The Centre for Health Protection (CHP) of the Department of Health is today (December 24) investigating a fatal case of invasive pneumococcal disease, and reminded the public to observe hygiene practices against the disease.

     The patient was a two-year-old girl with good past health, who has developed fever, cough and shortness of breath since December 18. She was brought to Pamela Youde Nethersole Eastern Hospital for medical attention on December 22 and admitted to the Paediatric Intensive Care Unit there for further management. Her condition deteriorated and she died yesterday (December 23).

     Her blood specimen tested positive for Streptococcus pneumoniae upon laboratory testing. The clinical diagnosis was severe pneumonia.

     Initial enquiries revealed that the girl had received pneumococcal vaccination. She had no travel history during the incubation period. Her mother, elder sister and elder brother had recent upper respiratory tract infection symptoms and are in stable condition. No other similar cases or outbreaks have been reported so far at the kindergarten-cum-child care centre she attended. Investigations are ongoing.
 
     The case will be referred to the Coroner for investigation.

     "Pneumococcal infection is caused by the bacteria Streptococcus pneumoniae (pneumococcus). It causes a wide range of diseases. More common ones include middle ear infection and chest infection. It may also cause various forms of invasive pneumococcal diseases, such as infection of the brain membranes and blood stream. The infection can be serious or even life-threatening," a spokesman for the CHP said.

     Pneumococci are commonly found in the nose and throat of healthy people, particularly in children. Occasionally, these bacteria will cause an infection. They mainly spread through droplets via coughing and sneezing, close contact with the patients or contact with materials soiled with the bacteria.

     To prevent pneumococcal infection, the CHP appealed to the public for pneumococcal vaccination and hygiene practices:
 

• Keep hands clean at all times. Perform hand hygiene frequently, especially before touching the mouth, nose or eyes, after touching public installations such as handrails or door knobs or when hands are contaminated by respiratory secretion after coughing or sneezing;
• Wash hands with liquid soap and water properly. When hands are not visibly soiled, clean them with 70 to 80 per cent alcohol-based handrub as an effective alternative;
• Cover nose and mouth with tissue paper when sneezing or coughing. Dispose of the soiled tissue paper into a lidded rubbish bin, and then wash hands thoroughly;
• Put on a surgical mask when having respiratory symptoms;
• Maintain good indoor ventilation. Avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks while in such places; and
• Refrain from work or school when having respiratory symptoms. Seek medical advice if symptoms persist or deteriorate.

    
     The public may visit the CHP's invasive pneumococcal disease page for more information.

     The Constitutional and Mainland Affairs Bureau (CMAB) invites public views on the implementation of the United Nations International Covenant on Economic, Social and Cultural Rights (the Covenant) in the Hong Kong Special Administrative Region (HKSAR) starting from today (December 24).

     The Central People's Government (CPG) will submit China's third report under the Covenant. The HKSAR Government will submit its report to the CPG on the implementation of the Covenant in the HKSAR for incorporation as part of China's report.

     In accordance with the established practice, the Government has prepared an outline of the topics for inclusion in the report to facilitate public comments on relevant issues. Copies of the outline of the report can be obtained from the Home Affairs Enquiry Centres of District Offices. It is also available on the CMAB website at www.cmab.gov.hk.

     "Members of the public may submit their views to us by February 4, 2019, on the implementation of the Covenant in respect of the topics in the outline, or suggest any additional topics that they consider we ought to include in the report of the HKSAR. We will consider carefully all the comments and suggestions received in drafting the report," a CMAB spokesman said.

     Members of the public who would like to express their views can write to the Constitutional and Mainland Affairs Bureau (Team 5), 12/F, East Wing, Central Government Offices, 2 Tim Mei Avenue, Tamar; or send their submissions by fax to 2840 0657, or by email to icescr_consultation@cmab.gov.hk.

     The Centre for Health Protection (CHP) of the Department of Health today (December 24) reported the latest number of cases of Legionnaires' disease (LD), and stressed the importance of using and maintaining properly designed man-made water systems, and that susceptible groups should strictly observe relevant precautions.

     From December 16 to 22, one community-acquired LD case was reported. The female patient, aged 51 with underlying illnesses, lives in Tai Yeung Che, Lam Tsuen, Tai Po.

     "Epidemiological investigations are ongoing to identify potential sources of infection, high-risk exposure and clusters, if any," a spokesman for the CHP said.

     Regarding a cluster of LD cases involving three patients announced on December 4, the CHP conducted joint epidemiological investigation with the estate management and the Electrical and Mechanical Services Department at The Wings IIIA and its surroundings. Water samples and environmental samples were collected at possible sources of infection at the estate and its surroundings, namely the water fountain at the main entrance, a waterfall between Towers 2 and 3, water tanks for Tower 1 to 3, clubhouse facilities of The Wings IIIA and cooling towers nearby, for testing.
 
     Laboratory testing results revealed that all water samples and environmental samples were tested negative for Legionella pneumophila serogroup 1. As legionellae are found in various environmental settings and aqueous environments, the sources of infection of the cases are yet to be ascertained.

     As of December 22, 104 LD cases had been reported in 2018. In 2017 and 2016, there were 72 and 75 cases respectively.

     "Men, people aged over 50, smokers, alcoholics and persons with weakened immunity are more susceptible to LD. Some situations may also increase the risk of infection, including poor maintenance of water systems leading to stagnant water; living in areas with old water systems, cooling towers or fountains; using electric water heaters, whirlpools and spas or hot water spring spas; and recent stays in hotels or vessels," the spokesman said.

     Legionellae are found in various environmental settings and grow well in warm water (20 to 45 degrees Celsius). They can be found in aqueous environments such as water tanks, hot and cold water systems, cooling towers, whirlpools and spas, water fountains and home apparatus which support breathing. People may get infected when they breathe in contaminated droplets (aerosols) and mist generated by artificial water systems, or when handling garden soil, compost and potting mixes.

     Immunocompromised persons should:
 

• Use sterile or boiled water for drinking, tooth brushing and mouth rinsing;
• Avoid using humidifiers, or other mist- or aerosol-generating devices. A shower may also generate small aerosols; and
• If using humidifiers, or other mist- or aerosol-generating devices, fill the water tank with only sterile or cooled freshly boiled water, and not water directly from the tap. Also, clean and maintain humidifiers/devices regularly according to manufacturers' instructions. Never leave stagnant water in a humidifier/device. Empty the water tank, wipe all surfaces dry, and change the water daily.

    
     The public should observe the health advice below:
 

• Observe personal hygiene;
• Do not smoke and avoid alcohol consumption;
• Strainers in water taps and shower heads should be inspected, cleaned, descaled and disinfected regularly or at a frequency recommended by the manufacturer;
• If a fresh water plumbing system is properly maintained, it is not necessary to install domestic water filters. Use of water filters is not encouraged as clogging occurs easily, which can promote growth of micro-organisms. In case water filters are used, the pore size should be 0.2 micrometres (µm) and the filter needs to be changed periodically according to the manufacturer's recommendations;
• Drain and clean water tanks of buildings at least quarterly;
• Drain or purge for at least one minute the infrequently used water outlets (e.g. water taps, shower heads and hot water outlets) and stagnant points of the pipework weekly or before use;
• Seek and follow doctors' professional advice regarding the use and maintenance of home respiratory devices and use only sterile water (not distilled or tap water) to clean and fill the reservoir. Clean and maintain the device regularly according to the manufacturer's instructions. After cleaning/disinfection, rinse the device with sterile water, cooled freshly boiled water or water filtered with 0.2 µm filters. Never leave stagnant water in the device. Empty the water tank, keep all surfaces dry, and change the water daily; and
• When handling garden soil, compost and potting mixes:

     1. Wear gloves and a face mask;
     2. Water gardens and compost gently using low pressure;
     3. Open composted potting mixes slowly and make sure the opening is directed away from the face;
     4. Wet the soil to reduce dust when potting plants; and
     5. Avoid working in poorly ventilated places such as enclosed greenhouses.

     The public may visit the CHP's LD page, the Code of Practice for Prevention of LD and the Housekeeping Guidelines for Cold and Hot Water Systems for Building Management of the Prevention of LD Committee, and the CHP's risk-based strategy for prevention and control of LD.

     The effective exchange rate index for the Hong Kong dollar on Monday, December 24, 2018 is 105.2 (down 0.2 against last Saturday's index).

     The effective exchange rate index for the Hong Kong dollar on Saturday, December 22, 2018 was 105.4 (up 0.2 against as last Friday's index).

     The Buildings Department approved 19 building plans in October, with seven on Hong Kong Island, three in Kowloon and nine in the New Territories.
 
     Of the approved plans, seven were for apartment and apartment/commercial developments, seven were for commercial developments, one was for factory and industrial developments, and four were for community services developments.
 
     In the same month, consent was given for works to start on 12 building projects which, when completed, will provide 190 025 square metres of gross floor area for domestic use involving 3 083 units, and 24 897 sq m of gross floor area for non-domestic use. The department has received notification of commencement of works for nine building projects.
 
     The department also issued 20 occupation permits, with six on Hong Kong Island, eight in Kowloon and six in the New Territories.
 
     Of the buildings certified for occupation, the gross floor area for domestic use was 38 720 sq m involving 409 units, and 189 064 sq m was for non-domestic use.
 
     The declared cost of new buildings completed in October totalled about $5.7 billion.
 
     In addition, eleven demolition consents involving 11 building structures were issued.
 
     The department received 2 804 reports about unauthorised building works (UBWs) in October and issued 1 248 removal orders on UBWs.
 
     The full version of the Monthly Digest for October can be viewed on the Buildings Department's homepage (www.bd.gov.hk).