Credit http://www.news.gov.hk
# 7053
Earlier today (see Hong Kong: SFH On H7N9) we learned that Hong Kong has activated their `Alert Response Level’ as part of their Framework of Government’s Preparedness Plan for Influenza Pandemic.
This plan provides for three levels of Response, with `ALERT’ being the lowest level, followed by SERIOUS and then EMERGENCY.
The ALERT Level is activated when:
2. Alert Response Level depicts the scenarios of confirmation of highly pathogenic avian influenza (HPAI) outbreaks in poultry populations outside Hong Kong; confirmation of HPAI in Hong Kong in imported birds in quarantine, in wild birds, in recreational parks, in pet bird shops or in the natural environment. Upon the advice of the Director of Agriculture, Fisheries and Conservation (DAFC), the Secretary for Food and Health (SFH) will activate this Response Level.
3. Another scenario depicts confirmation of human case(s) of avian influenza outside Hong Kong. SFH will activate this Response Level upon the advice of Director of Health (DoH).
Today’s developments satisfy section 3 of the plan, and so the lowest level response has been activated.
One of the steps being taken is enhanced surveillance at Hong Kong’s points of entry, as evidenced by the following report from http://www.news.gov.hk.
Shanghai, Anhui travellers monitored
April 02, 2013
Announcements will be made at Hong Kong's entry points appealing to travellers from Shanghai and Anhui to report to port health officers if they feel unwell.
Centre for Health Protection Controller Dr Leung Ting-hung said leaflets will also be given to travellers reminding them to inform local staff or health officers at immigration checkpoints if they feel ill.
Dr Leung said the H7N9 virus is an avian flu, but there is no evidence it has the potential for human-to-human transmission.
He said he has written to all doctors in Hong Kong reminding them to report any suspected cases to the centre, which is monitoring the situation.
Speaking at the same briefing, Hospital Authority Chief Infection Control Officer Dr Dominic Tsang said hospital accident and emergency departments and outpatient clinics will watch for fever patients.
Those with symptoms will be isolated, and healthcare teams will be provided with infection control equipment.
Dr Tsang said an avian flu rapid test result can be released within a day.
While the screening of inbound passengers for disease symptoms is quite often the first visible public health response when an emerging virus threatens, its track record of preventing disease entry into countries is spotty at best.
Last April, in EID Journal: Airport Screening For Pandemic Flu In New Zealand, we saw a study that found the screening methods used at New Zealand’s airport were inadequate to slow the entry of the 2009 pandemic flu into their country, detecting less than 6% of those infected.
New Zealand did not employ thermal scanners, although countries that did, didn’t fare much better.
In December of 2009, in Travel-Associated H1N1 Influenza in Singapore, I blogged on a NEJM Journal Watch article on of a new study that has been published, ahead of print, in the CDC’s EID Journal entitled:
Epidemiology of travel-associated pandemic (H1N1) 2009 infection in 116 patients, Singapore. Emerg Infect Dis 2010 Jan; [e-pub ahead of print]. Mukherjee P et al
Travel-Associated H1N1 Influenza in Singapore
Airport thermal scanners detected only 12% of travel-associated flu cases; many travelers boarded flights despite symptoms.
Often these measures are of greater use in reassuring the public, than they are in actually preventing disease entry into a country or region.
Despite a low likelihood of success, there may be some value in trying to limit the number of infected persons arriving into a country. That may slow the spread of an illness and could allow more time to develop and deploy a vaccine.
Despite great leaps in technology in recent years, we possess no technological shield that would keep an emerging pandemic virus at bay.
Making it desirable that – whenever possible – outbreaks of emerging viruses are quashed as quickly as possible at the source, before they can board an airplane and spread inexorably around the globe.
