H7N9 reported in Hong Kong 18 month old girl

Imported human case of avian influenza A(H7N9) in Hong Kong under CHP investigation
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     The Centre for Health Protection (CHP) of the Department of Health (DH) is today (March 4) investigating an imported human case of avian influenza A(H7N9) in Hong Kong affecting an 18-month-old girl.

     The patient, with good past health, developed mild fever and consulted a private doctor on February 28. She attended the Accident and Emergency Department of Queen Elizabeth Hospital (QEH) for febrile convulsion on March 1. She was admitted to isolation ward for treatment after her nasopharyngeal swab tested positive for influenza upon preliminary laboratory testing by QEH on March 2. Her fever subsided completely and she was discharged in stable condition on March 3.

     Her specimen was sent to the CHP's Public Health Laboratory Services Branch for routine detection of respiratory viruses on March 3 and tested positive for avian influenza A(H7N9) virus today.

     According to the patient's attending clinician, the patient was initially admitted to QEH for febrile convulsion. She had no signs of pneumonia. There was no known history of suspicious exposure at the time of admission.

     Upon confirmation as avian influenza A(H7N9) today, the patient was admitted to Princess Margaret Hospital (PMH) for isolation and testing. She is now asymptomatic with no fever.

     Initial epidemiological investigations by the CHP revealed that the patient, who lives in To Kwa Wan, had travelled to Shunde, Foshan, Guangdong, from February 5 to 27 during which she was brought to a nearby wet market by her mother on February 24 but they did not buy any poultry. She had stayed in local residence with no known poultry nearby.

     "Further investigations into her travel and exposure histories are ongoing in parallel with contact tracing. Close contacts including relevant household members and patients who had stayed in the same room with the patient in QEH will be admitted for testing and observation, while other contacts including relevant healthcare workers, visitors, immigration staff at Lo Wu, the doctor and patients of the private clinic which the patient consulted on February 28, will all be put under medical surveillance," a spokesman for the CHP explained.

     The CHP will liaise with relevant Mainland health authority to follow up the patient's contacts during her stay in the Mainland.

     "The Serious Response Level under the Government's Preparedness Plan for Influenza Pandemic remains activated and the CHP's follow-up actions are in full swing," the spokesman said.

     This is the sixth confirmed human case of avian influenza A(H7N9) in Hong Kong. The CHP will notify the World Health Organization (WHO), the National Health and Family Planning Commission as well as health and quarantine authorities of Guangdong and Macao.

     Locally, enhanced surveillance of suspected cases in public and private hospitals is underway. The CHP will continue to maintain liaison with the WHO, the Mainland and overseas health authorities to monitor the latest developments. Local surveillance activities will be modified upon the WHO's recommendations.

     "In view of human cases of avian influenza A(H7N9) confirmed locally and multiple cases notified by the Mainland, further cases are expected in affected and possibly neighbouring areas. Those planning to travel outside Hong Kong should maintain good personal, environmental and food hygiene at all times," the spokesman urged.

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

     Regarding health education for travellers, 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 proceeding.

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

     "We have enhanced publicity and health education to reinforce health advice on the prevention of avian influenza," the spokesman said.

     As of 4pm today, the CHP's hotline (2125 1111) for public enquiries have received 191 calls since the first confirmed human case of avian influenza A(H7N9) in Hong Kong.

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

* Do not visit live poultry markets and farms. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
* Avoid entering areas where poultry may be slaughtered, or contact with surfaces which might be contaminated by droppings of poultry or other animals;
* 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/Tuesday, March 4, 2014
Issued at HKT 21:18

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