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SFH on first cluster of indigenous human swine influenza cases (with video)

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Following are the opening remarks made by the Secretary for Food and Health, Dr York Chow, at a press conference on the first cluster of indigenous human swine influenza cases today (June 11):

As the Chief Executive announced earlier today, we have the confirmation of the first cluster of indigenous cases of human swine influenza in Hong Kong. Twelve secondary school students are infected. Dr Tsang will talk more about the cases later.

As there is no identifiable link to a place affected by Human Swine Influenza (HSI) outside Hong Kong or an imported index patient with them, our Fight the Pandemic campaign is now transiting from the containment to mitigation phase in gradual steps. We will gear up our medical services and beef up our health advice to the public, particularly those people who are at risk.

This morning, the steering committee reviewed the preparatory plans and also agreed on the implementation of a number of measures.

On school closure, the Secretary for Education has already ordered all primary schools, kindergartens, kindergarten cum child care centres and special schools to suspend classes for 14 days from tomorrow, and will review the need to continue the class suspension thereafter.

Let me explain why we close schools. Cases in Mexico, US, Canada and Japan have all shown that schools, particularly primary schools, are more vulnerable to flu attacks and are the first place to get a flu cluster, with young school children having a more than two-fold attack rate compared with older teenagers and adults. We do not want to see the young kids coming down with HSI.

Furthermore, as past flu seasons have shown, young children especially those under six with flu are more likely to get complications and hospitalised, and also a higher mortality rate.

We believe that by closing primary schools, kindergartens and special schools for two weeks, we can substantially slow down community spread, protect the very young and reduce the risk to the general public, thereby reducing the worries of parents, families and teachers as well as the burden on our hospital and clinics.

Let me take you through our other public health measures endorsed by the steering committee:

* The Hospital Authority (HA) will open eight Designated Flu Clinics (DFCs) from the coming Saturday for managing patients with influenza-like-illnesses (ILI), to be expanded to 18 DFCs contingent on demand. The clinics will open from 9am to 5pm. They shall cater for all patients with influenza-like symptoms (self-referred or referred by other medical practitioners), and shall operate similar to General Outpatient Departments, but without the need for prior booking. Dr Leung will talk more about it later.

* Current port health measures at border control points for inbound travellers will continue. These include health declaration, temperature screening, and boarding of flights by port health officers when alerted by crew to sick passengers. Port Health will post notices at all exit points and advise all departure and transfer travellers not to travel if they are having fever or flu symptoms.

* On the management of index patients and contacts, the HA will isolate and treat all index patients in HA hospitals during this early mitigation phase. They will increase surge capacity when necessary commensurate with disease incidence and demand.

* The Department of Health will subject very close contacts, such as family members, to directly observed chemoprophylaxis (DOC) and medical surveillance, as is the current practice. But if the number of local cases continues to increase, the department will gradually phase out the DOC arrangement and close the DOC clinics. The precise programme for phasing out DOC will depend on the spread and speed of build-up in confirmed local cases.

* The Centre for Health Protection will no longer perform tracing of social contacts, given that their risk approximates that of the general public since the disease has taken root in the community by this time.

* On treatment, the HA, in consultation with the DH, will assess the treatment protocol on a continuous basis, and may vary it as circumstances change. Specimens from selected patients may be taken for surveillance, based on clinical assessment and contact history. Mild cases will be discharged home and only severe cases will be admitted to hospitals.

* On the use of antiviral, as the number of local cases accumulates to a certain point, the DH will order post-exposure prophylaxis for close contacts to be generally stopped, reserving antiviral medication for treating more serious hospitalised inpatients.

Let me turn to other community and public institutions.

* For elderly homes, existing measures for outbreak at elderly homes will continue. Patients will be isolated and treated in HA hospitals. Others are to stay in institutions and wear masks and observe good personal hygiene.

* We advise people at workplaces to observe good personal hygiene and ensure proper disinfection of public places. Those with influenza-like illness should stay at home and wear masks if necessary only if they really need to go out.

* All conferences, exhibitions and public events may continue as usual. Organisers must ensure all participants observe good personal hygiene and disinfect all public places of the relevant premises properly. Organisers must advise those with influenza-like illness not to participate, stay at home and wear masks if necessary when going out.

* Public transport companies will have to step up vehicle cleaning and disinfection, and advise staff and passengers to maintain good personal hygiene, and wear masks if not feeling well.

* Public utilities companies will also have to step up cleaning and disinfection, advise staff to maintain good personal hygiene, and initiate pandemic preparedness plans to ensure no disruption to essential services.

As the Chief Executive has said this morning, the public has no need for panic. For the four high-risk groups, I have the following advice.

* For healthcare workers, they should take proper infection control measures to protect themselves and patients. Public sector workers have ample supplies of protection gear and training in infection control. Guidelines on infection control in clinics are available on CHP's website.

* The private medical sector and elderly care sector are advised to follow these guidelines closely to minimise their risk.

* For young children, parents should be watchful for fever and flu-like symptoms, take them to see a doctor early if the child is sick. Sick children should stay home. They should also avoid contact with other children who are unwell, avoid playgroups, tutorial classes especially large groups, avoid sharing toys, towels, eating utensils etc. with other children, and do not take aspirin unless approved by doctors.

* For pregnant mothers and persons with chronic diseases (such as diabetes, asthma, chronic lung diseases, renal disease, cardiovascular diseases, cancer patients, patients with immuno-suppression therapy or on steroids), they should maintain good personal hygiene, especially handwashing, avoid contact with persons with flu-like symptoms, and overcrowded places. They should make sure that there is good ventilation around and be mindful of fever and flu-like symptoms, and seek medical attention early. They should inform doctors of their medical condition when consulting for flu-like illnesses. I would also like to take this opportunity to appeal to the public: do not smoke. And particularly if you have chronic illnesses, do not smoke.

* For the elderly, the advice is the same as for persons with chronic illnesses. Elderly homes should remain vigilant to infection control measures and report influenza outbreaks to the CHP.

I would also like to appeal to parents that during the school closure, they should look after their children well, make sure that they observe good personal hygiene, and that they are taken care of and stay at home when sick.

The Government will try its utmost to minimise the impact of human swine influenza on Hong Kong. There is no need for panic and the last thing we want is complacency.

All our measures are taken to go an extra mile in our fight against the pandemic. At the same time, life must go on, only with the necessary heightened precautions and social distancing.

As the Chief Executive has said, we can only overcome crisis and win against the pandemic when people and the Government unite together. It means the following:
* Look after oneself,
* Care for others, especially family members, friends and neighbours,
* Care for the environment.

We have witnessed great community spirit, compassion, co-operation and self-sacrifice from our citizens since the beginning of the pandemic since early May. I am sure we can uphold this spirit, and are able to win this war against the pandemic and keep our society together.


Ends/Thursday, June 11, 2009
Issued at HKT 19:04

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Designated Flu Clinics

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12 Apr 2019