Re: Hong Kong - Human case of H5N1 Bird Flu Confirmed
Re: Hong Kong - Human case of H5N1 Bird Flu Confirmed
Secretary for Food and Health Bureau on avian flu
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Following is the Food and Health Secretary York Chow, Centre for Health Protection Consultant Community Medicine (Communicable Disease) SK Chuang and the Hospital Authority (HA) Chief Manager (Infection, Emergency Services), Dr. Liu Shaohuai today (November on the 18th) of avian influenza in the present inter-departmental meeting, the Central Government Offices West Wing lobby of the meeting transcript (Chinese part):
Secretary for Food and Health Bureau : I would like to announce to the public yesterday confirmed avian influenza case follow-up. Today we have food and Health Board held an inter-departmental Steering Committee (meeting) to understand the circumstances of the case and what follow-up work. The name of the fifty-year-old female patient, yesterday we confirmed H5 virus in patients with high-To, and we also follow up and contact her family situation, Dr SK CHUANG will explain the details later. Patients are staying at the Princess Margaret Hospital's intensive care room isolation of infectious diseases, the situation is serious, then later by Dr. Liu Shaohuai explain her situation.
Today, we have initially
tested the virus-based gene sequencing is 2.3.2, 2.3.2 type is a very common virus in Asia, in Hong Kong and the Mainland, including Shanghai, have, which is why it is difficult to use this reason to differentiate between what patients infection in Hong Kong or the Mainland. However, the time of its incubation period and disease, we think her a greater chance of infection in the mainland, so the most important thing now is that we know a patient, we must try to prevent another recurrence of the patient or other patients (poultry influenza infection), so have to work in Hong Kong in Hong Kong, we have informed Ministry of Health, the State also informed the authorities about the incident in Shanghai, they will make the appropriate preventive work.
In Hong Kong, because of bird flu infection is usually from poultry to person, so we are particularly concerned about the live poultry. Said yesterday, in the market, the markets in Tuen Mun has made cleaning; Today we started in the wholesale market and other places to do work. Fisheries and Conservation Department (AFCD), they will also enhance the cleaning and monitoring of the wholesale market, but also the next two days will inspect all thirty farms, to ensure that they do not have any unusual circumstances; also will step up inspection of chickens.
As for the chickens from the Mainland, we have with the Guangdong Entry-Exit Inspection and Quarantine Bureau contacts, it was agreed that beginning in the next few days, will strengthen the monitoring and testing of this sample increased by about per cent xxv.
Mainland, Hong Kong does not have any chicken farms for the case of any unusual, so special in this regard is not necessary to worry about, but we will spare prevention work.
Other aspects, including in markets or retail level, we will remind the chicken stall must pay attention to their health, and clean, we have to avoid contact with live chickens too many people.
At the same time, we will increase these days the commercials Bochu avian influenza, including to advise the public to the field, try not to go to live poultry or some not very clear where their hygiene, especially if the live poultry may be this risk. Because even if there is only one disease, the risk still exists. Over the past few years, the region still has human bird flu, avian flu and the mortality rate of up to fifty percent, so this is where we should pay particular attention, I hope you pay attention.
Although Hong Kong does not significantly increase the risk, but in this area must be done to prevent. Together with all government departments concerned will try to spare our work, any news will soon as possible. I asked Dr. Liu Shaohuai the following about the patient's condition.
HA Chief Manager (Infection, Emergency Services): The patient was diagnosed a woman, fifty-nine. After she was diagnosed yesterday, transferred from the Intensive Care Unit of Princess Margaret Hospital, Tuen Mun Hospital, Infectious Diseases Center intensive care unit. Currently, she's in serious condition, in need of oxygen, antibiotics, and the Tamiflu treatment; X-ray and medical examination are displayed on both sides of the lungs are affected, it is currently under close monitoring.
Department of Health Hospital Authority also increase with the response level to "severe." In the "serious" level, we will strengthen the monitoring, all patients presented with fever, and if the symptoms of influenza, together with travel history if he had had to Nanjing, Shanghai, Hangzhou, also went to the market or had contact with poultry birds, to the diagnosis and treatment of emergency room or in the ward, we will take samples to him for bird flu tests.
Starting today, the hospital visiting hours will be changed: two hours per day emergency ward, rehabilitation ward, compared with four hours. All health care workers and staff, and even family members visiting patients, the patients in our region need to wear surgical masks, infection control measures as an upgrade. We also take into account the progress of the disease and announced to the outside world.
Secretary for Food and Health Bureau : I call Dr Cheung question about contact tracing.
Centre for Health Protection Consultant Community Medicine (Communicable Diseases): We have tracked the eight close contacts of patients, including the families of three patients, and five (with the patient) living in Tuen Mun Hospital the same interval patient wards. Eight contacts were asymptomatic at present, we will draw some of their blood and throat samples for testing to see if they have a chance of infection.
In addition, we have also issued letters to doctors, as well as strengthening the monitoring of the HA, and notified other departments, including the World ( the World Health Organization) and the Ministry of Health. We will also send letters to the homes, including homes, schools, etc., so that everyone alert. Meanwhile, we have set up a hotline so far received about a dozen complaints from the public inquiry, there is no new suspected cases.
Reporter: This time the patient had private doctors, but also visited the Tuen Mun hospital emergency room, but have not found she was infected with bird flu, because the time interval is too long and relax? How to ensure that no future recurrence of this situation?
Secretary for Food and Health Bureau : hard to say whether lax because of this, because most of the people who have respiratory symptoms seek medical treatment or to Accident and Emergency Department, must depend on the seriousness of their symptoms and make a decision. Most doctors now look at symptoms, such as flu, is also human influenza, the H3 is more. Of course, if disease progression or other additional symptoms, they would stay alert and do some testing. In this case, I think they should be to raise the awareness of power, especially now there is a case of this, we must be particularly careful. So we hope that we note that the medical records if there is contact with poultry, as well as severe respiratory special cases, other tests have found that if there may be a viral infection, we will strengthen this area of the test. We have just decided that if the body temperature higher than that of (C) three eight degrees, or the symptoms of pneumonia, or X light to, the HA will conduct such tests, HIV tests to do this earlier, we can as soon as possible define whether the patient is infected with the avian influenza virus.
Reporter:
The patient in this situation is also quite long bloody sputum occur, why can not identify? Will a long time, so no measures to do something should be done?
Secretary for Food and Health:
This area Hennan sector, because we have not detailed the medical records for analysis, especially if the patient went to private doctors (visit), but also to have public hospitals. The most important is that we must become aware of, if there is doubt, try to do more tests to confirm that is what types of flu viruses.
Reporter: The patient saw a private doctor, and went to public clinics, but have found no (bird flu), why? Is the long incubation period failed to find? Or doctors complacent?
Secretary for Food and Health Bureau : I believe the majority of patients seeking treatment Xianshi, if respiratory symptoms, most are not bird flu, but there are other viral infection or bacterial infection, so doctors usually be the first to think of avian flu, usually consider whether influenza, seasonal influenza is, or other respiratory infections. I believe there are hundreds of people every day in this area will seek treatment, so generally speaking, doctors are from the most common disease to start treatment.
Reporter: China to find the source of the work going?
Secretary for Food and Health Bureau : We informed them only yesterday, so they will have to give them some time to follow up the incident. We will try to provide them with more information, such as patients live, or where she had to and so on. For the time being, we have not made very clear this patient information, particularly in Shanghai, she visited several areas in or near where, because of her present situation is more serious, there are some difficulties speaking terms. We need to be sure where she had to follow up the information to the Mainland. Nevertheless, in Hong Kong, will have to work our work, as the Mainland, particularly Guangdong Province, they also tie us chickens supplied to Hong Kong in terms of their work done enough, so this regard, we generally quite ease.
Reporter: She had private doctors, in fact, the Government has to investigate in this direction? For example, private doctors during the period, there will be other patients in the clinic, you will try to find ways to contact with those patients to see their situation?
Secretary for Food and Health Bureau : Please Department of Health Dr Cheung explained that they were to follow up those contacts.
Centre for Health Protection Consultant Community Medicine (Communicable Diseases): We are follow-up who has worked with private doctors and other doctors diagnosed patients who had the opportunity. Because of the time, the opportunity has passed for seven days, we will present the latest call to understand their situation, there have appeared a cold or other symptoms.
Reporter: eight contacts that whether people including her husband, children and patients in the ward at that time?
Centre for Health Protection Consultant Community Medicine (Communicable Disease): Yes, that eight persons are also in Princess Margaret Hospital for observation, should be in their last contact with the patient, observed seven days if no symptoms to be regarded as no problem.
Reporter: What is the situation that eight people?
Centre for Health Protection Consultant Community Medicine (Communicable Disease): they have no symptoms now eight, three (family) including the patient's husband and children, the other five had lived in the ward with her the same interval.
Reporter: commencement date, if there is no problem within seven days to be discharged?
Centre for Health Protection Consultant Community Medicine (Communicable Disease): the last time they start to contact with sick seven days, may each have a little different.
Reporter: At present, the patient's condition serious, the fact that delayed diagnosis of bird flu, if found early, the patient's condition is not so bad as they are now? In addition, Dr. Liu Tuen Mun Hospital will recognize in this case there is negligence?
Secretary for Food and Health Bureau : I begin by saying that according to experts said, no sooner off the viral infection is drug, giving antiviral drugs, the effect should be better. Of course, each patient reacts differently to the virus, and some relatively minor, some are more serious. All in all, "sick to the shallow medicine" is on at any moment, so we think that if detected early, can cure early. Therefore, we present the event of suspected cases have also asked the HA to do more early HIV testing in this area, I hope If there were this to happen, we can reach them early and give appropriate treatment.
As for the question whether the level of Tuen Mun Hospital and so did the time being it is difficult to comment on the medical records to be made clear before they can. The most important thing is they all try to heal the sick, if the patient has enough time or severity of medical records, so they need her income was admitted for further examination, of course they do.
Reporter: be sure that the doctor was aware of the Tuen Mun Hospital, her blood in sputum?
Secretary for Food and Health Bureau : We are not sure he was ever considered that the patient may be infected with this disease.
Reporter: You just said that with Liu doctors, will now take steps to check what local patients to travel, or in particular a number of fever patients in isolation. These measures are not taken earlier, so this patient was not special treatment? Is it because has been a very long time, it had deteriorated in alertness?
Secretary for Food and life and life: If this disease in the community or region has not appeared for some time, doctors thought it would be difficult the first time that the disease, so I just said that whenever we have the first case, all more difficult to diagnosis and treatment. Once such a case arise, I believe that health care workers will pay particular attention in this regard.
Reporter: a doctor, I would like to ask the patient the present situation, is deteriorating, there is no risk of death, how severe pneumonia, antibiotics are not effective, the need for intubation?
HA Chief Manager (Infection, Emergency Services): The patient is currently in serious condition, no need to intubation, but requires one hundred percent oxygen, taking antibiotics and Tamiflu treatment. She is currently in intensive care unit, the condition is of course a bit worse, but are closely observed, the doctor will then carry out other medical examination of her, especially the organ and so on.
Reporter: doctor, after the event, the HA has not the first time to understand, why did not the Tuen Mun Hospital found that patients with avian influenza viruses?
HA Chief Manager (Infection, Emergency Services): before we upgraded to serious levels, still alert, or in general, will be to examine patients with pneumonia and given the right prescription, we now have the name After the patient's condition deteriorated after admission for her we also did some virus testing. Department of Health yesterday by patient laboratory diagnosis, we have her transferred to Princess Margaret Hospital's infectious disease center.
Reporter: Why did the first time in her attendance did not find the virus?
HA Chief Manager (Infection, Emergency Services): We are general practice and practice at the time, are directed at community-based pneumonia, given some appropriate treatment. So the case for further analysis, we will later find out about.
Reporter: Is there time for her doctor to doctor understand the situation she was seeking medical treatment, or the HA will do this?
HA Chief Manager (Infection, Emergency Services): Tuen Mun Hospital will conduct a detailed analysis in this regard.
Reporter: has been done or going to do?
HA Chief Manager (Infection, Emergency Services): Hospital will do.
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http://www.info.gov.hk/gia/general/201011/18/P201011180246.htm
