Replies to LegCo questions

LCQ6: Prevention and control of infectious diseases in RCHEs

    Following is a question by the Hon Tam Yiu-chung and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (April 20):

Question :

    Regarding the prevention and control of infectious diseases in residential care homes for the elderly (RCHEs) to safeguard the health of elderly residents, will the Government inform this Council of :

(a) the following in the past three years :

(i) the five diseases with the highest incidence rates in RCHEs which fall within the meaning of infectious disease under the Quarantine and Prevention of Disease Ordinance, and the number of elderly residents infected with such diseases; and

(ii) the respective numbers of elderly residents infected with viral gastroenteritis and myiasis in RCHEs;

(b) the measures to strengthen the co-ordination among the Department of Health, the Hospital Authority and the Occupational Safety and Health Council, so as to avoid issuance of contradictory guidelines to RCHEs, and to enhance the effectiveness of such guidelines; and

(c) its plans to facilitate the efforts of RCHEs in strengthening the prevention and control of infectious diseases to safeguard the health of elderly residents?

Reply :

Madam President,

(a) From January 2002 to December 2004, the following five statutory notifiable infectious diseases under the Quarantine and Prevention of Disease Ordinance, Cap 141, had the highest reported number of infection cases in residential care homes for the elderly (RCHEs):


Statutory notifiable    Total number of infection cases
infectious diseases     in RCHEs from January 2002 to
                                 December 2004
                                         

Tuberculosis                1,112
Food poisoning            31
Amebic dysentery        2
Bacillary dysentery       2
Viral hepatitis               1


    For the same period, there were 1,520 infection cases involving viral gastroenteritis and 13 infection cases involving myiasis in RCHEs.

(b) In accordance to their respective ambit and responsibilities, the Department of Health (DH), the Social Welfare Department (SWD), and the Occupational Safety and Health Council (OSHC) have issued guidelines/code of practice to RCHEs respectively.  DH's Guidelines on Prevention of Communicable Diseases in Residential Care Homes for Elderly (the Guidelines) focuses on infection control within RCHEs.  SWD's Code of Practice for Residential Care Homes (Elderly Persons) (CoP) focuses on all the licensing aspects, including infection control.  OSHC's guidelines to RCHEs focuses on the occupational safety and health of the RCHE workers.  DH, SWD and OSHC, together with the Hospital Authority (HA), have been working closely together to ensure that the advice in these respective guidelines are consistent.  There are regular meetings between DH, SWD, HA and the Health, Welfare and Food Bureau to discuss interface issues.

    DH, SWD and OSHC review and update their respective guidelines on a need basis, with inputs from relevant parties.  At present, SWD is in the process of reviewing the CoP.  The revised CoP will have a new chapter on infection control.

(c) Apart from issuing guidelines, the Administration has taken the following measures to strengthen the prevention and control of infectious diseases in RCHEs:

(i) at the advice of DH, SWD has since November 2003 required each RCHE to designate an Infection Control Officer (ICO) to co-ordinate and monitor the prevention and control of infectious diseases within the RCHEs.  DH is providing training to the ICOs;  

(ii) SWD conducts regular and surprise inspections to all the RCHEs, to ensure that they comply with the licensing requirements including infection control.  Since 2003, a referral system has been set up under which DH will provide on-site training to RCHEs which are identified by SWD to require training on infection control;  

(iii) SWD in collaboration with DH conducted a special exercise in 2004 to jointly visit 90 RCHEs, including some identified to have a higher risk in terms of infection control.  After in-depth on-site assessments and subsequent data analysis, SWD and DH jointly formulated tailor-made action plans for 12 RCHEs to improve their infection control practices.  Nine have already made improvements.   SWD and DH will continue to monitor the progress of the remaining three;

(iv) recently, the Centre for Health Protection (CHP) of DH has joined hands with SWD to extend the sentinel surveillance system to 57 RCHEs.  RCHEs participating in the scheme will report statistics on fever and acute diarrhoea cases among their elderly residents to the CHP on a weekly basis.  This will facilitate the detection of community-wide increase in acute febrile illnesses such as influenza and acute gastroenteritis among the elderly population living in RCHEs, and the issue of timely health advice to the public; and

(v) to help RCHEs improve their infection control facilities, a one-off grant under the Lotteries Fund was made available for RCHEs to apply between late 2003 and March 2004 to cover expenses on infectious control facilities within their premises.  Over 400 RCHEs had benefited from the grant.

Ends/Wednesday, April 20, 2005