Avian Flu Diary: HK Govt To Make `Severe Respiratory Disease associated with a Novel Infectious Agent' A Statutorily Notifiable Disease

Credit - HK Gov

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Although we still don't know the cause, the source, or the extent of the unidentified pneumonia outbreak in Wuhan China, public health officials in Hong Kong, Taiwan, Macao, and even the United States are taking this situation seriously (see CDC Issues Level 1 (Watch) Travel Notice For Unidentified Pneumonia - Wuhan, China).

While the hope is this outbreak will end with the closure of the Wuhan Seafood market (which sold many types of animal products), we'd have to go several weeks without seeing any new cases before that assumption could be made.

And even if the current Wuhan outbreak is quelled, if this `new' virus is spreading in animals, it could conceivably pop up again someplace else.

With so many unknowns, and the possibility that the current situation could worsen, yesterday Hong Kong officials signaled their intent to increase their legal authority to isolate or quarantine suspected cases and to deal with any potential outbreak.

Today, Hong Kong's government published the following statement on making "Severe Respiratory Disease associated with a Novel Infectious Agent" a statutorily notifiable infectious disease.

Government to gazette inclusion of "Severe Respiratory Disease associated with a Novel Infectious Agent" as statutorily notifiable infectious disease under Prevention and Control of Disease Ordinance

The Government will publish the Prevention and Control of Disease (Amendment) Regulation 2020 and the Prevention and Control of Disease Ordinance (Amendment of Schedule 1) Notice 2020 in the Gazette tomorrow (January 8) to include "Severe Respiratory Disease associated with a Novel Infectious Agent" as a statutorily notifiable infectious disease set out in Schedule 1 of the Prevention and Control of Disease Ordinance (Cap. 599) and amend its subsidiary legislation, namely the Prevention and Control of Disease Regulation (Cap. 599A). The Amendment Regulation and the Notice will take effect on the same day as publication in the Gazette.

A Government spokesman today (January 7) said, "Including 'Severe Respiratory Disease associated with a Novel Infectious Agent' as a statutorily notifiable infectious disease will strengthen Hong Kong's capability to enhance surveillance of this disease, and is important in the prevention and control of infectious diseases in Hong Kong."

"Severe Respiratory Disease associated with a Novel Infectious Agent" refers to a cluster of viral pneumonia cases of unknown cause occurring in Wuhan, Hubei Province, since December last year. Since the causative pathogen is still unknown, the prevention work focuses on identifying cases with possible exposure to the high-risk area, i.e. Wuhan, and promptly carrying out public health measures to prevent the spread of disease to Hong Kong.

"The Mainland health authorities are still investigating the causative pathogen of the disease. Once a specific infectious agent related to 'Severe Respiratory Disease associated with a Novel Infectious Agent' is identified, the name of the disease in Schedule 1 will be suitably revised and its related infectious agent will be added to Schedule 2 to the Ordinance," the spokesman added.

The reporting details of "Severe Respiratory Disease associated with a Novel Infectious Agent" are as follows:

Clinical Description: According to announcements from the Mainland health authorities, a number of viral pneumonia cases with unknown cause related to a seafood wholesale market in Wuhan have been identified since December 2019 in Wuhan, Hubei Province. Symptoms have mainly been fever while a few patients have presented with shortness of breath.

Reporting Criteria: Medical practitioners are requested to make a report to the Centre for Health Protection (CHP) for further investigation if they encounter an individual with fever and acute respiratory illness, or pneumonia, and who had visited Wuhan (regardless of whether the individual had visited wet markets or seafood markets there) within 14 days prior to the onset of symptoms.

Laboratory Criteria: Not applicable. (Since the causative pathogen is still under investigation by the Mainland health authorities, there is no laboratory test for the disease at present.)

Case Classification:

Suspected case: A case that fulfils the reporting criteria.

Probable case:

A case that fulfils the reporting criteria;

Has pneumonia confirmed by chest X-ray; and

Falls into one of the following circumstances: had either (a) exposure to the seafood wholesale market in Wuhan; or (b) close contact with a pneumonia case with unknown cause and epidemiologically linked to the above market, within 14 days before onset of symptoms.

3. Confirmed case: Not applicable.

The spokesman explained, "The amendment is made since 'Severe Respiratory Disease associated with a Novel Infectious Agent' is currently not a notifiable disease under the Ordinance, so the Department of Health (DH) does not have the legal power to effectively handle confirmed or suspected cases if the patients are not co-operative and refuse to, for example, be isolated or quarantined."

The spokesman said, "According to the Regulation, medical practitioners are required to notify the DH if they have reason to suspect any case under the scheduled infectious diseases set out in Schedule 1 to the Ordinance. The reporting of infectious diseases is an important element in the surveillance, prevention and control of the spread of infectious diseases. As for 'Severe Respiratory Disease associated with a Novel Infectious Agent', suspected cases are those that fulfil the above reporting criteria. The CHP will continue to maintain close liaison with the National Health Commission and closely monitor the latest developments of the cluster of pneumonia cases in Wuhan. The reporting criteria will also be adjusted in a timely manner according to the prevailing situation.

"Apart from setting out the control and prevention measures of the spread of infectious diseases in Hong Kong, the Regulation also provides measures to prevent the introduction into and transmission from Hong Kong of specified diseases. Specifically, the Government can prohibit cases of a specified disease and their contacts from leaving Hong Kong as a measure to prevent a specified disease. Hence, the addition of 'Severe Respiratory Disease associated with a Novel Infectious Agent' to the list of specified diseases helps enhance the work of prevention and control of infectious diseases being exported from Hong Kong."