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Two cases of scarlet fever complicated with toxic shock syndrome under investigation

     The Centre for Health Protection (CHP) of the Department of Health is investigating two cases of scarlet fever complicated with toxic shock syndrome.

     The first one is a fatal case involving a 14-year-old girl with good past health. She presented with on and off low-grade fever since January 6, associated with cough, runny nose and malaise.

     The girl sought medical consultation from three different private clinics for five times from January 6 to 17. Her condition did not improve and she developed rapid breathing since January 17 and attended the Accident and Emergency Department of Pamela Youde Nethersole Eastern Hospital early next morning. She was admitted to Paediatric Intensive Care Unit with septic shock, pneumonia and pleural effusion.  Her condition deteriorated and she passed away later in the same day.

     Her pleural aspirate specimen tested positive for streptococcus pyogenes (Group A).

     The girl lived with her parents and a younger brother in Eastern District.  Her mother and younger brother had recent upper respiratory infection symptoms.  Swabs will be taken from them for further tests.

     The girl used to study at a secondary school in Happy Valley and last attended school on January 16.  There has been no report of outbreak of respiratory illness in the school.  

     As a precautionary measure, the school is advised to suspend class tomorrow for thorough cleansing and disinfection.  She did not travel outside Hong Kong before onset of symptoms. But she travelled to Macau from January 7 - 8.

     The second case involves an 11-year-old boy with good past health. He presented with cough and runny nose since January 8 and developed fever since January 13.  

     He was admitted to a private hospital on January 15. Group A streptococcus was isolated from his blood specimen.

     He was transferred to Paediatric Intensive Care Unit of Pamela Youde Nethersole Eastern Hospital on January 17.  On the same day, he also developed generalised sandpaper-like skin rash. He is now in stable condition.

     He is studying in a primary school in Wan Chai District.  He last attended school on January 13. The school will start holiday tomorrow and as a precautionary measure, the school is advised to carry out thorough cleansing and disinfection.

     The CHP's investigation revealed that the patient has no recent travel history. His home contacts are asymptomatic.

     CHP's investigation into the above two cases continues.

     A CHP spokesman explained that scarlet fever is caused by Group A Streptococcus bacteria and can be cured by appropriate antibiotics. The disease usually affects children between two to eight years of age and presents as fever, sore throat and rash. The rash appears over the trunk and neck and spreads to the limbs especially the armpits, elbows and groin. The illness is usually clinically mild but can be complicated by shock, heart and kidney diseases.

     "Scarlet fever is transmitted through either the respiratory route or direct contact with infected respiratory secretions," he said.

     People who are suspected to have scarlet fever should consult their doctors.

     To prevent infection, members of the public are advised to:

* maintain good personal and environmental hygiene;
* keep hands clean and wash hands properly;
* wash hands when they are dirtied by respiratory secretions, e.g. after sneezing;
* cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly; and
* maintain good ventilation.

Ends/Thursday, January 19, 2012
Issued at HKT 21:09


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