The Centre for Health Protection (CHP) of the Department of Health is today (January 16) investigating two cases of severe paediatric influenza A infection, four influenza A outbreaks at kindergartens in Sham Shui Po, Kowloon Tong, Hung Hom and Wan Chai respectively, as well as an influenza-like illness outbreak at a kindergarten in Tsing Yi.
The first case of severe paediatric influenza A infection involves a 11-month-old girl with underlying illness. She has presented with fever, cough and shortness of breath since January 14 and was admitted to Prince of Wales Hospital (PWH) on the same day. She was transferred to PWH's paediatric intensive care unit for further management yesterday (January 15). She is now in a critical condition. Her nasopharyngeal aspirate tested positive for influenza A virus upon laboratory testing. The clinical diagnosis was influenza A infection complicated with severe pneumonia.
Initial enquiries revealed that the patient had not received seasonal influenza vaccination for the current season and had no travel history during the incubation period. Her elder brother with recent upper respiratory symptoms earlier sought medical attention without admission and has been in a stable condition. Her other home contacts have remained asymptomatic so far.
The second case involves a 11-month-old boy with good past health, who has presented with fever, cough, runny nose and malaise since January 9. He developed head and limbs twitching on January 10 and was admitted to Queen Mary Hospital (QMH) on the same day. He is now in a stable condition. His nasopharyngeal swab tested positive for influenza A virus upon laboratory testing. The clinical diagnosis was influenza A infection complicated with encephalopathy.
Initial enquiries revealed that the patient had not received seasonal influenza vaccination for the current season and had no travel history during the incubation period. His father with recent upper respiratory symptoms earlier sought medical attention. His grandmother was admitted to QMH for influenza A and had already discharged after management, while his grandfather was admitted to the same hospital for other medical condition. All three are in a stable condition. Other home contact has remained asymptomatic so far.
Regarding outbreaks at kindergartens, the outbreak at the kindergarten in Sham Shui Po affected eight boys and 12 girls, aged 3 to 5, who have developed fever, cough, sore throat and runny nose since January 4. All of them sought medical attention. Among them, three students required hospitalisation and two were discharged following treatment. All patients have been in a stable condition. The respiratory specimens of three students tested positive for influenza A virus upon laboratory testing.
For the outbreak at the kindergarten in Kowloon Tong, it involves 11 boys and 10 girls, aged 3 to 6, who have developed similar symptoms since January 8. All of them sought medical attention. One student required hospitalisation and was discharged following treatment. All patients are in a stable condition. The respiratory specimens of three affected students tested positive for influenza A virus upon laboratory testing.
For the outbreak at the kindergarten in Hung Hom, it involves 11 boys and 12 girls, aged 2 to 3, who have developed similar symptoms since January 4. All of them sought medical attention. One student required hospitalisation and was discharged following treatment. All patients are in a stable condition. The respiratory specimens of two affected students tested positive for influenza A virus upon laboratory testing.
For the outbreak at the kindergarten in Wan Chai, it involves 11 boys and 10 girls, aged 3 to 6, who have developed fever, cough and sore throat since January 4. Twenty of them sought medical attention. Among them, one student required hospitalisation and was discharged following treatment. All patients are in a stable condition. The respiratory specimens of five affected students tested positive for influenza A virus upon laboratory testing.
For the outbreak of influenza-like illness at a kindergarten in Tsing Yi, it involves 24 students including 10 boys and 14 girls, all aged 4, as well as a female staff member. They have developed fever, cough and sore throat since January 14. Twenty-three of them sought medical attention. Two of the affected students required hospitalisation and one was discharged following treatment. All patients are in a stable condition.
Officers of the CHP have conducted site visits to the five schools and advised the schools to adopt infection control measures against respiratory infections. The schools have been put under medical surveillance.
A spokesman for the CHP said, "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.
"Particularly, children, people aged 50 to 64 years, the elderly and those with underlying illnesses who have not yet received influenza vaccination this season are urged to get vaccinated as early as possible to prevent seasonal influenza as it takes about two weeks for antibodies to develop in the body after vaccination. They should promptly seek medical advice if influenza-like symptoms develop so that appropriate treatment can be initiated as early as possible to prevent potential complications. Parents and carers are reminded to render assistance in prevention, care and control for vulnerable people," the spokesman added.
Besides receiving seasonal influenza vaccination as early as possible for personal protection, the public should maintain good personal and environmental hygiene for protection against influenza and other respiratory illnesses. For more information, please visit the CHP's influenza page and weekly Flu Express.
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