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Following is a question by the Hon Chan Yuen-han and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (November 28):
Question:
Regarding pneumococcal diseases, will the Government inform this Council:
(a) given that the Scientific Committee on Vaccine Preventable Diseases under the Centre for Health Protection of the Department of Health pointed out in the Recommendations on the Use of Pneumococcal Vaccines issued in October this year that the average annual incidences of invasive pneumococcal diseases ("IPD") among children aged below two and elderly people above 65 years of age were 7.7 per 100 000 during the period from 2000 to 2004, whether the Government knows the specific method of computing such data and how such method compares with those adopted by other places for computing similar data;
(b) of the incidences of IPD among children of different age groups (including below one year, one to under two, two to under five and five to seven years of age) during the period from 2000 to 2004;
(c) in the past five years, of the respective numbers of children and elderly people infected with invasive Streptococcus pneumoniae together with the number of cases in which the infection had resulted in serious complications, broken down by the type of disease (including meningitis, bacteremia, pneumonia and otitis media), as well as the number of deaths caused by pneumococcal diseases;
(d) whether it knows how the Streptococcus pneumoniae carriage rate among children in Hong Kong compares with those in countries such as the United States, Canada, the United Kingdom and Australia before and after they have carried out pneumococcal vaccination programmes on a national basis; and
(e) whether the Government has analysed the threat posed by Streptococcus pneumoniae to young children in Hong Kong; if it has, of the scope and findings of the analysis; if not, the reasons for that?
Reply:
Madam President,
(a)&(b) The Centre for Health Protection (CHP) of the Department of Health (DH) analysed and assessed the incidence rates of invasive pneumococcal diseases (IPD) in Hong Kong based on the following data provided by the Hospital Authority (HA).
(i) Data from the findings of Streptococcus pneumoniae isolation conducted by laboratories in all public hospitals under HA in Hong Kong between 2000 and 2004 on blood, cerebrospinal fluid and samples from other sterile body sites; and
(ii) Records maintained by all public hospitals under HA in Hong Kong between 1997 and 2004 on cases clinically diagnosed as IPD upon the discharge of patients, including cases of meningitis, septicaemia and bacteraemic pneumonia (using the International Classification of Diseases ICD-9-CM as the classification criteria).
The average incidence rates of IPD of different age groups based on the data in paragraph (i) are set out in Annex I.
The average incidence rates of IPD of different age groups based on the data in paragraph (ii) are set out in Annex II.
According to literature, similar approaches have also been adopted in conducting epidemiological data analysis for IPD in other places (e.g. the United States and Canada).
(c) Between 2000 and 2004, the actual number of children aged below 5 and elderly people aged 65 or above who suffered from various serious complications caused by Streptococcus pneumoniae, including meningitis, septicaemia and bacteraemic pneumonia and were hospitalised in public hospitals under HA are set out in Annex III.
As it takes time to process the relevant data, we are unable to provide data for 2005 and 2006 at the moment. We also do not have the corresponding data for otitis media.
(d) We do not have data on the Streptococcus pneumoniae carriage rate among children in Hong Kong or in other countries. However, it would be better to assess the efficacy of a vaccine by comparing the incidence rates before and after the national vaccination. According to literature, the incidence rates of IPD in the United States, Canada, the United Kingdom and Australia before and after their national vaccination programmes are set out in Annex IV.
(e) The Scientific Committee on Vaccine Preventable Diseases (the Committee) under CHP of DH has conducted an epidemiological analysis on the threat posed by IPD to children, including its fatality and incidence rates, and also carried out scientific assessments and made recommendations on the vaccines against IPD. The Committee carries out scientific assessments of new vaccines and combination vaccines (including Streptococcus pneumoniae) on a regular basis. In considering whether to include a new vaccine in the Childhood Immunisation Programme, DH needs to take into account a number of scientific factors, including epidemiology (such as incidence and fatality rates); disease burden; the safety, efficacy, side effects, cost-effectiveness and adequacy of supply of the vaccine, etc. The acceptance of the vaccine by the public, the availability of other preventive measures and the administrative arrangements for vaccination are also factors for consideration. Early last year, DH commissioned a local university to carry out a study on the possibility of incorporating new vaccines and combination vaccines (including vaccines against Streptococcus pneumoniae) into the Childhood Immunisation Programme. The study is expected to complete some time later.
Ends/Wednesday, November 28, 2007
Issued at HKT 12:46
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