Replies to LegCo questions
LCQ8: Pneumococcal diseases
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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