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Following is a question by the Hon Yeung Yiu-chung and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (June 11):
Question:
Will the Government inform this Council:
(a) whether it has a mechanism for the surveillance, early warning, treatment and study of infectious diseases; if it has, of the details of the mechanism;
(b) of the rationale and details of the study on setting up in Hong Kong an organisation similar to the Centres for Disease Control and Prevention in the United States of America; whether the functions of this organisation will overlap with those of the Department of Health; if so, of the improvements to be made by the authorities; and
(c) of the details of the education and training for the prevention, control and treatment of infectious diseases?
Reply:
(a) The Government has established mechanisms on communicable disease surveillance and response, treatment and research through collaboration with the Hospital Authority (HA), medical profession, academic sector and overseas health authorities.
The Department of Health (DH) has a well-established surveillance system on communicable diseases. Under the Quarantine and Prevention of Disease Ordinance (Cap. 141), there are 28 notifiable infectious diseases, and medical practitioners are required to notify DH of notifiable infectious diseases. Moreover, they are encouraged to report to DH other infectious diseases of public health significance or unusual illness patterns.
DH also operates a sentinel surveillance system through a network of hospitals, clinics and laboratories in the public and private sectors to monitor the trend of influenza-like illness, hand, foot and mouth disease, antibiotic resistance, acute conjunctivitis and acute diarrhoeal diseases in the community. DH also works closely with the Education and Manpower Bureau and Social Welfare Department to disseminate guidelines on prevention of communicable diseases to institutions including childcare centres, kindergartens, schools and elderly homes and to remind them to report to DH any outbreaks of communicable diseases.
When DH receives report of infectious diseases, epidemiological investigations will be carried out immediately to identify the source of infection, to perform active case finding and contact tracing, to provide health advice and chemoprophylaxis if indicated, and to institute appropriate control measures to prevent spread of the disease. Analysis of the information collected, and early warning if necessary, will be disseminated to the health care professionals and the public through different means such as fax and press release. They may also be published in bulletins and on DH's website.
The Government has set up various expert working groups (e.g. on avian influenza and severe acute respiratory syndrome (SARS)) and interdepartmental coordinating committees (e.g. on SARS, dengue fever, cholera of enteroviral infection) to facilitate disease control and research. In dealing with the recent large scale outbreak of SARS, DH retrieves online real time patient data from the eSARS system developed in the HA and, working in collaboration with the police, makes use of the Police's Major Incident Investigation and Disaster Support System (MIIDSS) for contact tracing and to provide early alert of potential clusters of SARS which warrant intervention and investigation. A Multi-disciplinary Response Team for SARS has also been set up involving the Food and Environmental Hygiene Department (FEHD), Housing Department, Buildings Department, Electrical and Mechanical Services Department, Environmental Protection Department and Drainage Services Department to address any environmental factors identified in the investigation of SARS cases.
Treatment of communicable diseases is generally based on best available research findings. When these are not available, we will rely on any empirical evidence and/or expert advice to derive treatment protocols which are in the best interest of patients.
Study of communicable diseases is part and parcel of the work of DH and HA. Research in this field is also carried out by the tertiary institutions.
On the international front, Hong Kong keeps abreast of latest developments through regular information exchange and skill transfer with the Mainland, World Health Organization and overseas health authorities.
(b) New emerging communicable diseases, regardless of their places of origin, can soon be of global concern due to the massive international flow of people nowadays. This calls for a new approach for disease prevention and control with global emphasis, such as setting up an organisation similar to the Centres of Disease Control and Prevention in the United States. In studying options for this proposed organisation, we will be examining the roles and functions of DH to ensure there will be no overlap of function. We expect that at the initial stage the organisation's major areas of work will include further enhancing the surveillance, prevention and control of communicable diseases to protect public health, gathering intelligence of diseases from other CDCs around the world and conducting researches to foster new knowledge.
(c) Structured training programmes on epidemiology, communicable diseases control, public health, laboratory technologies etc. are available both locally and overseas. There are also work attachment programmes to overseas health authorities. Moreover, relevant Colleges of the Hong Kong Academy of Medicine conduct academic assessment through fellowship examinations.
On the job training is provided in the DH and the HA through direct supervision, academic meetings, seminars, conferences and training courses. HA adopts a structured and coordinated approach in providing training to its staff on the prevention, control and treatment of infectious diseases and hospital-acquired infections. At present, every acute hospital has an infection control team (ICT), comprising a part-time Infection Control Officer who is a specialist doctor, and one to two full-time Infection Control Nurses. The ICTs organise on a regular basis structured programmes and talks on infection control for all staff in their respective hospital/clusters. In addition, the Queen Mary Hospital, the Prince of Wales Hospital and the Princess Margaret Hospital organise weekly infectious disease workshops, which are open to all HA doctors, to enhance their knowledge and promote experience sharing in the prevention, control and treatment of infectious diseases.
At the corporate level, the HA Institute of Health Care provides basic infection control training to about 500 nurses each year and infectious disease control training to about 200 nurses. The Task Force on Infectious Disease Control in the HA Head Office also organizes training activities on infectious disease control, including commissioned training by overseas experts.
During the SARS crisis, all HA hospitals have organised infection control training to update all levels and disciplines of staff on infection control guidelines relating to SARS management. These training programmes are also extended to some private practitioners and the staff of private hospitals. In addition, HA has developed a set of e-learning materials entitled "Training on SARS Infection Control Precautions" to facilitate self-learning by all staff members. Reinforcement training sessions for healthcare support workers will also be organised in all seven clusters in June 2003.
In the wake of the SARS outbreak, the Chief Executive announced on April 22, 2003 that the Administration would seek the approval of the Finance Committee (FC) of the Legislative Council to establish a fund for, among others, supporting training or further studies of medical and nursing staff. In this connection, the Government will seek FC's approval on June 20, 2003 on the establishment of a Training and Welfare Fund for HA at $200 million to strengthen training of health care staff of HA to enhance their expertise in infectious disease control in the hospital setting.
At the community level, DH and the FEHD disseminate guidelines on how to maintain personal and environmental hygiene respectively in order to avoid contracting and spreading communicable diseases. These guidelines are available to members of the public and institutions including childcare centres, kindergartens, schools and elderly homes.
End/Wednesday, June 11, 2003
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