Replies to LegCo questions

LC Urgent Q1: Zika virus

Following is an urgent question by the Hon Priscilla Leung under Rule 24(4) of the Rules of Procedure and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (February 3):

Question:

There have been several thousand cases of Zika virus infection in Brazil since it reported the first infection in May last year. According to the information of the World Health Organization (WHO), the Zika epidemic is spreading rapidly, with reported infection cases in more than 20 countries in Central and South America at present. WHO anticipates a tendency for the epidemic to spread explosively. WHO has pointed out that Zika virus may be associated with microcephaly in infants and Guillain-Barr赌 Syndrome (an infective polyneuritis). It is learnt that Zika virus mainly spreads through the Aedes aegypti mosquito. Some experts have pointed out that the Aedes albopictus mosquito, which is commonly found in Hong Kong, can also transmit the virus, and thus the public are very concerned about a possible outbreak of Zika epidemic in Hong Kong. In this connection, will the Government inform this Council:

(1) of the immediate measures taken by the authorities to provide the public (in particular pregnant women and outbound travellers) and the tourism sector with information and health advice on the Zika virus; whether they will consider the issuance of an outbound travel alert immediately for countries and regions with serious Zika epidemic outbreak, and ensure that the Food and Health Bureau and the Security Bureau are in close communication on this issue, so as to avoid the recurrence of the chaotic situation in June last year caused by the incongruent information issued in relation to the outbreak of the Middle East Respiratory Syndrome in South Korea;

(2) as the Zika epidemic is spreading rapidly across the globe, whether the authorities have kept themselves updated on the latest development of the epidemic, and whether they have currently assessed the risk of a Zika epidemic outbreak in Hong Kong; if they have, of the assessment outcome; if not, the reasons for that; and

(3) whether the authorities have immediately put in place contingency measures in case of an outbreak of Zika epidemic in Hong Kong, including anti-mosquito operations, epidemic prevention measures at boundary control points, screening of infection cases at outpatient clinics as well as accident and emergency departments, formulation of clinical and medication guidelines, etc.; if they have, of the details; if not, how the authorities ensure that the epidemic can be brought under control in case of an outbreak in Hong Kong?

Reply:

President,

Zika virus infection is a disease caused by Zika virus which is mainly transmitted by mosquitoes. Zika virus infection is endemic in some parts of Africa and Asia, and was first identified in the South Pacific after an outbreak on Yap Island in the Federated States of Micronesia in 2007. Prevalence of Zika virus infection has been detected in the Americas since 2014, with the outbreak of Zika virus infection in Brazil starting in mid-2015.

Zika virus is primarily transmitted to humans through bites of Aedes mosquitos. The incubation period is not clear, but likely to be a few days to a week. People infected with Zika virus will develop symptoms including mild fever, rash, muscle pain, joint pain, headache, retro-orbital pain and conjunctivitis, which last for a few days. At present, there is no specific medication for the disease. Symptomatic treatment is given to relieve discomfort. At present, around 70-80 per cent of infected people are asymptomatic and most infected people can recover fully.

In the past, people infected with Zika virus developed relatively mild illness and therefore the disease did not raise much concern. However, due to its latest spread in the Americas and the reports of its strong link with microcephaly of infants, the virus is now under close international attention.

At the emergency meeting held on February 1, 2016, the World Health Organization (WHO) declared that the relationship between Zika virus infection and the recent cases of microcephaly in infants and other neurological disorders constituted a Public Health Emergency of International Concern and recommended a series of preventive and control measures.

My reply to the three parts of the question is as follows:

(1) The travel health advice issued by the Department of Health (DH) is mainly to provide information on any disease outbreak around the world, give health advice on protection against disease vectors and make recommendation on vaccinations. The advice is issued in the light of a disease's risk of spreading in the affected areas and import to Hong Kong. Factors taken into account include the prevalence and spreading of the disease in the affected areas, and whether there are close economic ties and extensive travel between Hong Kong and the affected areas. Before issuing a travel health advice, the DH will make reference to the advice given by WHO and other overseas health authorities.

Moreover, the Government has put in place the Outbound Travel Alert (OTA) System, which aims to help Hong Kong residents better understand the possible risks to personal safety in travelling to overseas places that are popular with Hong Kong residents. Should there be public health reasons, the Security Bureau may, based on the advice of the Food and Health Bureau, disseminate information through the OTA System to help the public and the tourism industry better understand the possible health risks and make arrangements accordingly. The Food and Health Bureau and the Security Bureau have been maintaining close communication with each other.

The DH issued an alert on January 18, reminding outbound travellers of the risk of Zika virus infection.

After an emergency meeting on February 1, the emergency committee of the WHO recommended that travel or trade restrictions should not be imposed on countries and areas with Zika virus infection outbreaks. Nevertheless, in view of the rapid spread of the Zika virus infection around the world, the DH has already issued a travel advice suggesting that, if not necessary, pregnant women and women preparing for pregnancy should consider deferring their trip to areas with past or current evidence of ongoing Zika virus transmission. Those who must travel to any of these areas should seek medical advice of their doctor before the trip, adopt contraception if appropriate and strictly follow steps to avoid mosquito bites during the trip. Travellers should apply mosquito repellent for 14 days after returning from the affected areas. If a female partner is at risk of getting pregnant, or is already pregnant, condom use is advised for a male traveller. Travellers should consult and reveal to their doctor their travel history if symptoms develop. The travel advice has been uploaded to the website of the Centre for Health Protection (CHP), the DH's Travel Health Service homepage and the Security Bureau's Outbound Travel Alert website.

The DH has maintained close communication with the tourism sector and other stakeholders, especially travel agents organising tours to the affected areas and their tour leaders and tour guides, to provide them with up-to-date disease information and health advice regularly. It will continue to closely monitor the latest developments in neighbouring and overseas areas.

(2) Zika virus is primarily transmitted to humans through bites of Aedes mosquitoes, and Aedes aegypti is considered the most important vector for Zika virus transmission to humans. Although Aedes aegypti is currently not found in Hong Kong, other Aedes mosquito species such as Aedes albopictus are also considered potential vectors. Since Aedes albopictus is widely present locally, there is a risk of secondary spread of imported infections in Hong Kong. Furthermore, extensive international travel will increase the risk of imported Zika virus cases in Hong Kong.

(3) The Food and Health Bureau held an inter-departmental meeting with the DH, the Food and Environmental Hygiene Department (FEHD) and the Hospital Authority (HA) on February 1, 2016 to discuss the latest local risk assessment as well as prevention and control measures against Zika virus infection. First of all, to enhance the surveillance of Zika virus in Hong Kong, the Government will publish in the Gazette the Prevention and Control of Disease Ordinance (Amendment of Schedule 1) Notice 2016 on February 5, 2016 to make Zika virus infection a statutorily notifiable infectious disease under the Prevention and Control of Disease Ordinance (Cap. 599) with immediate effect on the same day. The CHP of the DH is to be notified of any confirmed case for investigation and follow-up actions. The CHP has sent letters to inform doctors and hospitals of the relevant legislative amendments. The Government will also put in place the following preventive measures to safeguard against the import of the virus to Hong Kong:

On epidemic prevention measures at boundary control points, to prevent the import of Zika virus to Hong Kong, the Port Health Office has implemented a series of measures at various boundary control points (BCPs) in the territory. Details are as follows:

(i) The Port Health Office will carry out regular inspections at BCPs to ensure that good environmental hygiene is maintained and proper mosquito control measures are in place. The Port Health Inspector will enhance the training for cleansing service and pest control contractors at BPCs to ensure that vector control measures are effective.

(ii) Health promotion at BCPs will be enhanced through pamphlet distribution and poster display to remind travellers of the preventive measures against Zika virus.

(iii) Moreover, temperature checks will be conducted on an ongoing basis for all inbound travellers at all BCPs. Suspected cases will be referred to medical institutions for follow-ups. The DH will also encourage tourists travelling from the affected countries and areas and Hong Kong residents returning from those places to apply mosquito repellent for 14 days after arrival in Hong Kong to reduce the risk of disease transmission. This is the most important thing. I want to reiterate that I hope all Hong Kong residents who travelled to these areas to apply mosquito repellent for 14 days after returning to Hong Kong, reducing the risk of an infected person to transmit the virus to Aedes mosquitoes in Hong Kong.

Regarding out-patient clinics and Accident and Emergency Departments, the HA will take active measures in response to the DH's notification guidelines. It will inform frontline staff that Zika virus has been made a statutorily notifiable infectious disease and update the electronic system so that doctors can make the relevant notifications. Travellers who develop clinical symptoms within two weeks after returning Hong Kong from affected areas will be arranged for diagnostic tests for Zika virus infection. At the same time, tests for dengue fever and chikungunya fever will also be conducted. The HA will work closely with the Public Health Laboratory Services Branch of the CHP, specimens will be sent for virus testing so that confirmed cases can be identified as early as possible. The relevant information has been disseminated to the Accident and Emergency Departments and out-patient clinics.

Although there is no medication or vaccine against Zika virus at present, the HA will keep close watch on relevant guidelines from the CHP and the WHO, and take the appropriate actions accordingly.

On mosquito elimination, in response to the several local dengue fever cases which came to light in the past two years, FEHD has stepped up its mosquito control work particularly during the winter period. FEHD has since October 2015 increased the number of surveillance areas with ovitraps for Aedes albopictus across the territory from 44 to 52. Surveillance operations for Aedes albopictus in all port areas (except the airport where surveillance is done once a week) have also been stepped up from once a month to twice a month since November 2015. Since Aedes albopictus may carry both dengue fever and Zika virus, our continuous efforts on the above front will help enhance the surveillance of dengue and Zika vectors. In 2016, FEHD will keep up the momentum of its work in mosquito control. This includes:

(i) increasing the number of out-sourced pest control roving teams in winter (from December 2015 to March 2016) to 266 teams, i.e. maintaining the same number of teams as in summer 2015;

(ii) stepping up mosquito control work during the year-end clean-up campaign launched on January 15, 2016;

(iii) implementing the Anti-mosquito Campaign (Note) in 2016 by three phases. The first phase will be launched from February 15 to March 18. To upkeep the effectiveness of the campaign, FEHD will, immediately after each phase of the campaign, conduct thematic operations across the territory to enhance the mosquito control work in strategic areas; and

(iv) having regard to the fact that works sites are prone to the breeding of mosquitoes, FEHD will continue to liaise with relevant departments (e.g. the Civil Engineering and Development Department), brief the contractors of various works departments on the importance of mosquito prevention, as well as enhance the efforts to eliminate mosquitoes within particular works sites where necessary.

We will continue to closely monitor the latest developments in overseas and maintain liaison with WHO and health authorities of the Mainland and neighbouring areas. The local response and health surveillance will also be adjusted if necessary.

Note: The Campaign aims at enhancing public awareness of the potential risks of mosquito-borne diseases, as well as encouraging the community and various government departments to make concerted efforts and actively participate in anti-mosquito work.

Ends/Wednesday, February 3, 2016
Issued at HKT 21:04

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