Surveillance of acute flaccid paralysis in Hong Kong: 1997 to 2002

Objectives. To describe the characteristics of patients reported with acute flaccid paralysis between 1997 and 2002, and to evaluate the performance of the acute flaccid paralysis surveillance system using indicators recommended by the World Health Organization. Design. Retrospective study. Setting. Department of Health, Hong Kong. Participants. Children aged younger than 15 years who were reported to the Department of Health between 1997 and 2002 with acute flaccid paralysis. Results. Of 120 children with acute flaccid paralysis reported between 1997 and 2002, 42% were younger than 5 years of age. None of the cases were acute poliomyelitis or polio-compatible. A neurological cause was identified in 67.5% of cases, of which the most common was Guillain-Barré syndrome (42%), followed by transverse myelitis (15%). All except one of the performance indicators consistently met World Health Organization requirements and thus demonstrated the effectiveness of the acute flaccid paralysis surveillance programme. The acute flaccid paralysis notification rate consistently exceeded 1.0 per 100 000 population below 15 years of age. The requirement for adequate stool investigation was the single indicator that did not satisfy World Health Organization requirements. This highlighted the importance of maintaining physicians' awareness of acute flaccid paralysis surveillance. Conclusion. Hong Kong should remain vigilant for acute flaccid paralysis. The effective surveillance system and its evaluation may serve as a model for surveillance of other infectious diseases.published_or_final_versio

Proceedings of The First Current Topic in Infectious Diseases: Consensus Meeting on Conjugate Vaccines of the Center of Infection

Titles include: 1. Invasive Haemophilus Influenzae b Disease: Overview and Disease Burden in Hong Kong (YL LAU) ; 2. Overview and Disease Burden of Haemophilus Influenzae Type b in China (YH YANG) ; 3. Factors to Consider in the Routine Use of Hib in Hong Kong (THF TSANG) ; 4. Burden of Pneumococcal Disease in Hong Kong (CB CHOW) ; 5. Overview and Disease Burden of Streptococcus Pneumoniae in China (YH YANG) ; 6. Resistance in Pediatric Isolates of Pneumococci. Results from a Territorywide Carriage Study (SSS CHIU) ; 7. Serotype Distribution of Invasive and Noninvasive Strains of Pneumococci in Hong Kong (PL HO) ; 8. Overview of Conjugate Pneumococcal Vaccine: Serotype Coverage, Efficacy and Status of Usage in other Countries (SSY WONG)Conference Theme: The First Current Topic in Infectious Diseasespublished_or_final_versio

Infection fatality risk of the pandemic A(H1N1)2009 virus in Hong Kong

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Identification of novel porcine and bovine parvoviruses closely related to human parvovirus 4

Human parvovirus 4 (PARV4), a recently discovered parvovirus found exclusively in human plasma and liver tissue, was considered phylogenetically distinct from other parvoviruses. Here, we report the discovery of two novel parvoviruses closely related to PARV4, porcine hokovirus (PHoV) and bovine hokovirus (BHoV), from porcine and bovine samples in Hong Kong. Their nearly full-length sequences were also analysed. PARV4-like viruses were detected by PCR among 44.4% (148/333) of porcine samples (including lymph nodes, liver, serum, nasopharyngeal and faecal samples), 13% (4/32) of bovine spleen samples and 2% (7/362) of human serum samples that were sent for human immunodeficiency virus and hepatitis C virus antibody tests. Three distinct parvoviruses were identified, including two novel parvoviruses, PHoV and BHoV, from porcine and bovine samples and PARV4 from humans, respectively. Analysis of genome pequences from seven PHoV strains, from three BHoV strains and from one PARV4 strain showed that the two animal parvoviruses were most similar to PARV4 with 61.5-63% nt identities and, together with PARV4 (HHoV), formed a distinct cluster within the family Parvoviridae. The three parvoviruses also differed from other parvoviruses by their relatively large predicted VP1 protein and the presence of a small unique conserved putative protein. Based on these results, we propose a separate genus, Hokovirus, to describe these three parvoviruses. The co-detection of porcine reproductive and respiratory syndrome virus, the agent associated with the recent 'high fever' disease outbreaks in pigs in China, from our porcine samples warrants further investigation. © 2008 SGM.published_or_final_versio

Age-specific incidence rate in severe or symptomatic infection due to pandemic H1N1 2009 influenza virus

Poster Abstract Session - Influenza and H1N1 Diagnosis, Epidemiology, and Viral Outcome: abstract no. 1133BACKGROUND: Age-specific incidence of the 2009 pandemic influenza provides the scientific basis of public health policies and the basic science research on the age-related susceptibility to influenza. While previous epidemiological studies provided vital information for public health policies, most did not incorporate age-specific data of asymptomatic, symptomatic and severe infection in the analysis. In this study, we incorporated data from seroprevalence and microbiologically-confirmed infection to estimate the relative impact of the pandemic influenza on various age groups. METHODS: For the determination of pre-pandemic and post-pandemic seroprevalence, archived plasma samples randomly collected at the clinical biochemistry department of Queen Mary Hospital in the years 2007 and 2010 were used respectively. Microbiologically-confirmed cases and severe cases reported to the Centre for Health Protection (CHP) from May 1, 2009 to May 23, 2010 were included in our analysis. This study was approved by the institutional review board of the Hospital Authority of Hong Kong. RESULTS: 795 and 1000 plasma samples were collected in 2007 and 2010 respectively. In 2007, 8.7% and 14.2% of individuals had HI titers ≥40 and ≥10 respectively. The pre-existing cross-reactive antibodies were mainly found in patients aged >70 years old. In 2010, the overall proportion of individuals with HI titers ≥40 and ≥10 is 23.2% and 42.2%. The highest overall microbiologically-confirmed incidence rate was found in the 0-10 year age group, and decreased with increasing age (ρ=-1.0, p<0.01). A total of 282 severe cases were reported with a mean age was 47.6 years. The incidence rate of severe cases showed an apparent bimodal age distribution, with higher incidence rate in the age group 0-10 and those older than 50 years old, and the highest incidence rate being those between 51 and 60 years old. CONCLUSION: While the young adults were most commonly infected, the clinical consequence is most alarming in children and older adults aged over 50 years. Public policies should continue to target this high risk group.published_or_final_versionThe 49th Annual Meeting of the Infectious Diseases Society of America (IDSA 2011), Boston, MA., 20-23 October 2011

Home Telehealth Uptake and Continued Use Among Heart Failure and Chronic Obstructive Pulmonary Disease Patients: a Systematic Review

Background Home telehealth has the potential to benefit heart failure (HF) and chronic obstructive pulmonary disease (COPD) patients, however large-scale deployment is yet to be achieved. Purpose The aim of this review was to assess levels of uptake of home telehealth by patients with HF and COPD and the factors that determine whether patients do or do not accept and continue to use telehealth. Methods This research performs a narrative synthesis of the results from included studies. Results Thirty-seven studies met the inclusion criteria. Studies that reported rates of refusal and/or withdrawal found that almost one third of patients who were offered telehealth refused and one fifth of participants who did accept later abandoned telehealth. Seven barriers to, and nine facilitators of, home telehealth use were identified. Conclusions Research reports need to provide more details regarding telehealth refusal and abandonment, in order to understand the reasons why patients decide not to use telehealth

Risk factors for community-associated methicillin-resistant Staphylococcus aureus infection in Hong Kong

OBJECTIVES: The risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection were not well understood. The objective of this study was to identify risk factors associated with CA-MRSA infection in Hong Kong. METHODS: We carried out a matched case control study. Cases and controls were recruited from 14 acute public hospitals in Hong Kong. One control was individually matched to one case based on sex, age, admission date and ward location. We interviewed each case and control by telephone using a standard questionnaire. We used a conditional logistic regression model for multivariate analysis. RESULTS: We successfully recruited 127 pairs of matched case and control. We found that sharing of personal items with other persons had a higher risk of CA-MRSA infection (Adjusted matched odds ratio [aOR]: 4.71, 95% confidence interval [CI] 1.43-15.59). On the other hand, patients who had frequent hand washing practice (aOR: 0.21, 95%CI 0.06-0.72) and those who reported history of acne (aOR: 0.12, 95%CI 0.02-0.74) had a lower risk of CA-MRSA infection. CONCLUSIONS: We concluded that sharing of personal items with other persons is a risk factor for CA-MRSA infection while frequent hand washing is a protective factor against the infection.link_to_subscribed_fulltex

Real-time estimation of transmissibility of pandemic influenza in Hong Kong

Conference Theme: Healthcare Reforms in Comparative Health SystemsAbstract and Poster PresentationThe RACMA/HKCCM International Conference on 'Healthcare Reforms in Comparative Health Systems', Hong Kong, China, 4-6 September 2010

Excess mortality associated with influenza A and B virus in Hong Kong, 1998–2009

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