Thursday, December 5, 2013

ProMED: Avian influenza, human: China (HK) H7N9, quarantine

Date: Wed 4 Dec 2013
Source: The Standard [edited]

A total of 17 people who had contact with an Indonesian domestic helper critically ill with the [avian influenza] H7N9 strain are being sent to a holiday village for quarantine -- the 1st time the procedure has been activated since the SARS outbreak in 2003. The 36-year-old helper was confirmed on Monday [2 Dec 2013] as the 1st human case of H7N9 [avian influenza] in the city. She traveled to Shenzhen on 17 Nov 2013 to buy a live chicken at a market before slaughtering and cooking it in her employers' flat at Palatial Coast, Tuen Mun. She started displaying symptoms on 21 Nov 2013 and remains in critical condition in the intensive care unit of Queen Mary Hospital.

Among the 17 contacts are the helper's 2 employers and 8 of their family members, including their 2 sons, aged 10 and 13, and their parents, aged 78 and 80, who also live with them. They were sent to the Lady McLehose Holiday Village in Sai Kung for observation and retests. They could stay at the village for 10 days, which is the incubation period for this virus infection.

The rest of the close contacts, isolated at Princess Margaret Hospital, will also be moved to the camp over the next few days. The 10 family members and the helper's 33-year-old friend who accompanied her to Shenzhen have all tested negative for H7N9, which has so far killed 45 of 140 people infected in the mainland. 4 of the 10 have shown upper respiratory symptoms. 6 patients in the same ward as the helper at Tuen Mun Hospital where she was first admitted last Wednesday [27 Nov 2013] are waiting to be tested.

The 17 are among 200 contacts who have been traced and are being closely monitored. Another 7 doctors who had treated the woman at Tuen Mun and Queen Mary hospitals have upper respiratory symptoms but also tested negative. 2 private doctors in Tuen Mun who saw the woman still have to be tested. The Authorities said the risk of human-to-human transmission is low. "There is so far no evidence of the virus spreading to other persons," said Centre for Health Protection controller Leung Ting-hung. The Hospital Authority, meanwhile, said it will not allow visits at isolation wards in public hospitals.

[Byline: Mary Ann Benitez, Hilary Wong]

Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Time will tell whether this is an over-action. So far there has been limited evidence of human-to-human transmission of avian H7N9 influenza virus infection. However the predominantly island location of Hong Kong provides an opportunity to critically examine this possibility.

Hong Kong is one of the 2 Special Administrative Regions of the People's Republic of China, the other being Macau. It is situated on China's south coast and, enclosed by the Pearl River Delta and South China Sea, With a land mass of 1104 sq km (426 sq mi) and a population of 7 million people, Hong Kong is one of the most densely populated areas in the world. Hong Kong's population is 93.6 percent ethnic Chinese and 6.4 percent from other groups. Hong Kong's Cantonese-speaking majority originate mainly from the neighbouring Canton (now Guangdong) province.

Under the principle of "one country, 2 systems", Hong Kong has a different political system from mainland China. Hong Kong's independent judiciary functions under the common law framework. Hong Kong Basic Law, its constitutional document, which stipulates that Hong Kong shall have a "high degree of autonomy in all matters except foreign relations and military defence," governs its political system. Hong Kong had the longest life expectancy of any region in the world in 2012. Maps of Hong Kong can be accessed at and - Mod.CP]

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