The Controller of the Centre for Health Protection (CHP) of the Department of Health (DH), Dr Wong Ka-hing, today (January 18) urged the community to continue heightening their vigilance against seasonal influenza as the latest surveillance data indicated that the local seasonal influenza activity has continued to increase in the past two weeks and may continue to rise in the period ahead. As young children are particularly affected in this influenza season, the CHP appealed to parents who have not yet arranged vaccination for their children in this season to do so as soon as possible to strengthen their personal protection.
Dr Wong today hosted a press conference to report on the latest situation of the winter influenza season in Hong Kong. Among the respiratory specimens received by the Public Health Laboratory Services Branch of the CHP, the circulating influenza viruses of this season were predominantly influenza A(H1N1)pdm09 (85 per cent of all positive influenza detections). Past epidemiological data shows that children and adults aged 50 to 64 years were relatively more affected in seasons dominated by influenza A(H1).
The weekly number of institutional influenza-like illness (ILI) outbreaks reported to the CHP has sharply increased from six cases in the week ending January 5 (affecting 28 persons) to 121 cases (affecting 968 persons) in the week ending January 12 while 148 cases (affecting 989 persons) have been recorded in the first five days of this week (as at January 17). Majority of the outbreaks occurred in kindergartens/child care centres (KG/CCCs) (70 per cent), followed by primary schools (16 per cent) and residential care homes for the elderly (4 per cent).
In public hospitals, the overall admission rate with principal diagnosis of influenza has increased from 0.88 cases (per 10 000 population) in the week ending January 5 to 1.19 cases (per 10 000 population) in that ending January 12. The influenza admission rate was highest among children aged below six years, which increased from 6.49 to 9.23 cases (per 10 000 population) in the corresponding period, exceeding the highest weekly rate recorded in recent years.
Dr Wong said, "In view of the sharp increase in the number of ILI outbreaks in KG/CCCs in the past two weeks and the extraordinary high influenza-associated admission rate among children aged less than 6 years in public hospitals, the Government convened an interdepartmental meeting yesterday to review the latest local situation. The Government has recommended that as a targeted measure to enhance disease prevention and control at the KG/CCCs, all KG/CCCs with an ILI outbreak should suspend classes for a period of seven days starting tomorrow (January 19) to interrupt influenza transmission within the affected schools. The above measure is applicable for all KG/CCCs with outbreak before the Chinese New Year holiday."
Dr Wong explained, "As young children may not have the ability to observe strict personal and hand hygiene, they are prone to influenza infection and its complications. This additional measure is expected to reduce the risk of acquiring influenza infection in school settings. The Government will review the situation before the end of the Chinese New year holiday to see if this measure needs to be extended."
The CHP today has informed all affected KG/CCCs about the arrangement, and uploaded the list of affected KG/CCCs on the CHP website (www.chp.gov.hk/files/pdf/kgccc_suspension_list_eng.pdf). If new KG/CCCs are added, the list will be updated daily in the evening from Monday to Saturday to help parents grasp the information.
Vaccination is one of the most effective ways to prevent seasonal influenza and its complications. To increase the seasonal influenza vaccination uptake rate among school children, the DH in the 2018/19 year has launched the School Outreach Vaccination Pilot Programme (pilot programme) for primary schools. Besides, the DH has actively assisted primary schools not participating in the pilot programme and KG/CCCs to arrange outreach vaccination at their schools such as through the Enhanced Vaccination Subsidy Scheme Outreach Vaccination newly launched in the 2018/19 year.
As of January 13, the number of primary schools with outreach influenza vaccination has increased more than five-fold from 65 in the 2017/18 year to 394 in the 2018/19 year while the number of KG/CCCs with outreach influenza vaccination has increased from 60 to 168 correspondingly, representing a 180 per cent increase.
As of January 13, about 427,000 and 515,000 doses of seasonal influenza vaccines (SIVs) had been administered via the Government Vaccination Programme and Vaccination Subsidy Scheme (VSS) (including Enhanced VSS Outreach Vaccination) respectively, increasing by 5.3 per cent and 83.2 per cent from the same period in the 2017/18 year. Including the 110,000 doses administered through the School Outreach Vaccination Pilot Programme, the total number of doses administered via various vaccination programmes was about 1,053,000, representing a 53.2 per cent increase from the same period in the 2017/18 year.
Among them, 332,000 doses of SIVs were administered to children aged 6 months to under 12 years, increasing by 141 per cent compared with the same period last year and reaching an overall coverage rate of 42.8 per cent. While the coverage rate of children aged 6 months to under 6 years is 30.1 per cent, the coverage rate of children aged 6 to under 12 years is 53.7 per cent.
The CHP appealed to parents who have not yet arranged their children (particularly those with chronic diseases) to receive the SIV this season to do so as soon as possible through the VSS. Children aged 6 months to under 12 years can receive subsidised SIV at $210 per dose at the clinics of VSS doctors.
The CHP will again issue letters today to doctors, hospitals, institutions and schools to appeal for reinforcement in preventive measures so as to mitigate the impact of seasonal influenza. The CHP will encourage VSS doctors to promote and provide SIV to eligible groups, and doctors taking part in the Enhanced VSS Outreach Vaccination to arrange outreach vaccination for schools especially KG/CCCs.
The CHP will particularly encourage all KG/CCCs to arrange outreach vaccinations at their schools for their students, and reminded that all KG/CCCs are eligible for the Enhanced VSS Outreach Programme. Participating doctors providing vaccination to students at schools will not impose any charges. Under the programme, no quotation or tender is required from schools in choosing a doctor and schools have flexibility in arranging the date and time of outreach vaccination.
Schools should actively check the body temperature of all students every day during this influenza season when they arrive at school so as to identify students with fever. This additional measure should be strictly followed and continue throughout this winter influenza season.
To prevent outbreaks of influenza and other respiratory infections, it is of prime importance that children with fever, regardless of the presence of respiratory symptoms, should not be allowed to attend school. They should seek medical advice and avoid school till 48 hours after the fever has subsided. Schools should also measure and record students' body temperature properly. Schools are reminded to follow the Guidelines on Prevention of Communicable Diseases on preventive and control measures as well as management of outbreaks, which should be reported to the CHP for prompt follow-up.
The Education Bureau reminds schools that during the class suspension period, schools should remain open and arrange staff to look after students who would be unattended at home and hence have to return to school; and to handle school matters and parents' enquiries. Schools have to make necessary arrangements for the students concerned to minimize the risk of transmission of influenza. Schools should clean their premises thoroughly to ensure environmental hygiene.
In order to minimise the chance of infection, the Social Welfare Department (SWD) advises members of the public not to take their children or family members to affected child care centres and special child care centres. However, these centres will remain open to continue their service provision for members of the public who might have difficulty in taking care of their children or family members.
In addition, parents may make use of the services provided under the Neighbourhood Support Child Care Project where necessary. For enquiries, please call the SWD hotline at 2343 2255.
Besides receiving seasonal influenza vaccination as early as possible for personal protection, the following measures are advised to prevent influenza and respiratory tract infections:
- Wash hands with liquid soap and water properly whenever possibly contaminated;
- When hands are not visibly soiled, clean them with 70-80 per cent alcohol-based handrub as an effective alternative;
- Cover nose and mouth while sneezing or coughing and wash hands thoroughly afterwards;
- Dispose of soiled tissue paper properly in a lidded rubbish bin;
- Put on a surgical mask when respiratory symptoms develop;
- Maintain good indoor ventilation;
- When influenza is prevalent, avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks in such places; and
- Maintain a balanced diet, exercise regularly, take adequate rest, do not smoke and avoid overstress.
For the latest information on influenza activity, please visit the CHP's influenza page and weekly Flu Express. As for vaccination, the public may call the CHP's hotline at 2125 2125 or visit the CHP's Vaccination Schemes page.