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Following is a question by the Hon Emily Lau and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (October 29):

Question :

At the end of last month, two students from the same secondary school were successively confirmed to have contracted open tuberculosis ("TB"), which is highly infectious. In this connection, will the Executive Authorities inform this Council:

(a) whether they have taken measures promptly to enhance efforts to prevent the spread and outbreak of TB in the community; if so, of the details of such measures; if not, the reasons for that;

(b) whether health education programmes on strengthening the prevention of TB will be launched in schools, homes for the elderly and other communities; if so, of the details;

(c) of the measures in place to cope with the outbreak of TB in the community; and

(d) whether they have conducted researches on TB and updated the information on the TB germ regularly; if so, whether the information obtained has indicated mutation of the TB germ into a new strain?

Reply :

(a) The Department of Health (DH) confirmed on October 9, 2003 that two students of a secondary school in Wang Tau Hom had come down with tuberculosis (TB). The two students were given anti-TB treatment once they were confirmed to have TB. They were also given sick leave until they were rendered non-infectious. Upon notification of these cases, we have conducted active case finding in the school and among their family members to investigate the close contacts of the two students to prevent any potential spread of the disease. As at October 17, 2003, about 160 staff and students of the school, as well as the household contacts of the patients, had chest X-ray taken to ascertain that they had not contracted the disease.

Moreover, we have stepped up educational work in the school. DH has organised a health talk on TB prevention and control for staff, and distributed to them video compact discs and pamphlets of health advice on TB. DH also arranged a meeting for the parents and teachers of the school to inform them of the precautionary measures they should take to prevent TB.

(b) DH has been providing health education on TB in schools, elderly homes and within the community on an on-going basis. In 2002, DH has organised over 1,000 health talks related to this subject.

The World TB Day is an annual reminder of the potential threat of TB and need for prevention and effective control. DH maintains websites on the Internet dedicated to TB (www.info.gov.hk/tb_chest and www.cheu.gov.hk for "Healthzone"), TB telephone hotline and a 24-hour health education hotline to facilitate the public to access information on TB. A range of social marketing means is also utilised to publicise related messages.

(c) TB is endemic in Hong Kong but the overall trend is declining. Each year there are about 7,000 cases of TB notified to DH. The majority of persons infected by the TB germ will remain healthy because of natural personal immunity. When the infection is quiescent, the individual has no symptoms, nor will the person transmit the infection to others.

We have put in place a set of comprehensive measures with multi-pronged approach consisting of surveillance, prevention, case finding and contact tracing as well as effective treatment to prevent upsurge of TB cases in the community. BCG (Bacilli Calmette-Guerin) vaccination is given to around 99 per cent of newborn babies. The vaccine is also recommended for children under the age of 15 who have never received it before.

On disease notification and surveillance, TB is a notifiable disease under the Quarantine and Prevention of Disease Ordinance (Cap. 141). A medical practitioner who makes a diagnosis of TB is required to notify the case to the Director of Health. DH staff will trace close contacts of TB patients for assessment and early treatment to contain the spread of the infection. DH runs TB and Chest clinics throughout the territory to provide free medical treatment and assessment. Directly observed anti-TB treatment is highly effective in curing the disease. The Hospital Authority also provides hospital services for TB patients.

In case of a TB outbreak in the community, the above control measures will be intensified to control the source of infection and interrupt its spread. The regimen of surveillance, case-finding contact tracing and supervised treatment has been effective in controlling outbreak of TB in the community.

(d) DH maintains a strong surveillance system for tracking TB epidemiology in Hong Kong and assessing its changing trend. DH and collaborating parties also undertake continuous research on TB. DH's Tuberculosis Reference Laboratory supports the Department's TB and Chest Service in providing a range of laboratory services for the clinical management of TB and organising and participating in TB surveillance and epidemiological studies. In collaboration with the TB and Chest Service, the Laboratory is actively involved in a number of TB clinical trials, as well as epidemiological studies. We have been monitoring the prevalence of multi-drug resistance of TB strains, which has caused concern in the effective treatment of TB, and have found the prevalence of those strains to be declining from the surveillance data in recent years.

End/Wednesday, October 29, 2003

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