Severe case of influenza A and invasive pneumococcal co-infection in unvaccinated child

     The Centre for Health Protection (CHP) of the Department of Health received a notification yesterday (January 10) of a severe paediatric case of co-infection with influenza A and invasive pneumococcal disease in a young child who has not yet received the seasonal influenza vaccination (SIV). The CHP urged the public who have not yet received the SIV to act immediately to minimise the risk of serious complications and death after infection.

     "A four-year-old boy with a history of good health developed high fever, cough and abdominal pain last week. He sought medical attention at the general outpatient clinic of a private hospital on January 5 and consulted a private doctor on January 7 before being admitted to Canossa Hospital on the same day. His blood sample was tested positive for Streptococcus pneumoniae. He was transferred to the paediatric intensive care unit of Queen Mary Hospital for treatment on January 8. His nasopharyngeal swab specimen was tested positive for influenza A (H1) virus upon laboratory testing. The clinical diagnosis was co-infection with influenza A and severe invasive pneumoccocal disease complicated by pneumonia. He remains hospitalised in a serious condition," a spokesman for the CHP said.

     The boy had no travel history during the incubation period. His household contacts are currently asymptomatic so far. Initial investigation revealed that the kindergarten where the boy was attending did not participate in the SIV School Outreach Programme (SIVSOP). The CHP reiterated its call to the parents of those schools not participating in SIV outreach activities to bring their children to receive SIV as soon as possible, as research studies have shown that influenza vaccination among children can reduce serious complications.

     To boost the SIV coverage rate among schoolchildren, special arrangements have been made under the SIVSOP this year. The DH has earlier issued a letter to all kindergartens and child-care centres indicating that they can choose between injectable inactivated influenza vaccines and nasal live-attenuated influenza vaccines (i.e. nasal vaccines) at the same or different outreach vaccination activities. Schools that have not yet set a date for vaccination should arrange vaccination activities as soon as possible in the next two weeks to protect the health of schoolchildren and minimise absenteeism due to influenza which can affect their learning.

     "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 six months and above (except those with known contraindications) who have not yet received the SIV should act immediately, particularly the elderly and children who have higher risk to get infected with influenza and other complications," the spokesman said.

     The spokesman reminded the public that Hong Kong has entered the influenza season. As the weather gets colder, the seasonal influenza activity is expected to increase further in the coming weeks 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 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;
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;
Maintain good indoor ventilation;
When having respiratory symptoms, wear a surgical mask, consider whether to go 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 seasonal influenza and invasive pneumococcal disease webpages.