Department of Health

A confirmed case of SARS in Guangdong

5 January 2004

Dear Doctor,

Subsequent to my letter sent to you on 27 December regarding a suspected case of SARS in Guangdong, the World Health Organisation today classified this case as a confirmed case of SARS. The patient is a 32-year-old man who worked as a television producer in Panyu (??), Guangzhou (??). He developed a fever and headache on 16 December and was diagnosed as having pneumonia on 20 December. He was isolated in hospital since then for observation. On 24 December, the patient was transferred to a hospital designated for treating SARS patient in Guangzhou. The patient has been suspected of contracted SARS since 26 December. Eighty-one contacts of the patient reportedly did not have fever. The patient reported no history of contact with health care workers or wild animals.

In Hong Kong, we are maintaining mandatory health declarations and temperature screening checks for passengers arriving from Guangdong. In addition, we are stepping up broadcasts at seaports and border check points and health information leaflets are available to travelers at the border check points. We will continue to deploy staff to assist travelers reported sick and distribute health information sheets and health alert cards to flight passengers arriving from Guangzhou.

Please take special notice of febrile patients with respiratory symptoms, who reported history of visiting Guangdong Province during 10 days before symptom onset. Please ensure that masks are worn on these patients. Furthermore, if the patient has radiological evidence of pneumonia, you may wish to refer the patient to the Accident and Emergency Department (AED) of public hospitals for assessment.

To strengthen disease surveillance in connection with the SARS case in Guangdong, we wish to solicit your assistance in notifying us of patients with pneumonia AND history of visiting Guangdong Province during 10 days before symptom onset. If you come across such cases, please fill in Appendix I (Clinical Record Form for Community Acquired Pneumonia Cases with Travel History to Guangdong within 10 days of onset (RTF format)) and fax to appropriate addresses on that form. Please obtain patient consent for data transfer, and explain to the patient that DH staff will approach him/her to collect more information about contact history. For your easy reference, the telephone and fax number of the Regional Offices are:

Regional Office	Fax No.	Tel. No.
Hong Kong	2572 7582	2961 8729
Kowloon	2375 8451	2199 9149
New Territories East	2699 7691	2158 5107
New Territories West	2439 9622	2615 8571

Please note that the above new system is not a substitute for notifying SARS cases. To notify a patient with high degree of suspicion of SARS, please call the respective Regional Offices during office hours, or call the DH Medical Control Officer (MCO) on pager 71163300 call 9179 after office hours.

Please maintain due vigilance in infection control measures in your health care facility and maintain good staff sickness records. Important things to observe include the followings:

Environment control

to avoid overcrowding in the patient waiting areas by scheduling patient appointment and reminding patients to adhere to it;
to provide adequate ventilation to the clinic;
to clean and disinfect the environment using 1:99 household bleach at least once daily or more frequently as indicated (for places such as patient lavatories). When there is a suspected SARS case, after transferal of suspected SARS patient, immediate disinfection of affected areas using 1:49 household bleach is recommended. It is preferably to evacuate the clinic before disinfection and leave the disinfected area vacant for 30 minutes.
to clean and disinfect equipment used in patient care; and
to maintain proper disposal of clinical wastes.

Precaution for health care workers

to exclude sick staff from duties and to remind them to obtain medical advice as necessary;
to wash hands after each patient contact, change of gloves/masks, gown/white coat/uniform; and
to wear personal protective equipment as appropriate for the setting, e.g., surgical/N95 masks, goggles, face shields, gowns, caps, gloves for high-risk procedures such as suctioning.

Precaution for patients

to request patients and accompanying persons to inform staff when they have fever and arrange medical assessment accordingly; and
to request patients and accompanying persons to wear surgical masks if they have symptoms of respiratory tract infection.

Advice and information for health care professionals can be found in the DH website: http://www.info.gov.hk/info/sars/e_profession.htm.

   Yours faithfully,

  (Dr Thomas TSANG)

   for Director of Health



	Last revision date: 22 March 2007