Wednesday, July 30, 2014

Hong Kong’s Ebola Response

image
Credit CDC PHIL

 

# 8893

 

Now that the tabloid press has discovered the Ebola outbreak in western Africa (and only 5 months after it began . . . ), and some have unabashedly begun promoting it as a `global pandemic threat’ , I’m finding it increasingly difficult to write anything about the outbreak without feeling like I’m aiding and abetting a media circus that has seriously jumped the shark. 

 

While it may not sell newspapers - the Ebola virus (as it stands now) -  is seriously lacking in the `global pandemic potential’ department.

 

It is not `airborne’ (unless flying coach or 1st class), and it isn’t all that easy to catch.

 

Health care workers, and family members – those most likely to come into contact with bodily fluids – are at greatest risk of exposure, along with those harvesting, preparing, or consuming infected bushmeat.  While one can argue that the virus could `mutate’ and become more transmissible over time, for now we’ve seen no evidence of that occurring. 

 

If it does, you can be sure I’ll post an update.

 

Hyperbolic headlines aside, there are legitimate concerns that an infected person could board an airplane in the outbreak zone, and travel to the UK, EU, North America, Hong Kong, or any other international destination. 

 

It has happened before with many other exotic diseases, and nothing prevents it from happening with Ebola. The general consensus is, however, that if an infected individual did arrive on our shores -  that with the public health resources available here – the risk to the general public would be low. 

 

As you might expect, public health agencies are alerting doctors, hospitals, and airlines on how to deal with this potential threat (see CDC Teleconference & HAN Notice On Ebola & CDC Interim Ebola Exposure Guidance For Airlines, Flight Crews). 

 

We saw the ECDC issue similar advice earlier this summer (see Rapid Risk Assessment on Ebola (June 9th)).

 

Today Hong Kong’s CHP, which has an enviable record of both being proactive, and willing to share information with the public, has issued the following  statement and sent letters to local doctors.

 

Ebola virus under watch

July 30, 2014

The Centre of Health Protection and the Hospital Authority have boosted surveillance and control measures for the Ebola virus in light of the outbreak in West Africa.

The centre’s Community Medicine Consultant Dr Chuang Shuk-kwan told reporters today more than 1,200 cases have been confirmed in Guinea, Liberia and Sierra Leone since March.

Anyone in Hong Kong with a fever who visited these three countries in the last three weeks will be sent to the Communicable Disease Centre in Princess Margaret Hospital for isolated treatment, she said.

The authority’s Chief Infection Control Officer Dr Dominic Tsang said the patient will be immediately tested for the virus.

Letters will be sent to all doctors today explaining the assessment criteria for Ebola, and reminding them to report suspected cases.

Travellers going to the three countries are advised to ensure good personal hygiene; avoid contact with ill people, body fluids and animals; cook food thoroughly; and, consult a doctor immediately if they feel ill.

Click here for information on the virus.

 

 

This is the letter sent to Hong Kong’s Physicians.

 

 

Our Ref. : (2) in DH SEB CD/8/15/1                     30 July 2014
Dear Doctor,


Updated Situation and Reporting Criteria of Ebola Virus Disease

Further to our letter sent to you on April 2, 2014, we would like to provide updates on the latest situation of the outbreak of Ebola Virus Disease (EVD). Since the first report of the EVD outbreak in West Africa in March this year, the cumulative numbers of cases attributed to EVD are continuously increasing.

<SNIP Case count updates >

The risk of infection for travellers is still low at the present moment. Person-to-person transmission was resulted from direct contact with body fluids or secretions of an infected patient. However, medical practitioners should always consider EVD in the differential diagnosis of febrile illness in any person with recent (within 21 days) travel history to affected areas/countries, i.e. Guinea, Liberia and Sierra Leone (as of July 29, 2014). The Centre for Health Protection will closely monitor the situation and update the affected areas from time to time.

Please refer to our website (http://chp.gov.hk/files/pdf/evd_affected_area.pdf) for the updated list of affected areas/countries. In this regard, we would like to solicit your assistance in notifying the CHP if you encounter patients fulfilling both the Clinical Criteria AND Epidemiological Criteria below:

Clinical Criteria

Suffering from a sudden onset of fever (≥ 38°C , 100.4°F);

OR

Having at least one of the following symptoms/signs: inexplicable bleeding, bloody diarrhoea, bleeding from gums, bleeding into skin (purpura), bleeding into eyes, or haematuria;

OR

Any inexplicable sudden death.

AND

Epidemiological Criteria

One or more of the following within 21 days before onset of illness:

Close contact* with a confirmed or probable case of Ebola Virus Disease or his/her bodily fluids;

 OR

Resided in or history of travel to an affected area/country#;

* Such as sleeping in the same household with a case, direct physical contact with the case (dead or alive) during the illness, direct physical contact with the (dead) case at the funeral, touched his/her blood or body fluids (including semen) during the illness, touched his/her clothes or linens, breastfed by the patient (baby).


# Affected countries (as of July 29, 2014): Guinea, Liberia, and Sierra Leone. For the updated list of affected countries/areas, please refer to the following website: http://chp.gov.hk/files/pdf/evd_affected_area.pdf

Patients meeting the above reporting criteria should be isolated immediately. Medical practitioners are reminded to notify the Central Notification Office (CENO) of CHP via fax (2477 2770), phone (2477 2772) or CENO On-line (http://ceno.chp.gov.hk/). Please also call our Medical Control Officer at 7116 3300 a/c 9179 for prompt investigation. CHP will make arrangement to send the patient to the Hospital Authority Infectious Disease Centre in Princess Margaret Hospital for isolation, testing and treatment.

For further information on EVD, please refer to the Annex or visit the CHP website at

http://www.chp.gov.hk/en/view_content/34199.html

Thank you for your ongoing support in combating communicable diseases.

Yours faithfully,

(Dr S K CHUANG)

for Controller, Centre for Health Protection Department of Health

No comments: