Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January to March 2009)

[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: School management urged to be vigilant against seasonal influenza (2/9/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 9) urged school management to strictly adopt precautionary measures that the CHP promulgates against seasonal influenza.


A CHP spokesman said an increase in schools reporting influenza-like illness (ILI) outbreaks was expected as Hong Kong had entered the traditional flu season.

He said the CHP is putting up a list of 11 new ILI institutional outbreaks affecting 51 people on its daily update today, mostly involving schools.

During 2005-07, the highest number of institutional outbreaks of ILI reported every week during the flu season was between 10 and 32.

In 2008, the highest weekly number of outbreaks was 106.

"We anticipate that the rise of reported ILI outbreaks will persist over the next four to six weeks as Hong Kong stays in the influenza season.

"Also, an increased number of influenza-related complications among children during the flu season is expected," the spokesman said.

In 2008, about 1,200 children aged 12 years or below were hospitalised under the Hospital Authority due to influenza, while the figures for 2007 was about 1,400.

"Young children, who are at higher risk of hospitalizations due to influenza related complications, are urged to get vaccinated against the disease if they have not already done so," the spokesman said.

The spokesman said an updated guideline entitled "Arrival of the Winter Influenza Season in Hong Kong" with highlights on hygiene and infection control measures was sent to schools, kindergartens and child care centres before the flu season. School management have been briefed on the criteria of class suspension when there is a flu outbreak in their schools.

They are also advised to keep parents properly informed about the latest situation.

To prevent possible outbreak of respiratory diseases especially influenza, the spokesman remind parents not to send their children with fever and respiratory symptoms to school.

Children with acute febrile illness should not attend school until their symptoms have subsided and 48 hours after fever has come down.

Furthermore, some 130 representatives from schools and other institutions had attended health talks on the prevention of influenza organised by CHP in collaboration with Education Bureau and Social Welfare Department.

"CHP will closely liaise with schools, kindergartens and child care centres to manage ILI outbreaks," the spokesman said.

Meanwhile, members of the public are reminded to take the following measures to prevent influenza and other respiratory illnesses:
*Build up good body immunity by having a proper diet, regular exercise and adequate rest, reducing stress and avoiding smoking;
*Maintain good personal and environmental hygiene;
*Wash hands after sneezing, coughing or cleaning the nose;
*Maintain good ventilation; and
*Avoid visiting crowded places with poor ventilation.

People, particularly young children, elderly people and those with chronic diseases, should wear face masks and consult their doctors for medical advice promptly if they developed influenza-like symptoms.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: CHP investigating a gastroenteritis outbreak at a primary school (2/11/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 11) reminded members of the public and management of institutions to maintain strict personal and environmental hygiene to prevent gastroenteritis.


The appeal was made following CHP's investigation of a gastroenteritis outbreak affecting 35 students of a primary school in Tuen Mun.

The affected, comprising 15 boys and 20 girls aged between 8 and 12, developed symptoms of gastroenteritis, including diarrhoea and vomiting, since February 5.

Five of the affected consulted private doctors and one attended Accident and Emergency Department of Tuen Mun Hospital.

All of them are in stable condition.

Officers of the CHP provided health instructions to the staff concerning proper disinfection, proper disposal of vomitus and stools, as well as personal and food hygiene.

CHP will closely monitor the school for further cases and provide health advice when necessary.

To prevent contracting gastroenteritis, members of the public are advised to-
* Ensure proper personal hygiene;
* Wash hands thoroughly before eating or preparing food and after using toilet or handling vomitus or faecal matter;
* Avoid food that is not thoroughly cooked.

Members of the public can obtain more information on the prevention of gastroenteritis from CHP's website (http://www.chp.gov.hk) or call the Central Health Education Unit hotline, 2833 0111.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Queen Mary Hospital response to patient cases of mucormycosis (2/11/2009) [QMH]

The following is issued on behalf of the Hospital Authority:

The Queen Mary Hospital (QMH) spokesperson made the following announcement today (Wednesday, 11 February 2009) regarding patient cases of mucormycosis:


1. Mucormycosis is a rare disease due to Murorales. These fungal spores are ubiquitously found in environment, food and wooden material.
2. Most patients who developed this disease are very immunosuppressed due to leukaemia/lymphoma and the chemotherapy.
3. Most such cases are caused by inhalation or inoculation of the spores into sinus, lung, skin or tongue which may spread to their parts of the body such as the brain. The disease has a very high fatality of over 50% despite treatment. Instestinal mucormycosis are very rare.
4. In QMH since the period 2004, only four cases of mucorales are cultured from respiratory and skin specimens. None of these positives are found in intestinal tissue or stool.
5. In November 2008, a six years old boy on treatment for acute lymphocytic leukaemia died of ileocecal mucormycosis 23 days after onset of abdominal distension.
6. In January 2009, another 11 years old boy on treatment for acute myeloid leukaemia developed right lower abdominal pain was found to have gangrenous appendicitis due to mucormycosis.
7. This morning we have a third male patient (Aged 38) who on treatment for acute lymphocytic leukaemia and has acute gangrenous appendicitis due to mucormycosis.
8. Enhancement of culture testing in this group of patients showed three additional patients in our bone marrow transplant units who has stool positive for this fungus. Retrospective review of patients' record showed another 57 years old man who died from perforation of intestinal lymphoma also had intestinal mucormycosis in October 2008.
9. We now stopped admissions to our bone marrow transplant unit till we have enough supply of the antifungal drug active against mucorales and gave antifungal treatment for all possible cases.
10. All patients are advised to eat and drink only boiled food items. All non-sterile wooden tongue depressors and chopsticks are stopped. Two strains of mucorales can be grown from pre-packed food items which are still be identified. All strains can be killed at 80 degree Celsius after one minute but it can grow at 50 degree Celsius.
11. The Centre for Health Protection and Hospital Authority Head Office are informed.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: CHP keep close watch on gastrointestinal mucormycosis case (2/11/2009) [CHP]

In response to media enquiries, a spokesman for the Centre for Health Protection (CHP) of the Department of Health said CHP received a report from Queen Mary Hospital today (February 11) about confirmed cases of invasive gastrointestinal mucormycosis due to rhizopus species.


The spokesman said the species could be found in the environment, food and wooden material.

He stressed that healthy people did not need to be worried of being infected as mucormycosis almost exclusively affected severely immunocompromised patients including people suffered from leukemia, lymphoma and chemotherapy.

He noted that CHP would closely liaise with the Hospital Authority to monitor the situation.

The spokesman said to prevent gastrointestinal mucormycosis, severely immunocompromised patients should strictly observe the following measures:

1)Follow doctors' advice on management of underlying disease;
2)Maintain good personal hygiene; and
3)Eat and drink only well cooked or boiled items as all strains can be killed at 80 degree Celsius after one minute.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Public urged to be vigilant against community-associated MRSA (2/11/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 11) called on people to be vigilant against infection from community-associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) - a drug resistant bacterium.


The appeal was made following CHP's investigation into a confirmed CA-MRSA case involving a 64-year-old woman.

The woman began to develop cough on January 24 and then fever on January 27.

She was admitted to Princess Margaret Hospital on January 29 with high fever. She was diagnosed with pneumonia and sepsis and her blood grew CA-MRSA. She is now in the hospital in serious condition.

CHP's investigations showed that she came from the Philippines and had stayed with relatives in Wong Tai Sin since January 17. Her household contacts in Hong Kong did not develop any symptom of CA-MRSA.

MRSA is a type of bacteria that is resistant to beta-lactam antibiotics. It is a common infection worldwide. In recent years, many countries observed MRSA infections in healthy individuals who had not been hospitalised or stayed in other healthcare facilities or institutions, nor received medical procedures in the past one year prior to onset of symptoms.

They are known as CA-MRSA infections and usually have special patterns of antibiotic resistance. It is widely recognised that indiscriminate use of antibiotics may contribute to antibiotics resistance.

People are advised not to use antibiotics without medical professional advice. If they are advised by doctors to take antibiotics, they should take the medicine according to the prescribed frequency and dosage.

People are advised to observe good personal hygiene including washing hands with soap frequently.

For further information on CA-MRSA, please visit the CHP website: http://www.chp.gov.hk.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Macau Daily Times - Macau signs emergency service protocol with Hong Kong

Macau signs emergency service protocol with Hong Kong

Thursday, 12 February 2009
by Sara Farr

Macau doctors will benefit from a service protocol that was signed yesterday with the neighbouring SAR, which will see local doctors receive emergency service training from Hong Kong.


With the protocol doctors in Macau benefit from professional training in specific trauma areas mainly accident-related and first aid-related emergencies, as well as have the opportunity to go to Hong Kong for additional training. Hong Kong Health Authority experts will also come to Macau to ?orientate? local doctors in practices and techniques within these areas.

Lei Chi Ion, director of the Health Bureau, said that ?this protocol will only improve the hospital's emergency ward capability and capacity.?

This is the second time Macau signs a health service protocol with the neighbouring SAR, after both regions' health authorities signed a ?technical medicine? agreement in 2007.

Cheong Wai Lun, director of the Cluster Services of the Health Authority in Hong Kong, said this protocol was positive for both SAR's as it would allow for the exchange of both regions' doctors to learn from one another with the ?outreach program training,? ?scientific exchange,? and ?in loco orientation.?

Macau is also looking into hiring more doctors from both the mainland and Portugal who are specialised in different types of medicine, but who mainly work within the trauma unit and have a vast experience in first-aid, screening and patient treatment.

So far, the Conde Sao Januario Hospital Centre has a total of four such doctors, two of which are from Portugal and another two from the mainland, Lei said.

When asked about the progress of the construction plan for the first public hospital in Taipa, the director of the Health Bureau said that works are still at a preliminary stage and recruitment will only begin according to the works progress and staff needs.

Meanwhile, Lei also said the number of flu cases increased this winter compared with that of last year, although no numbers were made available. However, the Health Bureau's director stressed that the rate was not alarming and it did not pose any risk of a flu outbreak in the SAR.

On the other hand, Macau has a contingency plan should a bird flu case be reported in Macau.

?We [the Macau health authorities] will increase our contingency plans and we will continue to pay attention to [bird flu] cases in the neighbouring regions,? Lei added.
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<cite cite="http://www.macaudailytimesnews.com/index.php?option=com_content&task=view&id=22745&Itemid=28">Macau Daily Times - Macau signs emergency service protocol with Hong Kong</cite>

 

[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: LCQ1: Preventive and control measures on seasonal influenza and avian influenza (2/12/2009)

LCQ1: Preventive and control measures on seasonal influenza and avian influenza
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Following is a question by the Hon Audrey Eu and an oral reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 11):

Question:
A number of confirmed cases of human infection of avian influenza have occurred on the Mainland since January this year, resulting in five deaths. At the same time, the World Health Organisation (WHO) has indicated that there is an increasing likelihood of a major global outbreak of influenza on a scale similar to that in 1968. In this connection, will the Government inform this Council:

(a) of the latest information about the avian influenza epidemic on the Mainland that the Government has obtained through the exchange and notification mechanism on infectious diseases; and
(b) in the face of the recent spate of fatal avian influenza cases on the Mainland and WHO's warning, what measures the Government will take to prevent the outbreak of influenza and human infection of avian influenza in Hong Kong?

Reply:

President, Hon Eu's question touches on seasonal influenza and avian influenza. First of all, I would like to explain the differences between the two. Seasonal influenza is caused by different strains of influenza virus transmitted among people. There are three known categories of influenza: A, B and C. The most common types of influenza in Hong Kong are influenza A H1N1 and H3N2. Minor changes of the antigen of influenza viruses every year lead to seasonal influenza. As such, reformulation of the influenza vaccine is required every year to cope with the mutation of viral strains. Influenza is mainly transmitted through air or droplet in crowded and enclosed areas, or through direct contact with the secretions of a person suffering from the disease.

As for avian influenza, it is usually caused by influenza A H5N1 and H9N2. While avian influenza normally infects birds, poultry are especially vulnerable to infections resulting in epidemics. According to the World Health Organisation (WHO), there have been over 400 human cases of avian influenza H5N1 globally since 2003, with the fatality rate of about 60%. Cases of human infection of avian influenza are usually the result of close contact with live poultry and their droppings. Wild birds are not a major channel of spreading avian influenza to human.

Up till now, there is no epidemiological evidence to show that avian influenza can be transmitted to humans through consumption of properly cooked poultry according to WHO.

Neither is there any evidence of efficient human-to-human transmission of the virus. In the circumstances, our strategy to prevent avian influenza is primarily on prevention of poultry from avian influenza infection, and minimising contact between the members of the public and live poultry.

An influenza pandemic occurs when there is an extensive human-to-human transmission of a new influenza virus or an influenza virus which has not been around for a long time. An influenza pandemic takes large toll as the majority of the population lack immunity to the virus.

My replies to the two parts of the question are as follows :

(a) As at February 10, the Department of Health (DH) has received notifications from the Ministry of Health (MoH) concerning eight confirmed human cases of avian influenza A H5N1 so far this year. Of these cases, five were fatal.

Investigations conducted by the Mainland health authorities reveal that seven cases had contact with diseased poultry or exposure history to live poultry market in the Mainland prior to the onset of symptoms.

The Mainland Government has taken preventive and control measures accordingly, including placing the close contacts of patients under medical surveillance and carrying out epidemiological investigations.

The MoH's investigation reveals that all eight cases are sporadic cases without epidemiological linkage and there are no obvious signs of human-to-human transmission of the virus at the moment. Details of the cases are at the Annex.

(b) To mitigate the effect of seasonal influenza, the Centre for Health Protection (CHP) has been closely monitoring the local influenza situation through different channels, including the sentinel surveillance in general out-patient clinics, private clinics, homes for the elderly, child care centres, etc. We provide free influenza vaccination for some high-risk target groups under the "Government Influenza Vaccination Programme" every year. The "Influenza Vaccination Subsidy Scheme" was also launched in November last year to provide government subsidies to encourage young children to receive influenza vaccination at private clinics, so as to reduce their risk of hospitalisation due to influenza. In addition, at end of last year, we have stepped up our preventive publicity and education efforts before the arrival of the winter influenza season.

The CHP has set up a dedicated webpage in its website to publish the updated figures and information on the influenza daily situation for public reference.

The CHP also disseminates relevant messages and guidelines to doctors, homes for the elderly, hostels for people with disabilities, schools, kindergartens and child care centres from time to time, so as to strengthen the surveillance, prevention and control of influenza. These measures have not only facilitated effective surveillance of influenza in Hong Kong, but also significantly heightened public alertness to influenza.

As for avian influenza, the Government has already put in place a series of measures to reduce the risk of virus transmission from poultry and birds to human. These measures include banning the keeping of backyard poultry, requiring the compliance with biosecurity measures in local farms, requiring vaccination for chickens in local farms and imported chickens, banning the keeping of live poultry overnight at retail level, as well as enhancing the testing of antibodies for chickens in local farms and imported chickens.

Besides, we have also arranged influenza vaccination for poultry workers and cullers to reduce the chance of genetic reassortment between human and avian influenza viruses. We are also actively pursuing the development of a poultry slaughtering plant to achieve complete segregation of humans from live poultry.

In respect of surveillance, avian influenza H5, H7 and H9 are currently notifiable infectious diseases under the Prevention and Control of Disease Ordinance. In addition to statutory notifications, the CHP also maintains close monitoring of the avian influenza situation locally through various means including laboratories and hospitals. On the other hand, DH has implemented temperature screening for in-bound travellers in all Immigration Control Points and will conduct further assessment on those with fever or illness.

For any suspected avian influenza cases, rapid diagnosis using molecular methods will be conducted by DH. Once avian influenza cases are detected, the DH will conduct epidemiological investigations promptly and take necessary control measures including contact tracing, environmental investigation, finding the source of infection and prevention of the spread of diseases. We have all along been maintaining close communication and co-operation with the Mainland and Macao health authorities to ensure expeditious and effective exchange of important information about infectious disease outbreaks and incidents of the three places.

Contingency measures have been taken to reduce the chance of infectious disease outbreak. In addition, we have been maintaining close liaison with WHO and the health authorities of other regions to obtain the latest information on avian influenza cases. Regular exercises and drills are also conducted to test and enhance the emergency preparedness of government departments in case of public health emergencies. Besides, health authorities in Hong Kong, the Mainland and Macao organise joint exercises regularly to review the emergency response and notification mechanism of the three places in handling cross-boundary public health emergencies.

Despite the occasional cases of human infection of avian influenza in other countries and places, there is no evidence yet of efficient human-to-human transmission of the virus. We will continue to minimise the risk of avian influenza and influenza pandemics through the above measures.

Ends/Wednesday, February 11, 2009
Issued at HKT 12:56
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<cite cite="http://www.info.gov.hk/gia/general/200902/11/P200902110136.htm">LCQ1: Preventive and control measures on seasonal influenza and avian influenza</cite>

 

[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Influenza outbreaks in primary schools under close watch (2/13/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 13) urged members of the public and management of institutions to take preventive measures against influenza-like-illness (ILI) by observing strict environmental and personal hygiene.


The appeal was made during the CHP's investigation of report of two influenza outbreaks in primary schools, affecting a total of 43 people.

The first case affected 21 students, comprising 14 boys and seven girls aged from six to 10, developed symptoms of ILI, including fever, cough and sore throat between February 6 and February 12. Twenty of them sought medical attention and another eight-year-old boy was admitted to Alice Ho Miu Ling Nethersole Hospital. His clinical specimens were tested positive to Influenza B.

In the second case, a total of 20 students and two staff, comprising 21 male and one female aged from seven to 32, developed symptoms of ILI, including fever, cough, running nose and sore throat between February 4 and February 13. Thirteen of them sought consultation at private doctors and out-patient clinics while one of them attended Accident and Emergency Department of Princess Margaret Hospital. An 11-year-old boy was admitted to Queen Elizabeth Hospital. His clinical specimens were tested positive to Influenza A. He has been discharged and all of them are in stable condition.

CHP officials have conducted field visits to the schools and provided health advice to the staff.

To prevent respiratory tract infection, the public are advised to adopt the following measures:
*Build up good body immunity by having a proper diet, regular exercise and adequate rest, reducing stress and avoiding smoking;
*Maintain good personal hygiene, wash hands after sneezing or coughing, and wear a mask when having symptoms of respiratory tract infection;
*Maintain good ventilation; and
*Avoid visiting crowded places with poor ventilation.

Members of the public, particularly children, elderly people and those with chronic diseases, should wear face masks and consult doctors promptly if they develop symptoms of respiratory tract infection.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Hospital Authority follow-up action on cases of intestinal mucormycoisis (2/13/2009) [QMH]

The following is issued on behalf of the Hospital Authority:

Following the announcement of Queen Mary Hospital (QMH) earlier this week on a cluster of invasive intestinal mucormycosis in immuno-compromised leukaemia patients in the last four months, the Hospital Authority (HA) is very concerned and convened a special meeting today (Friday, February 13) with experts in haematology, clinical oncology and microbiology to discuss the issues and follow up measures.

"HA is now collecting further data on cases with gastrointestinal mucormycoisis.
Results will be cross-checked with concerned hospitals before passing them to Centre for Health Protection," said the HA spokesman.

As at today, two cases were identified in preliminary reports from the Hospital Infection Control Officers of two public hospitals.

The one from United Christian Hospital was already announced yesterday (Thursday).

Another one was identified in Princess Margaret Hospital.In November 2007, a patient (male, aged 64) with Acute Myeloid Leukemia (AML), was confirmed by positive culture and histology.

He was admitted to PMH for treatment on 22 October 2007 and passed away on 21 November 2007. Meanwhile, in all public hospitals, all leukaemia, lymphoma and bone marrow transplant patients are considered as extremely immuno-compromised patients and following precautions would be adopted with immediate effect:

- All food items should be boiled before consumption for hospitalised leukemia, lymphoma and bone marrow transplant patients;
- Sterilised wooden tongue depressors and wooden chopsticks should be used on patients of leukemia, lymphoma and bone marrow transplant.

"Beginning on 17 February 2009, HA will commence a two-week surveillance. Stool samples from in-patients of leukemia or lymophoma or bone marrow transplant will be collected for culture."

"HA will form an expert panel to advise on treatment of mucormycosis for severely immuno-compromised patients," added the spokesman.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Confirmed case of dengue fever (2/13/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 13) urged people to guard against dengue fever following the laboratory confirmation of a case.


The case involved a 31-year-old woman who came to Hong Kong from Indonesia on January 29. She developed fever and nausea on February 1 and sought medical treatment the next day. Her symptoms persisted and was admitted to Prince of Wales Hospital on February 5. She is now in stable condition.

CHP's investigation revealed that her home contacts are asymptomatic.

CHP will continue to follow up the case.

This is the third case of dengue fever reported to CHP this year. A total of 42 cases of dengue fever were reported in 2008. All were classified as imported cases.

A spokesman for CHP urged the public to stay alert to the threat of dengue fever and to help prevent mosquito breeding by taking the following measures:
* Put all used cans and bottles into dustbins with covers;
* Change water for plants at least once a week, leaving no water in the saucers underneath flower pots;
* Tightly cover all water containers, wells and water storage tanks, and
* Keep all drains free from blockage.

Travellers should take the following preventive measures:
* Wear long-sleeved tops and trousers;
* Use insect repellent on the exposed parts of the body, and
* Use mosquito screens or nets when rooms are not air-conditioned.

Anyone feeling unwell after returning from their trip should consult a doctor as soon as possible and provide details of their travel to the doctor.

The latest information on dengue fever in other places can be found under "Travel Health News" on the Hong Kong Travel Health Service website at http://www.travelhealth.gov.hk/eindex.html. Travel agents, tour guides and travellers can visit the website for the latest news and advice on preventive measures.
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: SFH on mucormycosis cases (2/14/2009) [SFH]
A TIME'S MEMORYToday at 5:36

Following is the transcript of remarks made by the Secretary for Food and Health, Dr York Chow, at a stand-up media session after officiating at the opening ceremony of an optometry centre today (February 14):

Reporter:
What will you say about the outbreak of this particular kind of fungal disease? Will the Hospital Authority extend the two-week surveillance if there are more cases coming up?

Secretary for Food and Health:
The Hospital Authority is tracing the past record of all the patients that are receiving chemotherapy for blood diseases which have rendered them very low immunity to any infection. We need to spend some time on the archives before we know the extent it has affected our patients.
But the important part is to prevent these immuno-compromised patients to be exposed to the external environment which might be contaminated with this type of fungus as normal individuals will not be affected by these organisms.

Reporter:
Some doctors said it was difficult to totally ban patients from consuming food outside hospital. Do you have any appeal to the public?

Secretary for Food and Health:
I think for patients staying in the hospital, it should not be too difficult to prevent people from bringing in food from outside. But regarding those immuno-compromised patients who are discharged at home, it is important to educate their family members to ensure that even though they are preparing and cooking their own food, there are certain important steps they have to do in order to ensure that their food are prepared under very high temperature or boiled for certain minutes, and they should not add any unknown source or type of ingredients into their food.

(Please also refer to the Chinese session of the transcript)
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Crested Myna tested positive for H5 virus (2/15/2009) [AFCD]

Under the present avian influenza surveillance programme on dead wild birds, preliminary testing of a dead Crested Myna found in Tung Ping Chau has indicated a suspected case of H5 avian influenza, a spokesman for the Agriculture, Fisheries and Conservation Department (AFCD) said today (February 15), adding that further confirmatory tests were being conducted.


The bird carcass was collected at Shau Tau, Tung Ping Chau on February 12.

The spokesman said there were no poultry farms within three kilometres of where the dead bird was found.

"In view of the recent cases of H5N1 found in poultry and wild bird carcasses, the AFCD has phoned poultry farmers reminding them to strengthen precautionary and biosecurity measures against avian influenza. Pet bird shop owners, licence holders of pet poultry and racing pigeons have also been reminded to take proper precautions," the spokesman said.

The spokesman said the department would conduct frequent inspections of poultry farms, the wholesale market and the Yuen Po Street Bird Garden to ensure that proper precautions against avian influenza had been implemented.

The department would continue its wild bird monitoring and surveillance.

The Food and Environmental Hygiene Department (FEHD) will continue to be vigilant over imported live poultry as well as live poultry stalls. It will also remind stall operators to maintain good hygiene.

The Department of Health will enhance health education and distribute health advice leaflets.

AFCD, FEHD, the Customs and Excise Department and the Police will strive to deter the illegal import of poultry and birds into Hong Kong to minimise the risk of avian influenza outbreaks brought by imported poultry and birds that had not gone through inspection and quarantine.

All relevant government departments will continue to remain highly vigilant and strictly enforce preventive measures against avian influenza.

"The public can call 1823 Call Centre for follow up if they come across suspicious sick or dead birds, including carcasses of wild birds and poultry," the spokesman said.

Members of the public are reminded to observe good personal hygiene.

They should avoid personal contact with wild birds and live poultry and their droppings.

They should clean their hands thoroughly after coming into contact with them.

Poultry and eggs should be thoroughly cooked before consumption.

Advice on biosecurity measures for people working in poultry farms, wholesale and retail markets and health advice for the general public are available at the "H5N1 Health Advice" of AFCD website at www.afcd.gov.hk. The website also includes the latest information on the H5N1 infected birds found in Hong Kong this year.
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[Commonground]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

HK: Influenza outbreaks in primary schools under close watch

Press Release
The Centre for Health Protection (CHP) of the Department of Health today (February 16) urged members of the public and management of institutions to take preventive measures against influenza-like illness (ILI) by observing strict environmental and personal hygiene.

The appeal was made following CHP's investigation into reports of three influenza outbreaks in primary schools, affecting a total of 91 people. Two of the affected schools required class suspension.

The first case affected 32 students and two staff members of Ying Wah Primary School in Sham Shui Po, comprising 33 males and one female aged from seven to 32. They developed symptoms of ILI, including fever, cough and sore throat, since February 8.

19 of them have sought medical treatment. Another 11-year-old boy, who was admitted to Queen Elizabeth Hospital earlier, has been discharged while another nine-year-old boy was admitted to a private hospital in Kowloon and is now in stable condition. Clinical specimens of these two students tested positive for Influenza A.

In the second case, a total of 37 students (comprising 24 boys and 13 girls aged from six to 11) of Fanling Assembly of God Church Primary School developed ILI symptoms between February 6 and 16. Among them, 36 have sought medical attention. Another eight-year-old boy was admitted to Alice Ho Miu Ling Nethersole Hospital and is in stable condition. His clinical specimen tested positive for Influenza B.

A CHP spokesman said, "Due to an increased number of affected people in these two schools, CHP advised the schools to suspend classes for a week from tomorrow (February 17) to February 23 for thorough disinfection to prevent further spreading of diseases."

Meanwhile, there was an influenza-like illness outbreak in another primary school in Kowloon Tong, affecting 19 students and one staff member. The affected, comprising six males and 14 females aged from six to 32, had ILI symptoms between February 8 and 14. 17 of them have consulted a doctor and required no hospitalisation. Their conditions are stable.

CHP officials have conducted field visits to the schools and provided health advice to the staff.
-snip-

Ends/Monday, February 16, 2009
Issued at HKT 19:28

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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Close watch on influenza-like illness outbreaks in primary schools (2/17/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 17) urged members of the public and management of institutions to take preventive measures against influenza following the CHP's investigation into reports of influenza-like illness (ILI) outbreaks in two primary schools, affecting a total of 44 people.


The first case involved a primary school in Tsuen Wan. The affected, 14 males and eight females, developed ILI symptoms, including fever, cough and sore throat from February 13 to 16. They comprised 20 students aged between seven and 12, and two staff members. All of them have sought medical treatment and did not require hospitalisation. They are in stable condition.

The second case involved a primary school in Sha Tin. Twenty-two students, comprising seven boys and 15 girls aged between six and 11, developed ILI symptoms from February 11 to 16. Among them, 19 have sought medical attention. Another seven-year-old girl was admitted to Prince of Wales Hospital and her clinical specimens tested positive for Influenza A. She has been discharged. All of them are in stable condition.

CHP officials have conducted field visits to these schools and provided health advice to the staff.

To prevent respiratory tract infection, the public are advised to adopt the following measures:
* Build up good body immunity by having a proper diet, regular exercise and adequate rest, reducing stress and avoiding smoking;
* Maintain good personal hygiene, wash hands after sneezing or coughing, and wear a mask when having symptoms of respiratory tract infection;
* Maintain good ventilation; and
* Avoid visiting crowded places with poor ventilation.

Members of the public, particularly children, elderly people and those with chronic diseases, should wear face masks and consult doctors promptly if they develop symptoms of respiratory tract infection.
-

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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Warning on infant formula with possible Enterobacter sakazakii contamination (2/17/2009) [CFS]

The Centre for Food Safety (CFS) today (February 17) advised people not to consume certain batches of infant formula manufactured in France suspected of being contaminated with Enterobacter sakazakii.


EU authorities informed CFS today that the manufacturer concerned was recalling the product, as the South Korean authorities had found Enterobacter sakazakii in the concerned product.

Details of the product are as follows:

Manufacturer: Vitagermine
Product name: Babynat Organic Infant Milk (Lait en poudre pour b?mb?m Babynat 1 ) (900g)
Bar code: 3288131502014
Lot number: 17381
Expiry date: 13/10/2010

Enterobacter sakazakii can be found in the environment, but it generally causes disease only in people with weakened immune systems.

Enterobacter sakazakii can cause invasive infection such as bacteria in blood or meningitis.

Neonates (28 days old or below) and infants less than 2 months of age, in particular pre-term infants, low-birth-weight infants (< 2.5 kg) and infants with weakened immunity, are at greater risk.

For high-risk infants who cannot be breastfed, caregivers are encouraged to use, whenever possible and feasible, commercially sterile liquid formula.

According to the recommendation by Food and Agriculture Organization and World Health Organization, reconstitution of powdered infant formula with water that is no less than 70?J can significantly inactivate Enterobacter sakazakii.

"Based on information collected, the affected product has been imported into Hong Kong. The centre will continue its investigations," a CFS spokesman said.

"The CFS has alerted the trade to stop selling the particular product and is closely monitoring the situation.For more information on Enterobacter sakazakii, please browse the risk in brief on our website." [Website: http://www.cfs.gov.hk/english/programme/programme_rafs/programme_rafs_fm_02_04.html]
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: LCQ17: Prevention and control of influenza (2/18/2009)

Following is a question by the Hon Starry Lee and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 18):

Question:
During the peak of the influenza season in March last year, the Government set up an Expert Group to conduct an in-depth investigation into the deaths of three children with acute febrile illnesses. The investigation report released in April last year came up with 14 recommendations, including extension of the recommended age range of childhood vaccination for influenza. Subsequently, the Government launched the Influenza Vaccination Subsidy Scheme (IVSS) in November last year to encourage influenza vaccination of Hong Kong children between the age of six months and less than six years.
It has been reported that up to end of last month, the coverage rate of IVSS was less than 30%.
In this connection, will the Government inform this Council:
(a) of the latest coverage rate of IVSS and what measures are in place to encourage influenza vaccination of more eligible children;
(b) whether the Government will accept the remaining 13 recommendations made by the Expert Group; if it will, of the details of and timetable for implementing the recommendations; if not, the reasons for that; and
(c) whether it will issue guidelines on whether schools should suspend classes in case of an influenza outbreak; if it will, of the details; if not, the reasons for that?

Reply:
President,
(a) The Government introduced the Influenza Vaccination Subsidy Scheme (IVSS) in November 2008 to provide subsidy to encourage young children to receive influenza vaccinations from private doctors. To date, the Government has received applications for subsidy for over 100,000 injections of influenza vaccine, which include the first and second injections. The Scheme will last till the end of March this year. As there is still a month to go and there will be new applications during this period, the final coverage of IVSS will only be known and publicised after March. Since September 2008, the Government has been promoting the IVSS by different means, including Announcements of Public Interest on television and radio, as well as distribution of relevant information to medical practitioners, child care centres, kindergartens, health services units and all Public Enquiry Services Centres of the Home Affairs Department.In addition, the Department of Health (DH) has visited and briefed the 18 District Councils on the IVSS and organised two briefings. DH has also set up a dedicated website to provide details of the Scheme and a hotline to answer public enquiries.
(b) DH and the Hospital Authority (HA) have already taken appropriate follow-up actions on the remaining 13 recommendations made by the Investigation Panel in relation to the acute febrile deaths in three children in early 2008. Details are given in Annex.
(c) In times of influenza outbreaks, the Centre for Health Protection (CHP) would consider advising the affected schools to suspend classes for a period of time to control the outbreak, having regard to factors including the number of affected persons, the number of severely ill persons, the number of persons requiring hospitalisation, the progression of the outbreak, whether it is responsive to control measures, etc. Details have been incorporated in the updated Guidelines on Prevention of Communicable Diseases in Schools/Kindergartens/Kindergartens-cum- Child Care Centres/Child Care Centres, which have been sent to schools and uploaded onto the CHP's website for reference by the general public (website: http://www.chp.gov.hk/files/pdf/School_full_eng_20090115.pdf).
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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Case of necrotising fasciitis under investigation (2/18/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 18) received a report of a necrotising fasciitis case (flesh-eating disease) involving a 48-year-old man.


The patient returned from Shenzhen on February 15 with fever and bilateral lower limb swelling. He immediately attended Accident and Emergency Department of Pok Oi Hospital and was then transferred to Tuen Mun Hospital for further treatment. The patient's condition continued to deteriorate and he passed away today.

Laboratory tests on his blood and tissues of lower limbs yielded Vibrio vulnificus, a type of bacteria causing necrotising fasciitis.

A CHP spokesman said necrotising fasciitis was a serious bacterial infection of the soft tissue and fascia. It could destroy tissue andcause death within 12 to 24 hours after infection.

People are reminded to adopt the following preventive measures:
* Avoid exposure of open wounds or broken skin to seawater or salty water;
* Wounds should be thoroughly cleansed and properly covered;
* Wear thick rubber gloves when handling raw shellfish.

Patients should seek medical advice promptly if they developed symptoms and signs of infection like increasing redness, pain and swelling.
-

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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Mucormycosis infection of a QMH patient (2/18/2009) [QMH]

The following is issued on behalf of the Hospital Authority:

In response to the cases of gastrointestinal mucormycosis found at Queen Mary Hospital (QMH), the spokesperson of the hospital today (February 18) gave the following updates:

This afternoon an intestinal mucormycosis is just found in one of a total of approximately 20 body fluid samples of a deceased 42-year old female lymphoma patient.

Patient was admitted for chemotherapy. At present, there are five affected cases under treatment. The paediatric patient is recovering.

The two symptomatic adult patients are under critical conditions.

One is due to his terminal cancer and the other one is due to the complications developed after the Bone Marrow Transplant.

The condition of two other asymptomatic adult Bone Marrow Transplant patients is stable.

QMH will continue the surveillance on patients with immunosuppressed due to leukaemia/lymphoma and the chemotherapy. QMH understands the Bone Marrow Transplant patients' concern for the resumption of new admissions to our bone marrow transplant unit.

However, the hospital has to ensure the patient safety and service quality.

Mucormycosis is a rare disease due to Murorales. These fungal spores are ubiquitously found in environment, food and wooden material.

Most patients who developed this disease are very immunosuppressed due to leukaemia/lymphoma and the chemotherapy. Extensive investigation indicates pre-packed food is the most likely source in the affected patients. Education and instruction to patients on safe food and drinks have been strengthened.

No more pre-packed foods are provided for the leukaemia/lymphoma and the chemotherapy patients. The Centre for Health Protection and Hospital Authority Head Office are informed.
-

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[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: Influenza-like-illness (ILI) outbreak in school under close watch (2/19/2009) [CHP]

The Centre for Health Protection (CHP) of the Department of Health today (February 19) urged members of the public and management of institutions to take preventive measures against influenza by observing strict environmental and personal hygiene.


The appeal was made after CHP received a report of ILI outbreak in a secondary school this evening.

The school concerned is "Newman Catholic College" in Yau Ma Tei. It is noted that the school has decided to suspend classes from tomorrow (February 20) to February 23 for thorough disinfection.

CHP has commenced investigations and shall closely monitor the situation.

CHP appealed to all schools to report suspected infectious disease outbreaks to CHP as soon as possible.

To prevent respiratory tract infection, the public are advised to adopt the following measures:
* Build up good body immunity by having a proper diet, regular exercise and adequate rest, reducing stress and avoiding smoking;
* Maintain good personal hygiene, wash hands after sneezing or coughing, and wear a mask when having symptoms of respiratory tract infection;
* Maintain good ventilation; and
* Avoid visiting crowded places with poor ventilation.

Members of the public, particularly children, elderly people and those with chronic diseases, should wear face masks and consult doctors promptly if they develop symptoms of respiratory tract infection.
-

View Original Article

 

[Giuseppe]

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Re: Hong Kong (PRC SAR): Epidemiological Surveillance Updates from Centre of Heath Protection and other govt agencies (January 2009+)

Hong Kong: QMH announces reopening of Bone Marrow Transplant Unit (2/24/2009) [QMH]

The following is issued on behalf of the Hospital Authority:

Regarding the earlier announcement on a cluster of cases of gastrointestinal mucormycosis found at Queen Mary Hospital (QMH), a spokesperson for the hospital gave the following updates today (February 24):


QMH Bone Marrow Transplant unit will resume the admission of new bone marrow transplant patient tomorrow (February 25).

Since there were no new cases identified clinically or microbiologically in the past week and the drug Posaconazole is now available for treatment, QMH has to strike a balance between the safety of ward environment and the need of bone marrow transplant patients to undergo the procedure as early as possible.

It was decided to resume the admission of bone marrow transplant patients on the waiting list. New patients admitted for bone marrow transplant must have undergone pre-admission microbiological surveillance and weekly surveillance culture would be performed for bone marrow transplant in-patients.

At present, there are five affected cases under treatment.

The paediatric patient is recovering.

The other two asymptomatic adult bone marrow transplant patients are stable.

Another two symptomatic adult patients are on critical conditions.

One is due to his terminal cancer and the other one is due to the complications developed after the Bone Marrow Transplant.

QMH will continue the surveillance on patients with immunosuppressed due to leukaemia/lymphoma and chemotherapy treatment.

Mucormycosis is a rare disease due to Murorales. These fungal spores are ubiquitously found in environment, food and wooden material.

Most patients who developed this disease are very immunosuppressed due to leukaemia/lymphoma and the chemotherapy. Extensive investigation indicates pre-packed food is the most likely source in the affected patients.

Education and instruction to patients on safe food and drinks have been strengthened.

No more pre-packed foods are provided for the leukaemia/lymphoma and the chemotherapy patients.
-

View Original Article