Press Release

Epidemiological investigation and follow-up actions by CHP on confirmed human case of avian influenza A(H7N9)

4 December 2013

The Centre for Health Protection (CHP) of the Department of Health (DH) today (December 4) provided an update on the first confirmed human case of avian influenza A(H7N9) in Hong Kong.

"The CHP's epidemiological investigation, enhanced disease surveillance, port health measures and health education have been in full swing since the Government escalated the response level under the Preparedness Plan for Influenza Pandemic from 'Alert' to 'Serious'," a spokesman for the DH remarked.

As of 2pm today, no additional close contacts have been identified. The number of close contacts located remains at 17 while there are over 220 other contacts. Details are as follows:

(A) Specimens of the 17 close contacts all tested negative for the avian influenza A(H7N9) virus upon preliminary laboratory testing by the Public Health Laboratory Services Branch (PHLSB) of the CHP. They were prescribed with the antiviral Tamiflu prophylaxis and have to be quarantined for 10 days since their last contact with the patient. During isolation, if their health conditions change, further testing and surveillance will be conducted. They include:

1. Ten home contacts (including four with non-specific symptoms);
2. A female collateral aged 33, who visited Shenzhen with the patient; and
3. Six patients in Tuen Mun Hospital who stayed in the same cubicle with the confirmed patient (including one with non-specific symptoms).

Asymptomatic close contacts will be arranged to stay in the quarantine centre in Lady MacLehose Holiday Village in Sai Kung. It has been equipped with basic residential facilities, including suitable bungalows, rooms and activity premises.

(B) Over 220 other contacts, including two private doctors whom the patient consulted, their clinic staff, patients and accompanying relatives, health-care workers of Tuen Mun Hospital, Queen Mary Hospital and the ambulance service, and relevant hospital visitors, have remained well so far. Medical surveillance is ongoing and they have been offered Tamiflu prophylaxis.

The epidemiological investigation by the CHP, including contact tracing and tracing the source of infection, is ongoing.

"Upon the PHLSB's analysis, the genes of the virus of the confirmed case do not show any significant difference from the avian influenza A(H7N9) viruses isolated from human cases detected so far in the Mainland. There is also no evidence of genetic reassortment nor resistance to Tamiflu. We will continue to liaise and share the gene sequence based on established arrangements," the spokesman stressed.

Locally, enhanced surveillance over suspected cases in public and private hospitals is under way. The CHP will continue to maintain liaison with the World Health Organization (WHO), the Mainland and overseas health authorities to monitor the latest developments and obtain timely and accurate information. Local surveillance activities will be modified according to the WHO's recommendations.

"All border control points (BCPs) have implemented disease prevention and control measures. Thermal imaging systems are well in place at BCPs for body temperature checks of inbound travellers. The DH has liaised with the Auxiliary Medical Service and the Civil Aid Service to deploy additional manpower at BCPs to conduct random temperature checks using handheld devices," the spokesman remarked.

The Port Health Office of the DH has maintained liaison with the Shenzhen Entry-Exit Inspection and Quarantine Bureau while being on the alert for travellers and also cross-boundary students with fever or other symptoms. Suspected cases will be immediately referred to public hospitals for follow-up investigation.

Regarding health education to travellers at BCPs, distribution of health education pamphlets, the display of posters on avian influenza A(H7N9) in departure and arrival halls, in-flight public announcements, environmental health inspection and the provision of regular updates to the travel industry via meetings and correspondence have all been escalated. The DH will keep a close eye on the latest developments and adopt corresponding port health measures.

"We have enhanced publicity and health education on the prevention of avian influenza. Meanwhile, consulates, foreign domestic helpers' associations and non-governmental organisations serving ethnic minorities have been notified of the case, the latest developments and the preventive measures. Health educational materials are being distributed through them," the spokesman added.

An array of key publicity materials of the CHP, including those on avian influenza, influenza, guidelines for proper hand washing and personal and environmental hygiene in various languages, including Indonesian, Hindi, Nepali, Urdu, Thai and Tagalog, can be accessed in the CHP's website (This link will open in a new windowwww.chp.gov.hk/en/submenu/424.html).

The CHP's hotline (2125 1111) has been set up for public enquiries and operates from 9am to 6pm. As of 4pm today, 37 enquiries were received.

"Travellers, especially those returning from avian influenza A(H7N9)-affected areas, with fever or respiratory symptoms are reminded to immediately wear facial masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should also pay special attention to patients who might have had contact with birds, poultry or their droppings in affected areas," the spokesman advised.

The spokesman also urged travellers not to visit live poultry markets in the affected areas and to avoid direct contact with poultry, birds and their droppings. If contact has been made, they should thoroughly wash their hands with soap and water.

Members of the public should remain vigilant and are reminded to take heed of the following preventive advice against avian influenza:

• 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 such as escalator handrails, elevator control panels or door knobs; or when hands are dirtied by respiratory secretions after coughing or sneezing;
• Cover the nose and mouth while sneezing or coughing, and hold the spit with a tissue and put it into a covered dustbin;
• Avoid crowded places and contact with fever patients; and
• Wear a mask when respiratory symptoms develop or when taking care of fever patients.

The public may visit the CHP's avian influenza page (This link will open in a new windowwww.chp.gov.hk/en/view_content/24244.html) and its website (This link will open in a new windowwww.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf) for more information on avian influenza-affected areas.