Epidemiological investigation and follow-up actions by CHP on confirmed human case of influenza A(H9N2)

     The Centre for Health Protection (CHP) of the Department of Health (DH) is today (December 30) investigating a confirmed human case of influenza A(H9N2) affecting a man aged 86.

     The patient is a Hong Kong resident living in Huangbeiling, Luohu, Shenzhen. He has underlying illnesses and has developed chills and cough with sputum since December 28. Upon entry at Lo Wu Border Control Point (BCP) on the same day, he was transferred by ambulance direct to the Accident and Emergency Department of North District Hospital (NDH), where he presented with low fever. He was then admitted to the isolation ward. He was transferred to Princess Margaret Hospital today for further management.

     His clinical diagnosis was chest infection. He has been in stable condition all along and is currently afebrile.

     His sputum specimen tested positive for the influenza A(H9N2) virus upon testing by the CHP's Public Health Laboratory Services Branch.

     "The epidemiological investigations, enhanced disease surveillance, port health measures and health education against avian influenza are all ongoing," a spokesman for the DH remarked.

     Investigations by the CHP revealed that the patient had no recent poultry contact, consumption of undercooked poultry, or contact with patients. His home contact in Shenzhen has remained asymptomatic.

     Over 50 health-care workers of NDH and the ambulance service have been put under medical surveillance.

     "The H9N2 virus is of avian origin and has been isolated mainly from poultry. Rare and sporadic human cases have been reported and are generally mild respiratory tract infections. The public should avoid contact with poultry and other birds, including chickens, ducks and sparrows," the spokesman explained.

     Influenza A(H9) is a local statutorily notifiable infectious disease. Two local cases were reported in 1999. One local case was respectively filed each in 2003 and 2007. An imported case was recorded in 2008 while an imported case and one with the source of infection unclassified were filed in 2009. All are mild infections and the patients have recovered. No deaths have been recorded so far.

     Locally, enhanced surveillance over suspected cases in public and private hospitals is under way.

     As the patient was staying in Shenzhen for the whole incubation period, the CHP will inform the health authority of Guangdong of the case for necessary investigation and follow-up action.

     The case will also be notified to the World Health Organization (WHO), the National Health and Family Planning Commission, and the health authority of Macau.

     The CHP will issue letters to doctors and hospitals to keep them abreast of the latest situation.

     "We will remain vigilant and maintain liaison with the WHO, the Mainland and overseas health authorities. Local surveillance activities will be modified according to the WHO's recommendations," the spokesman said.

     "All BCPs have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.

     Regarding health education for travellers, distribution of pamphlets, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are all proceeding.

     "We have enhanced publicity and health education against avian influenza. The CHP has also sent letters to government departments and related organisations to reinforce health advice against avian influenza," the spokesman said.

     "Travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.

     Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:

* Do not visit live poultry markets. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear masks when respiratory symptoms develop or when taking care of fever patients.

     The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf) for more information on avian influenza-affected areas and provinces.

Ends/Monday, December 30, 2013
Issued at HKT 18:43