Friday, January 23, 2015

Hong Kong Reports 2nd Imported H7N9 Case Of The Season



# 9618

Reports have been filtering through the Chinese language Hong Kong press for about an hour, but I’ve held off until I could find something  official.  


We saw this season’s first imported case late in December (see Hong Kong Official Statements On H7N9 Case) which prompted the raising of their  Influenza Pandemic Response Level on December 27th.


Hong Kong’s CHP has just posted the following detailed statement:



CHP investigates imported human case of avian influenza A(H7N9)

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 23) investigating the second imported human case of avian influenza A(H7N9) in Hong Kong this winter.

"Based on the seasonal pattern, it is likely that the activity of avian influenza viruses might further increase in winter and heightened vigilance is warranted. As the Serious Response Level under the Preparedness Plan for Influenza Pandemic remains activated, we again urge the public to maintain strict personal, food and environmental hygiene both locally and during travel," a spokesman for the CHP said.

Epidemiological investigations and control measures

The male patient, aged 79 with good past health, has presented with runny nose, sore throat and cough with sputum since January 19 and consulted a private doctor on the same day. He then attended the Accident and Emergency Department (AED) of Alice Ho Miu Ling Nethersole Hospital yesterday (January 22) and was found febrile. He has been transferred to the Hospital Authority Infectious Disease Centre in Princess Margaret Hospital for further management and isolation and has been in stable condition all along.

His nasopharyngeal aspirate tested positive for avian influenza A(H7N9) upon preliminary laboratory testing by the CHP's Public Health Laboratory Services Branch.

Initial epidemiological investigations revealed that the patient had travelled to Zhangmutou, Dongguan, Guangdong, on January 5 on his own during which he had visited a wet market with live poultry stalls but with no direct contact with poultry. He returned to Hong Kong on January 19 via Lo Wu Control Point. Based on information available thus far, it is classified as an imported case. Investigations are ongoing.

Contact tracing conducted so far located two close contacts who accompanied the patient to the AED.

(A) Close contacts
     Close contacts will be put under quarantine and prescribed with antiviral presumptive treatment until the completion of the five-day treatment or ten days after last exposure to the patient, whichever is earlier. They include the patient's son and a female family member who are asymptomatic.
(B) Other contacts
     Tracing of other contacts, including relevant healthcare workers, ambulance officers, immigration officer and the doctor whom the patient consulted as well as relevant staff and clients, is underway. Other contacts will be put under medical surveillance.
     The CHP is communicating with the relevant Mainland health authority to follow up the situation during the patient's stay in the Mainland.

Enhanced surveillance
     The CHP has enhanced surveillance of suspected cases in public and private hospitals, and activated electronic reporting system to monitor cases real-time with the Hospital Authority. Clinicians should pay special attention to patients with fever or influenza-like illness who visited wet market with live poultry or had contact with poultry in affected areas within the incubation period, that is ten days before onset.

Letters to doctors, hospitals, kindergartens, child care centres, primary and secondary schools as well as residential care homes for the elderly and the disabled will be issued to alert them to the latest situation.

The case will be notified to the World Health Organization, the National Health and Family Planning Commission (NHFPC), the health authorities of Guangdong and Macau, and the quarantine authority of Shenzhen.

To date, 506 cases have been reported by the Mainland health authorities since March 2013, including 489 cases in the Mainland and 17 cases exported to Hong Kong (12 cases), Taiwan (four cases) and Malaysia (one case).

(Continue . . .)

Complicating matters, Hong Kong is in the midst of a particularly nasty seasonal flu outbreak, with Dr. Ko Wing-man, Hong Kong’s Secretary of Food & Health stating in a press conference today:


However, in the past few days, there were reports of a more drastic increase in the number of patients requiring intensive care. If this trend is going to continue, we might then expect a particular high peak in this season.

I am more concerned about the capacity of the Accident and Emergency Departments and Intensive Care Units in public hospitals. We will be liaising with the Hospital Authority (HA) to make sure that they have the measures in hand to address the situation. For individual citizens, it is more important to look at how to prevent or minimise the risk of contracting the illness.

This must be done through healthy lifestyle and emphasis in personal hygiene and hand washing. We also advise people to take influenza vaccination. Although the protection rate of the vaccine being used this year is apparently lower than that in past years, experts are of the opinion that having vaccination is still better than not.

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