Thursday, June 14, 2012

CHP: Updating The Hong Kong H5N1 Case



# 6388



The Centre For Health Protection (CHP) produces an online bi-weekly Communicable Diseases Watch  report which usually features one or more current infectious disease investigations ongoing in Hong Kong.


Today’s issue - Communicable Diseases Watch Volume 9, Number 12, Week 22-23 (May 27, 2012 – Jun 9, 2012) - provides updated details on the condition and investigation into the 2-year old from Guangdong Province who is being treated at the Princess Margaret Hospital for H5N1.




As I wrote last week in H5N1 And The Hong Kong Public Health Response, the CHP does a remarkably thorough job of surveillance and reporting on H5N1 – along with many other public health threats – in Hong Kong.


Would that every public health agency around the globe be as capable, and open.


A few excerpts (slightly reparagraphed for readability) from today’s report, but follow the link to read the article in its entirety:


An imported human case of influenza A(H5N1) infection in Hong Kong, June 2012

Reported by DR HENRY WONG, Medical Officer, and Dr Alice Wong, Senior Medical Officer, Respiratory Disease Office, Surveillance and Epidemiology Branch, CHP.

The Centre for Health Protection (CHP) confirmed a case of imported human influenza A (H5) infection affecting a 2-year-old boy on June 1, 2012. He lived with his parents and maternal grandmother in Gangzhou, Mainland China. He presented with fever and runny nose since May 23, 2012 while in Guangzhou. He sought medical attention but his symptoms persisted. He was then brought to Hong Kong on May 26 and sought medical attention from a private medical clinic in Mong Kok.


Subsequently, he developed febrile seizures and was admitted to Caritas Medical Centre (CMC) Special Care Unit (SCU) on May 28. The clinical diagnosis was encephalitis. His nasopharyngeal aspirate (NPA) collected on May 28 was confirmed to be influenza A virus of subtype H5 by Public Health Laboratory Branch (PHLSB) of CHP on June 1 and later confirmed to be influenza A(H5N1) infection on June 2. The patient was put on Tamiflu and antibiotics. He was transferred to Princess Margaret Hospital (PMH) for isolation and treatment on June 1.


Magnetic resonance imaging (MRI) scan for the brain on June 2 was suggestive of obstructive hydrocephalus. Emergency operation was performed on the same day to relieve the hydrocephalus.

Cerebrospinal fluid specimens taken on June 2, 3, 4 and brain tissue specimen taken on June 2 were tested positive for influenza A(H5) by polymerase chain reaction. He is currently under intensive care treatment in PMH and is in serious condition. His parents were asymptomatic and had been quarantined in PMH until June 9. NPAs taken from them were tested negative for influenza A(H5).


CHP had traced around 90 people who might have got into contact with the patient in the private medical clinic in Mong Kok, ambulance and CMC. NPAs taken from eight contacts including three healthcare workers from CMC, two patients from CMC, two health care workers of the private clinic and another patient who attended the same clinic, who reported respiratory symptoms were tested negative for Influenza A (H5). They were all put under medical surveillance.

Epidemiological investigation revealed that the patient was brought by his mother to buy a live duck in a wet market near his residence in Guangzhou during the period of May 17-19. From May 20-22, he travelled with his parents by private car to Anhui province but had no direct poultry contact during the trip.

(Continue . . . )



This edition of the CDW also contains reports on a case of listeriosis in a tourist, a case of Streptococcus suis infection, as well as a 3-year review of institutional scabies outbreaks in Hong Kong.


You’ll also find a series of charts showing surveillance data on a variety of infectious diseases.



For a listing of weekly, bi-weekly, and other reports from the CHP you can visit their Disease Control Page.