Replies to LegCo questions
LCQ5: Influenza
Following is a question by the Hon Mrs Anson Chan and a reply by the Secretary
for Food and Health, Dr York Chow, in the Legislative Council today (April 9):
Question:
Last month, a rampant outbreak of influenza (flu) was suspected to have caused
the deaths of three children. In view of the situation, the Government announced
on the 12th of last month that the Easter holiday for all primary schools and
kindergartens in Hong Kong would be advanced to start from the following day and
last for two weeks. In this connection, will the Government inform this Council:
(a) for the past five years, of a breakdown of the monthly number of flu
infection cases by age groups; the number of people who died of flu and
associated complications each year; the number of people who received flu
vaccine each year and, among them, the respective numbers of children and
elderly people; the respective numbers of flu outbreaks in schools and
residential homes for the elderly; and the respective numbers of flu cases
confirmed by private doctors and doctors in the public medical system;
(b) given that the Secretary for Food and Health had told the media at noon on
March 12 that school closure was unnecessary but then late that night he
suddenly announced the advancement of the holidays for primary schools and
kindergartens, of the factors considered by the authorities which led to the
inconsistent decisions; the reasons for announcing the decision on school
closure so late at night, which resulted in many parents, who were unaware of
the authorities' decision, being unable to make appropriate arrangements; how
the Government will prevent similar incidents which cause nuisance to the public
from happening in the future; and
(c) of the other measures, apart from appointing an expert group to investigate
the three cases of child death, to be implemented to avoid children being killed
by flu?
Reply:
Madam President,
First of all, I would like to clarify the point raised in the question about the
death of three children. As already mentioned in the information released by the
Centre for Health Protection (CHP) under the Department of Health (DH) earlier,
influenza virus was identified in two of the children, while no influenza virus
was found in the remaining child. I now reply to different parts of the
question.
(a) As a member of the World Health Organisation's Global Surveillance Network,
Hong Kong has a comprehensive influenza surveillance system. We adopt a
multi-pronged approach for influenza surveillance, which includes the setting up
of sentinel surveillance systems in private and government clinics, monitoring
hospital admissions, conducting laboratory surveillance, etc. From 2004 to 2007,
the number of influenza-like illness(*) recorded by sentinel private doctors
ranged between 30.3 and 89.5 per 1 000 consultations each year while the
corresponding number at general outpatient clinics ranged between 1.4 and 19.7
per 1 000 consultations each year. Please refer to Table 1 for details.
From 2004 to 2007, the number of admissions to hospitals under the Hospital
Authority (HA) due to a principal diagnosis of influenza was about 1 800 to 3
200 each year and the average admission rate was around 270 to 470 per million
population. As to the age distribution, the figures vary from year to year, but
in general the admission rates of elderly persons (aged 65 or above) and
children (aged 14 or below) were higher. Hospital admissions and admission rates
from 2004 to 2007 broken down by age groups are set out in Table 2 and Figure 1.
The Public Health Laboratory Centre (PHLC) of the DH is responsible for
laboratory surveillance of influenza viruses. Out of the influenza virus samples
tested, most of the viruses detected in 2003, 2004, 2005 and 2007 were influenza
A (H3N2) virus while most of those detected in 2006 were influenza A (H1N1)
virus. As at March 29 this year, the PHLC has conducted tests on a total of 1
974 influenza virus samples, of which the majority (971 samples) were influenza
B virus. Please refer to Table 3 for details.
According to death registration statistics, the number of deaths principally
caused by influenza each year from 2002 to 2006 ranged between 0 and 26 (0 in
2002, 7 in 2003, 19 in 2004, 26 in 2005 and 8 in 2006).
We do not have the total number of persons receiving influenza vaccination each
year. However, the quantity of vaccines used for the annual Government Influenza
Vaccination Programme (GIVP) increased from around 170 000 doses in 2003-04 to
around 280 000 doses in 2007-08. In 2007-08, about 190 000 elderly persons and 2
600 children aged between 6 and 23 months from families receiving Comprehensive
Social Security Assistance (CSSA) were given influenza vaccination under the
GIVP. According to the information provided by vaccine importers, around 670 000
to 1.1 million doses of influenza vaccines were purchased by private doctors and
private hospitals each year. Please refer to Table 4 and Table 5 for details.
From 2004 to 2007, the number of influenza outbreaks in schools ranged between
32 and 94 each year, while the corresponding number in residential care homes
for the elderly (RCHEs) ranged between 9 and 162. Please refer to Table 6 for
details.
Although the sentinel surveillance systems in private and public clinics are by
no means representing all confirmed cases of influenza, they are able to duly
reflect the overall influenza situation and trend in Hong Kong.
(b) As I mentioned at the media session in the morning of March 12, the
Administration would closely monitor the influenza situation and would, in the
light of the disease situation in the whole community, decide if there was a
need to step up control measures. In the evening of March 12, I announced the
decision for all kindergartens, kindergartens cum child care centres, primary
schools and special schools to take an early Easter break, having regard to the
increased number of reported influenza cases in that afternoon and the
expectation that the influenza peak would continue for some time, as well as the
concerns and anxiety of parents and the school management as to whether children
should be allowed to attend schools. This was coupled with the fact that in the
evening of March 12, influenza virus was known to have been identified in the
deceased seven-year-old child, and that the CHP received increasing number of
reported cases of influenza from schools in the afternoon of the same day.
Having taken into account the above factors and after discussion among relevant
policy bureaux and departments, we made the decision to advance the Easter break
and announced the decision immediately with a view to minimising public health
risk and relieve the anxiety of the school management and parents.
The decision was made as a precautionary measure, which aimed to minimise the
chance for children contracting influenza in schools and allow schools to be
thoroughly cleansed to ensure environmental hygiene.
The CHP under the DH will closely monitor the influenza situation in Hong Kong
and provide timely data analysis and health advice. Should there be a similar
incident in the future, the Administration will still notify parents and schools
as early as practicable to facilitate their preparations.
(c) To prevent and control infectious diseases, the Administration will provide
timely information and proper analysis to the public as soon as practicable to
enhance their understanding of the disease situation. The CHP also keeps the
public informed of the disease situation and trends of influenza by uploading
updates to its website.
In curbing the spread of influenza so as to reduce the development of
complications in infected children and the resultant child deaths, one of the
CHP's key tasks is to educate the community on how to prevent and control the
disease. Among other things, people who have influenza symptoms should take rest
at home to prevent the spread of the disease to others. In March this year, the
CHP and the Education Bureau (EDB) organised four large-scale talks on
"Prevention and Control of Influenza" for schools to enhance their knowledge of
prevention and control of influenza and provide a platform for schools to
exchange experience.
To prepare for class resumption, apart from the guidelines on school resumption
arrangements issued by the EDB, the CHP has issued to all schools up-to-date
guidelines on measurement of body temperature, cleansing and disinfection, and
personal hygiene. The CHP also advised the schools to deploy dedicated staff or
set up a crisis management team to co-ordinate and oversee matters relating
environmental hygiene of schools, to brief staff and students on influenza, and
advise parents to adopt influenza prevention measures in order to prevent the
spread of influenza in schools.
Note:
(*) Influenza-like illness is a clinical diagnosis. It generally refers to cases
where the patient develops fever (over 38 degrees Celsius) and cough or sore
throat. The illness is not equivalent to confirmed influenza.
Ends/Wednesday, April 9, 2008
Issued at HKT 16:08
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