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Following is a question by the Hon Frederick Fung and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (May 21):
Question:
As reported, an epidemic of enteroviral infections among young children has swept through a number of mainland cities in recent months, resulting in several thousand hospital admissions and dozens of deaths so far. In this connection, will the Government inform this Council:
(a) whether it has grasped the latest information about the epidemic on the Mainland, including the types of viral strains found in such cases in various places, the transmission mode of the disease, the mutation of the virus, etc., and whether it has, based on the relevant information, assessed the risk of an outbreak of an epidemic of enteroviral infections in Hong Kong; if it has, of the results; if not, the reasons for that;
(b) of the number of enteroviral illness cases found in Hong Kong in recent months; whether it has analysed the transmission mode for such cases and the trend of infections, as well as compared them with the epidemic on the Mainland; if so, of the results of analysis; and
(c) of the specific measures to prevent a local outbreak of an epidemic of enteroviral infections, for example, whether it will strengthen monitoring and raise the hygiene levels in high-risk places such as child care centres and kindergartens, and expeditiously disseminate information about the epidemic to members of the public?
Reply:
Madam President,
The Government is on guard against Hand-Foot-Mouth Disease (HFMD) and Enterovirus (EV-71) infections and is implementing comprehensive preventive, control and surveillance measures to protect public health. In view of recent upsurge in HFMD and EV-71 infections in some parts of the Mainland and neighbouring regions including Taiwan and Singapore, Hong Kong should remain vigilant. Our reply to the various parts of the question is as follows-
(a) The Centre for Health Protection (CHP) of the Department of Health (DH) has already put in place a surveillance system to closely monitor HFMD and EV-71 infections in Hong Kong and neighbouring regions. The surveillance system includes outbreak notification, laboratory surveillance and sentinel surveillance at specific clinics and child care centres. In addition, the CHP has maintained close liaison with the Ministry of Health and the health authorities of Guangdong Province and Macao through an established mechanism. A point-to-point instant communication mechanism has also been set up among the three places to facilitate timely exchange of information about any sudden upsurge in infectious diseases of unknown nature or of public health significance. In response to the recent situation of HFMD and EV-71 infections in the Mainland, the CHP has maintained good communication with the Ministry of Health and the health authorities of neighbouring places to keep track of the latest development.
HFMD is caused by viruses. It is transmitted by direct contact with nasal and throat discharges, saliva, erupted blisters, or the stool of infected persons. In Hong Kong, Coxsackie A virus is the most common causative agent for HFMD, causing about 75% of HFMD outbreaks. EV-71 virus is another causative agent for HFMD and associated with some 20% of HFMD outbreaks in Hong Kong.
HFMD occurs in Hong Kong throughout the year and the peak is usually in summer time, particularly between May and August. The surveillance figures of the CHP indicate that there has been an increase in HFMD cases in recent months. According to surveillance figures reported in April, the consultation rate for HFMD cases among sentinel private doctors ranged from 1.3 to 1.9 cases per 1 000 consultations, which was higher than that reported in March (ranged from 0.5 to 1.5 cases per 1 000 consultations).
(b) From January 1 to May 19, 2008, a total of 22 cases of EV-71 infections were recorded in Hong Kong. The figure is higher than that recorded in the corresponding period in previous years. Details are as follows:
Number of EV-71 cases in Hong Kong in recent years
Year Number of cases Number of fatal cases
2004 35 0
2005 8 0
2006 16 0
2007 12 0
2008
(as at May 19) 22 0
So far this year, the Mainland has recorded over 41 000 HFMD cases. Most occurred in Anhui Province, Guangdong Province, Jiangsu Province, Shanghai Municipality, Henan Province, Zhejiang Province, etc. The mode of transmission of HFMD in the Mainland is similar to that in Hong Kong, i.e. usually through droplets and contact with erupted blisters or the stool of infected persons.
(c) For effective prevention and control of EV-71 infections and HFMD, there must be close collaboration among the Government, the healthcare sector, schools, institutions and parents to reinforce personal and environmental hygiene measures. It is also important to detect the disease at an early stage, to make prompt diagnosis and to closely monitor for outbreaks and swiftly adopt infection control measures.
The CHP has been working closely with the Hospital Authority and private hospitals to conduct surveillance on children with severe complications caused by Enterovirus since May 9.
The CHP may consider advising affected schools, child care centres or kindergartens to suspend classes for thorough cleansing and disinfection for a period of 14 days when situation warrants. The DH and related departments have briefed the management of schools and nurseries as well as parents on the latest development about EV-71 and HFMD and the preventive measures through health talks, letters, posters and leaflets.
In addition, the CHP has issued guidelines on clinical diagnosis and management of EV-71 infections and HFMD to doctors to facilitate appropriate clinical treatments. The DH will also distribute pamphlets about HFMD to travellers at immigration checkpoints and provide the tourist industry with the latest information.
Timely risk communication can enhance understanding of the disease and raise the awareness among the general public. In this connection, the CHP has since May 9 uploaded onto its website (www.chp.gov.hk) a daily report on the latest development of EV-71 and HFMD in Hong Kong and neighbouring regions. Besides, publicity through television and radio will also be intensified to increase public alertness.
Ends/Wednesday, May 21, 2008
Issued at HKT 13:09
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