the established indicators for the monitoring of seasonal influenza activity.
The spokesman said the new weekly reporting of surveillance indicators will replace the current daily reporting of laboratory confirmed cases.
CHP and Hospital Authority will continue to report daily information of ILI outbreaks in schools and fatal / severe cases, he said.
Latest influenza situation will be published weekly at CHP's website at www.chp.gov.hk under "Swine and Seasonal Flu Monitor".
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The Department of Health today (September 25) advised a primary school to suspend classes for seven days starting tomorrow to stop the possible spread of human swine influenza (HSI) in the school.
The advice was made following the outbreak of HSI in HKUGA Primary School in Eastern District, a spokesman for the department said.
Investigation revealed that 79 students, aged between five and 11, and three staff at the school developed influenza-like illness symptoms since September 3.
Two of them required hospitalisation and have been discharged. All affected persons are in stable condition. Laboratory results showed that four students and a staff were confirmed to have been infected with HSI.
The department has visited the school and advised staff on infection control measures. The school has been put under medical surveillance.
The spokesman called on parents to pay attention to the health condition of their children, and to remind them to observe good personal and environmental hygiene.
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Starting next Monday (September 28), the Centre for Health Protection (CHP) of the Department of Health will adopt a series of surveillance indicators for human swine influenza (HSI) to be reported weekly, a CHP spokesman said today (September 25).
The indicators include the percentage tested positive for HSI among patients in Designated Flu Clinics (DFC), the number of DFC attendances for influenza-like-illness (ILI) and the consultation rates of ILI at sentinel private doctors' clinics.
"Latest laboratory surveillance data reveals that HSI is the predominant influenza virus strain circulating in Hong Kong, representing over 80 percent of all circulating influenza viruses.
"Over 60 percent of patients with ILI attending DFC are tested positive to HSI.
"At this stage of HSI pandemic, the number of laboratory confirmed cases is no longer a useful surveillance indicator," the spokesman said.
World Health Organization recommends that for countries already experiencing community-wide transmission, the focus of surveillance activities may shift to reporting against the established indicators for the monitoring of seasonal influenza activity.
The spokesman said the new weekly reporting of surveillance indicators will replace the current daily reporting of laboratory confirmed cases.
CHP and Hospital Authority will continue to report daily information of ILI outbreaks in schools and fatal / severe cases, he said.
Latest influenza situation will be published weekly at CHP's website at www.chp.gov.hk under "Swine and Seasonal Flu Monitor".
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So Hong Kong finally stopped counting. I know they are known for flu surveillance, but they counted every case for two months after most of the rest of the world stopped.
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