Fever Checks At Hong Kong School – Credit HK Govt.
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Two related stories out of Hong Kong this morning.
First, the risk assessment from Hong Kong’s SCEZD (Scientific Committee On Emerging And Zoonotic Diseases) on the emerging H7N9 virus, and then some basic hygiene advice from Dr Leung Ting-hung to the public on preventing the spread of the virus.
Although considerably more restrained than the risk assessment recently published in the Chinese Science Bulletin: Early H7N9 Risk Analysis, the SCEZD concedes that additional human infections, and expansion of the this outbreak are both likely, and that while, ` . . . risk of human-to-human transmission appears to be low, the actual risk is currently unknown . . . ‘
One should not be deceived by their seemingly low-keyed approach, as Hong Kong’s CHP has a lot of experience dealing proactively with emerging infectious disease outbreaks. Their bitter experience with SARS in 2003 (see SARS And Remembrance) pretty much ensures that they take this H7N9 threat very seriously.
30 April 2013
The Scientific Committee on Emerging and Zoonotic Diseases (SCEZD) of the Centre for Health Protection (CHP) of the Department of Health today (April 30) convened a meeting to assess the risk and local response in view of the recent human cases of avian influenza A(H7N9) in the Mainland.
The SCEZD reached a consensus view that the emergence of human infections with the novel avian influenza virus reported in the Mainland since March 31 is of concern as further human sporadic infections and expansion of geographic spread in the Mainland and other countries/areas is anticipated.
At the meeting, the members of the SCEZD agreed that the current epidemic strain of the avian influenza A(H7N9) virus is a novel reassortant avian influenza virus which does not cause illnesses in birds, but has gained some abilities to cross species barriers, causing sporadic poultry-to-human transmission which may result in severe disease in infected people. Genetic and epidemiological findings showed that patients are likely to be infected through exposure to infected poultry or its contaminated environment such as wet markets. However, the exact source and mode of spread still require further investigations.
While family clusters of infection suggest that limited human-to-human transmission may have occurred in close contacts, exposure to a common source can also be one of the explanations. Hence, the members are of the view that there is no evidence of sustained human-to-human transmission at present but the main concern is whether the virus will further adapt to enable efficient human-to-human transmission, which may result in a pandemic.
Turning to the local response, the SCEZD concurred with the view that the enhanced preventive and control measures for human infection with avian influenza should be continued. Surveillance for human avian influenza A(H7N9) infection is crucial. Although the risk of human-to-human transmission appears to be low, the actual risk is currently unknown and control measures, such as appropriate infection control precautions, isolation of suspected cases and quarantine of close contacts of confirmed cases, should be enforced.
As for treatment of patients infected with the avian influenza A(H7N9) virus, the members considered that the avian influenza A(H7N9) virus is expected to be sensitive to the neuraminidase inhibitors, oseltamivir (Tamiflu) and zanamivir (Relenza). Confirmed or highly suspected cases should receive antiviral treatment with a neuraminidase inhibitor as early as possible.
The SCEZD also recommends to continue intensive surveillance for avian influenza A(H7N9) virus infection in both humans and poultry/birds; maintain a high level of alert, preparedness and response for avian influenza A(H7N9) virus infection; strengthen publicity and public education on the prevention of the disease; and maintain close liaison with international and Mainland health authorities and local academics to monitor the latest developments. In addition, the SCEZD agrees that further studies should be carried out to fill the knowledge gaps and close monitoring of the progress of development of an H7N9 vaccine is required.
Ends/Tuesday, April 30, 2013
In a related press release, Hong Kong’s Health chief, Dr Leung Ting-hung, upon leaving this meeting called for strict personal and environmental hygiene in the coming months to prevent the spread of the virus.
Health chief urges strict hygiene
April 30, 2013
Centre for Health Protection Controller Dr Leung Ting-hung has called for strict personal and environmental hygiene, as the next six months will be critical in the development of the avian influenza A(H7N9) virus.
He made the appeal after today's Scientific Committee on Emerging & Zoonotic Diseases meeting, with its Chairman Prof Yuen Kwok-yung.
They said while the public should not be overly worried about the situation, the possibility of H7N9 being imported to Hong Kong from the Mainland cannot be ruled out, so people should maintain good personal hygiene by washing hands frequently especially before touching their eyes, nose and month, and to avoid contact with live poultry.
Dr Leung said the coming months will be critical in the virus' development, and it cannot be predicted whether and when it will be transmitted among humans, therefore good personal and environmental hygiene must be kept at the highest standard at all times.
He said measures are already in place against any possible H7N9 case spreading in Hong Kong, including stringent monitoring of suspected cases and strengthening exchange of information with international and Mainland health organisations and authorities.
A working group will formulate medical strategy and make suggestions to frontline doctors on how to treat such cases.
More manpower has been deployed to boundary checkpoints to monitor the body temperature of travellers.
Prof Yuen said so far the genetic and epidemiological data indicates low efficiency in human to human transmission of the virus. However, as H7N9 does not kill poultry, it has been difficult to monitor, adding public vigilance must be maintained.
