Category Archives: China

China | Hong Kong – Third imported human case of H7N9 avian flu – 17 close contacts now under quarantine

The Centre for Health Protection (CHP) of the Department of Health (DH) today (February 24) reported the latest updates on the third imported human case of avian influenza A(H7N9) in Hong Kong this winter, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

Epidemiological investigations by the CHP have so far located 17 close contacts and 99 other contacts of the patient.

(A) Close contacts
——————

The close contacts will be put under quarantine and prescribed with antiviral presumptive treatment until the completion of the five-day treatment, or 10 days since last exposure to the patient, whichever is earlier. They include:

* An asymptomatic family member of the patient who tested negative for influenza A virus;
* Five asymptomatic healthcare workers (HCWs) involved in Queen Mary Hospital (QMH);
* Seven in-patients admitted to the same cubicle as the confirmed patient in QMH among which six were asymptomatic while the remaining one is under tracing; and
* Three patients and one who accompanied one of them attending the same private clinic in Aberdeen with the confirmed patient. They are all asymptomatic.

The Lady MacLehose Holiday Village in Sai Kung under the Leisure and Cultural Services Department has been converted to a quarantine centre for asymptomatic close contacts, including the HCWs involved in QMH.

(B) Other contacts
——————

Other contacts have been put under medical surveillance and they include:

* Another asymptomatic family member who visited the confirmed patient in QMH;
* 77 HCWs involved in QMH;
* 15 asymptomatic clinic contacts including a private doctor, staff and patients of the private clinic; and
* Six colleagues of the patient among whom one had mild upper respiratory tract infection symptoms before exposure to the patient while the rest are asymptomatic.

Investigations and contact tracing are ongoing.

China | Hong Kong – Priority flu care for seniors as death toll rises to 228

The elderly may be given priority allocation of influenza vaccines when new supplies become available later this year.

Scientific Committee on Vaccine Preventable Diseases Chairman Dr Chow Chun-bong told reporters today the infection situation for seniors aged 85 and above is very serious, so giving them priority is being considered.

The committee will also analyse the infection figures in chronic disease patients to see which diseases bring a higher risk of flu complications, and may also give these patients priority in getting flu vaccinations.

He said the committee will make its recommendation when more information on the vaccine supply is available.

Centre for Health Protection Controller Dr Leung Ting-hung said the Government is forming a working group to implement the committee’s recommendations, and will discuss ways to boost vaccine coverage.

He also reported 22 new severe adult influenza cases were recorded from noon yesterday to noon today, including 18 deaths. It brings the total number of severe adult cases to 322, including 228 deaths.

China | Hong Kong – Govt provides grant of US$500K to family of firefighter killed in the line of duty

About $4 million will be donated to the family of Principal Fireman Leung Kwok-kei who was fatally injured on duty last year.

The money will be granted under the Financial Assistance Scheme for Family Members of Those Who Sacrifice Their Lives to Save Others.

Officer Leung died on December 4 after sustaining serious head injuries in an explosion that occurred while he was attempting to rescue people from a gas leak in Shek Kip Mei Estate on November 22.

Secretary for Labour & Welfare Matthew Cheung, who chairs the committee approving the grants, presented the notification letter to Officer Leung’s family at the Fire Services Department Headquarters today and hailed the officer for his bravery.

“Mr Leung demonstrated a high degree of gallantry and selflessness to save and protect the lives of others. He spared no effort in rescuing people, risking his own life even in the face of grave danger. His professionalism and self-sacrifice command our greatest respect,” Mr Cheung said.

“We deeply mourn the loss of such an outstanding and devoted public servant. The grant represents the Government’s recognition of Mr Leung’s act of exceptional courage and gallantry of the highest order.”

China | Hong Kong – Ten more severe adult flu cases including seven deaths – in past 24 hours

Ten new severe adult influenza cases including seven deaths were reported from noon yesterday to noon today, Centre for Health Protection Controller Dr Leung Ting-hung has announced.

This brings the total number to 266 (181 deaths) so far. Apart from the seven deaths among newly reported cases, there was one additional death in the past 24 hours among previously reported cases requiring intensive care unit admission. Among all cases, 256 were A(H3N2), six were B and four were A pending subtype. In the last winter season in early 2014, 266 (133 deaths) were filed.

Meanwhile, no additional case of severe paediatric influenza-associated complication or death among children aged under 18 has been reported since yesterday via the ongoing reporting system. The total number of cases this year remains at 14 (no deaths). Among these cases, 13 were A(H3N2) and one was A pending subtype. In 2014, 27 (four deaths) were filed.

Briefing the media this afternoon, Dr Leung said flu activity remained at a high level and it is expected to remain that way for some time.

He urged people stay vigilant and pay attention to personal hygiene in a collective effort to slow down the spread of the disease and shorten the flu season.

China | 83 additional confirmed cases of human infection with avian influenza H7N9 – including 19 deaths

On 4 February 2015, the National Health and Family Planning Commission (NHFPC) of China notified WHO of 83 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus. Onset dates ranged from 20 December 2014 to 27 January 2015.

Below is a breakdown of the 83 cases included in this notification by epidemiological week of symptom onset:

  • On 20 December 2014: 2 cases
  • Week 52 (22 – 28 December 2014): 8 cases
  • Week 1 (29 December 2014 – 4 January 2015): 16 cases
  • Week 2 (5 – 11 January 2015): 21 cases
  • Week 3 (12 – 18 January 2015): 20 cases
  • Week 4 (19 – 25 January 2015): 13 cases
  • 26 – 27 January 2015: 3 cases

Cases ranged in age from 1 to 88 years with a median age of 56 years. Of the 83 cases, there were 19 deaths reported, ranged in age from 7 to 78 years with a mean age of 50 years. 60 of these 83 cases were male. The majority (78 cases, 93%) reported exposure to live poultry or live poultry markets; the exposure history of 4 cases is unknown.

Three family clusters were reported, each comprised of 2 cases; all had exposure to live poultry or live poultry markets. Cases were reported from 8 provinces: Fujian (30), Guangdong (30), Jiangsu (7), Jiangxi (1), Shandong (1), Shanghai (2), Xinjiang (1), and Zhejiang (11).

The Chinese Government has taken the following surveillance and control measures

  • Strengthen surveillance and situation analysis.
  • Reinforce case management and medical treatment.
  • Conduct risk communication with the public and release information.

WHO, in close collaboration with China, is monitoring the epidemiological situation and conducting further risk assessment based on the latest information.

Further sporadic human cases of avian influenza A(H7N9) infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. If this were to occur, community level spread is considered unlikely as the virus does not appear to have the ability to transmit easily among humans.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travellers should follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions

China | Notification of confirmed human case of avian influenza A(H5N6) in Yunnan

The Centre for Health Protection (CHP) of the Department of Health (DH) has been notified by the National Health and Family Planning Commission of a confirmed human case of avian influenza A(H5N6) today (February 9) affecting a 44-year-old man in Yunnan province.

The patient, with poultry exposure history, has developed fever, cough and chills since January 27. He was admitted to a local hospital on the same day and died on February 6.

“All novel influenza A infections (including H5N6) are notifiable diseases in Hong Kong,” a spokesman for the DH said.

“Locally, we will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments,” the spokesman said.

“In view of cases confirmed on the Mainland, members of the public should maintain good personal, food and environmental hygiene at all times during travel,” the spokesman urged.

“All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation,” the spokesman added.

Regarding health education for travellers, the display of posters and broadcast of health messages in departure and arrival halls, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are proceeding.

Travellers, especially those returning from avian influenza-affected areas with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Healthcare professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas.

The public should remain vigilant and take heed of the advice against avian influenza below:

* Do not visit live poultry markets and farms. Avoid contact with poultry, birds and their droppings;
* If contact has been made, thoroughly wash hands with soap;
* Avoid entering areas where poultry may be slaughtered and contact with surfaces which might be contaminated by droppings of poultry or other animals;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); and when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear masks when respiratory symptoms develop or when taking care of fever
patients.

The public may visit the avian influenza page of the CHP of the DH (www.chp.gov.hk/en/view_content/24244.html) for more information on avian influenza. The updated information of affected areas can be found on the following webpage:
www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf

China | Hong Kong – Number of cases of severe influenza to date rises to 224 including 145 deaths

The Centre for Health Protection (CHP) of the Department of Health today (February 9) reported the latest surveillance data of the winter influenza season, and again urged the public to heighten vigilance and get vaccinated early against seasonal influenza.

Regarding severe cases, from noon yesterday (February 8) to noon today, six additional cases of influenza-associated admission to intensive care units or death (including two deaths) among adults aged 18 or above have been recorded under the enhanced surveillance in collaboration with public and private hospitals reactivated since January 2. This brings the total number to 224 (145 deaths) so far. Apart from the two deaths among newly reported cases, there was one additional death in the past 24 hours among previously reported cases requiring intensive care unit admission. Among all cases, 213 were A(H3N2), five were B and six were A pending subtype. In the last winter season in early 2014, 266 (133 deaths) were filed.

Meanwhile, no additional cases of severe paediatric influenza-associated complication or death among children aged under 18 have been reported since yesterday via the ongoing reporting system. The total this year hence remains at 11 (no deaths) and all were A(H3N2). In 2014, 27 (four deaths) were filed.

Since December 2014, the CHP has issued three letters to schools reminding them a series of measures to prevent influenza and respiratory tract infection. They are also advised to make reference to the Guidelines on Prevention of Communicable Diseases in Schools/Kindergartens/Kindergartens-cum-Child Care Centres/Child Care Centres published by the CHP, which can be accessed at
www.chp.gov.hk/files/pdf/guidelines_on_prevention_of_communicable_diseases_in_schools_kindergartens_kindergartens_cum_child_care-centres_child_are_centres.pdf.

CHP has also enhanced the health education on prevention against influenza, including the collaboration with district offices and district councils through co-ordination by the Home Affairs Department, with a view to strengthening the promotion of health related messages in the local community.

The public should maintain good personal and environmental hygiene against influenza and other respiratory illnesses:

* Receive seasonal influenza vaccination for personal protection;
* Wash hands with liquid soap and water properly whenever possibly contaminated;
* When hands are not visibly soiled, clean them with 70 to 80 per cent alcohol-based handrub;
* Cover the nose and mouth when sneezing or coughing, and wash hands thoroughly afterwards;
* Dispose of soiled tissue paper properly in a lidded rubbish bin;
* Put on a surgical mask when respiratory symptoms develop;
* Maintain good indoor ventilation;
* When influenza is prevalent, avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks when staying in such places; and
* Maintain a balanced diet, exercise regularly, take adequate rest, do not smoke and avoid overstress.

The public may visit the CHP’s pages below for more information:

* The influenza page (www.chp.gov.hk/en/view_content/14843.html);
* The weekly Flu Express report (www.chp.gov.hk/en/view_content/2108.html);
* The update on severe seasonal influenza cases (www.chp.gov.hk/files/pdf/flu_update_en.pdf);
* The vaccination schemes page (www.chp.gov.hk/en/view_content/17980.html);
* The list of participating doctors (www.chp.gov.hk/en/view_content/34664.html);
* The Facebook Page (fb.com/CentreforHealthProtection); and
* The YouTube Channel (youtube.com/c/ChpGovHkChannel).

China | Hong Kong public health officials examine possibility of offering second H3N2 vax given severity of flu season

A group of experts will study the effectiveness of taking the vaccine for the new H3N2 virus in addition to the original influenza vaccine.

Speaking to reporters today, Centre for Health Protection Controller Dr Leung Ting-hung said the experts will consider this move in its advice to the Government on the best way to prevent flu.

He said the new vaccine will not be available until April or May, and he is not certain how many doses can be attained. However, he warned the shipment will not fulfil demand, so the Government will liaise with the supplier to buy as many doses as possible.

The committee will also advise on which groups of people should have priority in taking the new vaccine when it becomes available.

Dr Leung said the flu situation has stabilised in recent days but it is hard to foresee if this improvement will continue, so the centre will closely monitor developments.

From noon yesterday to noon today, six additional cases of severe flu were reported, bringing the total number to 224, including 145 deaths, so far.

China | Hong Kong – Influenza : High risk groups should consider wearing masks

Following is an urgent question by the Hon Andrew Leung under Rule 24(4) of the Rules of Procedure and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 4):

Question:

Seasonal influenza is raging in Hong Kong, resulting in a death toll of dozens in a month, including some young and healthy people.  It has been reported that there have been successive institutional outbreaks of influenza in a number of schools, and the medical wards of public hospitals are grossly overloaded amid a worsening trend of rampant influenza epidemic.  Given the lower protection rate of the influenza vaccine being used this year and the new vaccine is expected to be available in sufficient numbers only by March or April, will the Government inform this Council of the immediate measures in place to prevent influenza from spreading in densely populated places (such as immigration control points before and after the Lunar New Year) and in institutions?

Reply:

President,

The Centre for Health Protection (CHP) closely monitors influenza activity in the community through its surveillance systems covering childcare centres, residential care homes for the elderly, the Hospital Authority’s out-patient clinics and Accident and Emergency Departments, and clinics of private practitioners and Chinese medicine practitioners.  Besides, CHP monitors the positive influenza detections among respiratory specimens received by its Public Health Laboratory Services Branch.

Regarding prevention and control measures in the community, the CHP has produced a variety of publicity materials on the prevention of influenza to disseminate to the public through channels of television, radio and printed media.  Various publicity and health education channels e.g. websites and health education hotline have also been deployed for promulgation of health advice.  The CHP has also widely distributed the health education materials in public and private housing estates, health care settings, schools, non-governmental organisations, etc.  The main message which is so important that I need to reiterate is to advise the public to maintain healthy lifestyle, good personal and environmental hygiene. People should put on a surgical mask when respiratory symptoms develop to avoid spreading the infections to others.  Members of the public are advised to avoid going to crowded or poorly ventilated public places when influenza is prevalent. Over the past few days, I repeatedly reminded low immunity high risk groups, such as chronic patients to consider wearing a surgical mask especially when staying in these places.

Moreover, the CHP will maintain close liaison with the stakeholder and keep them updated of the latest developments of influenza.

For port health measures and public education efforts at boundary control points (BCPs), the Department of Health (DH) has already reminded relevant departments to regularly inspect and replenish the alcohol-based handrub at BCPs.  Moreover, the DH has been carrying out health screening at different BCPs, and patients will be transferred to medical institutions for follow-up if their cases fall within the reporting criteria of suspected infectious diseases including influenza.  Through press releases and announcements, the DH advises travellers who come from affected areas to Hong Kong to wear a surgical mask and seek medical examination if they present symptoms of respiratory diseases.  They should also inform the doctors of their travel and contact history.

As regards institutional and school outbreaks of influenza, the CHP requires the institutions and schools to report to the CHP if there is any outbreak involving a certain number of cases. The CHP will then conduct prompt epidemiological investigations, implement necessary public health control measures and provide appropriate health advice to the institutions or schools concerned. Following field investigations, the CHP will continue to closely monitor the institutions or schools to ascertain that the outbreak of influenza is under control on the following few days.

China | Hong Kong – Severity of current influenza epidemic said to rival that of 2003 SARS outbreak

Following is an urgent question by the Hon Cyd Ho under Rule 24(4) of the Rules of Procedure and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 4):

Question:

Since the beginning of 2015, influenza has been rampant in Hong Kong, with 122 cases of influenza associated admissions to intensive care units or death in January, in which 64 were fatal. The severity of the epidemic sets to rival that of the Severe Acute Respiratory Syndrome outbreak in 2003.  The Secretary for Food and Health said a few days ago that the vaccine this year had had a lower protection rate, while the vaccine targeting the H3N2 Switzerland influenza strain would be available in sufficient numbers only by March and April this year the earliest.  Given the warning by Professor Yuen Kwok-yung, Chair Professor of the Department of Microbiology of the University of Hong Kong, that the influenza virus has undergone reassortment, will the Government inform this Council of the immediate measures in place or solutions available to cope with the situation in which the aforesaid newly produced vaccine becomes ineffective due to a new round of reassortment of the virus, so as to ensure that there will be a sufficient supply of effective vaccine for public vaccination at that time?

Reply:

President,

Hong Kong usually experiences two influenza peak seasons every year – one between January and March and the other in July and August.  The winter influenza season arrived in late December 2014.

According to the World Health Organization (WHO), an antigenically drifted H3N2 strain, from A/Texas/50/2012 to A/Switzerland/9715293/2013, has been observed.  Locally, over 95% of the circulating H3N2 viruses also belonged to A/Switzerland/9715293/2013 strain.  The mismatch of the circulating and vaccine strain of H3N2 may reduce the vaccine effectiveness of protection of vaccine for H3N2 recommended by WHO, but it is expected that the seasonal influenza vaccines would afford a certain degree of cross-protection against different but related strains, and also reduce the likelihood of severe outcomes such as hospitalisations and deaths, particularly for high-risk groups.  As such, vaccination remains an important means to prevent influenza.  Hence, we still advise the public especially the high-risk groups to consider receiving vaccination as soon as possible although the protection of this year’s influenza vaccine is comparatively low.

As regards the vaccine against Switzerland type H3N2 seasonal influenza, our preliminary understanding is that the earliest timing for sizable production is around March to April.  The Administration will continue to closely monitor the production situation of these vaccines and examine whether their supply would be available within this influenza season.