China - Man, 86, hospitalized in Hong Kong with H9N2 avian flu after travel from Shenzhen, Guangdong province

[tetano]

Health authorities have confirmed a rare case of H9N2 avian flu human infection in the city.

The infected patient, an 86-year-old male from Shenzhen with a history of underlying illness, is now in a stable condition at North District Hospital in Sheung Shui. He is scheduled for transfer to Princess Margaret Hospital.

The man arrived at the Lo Wu border crossing on Saturday suffering from chills, a cough and excess sputum.

He was taken by ambulance to hospital where he then developed a mild fever. His initial clinical diagnosis was a chest infection but a sputum test was positive for the virus.

Over 50 medical and ambulance workers at the hospital are under medical surveillance. His relatives in Shenzhen have not displayed symptoms of illness, according to the department of health.

The man is not believed to have handled, consumed or had direct contact with live poultry, nor has he been in contact with patients infected with avian flu.

http://www.scmp.com/news/hong-kong/article/1393266/86-year-old-man-infected-h9n2-avian-flu

[tetano]

Re: HK: 86-year-old man infected with H9N2 avian flu

Epidemiological investigation and follow-up actions by CHP on confirmed human case of influenza A(H9N2)
************************************************** *********

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (December 30) investigating a confirmed human case of influenza A(H9N2) affecting a man aged 86.

The patient is a Hong Kong resident living in Huangbeiling, Luohu, Shenzhen. He has underlying illnesses and has developed chills and cough with sputum since December 28. Upon entry at Lo Wu Border Control Point (BCP) on the same day, he was transferred by ambulance direct to the Accident and Emergency Department of North District Hospital (NDH), where he presented with low fever. He was then admitted to the isolation ward. He was transferred to Princess Margaret Hospital today for further management.

His clinical diagnosis was chest infection. He has been in stable condition all along and is currently afebrile.

His sputum specimen tested positive for the influenza A(H9N2) virus upon testing by the CHP's Public Health Laboratory Services Branch.

"The epidemiological investigations, enhanced disease surveillance, port health measures and health education against avian influenza are all ongoing," a spokesman for the DH remarked.

Investigations by the CHP revealed that the patient had no recent poultry contact, consumption of undercooked poultry, or contact with patients. His home contact in Shenzhen has remained asymptomatic.

Over 50 health-care workers of NDH and the ambulance service have been put under medical surveillance.

"The H9N2 virus is of avian origin and has been isolated mainly from poultry. Rare and sporadic human cases have been reported and are generally mild respiratory tract infections. The public should avoid contact with poultry and other birds, including chickens, ducks and sparrows," the spokesman explained.

Influenza A(H9) is a local statutorily notifiable infectious disease. Two local cases were reported in 1999. One local case was respectively filed each in 2003 and 2007. An imported case was recorded in 2008 while an imported case and one with the source of infection unclassified were filed in 2009. All are mild infections and the patients have recovered. No deaths have been recorded so far.

Locally, enhanced surveillance over suspected cases in public and private hospitals is under way.

As the patient was staying in Shenzhen for the whole incubation period, the CHP will inform the health authority of Guangdong of the case for necessary investigation and follow-up action.

The case will also be notified to the World Health Organization (WHO), the National Health and Family Planning Commission, and the health authority of Macau.

The CHP will issue letters to doctors and hospitals to keep them abreast of the latest situation.

"We will remain vigilant and maintain liaison with the WHO, the Mainland and overseas health authorities. Local surveillance activities will be modified according to the WHO's recommendations," the spokesman said.

"All BCPs have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.

Regarding health education for travellers, distribution of pamphlets, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are all proceeding.

"We have enhanced publicity and health education against avian influenza. The CHP has also sent letters to government departments and related organisations to reinforce health advice against avian influenza," the spokesman said.

"Travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.

Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:

* Do not visit live poultry markets. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear masks when respiratory symptoms develop or when taking care of fever patients.

The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html) and website (https://www.chp.gov.hk/files/pdf/glo...nfluenza_e.pdf) for more information on avian influenza-affected areas and provinces.

Ends/Monday, December 30, 2013
Issued at HKT 18:43

http://www.info.gov.hk/gia/general/201312/30/P201312300427.htm

[Biological]

Re: China - Man, 86, hospitalized in Hong Kong with H9N2 avian flu after travel from Shenzhen, Guangdong province

"The H9N2 virus is of avian origin and has been isolated mainly from poultry. Rare and sporadic human cases have been reported and are generally mild respiratory tract infections. The public should avoid contact with poultry and other birds, including chickens, ducks and sparrows," the spokesman explained.

Influenza A(H9) is a local statutorily notifiable infectious disease. Two local cases were reported in 1999. One local case was respectively filed each in 2003 and 2007. An imported case was recorded in 2008 while an imported case and one with the source of infection unclassified were filed in 2009. All are mild infections and the patients have recovered. No deaths have been recorded so far." ....quote from above!

This is a compilation of reports from the Department of Health, HKSAR


1999 Influenza A virus H9N2 in Hong Kong
Discovery of first cases of influenza A virus (H9N2) in humans in HK
April 7, 1999
The Government Virus Unit of the Hong Kong Department of Health (DH) had isolated, in collaboration with local and international health authorities, a new strain of influenza A virus (H9N2) from two patients recently.
"This is the first time H9N2 viruses, an avian influenza virus, are isolated from humans in Hong Kong," Deputy Director of Health, Dr Paul Saw said today.
The two patients are girls aged one and four who recovered fully from influenza-like illnesses last (March) month.
Atypical influenza viruses were picked up from their clinical specimens of throat secretion by the enhanced influenza surveillance system set up to monitor the avian flu situation in Hong Kong since late 1997.
The specimens were sent to World Health Organisation (WHO) Influenza Collaborating Reference Laboratories in United Kingdom and United States for further identification.
Results available today confirmed that the virus was influenza A (H9N2). The WHO was informed of the finding.
Speaking at a press briefing, Dr Saw said: "This influenza A (H9N2) is an avian influenza virus which has been isolated from duck and chicken for many years."
"Detailed investigations are underway to find out how the patients contracted the viruses."
"At this stage, the two cases appeared isolated. Notwithstanding this, the Department of Health's special investigation team on avian influenza will work closely with local and overseas experts to assess the global health impact of this new discovery and its mode of transmission."
"This information will be released to the medical professions and the public when available."
Dr Saw said that this virus is sensitive to the drugs amantadine and rimantadine.
He added that Hong Kong has a good medical and health system with adequate resources to provide appropriate treatment for this condition.
With the experience gained in the control of the avian flu outbreak in late 1997, he said that the Department would be better equipped to co-ordinate efforts from international health authorities and local experts to monitor and control the situation.
Members of the public are advised at this stage to observe good ventilation, to have proper diet, exercise and rest to build up body resistance to combat infection. They are also advised to wash their hands after handling poultry or the birds' excreta.
The public can obtain updated information on influenza from the Department of Health's Homepage (http://www.info.gov.hk/dh/). They can also get information on the prevention of influenza from the Department's Central Health Education Hotline on Tel No: 2833 0111.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/1999/07_04_99.html

Information and advice to doctors on H9N2 influenza
April 8, 1999
The Government Virus Unit of Hong Kong Department of Health (DH) had isolated, in collaboration with local and international experts, a new strain of influenza A virus (H9N2) from two patients recently in April 1999.
The two patients were girls aged one and four. The four-year-old girl had history of asthma and eczema on regular steroid inhalation and salbutamol inhalation. The one-year-old girl had history of failure to thrive still under investigation. Both of them were hospitalised in early March 1999 due to influenza-like illnesses with fever 39 - 40 oC. Their initial clinical presentations were similar to those of typical influenza, with fever of acute onset, sore throat, vomiting and headache. Both of them had no complication and recovered fully.
Influenza A (H9N2) viruses have been isolated in birds for many years. They may cause very mild illness in birds like turkey, chicken and duck. They were isolated for the first time in humans in Hong Kong. The Department of Health is working closely with local and overseas experts to ascertain the mode of transmission of the virus and determine its public health impact.
The information gathered so far suggests that influenza A (H9N2) has similar clinical presentation as other influenza viruses. The appropriate management should consist of adequate rest, fluid replacement and antipyretic as necessary. Aspirin should be avoided in children. If there are signs of complications such as pneumonia, the patient should be hospitalised. The H9N2 virus is sensitive to amantadine and rimantadine.
Appropriate counselling on prevention of influenza should be given to patients and members of general public. Important messages include a balanced diet, regular exercise, adequate rest to maintain body immunity and no smoking. Observation of good personal hygiene and maintaining good ventilation are also useful. Members of the public are also advised to wash their hands after handling poultry or the birds' excreta.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/1999/08_04_99.html

Information and advice to child care workers & school teachers on H9N2 influenza
April 9, 1999
Influenza
Influenza is an acute illness characterised by fever, headache, muscle ache, running nose, cough and sore throat. The disease is usually self-limiting with recovery in 2-7 days. Three types of influenza virus are recognized : A, B and C, in which type A is more common. In Hong Kong, the two subtypes of influenza A (H1N1 and H3N2) are most commonly seen and the disease is more prevalent in February/March and July.
Avian ( H9N2) Influenza
To date, there are only two types of avian influenza virus, H5N1 and H9N2, that can affect humans. Influenza A (H9N2) viruses have been isolated in birds for many years. For the first time in Hong Kong, influenza A (H9N2) was recently found to have infected two children aged one and four. They developed acute fever (39-40oC), vomiting, sore throat and headache. Both of them recovered fully without any complication. The Department of Health is working closely with local and overseas experts to ascertain the mode of transmission of the virus and determine its public health impact.
Prevention
Good body resistance is important. This can be achieved through a balanced diet, regular exercise, adequate rest, reducing stress and no smoking. When one is feeling unwell, it is better to avoid crowded public places where the air ventilation is not good. Avoiding contact with live poultry will also minimise the chance of getting bird flu. Hands should be washed thoroughly with soap and water after handling live poultry. It is also prudent for children not to contact birds and chicken.
Treatment
The H9N2 virus is sensitive to amantadine. However, this drug should only be used carefully under doctor's supervision because it can cause neurological and gastrointestinal side effects. For general management, patients should have adequate rest and fluid intake. Anti-fever medicine and cough syrup are useful to reduce symptoms. Patients should also observe personal hygiene and wash their hands frequently. Aspirin should not be used in children because of the association with Reye's Syndrome.
For patients with underlying diseases or when there are signs of deterioration e.g. persistent high fever or shortness of breath, they should seek early medical advice. It is preferable to follow up the illness by the same doctor to avoid delay in diagnosis and treatment.
Advice to child care workers and school teachers
1. Child care workers and teachers are advised to take note of the health of children under their care and ensure that proper personal hygiene is observed. Children with influenza like illness should seek medical advice and stay at home. The Department of Health's Regional Offices are ready to provide assistance and support. Their addresses and telephone numbers are:
Hong Kong Region
30/F Wu Chung House
213 Queen's Road East
Wanchai
Hong Kong
Tel. No. : 2961 8729
Kowloon Region
1/F, Hospital authority
Building
147B Argyle Street
Kowloon
Tel. No. : 2199 9100
New Territories Region (East)
5/F Citylink Plaza
1 Shatin Station Circuit
New Territories
Tel. No. : 2684 5138
New Territories Region (West)
1/F
115 Castle Peak Road
Tsuen Wan
Tel. No. : 2413 8388 Ext 24, 25 or 40, or 2411 6949
2. Small animals kept at schools or child care centres should be carefully looked after. Replacement by other suitable substitutes should be considered. Children should be guided to keep a safe distance from the animals and refrain from direct contact with them.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/1999/09_04_99_2.html

Special Investigation Group on Avian Flu recommends close monitoring of situation and more scientific studies
April 11, 1999
The Special Investigation Group on Avian Flu met today to assess the impact of the discovery of influenza A (H9N2), an avian influenza virus, in humans and to make recommendations on the way forward.
The Group was chaired by the Deputy Director of the Hong Kong Department of Health, Dr Paul Saw and comprised public health doctors, veterinarians as well as both local and overseas experts in microbiology and epidemiology.
The Group commended the prompt detection of the two cases in Hong Kong which reflected the effectiveness of Hong Kong's influenza surveillance system.
It noted the satisfactory outcome and full recovery of the two girls in Hong Kong found to have contracted influenza A (H9N2). It also noted that the virus is usually causing mild symptoms, if any, among birds and poultry.
The Special Investigation Group initially considered that the discovery of the virus does not appear to pose an imminent major threat to public health. However, several investigations should be started, in case other H9 human cases appear later and because H9 viruses, similar to other influenza viruses, can change or re-assort and become more easily transmitted.
The situation should therefore be kept under close monitoring and surveillance.
Speaking after the meeting, Dr Keiji Fukuda, Chief of Epidemiology Section of the Influenza Branch of the Centres for Disease Control and Prevention (CDC) in Atlanta said: "The major question about the isolation of influenza A (H9N2) virus in humans is whether they pose a major health risk for people."
To answer this question, Dr Fukuda said the Group should find out
* whether there are other H9N2 infections in people in Hong Kong
* the mode of transmission of the virus to humans
* the risk factors of contracting this virus
* the relation between H9 infection in poultry and in people
To do this, the Special Working Group recommended that several different studies and activities be conducted. These included:
* most importantly, enhanced influenza surveillance should be continued
* epidemiological studies to identify risk factor and mode of transmission of these viruses
* prevalence studies to find out how common these infections are right now in birds and human
Dr Paul Saw said the Department of Health would co-ordinate actions recommended by the Special Investigation Group.
He said the Group also agreed that chicken and poultry are safe to eat if they are cooked thoroughly. However, public are reminded again to observe good personal hygiene by washing hands thoroughly after contact with poultry, animals and their excreta.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/1999/11_04_99.html

2003
Boy recovered from influenza A virus (H9N2)
December 9, 2003
The Department of Health (DH) is investigating a case of influenza A virus (H9N2) involving a five–year-old boy who has just recovered after treatment in hospital.
"This is the second time H9N2 viruses, an avian influenza virus, are isolated from humans in Hong Kong. The last case was detected in 1999 involving two girls who also made full recovery after having flu like symptoms," Dr Thomas Tsang, Consultant (Community Medicine) of DH said today (December 9).
The boy developed symptoms of fever, cough and runny nose on November 25. He was admitted to United Christian Hospital on November 27 and was subsequently discharged two days later.
Dr Tsang said that influenza A (H9N2) viruses were detected from the boy's nasopharyngeal aspirate specimen by the DH Public Health Laboratory Centre today. Further tests are being conducted to sequence the virus to confirm its identity.
The department has informed the World Health Organisation (WHO), Macau and Guangdong about the findings.
DH investigations so far revealed that the boy did not travel outside Hong Kong recently. Some family members have recent mild cough.
"This is an isolated case and the source of infection is being investigated. Based on previous experience, however, we will look especially into bird-to-human transmission.
"We will look into histories of bird and poultry exposure, visits to places with birds and animals, contact with diseased people or animals," Dr Tsang said.
The department will issue letters to doctors to alert the medical community, and liaise with the Education and Manpower Bureau to reinforce messages to kindergartens and schools on the importance of hygiene matters to prevent avian flu and other infectious diseases.
Influenza A (H9N2) is an avian influenza virus which has been isolated from duck and chicken for many years. Infection in humans is rare, and appears to present as a mild form of disease.
Dr Tsang said that Hong Kong has a very comprehensive avian influenza surveillance programme to detect the presence of any avian influenza in our environment and the possible reassortment of the viruses so that prompt responsive measures can be taken.
As a precautionary measure, members of the public are reminded to avoid contacts with live poultry to minimize the chance of being infected with avian influenza.
"Hands should be washed thoroughly with soap and water after handling live poultry.
"To build up good body resistance against influenza, the public are encouraged to maintain a balanced diet, do regular exercise, and have adequate rest. They should not smoke," Dr Tsang noted.
The public can obtain updated information on influenza from the Department of Health's Hompage (This link will open in a new windowhttp://www.dh.gov.hk). They can also get information on the prevention of influenza from the Department's Central Health Education Hotline on 2833 0111.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2003/03_12_09_1.html

Investigation into H9N2 case continues
December 10, 2003
Health team from the Department of Health (DH) today (December 10) visited a kindergarten in Lam Tin to carry out investigation and environmental inspection, and to provide health education to the school.
A five-year-old student of the kindergarten was found to have preliminary positive test result for influenza A (H9N2) yesterday. Gene sequencing today confirmed that the virus isolated from his nasopharyngeal aspirate was H9N2.
A spokesman for the department said the hygiene of the school was satisfactory but DH staff had reminded the school to take precautionary measures to prevent influenza in institutional setting. Staff of the Food and Environmental Hygiene Department (FEHD) carried out thorough disinfection in the kindergarten this morning.
"Investigation has also revealed that there was no abnormal sick leave pattern in the kindergarten in recent weeks.
"A total of 15 birds' excreta samples were collected in the open area outside the kindergarten for laboratory tests," the spokesman said, adding:"a health talk has been arranged for the parents of the students this evening".
Subject to the consent of the parents, DH staff will take blood and throat swab samples from their children to ascertain if they had been infected with influenza A (H9N2), the spokesman added.
DH staff visited the home of the five-year-old boy last night and disinfection was conducted by the FEHD. Three family members have mild cough without fever. Specimens were collected from his family members for examination. Laboratory results will be available in about a week's time. Environmental samples were also collected from the poultry stalls in the shopping arcade near the patient's residence.
The department has also sent letters to all doctors and Chinese medicine practitioners to alert them of the case.
The spokesman reiterated that influenza A (H9N2) is very rare, and appears to present as a mild form of disease. Bird-to-human transmission is the most likely possibility based on previous studies. The five-year-old boy and two girls who had contracted the disease in 1999 had fully recovered.
As a precautionary measure, members of the public are reminded to avoid contacts with live poultry to minimize the chance of being infected with avian influenza.
"Hands should be washed thoroughly with soap and water after handling live poultry.
"To build up good body resistance against influenza, the public are encouraged to maintain a balanced diet, do regular exercise, and have adequate rest. They should not smoke," the spokesman said.
The public can obtain updated information on influenza from the Department of Health's Homepage This link will open in a new window(http://www.dh.gov.hk/). They can also get information on the prevention of influenza from the Department's Central Health Education Hotline on 2833 0111.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2003/03_12_10_1.html

Experts discuss case of Influenza A (H9N2)
December 16, 2003
The Expert Working Group on Avian Influenza met today (December 16) to examine the progress of investigation over a recent case of influenza A virus (H9N2) involving a five-year-old boy who had recovered after treatment in hospital.
This remark was made by the Acting Deputy Director of Health, Dr Regina Ching, who chaired the meeting of the Expert Working Group on Avian Influenza today.
At the meeting, members of the working group were briefed of the epidemiologic investigations being carried out by the staff of the Department of Health (DH).
Results of the gene sequencing conducted by DH's Public Health Laboratory Centre confirmed the virus to be H9N2 but different from the two viruses isolated in 1999. Sequencing of internal genes had also been completed and showed that the virus genes were purely avian in origin.
Furthermore, initial test by the University of Hong Kong show that the virus from the boy was similar to the two virus strains found earlier this year through an on-going surveillance programme at the poultry markets. H9N2 viruses are widely distributed in nature and commonly found in live birds.
"At this point, we do not see evidence of circulation of the H9N2 virus in the human population. Our sentinel influenza rates are stable and our laboratory does not have further potential H9 virus isolated," Dr Ching said.
The meeting agreed that further epidemiologic and virologic investigations would be required to assess the significance of this finding and determine the source of infection in the child. In 1999, two girls with H9N2 also made full recovery after having flu like symptoms.
"As a precautionary measure, members of the public, including poultry traders should strictly observe personal and environmental hygiene.
"Parents should not let children touch live poultry and wild birds because young children may not be compliant in washing their hands," Dr Ching said.
The Expert Working Group on Avian Influenza was set up in 1997 to co-ordinate and keep under review the measures for the prevention and control of influenza A H5N1 infections.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2003/03_12_10_1.html

2004
Influenza A (H7 & H9) to be gazetted as notifiable diseases
30 December, 2004
The Government is to step up surveillance of influenza by adding influenza A(H7) and influenza A(H9) to the list of infectious diseases specified in the First Schedule to the Quarantine and Prevention of Diseases Ordinance.
Legislative amendment will take effect upon publication in the gazette tomorrow (December 31).
The amendment is made in view of the rapidly evolving global situation with avian influenza, a spokesman of the Department of Health (DH) said today (December 30).
The World Health Organization held an influenza pandemic consultation meeting earlier this month and it noted that human infections with influenza A(H5), A(H7), and A(H9) have been occurring at increasing frequency in recent years, the spokesman said.
Noting that Influenza A(H5) has been included in the list of statutorily notifiable diseases since January 30, 2004, the spokesman said the strengthening surveillance of influenza A(H7) and influenza A(H9) in Hong Kong is in line with local and global public health need.
"This will enhance the coverage of our infectious diseases surveillance system, enabling more effective and early detection and the implementation of appropriate public health control measures when necessary," he said.
Under the Prevention of the Spread of Infectious Diseases Regulations of the Ordinance, medical practitioners are required to notify the Director of Health if they have reason to suspect the existence of any infectious diseases listed in the First Schedule to the Ordinance.
"The Centre for Health Protection of DH is sending letters to individual doctors informing them about the amendment," the spokesman said.
A total of 30 infectious diseases are currently included in the First Schedule to the Ordinance.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2004/041230.html

2007
Girl recovered from influenza A virus (H9N2)
20 March 2007
The Centre for Health protection (CHP) of the Department of Health is investigating a case of influenza A virus (H9N2), a mild form of avian influenza, involving a nine?
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2007/070320.html

H9N2 case update
22 March 2007
The nasopharyngeal aspirate (NPA) specimen taken on March 20 from the nine-month-old girl at the Princess Margaret Hospital (PMH) was found to be negative to H9 virus, a spokesman for the Centre for Health Protection (CHP) said today (March 22).
The girl was originally admitted to the United Christian Hospital (UCH) on March 6 for fever and was discharged three days later.
She developed another episode of mild symptoms of upper respiratory tract infection since March 17, and was admitted to PMH for observation when her NPA specimen taken at UCH was confirmed to be influenza A (H9N2) on March 20.
She is currently diagnosed to have respiratory syncytial virus infection and is in stable condition.

The spokesman said the CHP had visited the girl's home and conducted contact tracing.
“NPA specimen taken from all the girl's home contacts also yielded negative result to H9 while serology tests are pending,” the spokesman said.
Meanwhile, the CHP has contacted the 10 children who had stayed in the same cubicle with the girl while the latter was under treatment in UCH.
Three of the 10 children and a healthcare worker of the hospital who had in contact with the girl reported to have mild upper respiratory infection symptoms.
“Clinical specimens are being taken from them, and preliminary results are expected in a few days.
“A variety of common respiratory viruses and bacteria can cause mild upper respiratory infection symptoms,” the spokesman added.
The spokesman said further genetic sequencing was being conducted to determine if the virus found in the girl's specimen from UCH was completely of avian origin.
Further investigation into the case with emphasis on the source of infection is ongoing.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2007/070322_1.html

Gene sequencing on H9N2 virus shows bird to human transmission more likely
23 March 2007
Genetic sequencing studies of the virus isolated from a nine-month-old girl with H9N2 infection showed that all the genes from the virus were entirely of avian origin, a spokesman for the Centre for Health Protection (CHP) of the Department of Health said today (March 23).
The spokesman explained that the test results indicated it was more likely that the virus was directly transmitted from bird to human and that there was no re-assortment with human influenza virus.
As regards the laboratory tests on the respiratory specimens taken from a healthcare worker and three children staying in the same cubicle in the United Christian Hospital with the baby girl in early March, all of them yielded negative result to H9 virus.
The four had shown mild upper respiratory infection symptoms and specimens were taken from them for testing yesterday.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2007/070323.html

CHP investigating a case of influenza A (H9N2) infection
30 Dec 2008
The Centre for Health Protection (CHP) of the Department of Health is investigating a case of influenza A (H9N2) infection, a mild form of avian influenza, involving a two–month-old girl.
The Controller of CHP, Dr Thomas Tsang said today (December 30) the baby girl, living in Shenzhen with her parents, developed vomiting, cough and runny nose (but no fever) and was admitted to Tuen Mun Hospital (TMH) on December 22. She was discharged on the next day.
The girl was taken back to Shenzhen and was re-admitted to TMH on December 29 because of high white blood cell count, which may be suggestive of underlying hematological condition.
Dr Tsang said influenza A (H9N2) virus was detected from the girl's respiratory specimen taken on December 22.
The girl was staying at hospital for isolation and further investigation. Her family members are asymptomatic all along and have been put under medical surveillance.
"Further genetic sequencing is being conducted to determine if the virus is completely of avian origin," Dr Tsang said.
"As the girl was staying in Shenzhen for the whole incubation period, we have informed the Guangdong health department of this case and they will carry out necessary investigation and follow up actions.
The department will inform the World Health Organization, the Ministry of Health, health authorities of Macao about the findings.
Influenza A (H9N2) is an avian influenza virus which has been isolated from duck and chicken for many years. Infection in humans is rare, and appears to present as a mild disease.
Dr Tsang noted that this was the fifth time H9N2 viruses, an avian influenza virus, were isolated from humans in Hong Kong.
Three girls and a boy were confirmed to have suffered from H9N2 infection in 1999, 2003 and 2007 respectively.
Hong Kong has a very comprehensive avian influenza surveillance programme to detect the presence of any avian influenza in our environment and the possible reassortment of the viruses so that prompt responsive measures can be taken, Dr Tsang said.
As a precautionary measure, people are reminded to avoid contact with live poultry to minimise the chance of being infected with avian influenza.
"Hands should be washed thoroughly with soap and water after handling live poultry.
"To build up good body resistance against influenza, the public are encouraged to maintain a balanced diet, do regular exercise, and have adequate rest. They should not smoke," Dr Tsang said.
Members of the public can obtain updated information on influenza from the CHP's website
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2008/081230-2.html

Update on H9N2 case
31 Dec 2008
The two-month-old baby girl who was confirmed to have been infected with influenza A H9N2 yesterday is still under isolation in Tuen Mun Hospital (TMH) in stable condition and her symptoms of the disease have subsided.
Nasopharyngeal aspirate specimens taken from her parents were tested negative for influenza A H9N2.
Staff of the Centre for Health Protection has contacted other patients and health care workers who might have been exposed to the baby girl and has put them under medical surveillance. So far, none of them have developed symptoms of respiratory infection.
Meanwhile, preliminary investigation by the health authority of Guangdong showed that a small number of chickens were kept in a food premises near the baby girl’s home in Shenzhen.
All her close contacts in Shenzhen and the workers in the food premises were asymptomatic and have been put under medical surveillance by the Guangdong health authority.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2008/081231-3.html

Gene sequencing of H9N2 virus shows avian origin
7 Jan 2009
The Centre for Health Protection (CHP) of the Department of Health today (January 7) completed gene sequencing on an influenza A (H9N2) virus found in a two-month-old girl in December 2008 and the results indicated all the genes were of avian origin.
A CHP spokesman said all the eight genes of the virus sample taken from the girl had been sequenced.
"DNA sequences of the genes concerned show that they are of avian origin and re-assortment with genes of human influenza origin has not been found.
"The virus is highly similar to the H9N2 virus isolated from another case involving a nine-month-old girl in 2007," he said.
The spokesman noted that the virus found in the two-month-old girl was sensitive to Tamiflu and Amantadine , two kinds of antiviral medicines.
The girl is still under treatment in Tuen Mun Hospital for another disease. Her symptoms of H9N2 infection have subsided. Nasopharyngeal aspirate specimens taken from the girl on January 2 were tested negative for influenza A H9N2.
All close contacts of the girl did not developed symptoms of H9N2 infection.
"The epidemiological and genetic findings so far suggest that the H9N2 virus has shown no signs of increased risk for human-to-human transmission," the spokesman said.
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2009/090107-2.html

3 Nov 2009
The Centre for Health Protection (CHP) of the Department of Health is investigating an imported case of influenza A (H9) infection, a mild form of avian influenza.
A spokesman for CHP said today (November 3) the woman, who aged 47 and lived in Guangdong Province, developed shortness of breath and cough with sputum on October 26. She went to Hong Kong for medical treatment and was admitted to Queen Mary Hospital on October 28. She is now in stable condition.
Influenza A (H9) virus was detected in the patient's respiratory specimen taken on October 29.
The patient had an underlying medical condition, requiring regular medication. As she stayed in Guangdong Province during the whole incubation period, CHP had informed health authority of Guangdong for its follow-up actions.
The woman is staying in isolation in hospital for further investigation. Her family members are asymptomatic and they have been put under medical surveillance.
The department informed the World Health Organization, the Ministry of Health, and the health authorities of Guangdong and Macao of the development, the spokesman said.
Influenza A (H9) is an avian influenza virus which has been isolated from duck and chicken for many years. Infection in humans is rare, and appears to present as a mild disease.
This is the sixth time that H9 viruses was found in humans in Hong Kong.
Four girls and a boy were confirmed to have suffered from H9 infection in 1999, 2003, 2007 and 2008 respectively.
The spokesman said, "Hong Kong has a comprehensive avian influenza surveillance programme to detect the presence of any avian influenza in our environment and the possible reassortment of the viruses so that prompt responsive measures can be taken."
As a precautionary measure, people are reminded to avoid contact with live poultry to minimise the chance of being infected with avian influenza.
"Hands should be washed thoroughly with soap and water after handling live poultry.
"To build up good body resistance against influenza, the public are encouraged to maintain a balanced diet, do regular exercise, and have adequate rest. They should not smoke." the spokesman said.
For further information on avian influenza, please visit the CHP website
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2009/091103-2.html

CHP investigating case of influenza A (H9N2) infection
23 Dec 2009
The Centre for Health Protection (CHP) of the Department of Health is investigating a case of influenza A (H9N2) infection - a mild form of avian influenza - involving a 35-month-old girl.

A spokesman for CHP said today (December 23) the girl, living in Sha Tin, developed symptoms of cough, fever, runny nose since late November. She was admitted to the Prince of Wales Hospital and was discharged on December 11. She has now recovered.

Influenza A (H9N2) was detected in the patient's respiratory specimen.

Investigation is ongoing.

The department will inform the World Health Organization.

Influenza A (H9) is an avian influenza virus which has been isolated from duck and chicken for many years. Infection in humans is rare, and appears to present as a mild disease.

This is the seventh time that H9 viruses was found in humans in Hong Kong. Five females and a male were confirmed to have suffered from H9 infection in 1999, 2003, 2007, 2008 and 2009.

"Hong Kong has a comprehensive avian influenza surveillance programme to detect the presence of any avian influenza in our environment and the possible reassortment of the viruses so that prompt responsive measures can be taken," the spokesman said.

As a precautionary measure, people are reminded to avoid contact with live poultry to minimise the chance of being infected with avian influenza.

"Hands should be washed thoroughly with soap and water after handling live poultry.

"To build up good body resistance against influenza, the public are encouraged to maintain a balanced diet, do regular exercise, and have adequate rest. They should not smoke." he said.

For further information on avian influenza, please visit the CHP website at
Department of Health - Press Release

http://www.dh.gov.hk/english/press/2009/091223-3.html

[Giuseppe]

Re: China - Man, 86, hospitalized in Hong Kong with H9N2 avian flu after travel from Shenzhen, Guangdong province

[Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).]


Epidemiological investigation and follow-up actions by CHP on confirmed human case of avian influenza A(H9N2)


The Centre for Health Protection (CHP) of the Department of Health (DH) today (December 31) provided an update on the confirmed human case of avian influenza A(H9N2) affecting a man aged 86.

"The epidemiological investigations, enhanced disease surveillance, port health measures and health education against avian influenza are all ongoing," a spokesman for the DH said.

The patient's home contact in Shenzhen has remained asymptomatic.

The 51 health-care workers (HCWs) of North District Hospital (NDH) and the ambulance service remain under medical surveillance.

Among them, an HCW of NDH presented with productive cough and sore throat and the respiratory specimen tested negative for the influenza A virus upon testing by the CHP's Public Health Laboratory Services Branch (PHLSB).

The officer who handled the patient upon his entry at Lo Wu Border Control Point is also asymptomatic. He has been put under medical surveillance. So far, there are no newly located contacts.

As the patient was staying in Shenzhen for the whole incubation period, the case is classified as an imported one. The CHP has passed investigation findings to the health authority of Guangdong for follow-up.

"Upon analysis by the PHLSB, the genes of the virus were determined to be of avian origin. They do not show significant differences from avian influenza viruses detected in Hong Kong and the Mainland in recent years. There is no evidence of genetic reassortment with genes of human influenza origin or resistance to the antiviral Tamiflu. We will continue to liaise and share the gene sequence with other health authorities based on established arrangements," the spokesman remarked.

The public is advised to avoid contact with poultry and wild birds, including chickens, ducks and sparrows.

"Travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.

Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:

• Do not visit live poultry markets. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
• Poultry and eggs should be thoroughly cooked before eating;
• Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
• Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
• Avoid crowded places and contact with fever patients; and
• Wear masks when respiratory symptoms develop or when taking care of fever patients.

The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html ) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf ) for more information on avian influenza-affected areas and provinces.


Ends/Tuesday, December 31, 2013
Issued at HKT 16:38
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[Treyfish]

Re: China - Man, 86, hospitalized in Hong Kong with H9N2 avian flu after travel from Shenzhen, Guangdong province

Border crosser arrives carrying bird flu

Kelly Ip

Tuesday, December 31, 2013
....Center experts were last night still trying to track the source of the virus, Leung said.
"The latest medical study found that sparrows and magpies carry the H9N2 virus and are able to transmit it," Leung said, noting such birds are common in the region. So people should avoid contact with birds and live poultry.
He also said there is a low risk of gene mixing among the different kinds of bird flu found in Hong Kong as live chickens cannot be kept overnight in markets while there has long been a ban on the import of live ducks.

Six females and a male were confirmed with H9N2 in 1999, 2003, 2007, 2008 and 2009 in Hong Kong. Five were local cases, one was imported and one was unclassified. All had mild infections and no deaths from H9N2 have been recorded.
University of Hong Kong microbiologist Ho Pak-leung said it would be difficult for health workers to track the origin of the latest case of H9N2.
"The virus is common in domestic poultry," Ho said, adding: "But it's not easy to transmit between humans."
Kenneth Tsang Wah-tak, a specialist in respiratory medicine, said: "This virus is not as serious as H5N1 and H7N9 and the virus is diluted in the air. As long as you don't touch birds - especially those that are dead - and their feces you need not worry too much."http://www.thestandard.com.hk/news_d...=20131231&fc=2