On a day when neighboring Guangdong Province has announced 14 H7N9 cases during the month of December, Hong Kong is reporting their 3rd imported case in less than 3 weeks - all with recent travel history to Gaungdong Province.
The patient denies recent contact with live poultry.
Complicating matters, he sought medical care on January 1st, and checked out of a local hospital against medical advice two days later, and traveled back to Hong Kong.
We also have reports today of new cases in Shandong and Jiangxi Province.
The Centre for Health Protection (CHP) of the Department of Health is today (January 5) investigating an imported human case of avian influenza A(H7N9) in Hong Kong, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.
The male patient, aged 62 with underlying illnesses, departed Hong Kong since December 15 last year and travelled to Zengcheng, Guangzhou. He has developed fever, cough and shortness of breath since January 1. He was admitted to a hospital for treatment in Dongguan during January 2 to 3. The patient discharged himself against medical advice on January 3 and returned to Hong Kong via Lo Wu on the same day. He attended the Accident and Emergency Department of Yan Chai Hospital yesterday (January 4) and was admitted for treatment on the same day. His condition deteriorated today and has been transferred to intensive care unit for further management. The patient is now in critical condition.
His endotracheal aspirate and nasopharyngeal aspirate specimen were confirmed to be positive for influenza A(H7N9) virus by the CHP's Public Health Laboratory Services Branch tonight.
The patient denied recent exposure to poultry or wet market.
His close contacts have remained asymptomatic so far and have been put under medical surveillance. Tracing of his other contacts in Hong Kong is underway.
"The case has been reported to Guangdong and Macau health authorities. We are communicating with the Mainland authority to follow up the patient's exposure and movements in the Mainland. Based on information available thus far, it is classified as an imported case. Epidemiological investigations are ongoing," a spokesman for the CHP said.
"Locally, three confirmed human cases of avian influenza A(H7N9) were recorded in the past three weeks. The activity of avian influenza is expected to increase in winter based on its seasonal pattern. Letters to doctors, hospitals, schools and institutions will be issued to alert them to the latest situation, " a spokesman for the CHP added.
Meanwhile, the CHP is closely monitoring 14 additional human cases of avian influenza A(H7N9) in Guangdong. According to the Health and Family Planning Commission of Guangdong Province’s announcement today, the distribution of the additional cases of last month are as follows: Guangzhou (3), Jiangmen (3), Jieyang (2), Shenzhen (2), Zhaoqing (2), Dongguan (1) and Zhongshan (1).
"The public should avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel, particularly in the upcoming Lunar New Year holidays. If feeling unwell such as having fever or cough, wear a mask and seek medical advice at once. Travellers returning from affected areas should consult doctors promptly if symptoms develop and let them know their travel history," the spokesman said.
The CHP's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up.
The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is underway. The travel industry and other stakeholders are regularly updated on the latest information.
The public should maintain strict personal, hand, food and environmental hygiene and take heed of the advice below while handling poultry:
- Avoid touching poultry, birds, animals or their droppings;
- When buying live chickens, do not touch them and their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume them immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs;
- Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done;
- Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to the toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and
- Wear a mask if fever or respiratory symptoms develop, when going to a hospital or clinic, or while taking care of patients with fever or respiratory symptoms.