Following a severe case of influenza A infection in a 10-month-old baby girl who had not received seasonal influenza vaccination (SIV) yesterday (January 27), the Centre for Health Protection (CHP) of the Department of Health (DH) today (January 28) received two more cases of severe paediatric influenza A infection in children who have not yet received the SIV. Another severe paediatric case of co-infection with influenza A and group A streptococcus was also reported.
The first case involved a six-year-old boy with good past health, who developed fever on January 26. He attended the Union Hospital yesterday and was later transferred to Prince of Wales Hospital, where he remains in the paediatric intensive care unit. His nasopharyngeal swab specimen tested positive for influenza A (H1) virus upon laboratory testing. The clinical diagnosis was influenza A infection complicated with shock. So far, his household contacts show no upper respiratory symptom and there has been no recent influenza outbreak at his school.
The second case involved a twelve-year-old boy with underlying illness who developed fever and cough yesterday. He was admitted to Tuen Mun Hospital today, where he remains in the paediatric intensive care unit. His nasopharyngeal swab specimen tested positive for influenza A (H3) virus upon laboratory testing. The clinical diagnosis was influenza A infection complicated with severe pneumonia and shock. He lives in a school dormitory and seven other students from the same school have recently developed upper respiratory symptoms. The CHP had conducted inspection at the school and provided health advice.
"The above-mentioned two boys had no travel history during the incubation period. An initial investigation revealed that they did not receive 2024/25 SIV. The CHP reiterated its call to the parents to bring their children to receive SIV as soon as possible," a spokesman for the CHP said.
Furthermore, an eight-year-old boy with good past health developed fever since January 23, and cough and shortness of breath since yesterday. He was admitted to the Princess Margaret Hospital on the same day, where he remains in the paediatric intensive care unit. His nasopharyngeal swab specimen tested positive for influenza A (H1) virus and his blood sample tested positive for group A streptococcus. The clinical diagnosis was co-infection with influenza A and group A streptococcus complicated with sepsis.
"Since the start of this influenza season in early January, the CHP has recorded eight cases (including three above-mentioned children) of severe influenza virus infection in children. Six of them were unvaccinated. Influenza vaccination has been scientifically proven to be one of the most effective ways to prevent seasonal influenza and its complications, while significantly reducing the risk of hospitalisation and death from seasonal influenza. All persons aged 6 months and above (except those with known contraindications) who have not yet received SIV should act immediately, particularly the elderly and children who have a higher risk of becoming infected with influenza and developing complications," he added.
Group A streptococcal infection is caused by bacteria, namely Streptococcus pyogenes, that can be found in the throat and on the skin. It can be transmitted by droplets and contact. The bacteria can cause mild diseases, including pharyngitis, impetigo and scarlet fever to invasive group A streptococcal infections (iGAS) such as necrotising fasciitis and streptococcal toxic shock syndrome. Anyone can get iGAS disease, but the elderly and young children, persons with chronic illnesses (e.g. diabetes) or immunocompromised persons may be at higher risk. People with breaks in the skin or with recent viral infections (e.g. chickenpox, influenza, etc.) are also at higher risk of developing iGAS disease. On the other hand, the disease can be effectively treated with antibiotics and prompt treatment helps alleviate symptoms faster and prevent complications.
The spokesman reminded the public that Hong Kong has entered the influenza season. As the seasonal influenza activity is expected to increase further while the activity of other respiratory infectious diseases may also increase. To protect their health and that of their family members, the public should not only receive SIV, but also maintain good personal and environmental hygiene, and take the following measures to prevent contacting influenza, Group A streptococcal infection and other respiratory illnesses:
- Wear surgical masks to prevent transmission of respiratory viruses from ill persons. It is essential for persons who are symptomatic (even if having mild symptoms) to wear a surgical mask;
- High-risk persons (e.g. persons with underlying medical conditions or persons who are immunocompromised) should wear surgical masks when visiting public places. The general public should also wear a surgical mask when taking public transport or staying in crowded places. It is important to wear a mask properly, including performing hand hygiene before wearing and after removing a mask;
- Avoid touching one's eyes, mouth and nose;
- Practise hand hygiene frequently, wash hands with liquid soap and water properly whenever possibly contaminated;
- When hands are not visibly soiled, clean them with 70 to 80 per cent alcohol-based handrub;
- Cover the mouth and nose with tissue paper when sneezing or coughing. Dispose of soiled tissue paper properly into a lidded rubbish bin, and wash hands thoroughly afterwards;
- Practise good wound care to reduce the chance of getting infected;
- Maintain good indoor ventilation;
- Avoid sharing personal items;
- When having respiratory symptoms, wear a surgical mask, consider to refrain from going to work or school, avoid going to crowded places and seek medical advice promptly; and
- Maintain a balanced diet, perform physical activity regularly, take adequate rest, do not smoke and avoid overstress.
​For the latest information, members of the public can visit the CHP's group A streptococcal infection and seasonal influenza webpages.
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