# 6361
We’ve some additional information this morning on Hong Kong’s first human H5N1 infection in 18 months (see HK Raises Alert Level: Toddler Hospitalized With H5 Flu), among them confirmation that the virus is indeed, H5N1.
Yesterday’s raise in Hong Kong’s pandemic response level – from ALERT To SERIOUS – is an intermediary step, and as outlined in Hong Kong’s Preparedness Plan for Influenza Pandemic, is implemented under one of two scenarios:
Serious Response Level
4. Serious Response Level depicts two possible scenarios. The first scenario depicts confirmation of HPAI outbreaks in the environment of or among poultry population in retail markets, wholesale markets or farms in Hong Kong due to a strain with known human health impact. Upon the advice of DAFC or Director of Food and Environmental Hygiene, SFH will activate this Response Level.
5. The second scenario depicts the confirmation of human case(s) of avian influenza in Hong Kong without evidence of efficient human-to-human transmission. Upon the advice of DoH, SFH will activate this Response Level.
The detection of a single (imported) case of H5N1 infection falls under the second scenario above. Were efficient H-2-H transmission suspected, the response level would have been boosted to the EMERGENCY level instead.
Hong Kong was the site of the first human cluster of H5N1 infection 15 years ago and bore the brunt of the SARS outbreak in 2003. And in 2010, they saw their first human infection from the H5N1 virus since 2003.
Authorities there are, quite understandably, quick to act whenever there is even a hint of threat from a novel flu virus.
First, an update on the patient’s condition, and that of family contacts, and then some local responses, including comments by York Chow.
Latest laboratory results received by the Centre for Health Protection (CHP) of the Department of Health today (June 2) confirmed that the two-year-old boy was infected with Influenza A (H5N1).
The boy is put under intensive care treatment in Princess Margaret Hospital (PMH) and is now in serious condition. Latest radiological imaging studies showed obstructive hydrocephalus. Investigation is underway for the underlying cause.
Preliminary investigation revealed that the boy had visited a wet market with live poultry in Guangzhou in mid-May.
"The boy's parents are all along asymptomatic, which means the chance of a human-to-human transmission is slim," a CHP spokesman said.
The parents are being quarantined at PMH and nasopharyngeal aspirates taken from them were tested negative. Laboratory tests of two health care workers of the private clinic and another patient who attended the same clinic were also tested negative for Influenza A (H5).
As at 4pm today, a total of six public enquiries have been received on the DH hotline (2125 1111).
Investigation continues.
Ends/Saturday, June 2, 2012
Issued at HKT 16:38
Hong Kong’s Secretary for Food and Health (SFH), Dr. York Chow, made some extensive remarks in English during a press conference earlier today regarding the 2-year-old boy from Guangdong Province.
His remarks appear on the info.gov.hk website.
(June 2):
Reporter: (On the condition of the patient.)
Secretary for Food and Health: The condition of the patient is not serious. For our contingency plan, whenever there is a local case of avian influenza in Hong Kong, we need to raise our alert to the serious level. That is the reason why I have just announced all those measures that we had to take, including raising the alert in the public hospitals; checking the imports of live chickens; inspecting our farms and birds and so on. We think it is an important measure to take for particularly Hong Kong, because we had experiences of outbreaks of avian influenza in Hong Kong. For this particular case, so far the chance of it being spread to other humans is relatively low. But we still need to go through the whole process of analysing the origin and channel of the infection and have to study the virology of the virus.
Reporter: (On temperature and health check at the border.)
The temperature check is only able to detect people with high temperature. With anybody who is suppressing their body temperature with medicine, it is always difficult to detect. What is more important for the whole exercise of checking body temperature is to alert our tourists and also our Hong Kong returnees to be aware of their health. In case there are any symptoms or signs, they should seek medical treatment. Everyday, we are able to detect more than 10 to 20 people with high temperature passing through our border. We do not quarantine them or take them to hospitals. We will check their contact history to see whether they have been exposed to poultry or birds and so on; and what type of infection they are likely to have. Many of them follow our advice and go to seek medical treatment.
Secretary for Food and Health:
Reporter: (On banning live poultry imported from the Mainland.)
We have done a lot in the last few years in controlling avian influenza in our poultry, including those imported from the Mainland as well as from our local farms. We are also handling our chickens at the retail level with the "no retention overnight" policy. These are effective policies as far as controlling avian influenza in Hong Kong is concerned. But as far as the whole environment is concerned, as you know that this year we have 20 dead wild birds tested positive for carrying the H5N1 virus. It means that if the virus is always in existence in our natural environment, although they might not be affecting our poultry, might not be affecting our humans, but they are there. In all aspects, we have to be very cautious all the time to ensure that all the measures we took are being followed by the respective stakeholders and Government regulators.
Secretary for Food and Health:
Reporter: (On whether there will be an import poultry ban.)
Secretary for Food and Health: I do not see any reason for changing our supply of live poultry at the moment. But we will of course always be vigilant about the situation. If we find anything that would increase the risk of H5N1 infection on humans, we will of course take extra measures.
Reporter: Do Hong Kong people need to be worried about the incident?At the moment, it is an isolated case. We feel that there is no need for panic among Hong Kong citizens. We have measures to tackle all types of infectious diseases, including controlling avian influenza through various means such as our control at poultry farms and retail level and so on. We also have very good diagnostic tools within the health care system. All the hospitals are equipped to test influenza virus by a fast test and are able to alert within a few hours. All in all, the only message I like to advise the public is to always maintain a good level of personal and environmental hygiene. When you visit other places outside Hong Kong, be careful of those wet markets and places where there might have poultry. It is always more risky when you get into a large concentration of animals if you do not know their health status.
Secretary for Food and Health:
Reporter: (On transmission mode of the virus.)
Secretary for Food and Health: For all experiences, the most common course of transmission is from infected poultry to human. Infected poultry means that the chicken is usually still alive. It is very rare that dead chicken or chilled or frozen chicken would transmit the virus to humans.
(Please also refer to the Chinese portion of the transcript)Ends/Saturday, June 2, 2012
Issued at HKT 14:53
And finally, a statement from the Hospital Authority on their ramped up surveillance, looking for additional potential infections.
Hospital Authority enhanced surveillance programme for patient with influenza symptom
The following is issued on behalf of the Hospital Authority:
The Central Committee on Infectious Diseases & Emergency Responses of the Hospital Authority (HA) held a special meeting today (June 2) afternoon to discuss and review infection control measures of activation of Serious Response Level in public hospitals after confirmation of an Influenza A (H5N1) case. The HA also implemented an Enhanced Surveillance Programme for patient with influenza symptom.
The HA spokesman reiterates that hospital staff at Accident & Emergency Departments and general outpatient clinics were reminded to be vigilant to patients. Triage assessment and appropriate segregation at waiting areas would be arranged.
Under the Serious Response Level, more stringent infection control measures will be enforced in public hospitals, which include no visiting at isolation wards unless on compassionate ground. For all acute hospitals, visiting hours would be not more than 2 hours per day and not more than 2 visitors per visit, and not more than 4 hours per day for all convalescent hospitals. Volunteering service in hospitals would be suspended. Visitors to public hospitals and clinics are advised to put on surgical masks if they have respiratory infection symptoms and perform hand hygiene before and after visiting patient areas.
According to the spokesman, HA would continue to work closely with the Centre for Health Protection in monitoring the latest situation and keep the general public as well as healthcare workers updated of the development on a regular basis.
Ends/Saturday, June 2, 2012
Issued at HKT 19:04
