# 5660
Dr. York Chow, who is an orthopedic surgeon by profession, has been the Secretary for Food and Health in Hong Kong since 2007.
Today (June 29th), the Health Secretary has responded at some length to two urgent questions posed by members of Hong Kong’s LC (Legislative Council) on the ongoing Scarlet Fever outbreak.
Under normal rules of procedure, members of the LC must give notice of a question 7 `clear days’ in advance of a public meeting, but under Rule 24(4) a member may ask permission to pose a question if it is `of an urgent character and relates to a matter of public importance’.
Both questions, submitted by Hon Chan Hak-kan and Hon Cheung Man-kwong, had some overlap – particularly in regards to the level of SF (Scarlet Fever) activity being reported on the Chinese mainland and in neighboring countries.
York Chow conceded that the current outbreak is likely a`regional phenomenon’ - and that the Hong Kong Centre for Health Protection (CHP) is in contact with other health departments in the region and is aware of `a simultaneous increase of SF cases in Mainland China and Macao’.
But beyond that, he was unable to offer any specifics, noting that scarlet fever is not a notifiable disease in many neighboring countries.
When asked to characterize the genetic changes to the bacterium, along with changes to treatment due to antibiotic resistance, he replied:
As of June 28, there have been four SF cases with complications and two fatal cases of SF in Hong Kong. Details are set out in the Annex.
Laboratory investigation of the two fatal cases showed that two different strains of Group A Streptococcus were involved (emm type 1 and emm type 12).
CHP, the Hospital Authority and the University of Hong Kong (HKU) have been working in collaboration on laboratory testing for the bacterium causing SF, including tests on antimicrobial resistance, serotypes, virulence genes and the new gene fragment reported by HKU. Further studies will be done to characterise the role and prevalence of the new genetic change and to project the outlook of the outbreak over time.
So far, all the Group A Streptococcus isolates detected are sensitive to penicillin, meaning that all antibiotics belonging to the penicillin group or first generation cephalosporins can effectively treat SF.
Local antibiotic resistance surveillance data showed that around 50-60% of Group A Streptococcus isolated in 2011 are resistant to erythromycin (which also predicts resistance to azithromycin and clarithromycin). As a result, antibiotics belonging to the macrolide group (e.g. erythromycin) should not be used as empirical treatment for SF.
The health secretary warned that this outbreak was expected to persist into the summer, and that the CHP has stepped up publicity and health education efforts.
The complete Q&A’s may be viewed in press releases from the Hong Kong government.
LC Urgent Q2: Scarlet fever in Hong Kong and neighbouring areas
In his remarks, York Chow stated that:
Health authorities of Guangdong, Hong Kong and Macao have exchanged the surveillance data and the analysis of SF in view of the rising number of cases this year.
Unlike Hong Kong, mainland Chinese officials have a history of holding infectious disease information close to the vest.
So it is disappointing, but not entirely unexpected, that we are not getting any specific numbers from the mainland.
Hong Kong, meanwhile, has released their latest daily update, indicating 17 new cases and 1 new outbreak in the last 24 hours.
