Hong Kong in Serious Response Level with Reference to Government's Preparedness Plan

9 December 2008

Dear Doctor,
Hong Kong in Serious Response Level
with Reference to Government's Preparedness Plan

I would like to alert you that the Government has activated the Serious
Response Level in response to the poultry outbreak caused by influenza A/H5 in a farm in Yuen Long on 9 December 2008 and has instituted a series of measures to control thespread of the outbreak. Among others, DH will enhance surveillance to detect any potential human cases. Poultry workers are considered as a higher risk group as they might have been exposed to H5 affected poultry. Although so far no human cases of avian influenza have been reported in Hong Kong in relation to this incident, you are reminded to stay vigilant and pay special attention to poultry workers who develop symptoms and signs compatible with avian influenza.

Please report any suspected cases to the Central Notification Office (CENO) of
CHP via fax (2477 2770), phone (2477 2772) or CENO On-line
(www.chp.gov.hk/ceno). I attach again the Reporting Criteria for Human
Influenza A(H5N1) for your easy reference (see Annex). For reporting outside office
hours, please contact Medical Control Officer (MCO) of DH at Pager: 7116 3300 call
9179. Please also refer patients fulfilling the reporting criteria to public hospitals for
further clinical management. Thank you.
Yours faithfully,
(Dr. SK CHUANG)
Consultant Community Medicine (Communicable Disease)
Centre for Health Protection
Department of Health

Annex:
Reporting criteria for Human Influenza A (H5N1) infection
An individual fulfilling both the Clinical Criteria AND Epidemiological Criteria
should be reported for further investigation.
Clinical Criteria
A person with acute respiratory illness, characterized by fever (temperature >38oC)
AND one or more of the following:

cough, sore throat, shortness of breath, and difficulty breathing; OR

person with severe pneumonia; OR

person died of unexplained acute respiratory illness.

Epidemiological Criteria
One or more of the following exposures in the 7 days prior to symptom onset:

contact with a human case of influenza A (H5N1); OR

contact with poultry or wild birds or their remains or to environments contaminated
by their faeces in countries/areas with documented avian influenza H5N1 infection
in birds and/or humans in the recent 6 months see List of affected areas ;OR

consumption of raw or undercooked poultry products in countries/areas with
documented avian influenza H5N1 infection in poultry and/or humans in the recent
6 months see List of affected areas ; OR

close contact with a confirmed H5N1 infected animal other than poultry or wild
birds; OR

worked in a laboratory that is processing samples from persons or animals that are
suspected from avian influenza infection
The list of affected areas is regularly uploaded to the Centre for Health Protection
(CHP) website (http://www.info.gov.hk/info/flu/eng/global.htm).