The Centre for Health Protection (CHP) of the Department of Health yesterday (January 23) received a report of a severe paediatric case of co-infection with influenza B and group A streptococcal in a child.
"A 12-year-old girl with good past health developed a fever, runny nose, and cough since January 17 and consulted private doctors on three occasions (January 17, 20 and 22). She attended the Accident and Emergency Department of Queen Elizabeth Hospital on January 22 for shortness of breath and was admitted to the paediatric intensive care unit. She was transferred to the paediatric intensive care unit of Hong Kong Children's Hospital for treatment on the following day (January 23). Her nasopharyngeal swab specimen tested positive for influenza B virus and her blood sample tested positive for group A streptococcal. The clinical diagnosis was co-infection with influenza B and group A streptococcal complicated with pneumonia, respiratory failure and septic shock. She is still hospitalised and in critical condition," a spokesman for the CHP said.
The girl did not travel during the incubation period. There has been no recent outbreak of influenza or group A streptococcal in her school. Her household contacts had upper respiratory symptoms prior to her disease onset. She received 2024/2025 seasonal influenza vaccination (SIV).
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, avoid going to crowded places, consider whether to go to work or school 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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