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The following is the transcript of the Secretary for Health Welfare and Food, Dr Yeoh Eng-kiong, at the press briefing on atypical pneumonia this afternoon (March 19):
Dr Yeoh: The total figures that we have today are 150 individuals who are either have pneumonia or kept under observation, the similar number yesterday was 123, an increase of 27. Patients with pneumonia, we have now 145 individuals, the comparative figure yesterday was 111. So we have an increase of 27 in total while an additional 34 with pneumonia. So I'll just briefly go through the numbers, where these come from. So, we now have 145 individuals with pneumonia and another five individuals that we are keeping under observation. So these are the sums. The comparative figures yesterday were 111 and 12 under observation. I'll give you the global figures. I think we don't need to go down which hospital they're treated in.
Just to go into the background, because the interest would be in the increases in the number of various clusters. Remember we had six clusters of cases. In all the five clusters - these are the clusters other than the Prince of Wales - there's only been one increase in the healthcare workers that this was related to the cluster within the general practitioner clinic. So there is just one additional health worker that has been infected and has come down with pneumonia.
The other increases for all six clusters, that's healthcare personnel, the total figure yesterday that we suspect has come down with the infection was 67, of which 55 had pneumonia. Today those total numbers are 75 of all the healthcare personnel and 70 with pneumonia.
The increases in cases had mainly been in the Prince of Wales cluster. So remember within the healthcare workers, there were six groups of patients. The increases have practically all been in the Prince of Wales cluster, so people are continuing to get pneumonia. And the only additional case for the other clusters is in the TB clinic.
Regarding the medical students, there has been no increase in the number. It still remains at 17.
With the relatives and other patients/close visitors, yesterday we had 39 who had pneumonia. The figures today are now 58, so there is an additional 19. Of the 19, we have included seven patients who were the so-called index patients. So the sums that we gave to you yesterday did not include the seven original patients that had the illness. The six patients were the ones in the various clusters, so the Prince of Wales Hospital, Kwong Wah Hospital, the Pamela Youde Eastern Hospital, the GP (general practitioners) group, the private hospital and the Queen Elizabeth Hospital, so there were six original patients who transmitted the infection to healthcare workers and their relatives. So although the six were originally not included in statistics yesterday, we have now included them in the other categories. Because originally when we presented them they were in the context of the original patients, so I think to give you the total figures of the number of people affected, we think we should include all those.
And there's a seventh patient who we included and this was the businessman who was transferred from Vietnam. He died in the hospital and we believe that he is the same category. So those seven are included now, so of the 19, seven are accounted for from these.
In the Prince of Wales group, we have six more patients who are not healthcare personnel that have now been hospitalised and have pneumonia and these are those who were in contact with the patients or visitors who were in close contact with the patients and the other secondary contacts. There are no increases in the Princess Margaret and the Kwong Wah clusters. In the Pamela Youde cluster, there are two more relatives or close contacts. In Queen Mary there is one more. And we also have two new patients who present with similar symptoms - a man and his nephew. So these are also close family contacts, but they have not infected any of the healthcare personnel, so we now include all of those in this 58. So the total numbers are150 that are under observation, of which 145 have pneumonia and five are under observation.
We also had two patients that were discharged, but these are the total number of cases, so of these 150 patients, two patients have improved and have been discharged from hospital. We also have five patients that died. Of the five patients that died, three were the original patients that were treated for pneumonia and died of the pneumonia.
The first patient was the doctor who came from Southern China to Hong Kong and he died and the second patient was the businessman who was transferred from Hanoi to Hong Kong. The patient died. The third patient that passed away was the original patient in the Pamela Youde Eastern Hospital. He was admitted in a fairly poor condition and he passed away. So three of the original patients, the ones that we think are the so-called index patients, the ones who brought the infection in then transmitted it to other people, have passed away.
We also have two patients in the Prince of Wales who passed away. These two patients were the contacts of the original patients that we've said were the source of the infection. And these patients were obviously living in the same ward and the same areas and in close contact with that patient. But these two patients had very severe illnesses from other causes. One had heart disease and the other had liver disease, very advanced disease. So they were very susceptible to infection. So whether the death could be ascribed to the pneumonia, we do not know, because the original illness itself is very severe.
So we have then to categorise five deaths. Three deaths are very clearly related or much more clearly related due to the pneumonia and for the other two, the pneumonia could have contributed. So that is why yesterday the Hospital Authority could not clarify these deaths. But they were included in the categorisation, so certainly these were patients that we suspect had this unique form of pneumonia, but they were patients that had other reasons for poor health.
(Break for Chinese statement)
Obviously we are very, very encouraged that the Chinese University has been able to detect this virus which belongs to the paramyxoviridae virus family, which is now thought to be the cause of this disease. In parallel, there have also been reports in Germany and Taiwan that they have found a similar virus. But I think all these need to be verified and confirmed by the World Health Organisation to make sure that we have the same virus. Because in these types of studies it takes a lot of time - first you need to find a virus, then you need to confirm that it is the virus that has caused the disease, and then to understand the behaviour of this virus. So there is still a lot of work to be done.
But this is a virus that causes respiratory infection and is thought that it's a variant of a respiratory virus that causes infections in children. Most children are exposed early on, so it is a variant of the virus and it is very, very peculiar that the variant of the virus that we see today is all in adults. So the behaviour of the virus is quite strange. And remember we talked about two possible causes. One is a new virus that may be giving you this very unique manifestation. The second is a virus that is already in existence, but has mutated or changed as a variant and caused a different reaction.
So the present identification of this variant seems to support this theory that it is more likely to be a variant of a virus that is already in existence but is changing its pattern of behaviour.
And this virus is an RNA virus and as Professor Tam was saying, the drugs that we're using, it seems to be consistent with our hypothesis and with the classification of this virus. Because RNA viruses theoretically can be treated with ribavirin, the drug we are using. And the immune response that we are seeing in the adults is also consistent with the steroids that we are giving. So it seems that if this is the virus that is causing the infection, the combination of treatments that we are using seems to be designed for it.
But obviously in many of the viral infections, these anti-virals are not to be given to everyone. So even if we can verify and prove it is a virus, it doesn't mean that everyone is going to go on ribavirin because ribavirin is a very toxic drug and it is not a drug that you give to everyone. So it's only for the severe cases.
And so far our responses have been really quite encouraging. Most of the health workers that we have given it to have shown responses so fortunately we've been able to help the healthcare staff through this period. Obviously we still have to be very cautious as it is still early days.
(Please also refer to the Chinese portion of the transcript)
End/Wednesday, March 19, 2003
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