[influenza] DGVI Nachricht H9N2 in Hongkong

From: "Heckler, Rolf" <Rolf.Heckler@xxxxxxxxxxxxxxxxxxxxx>
To: "Influenza Listserver (E-Mail)" <Influenza@xxxxxxxxxxxxx>
Date: Wed, 10 Dec 2003 09:01:53 +0100
Die DGVI informiert:
 
Eine Nachricht von 
Director of Health 
Hong Kong SAR, China 
 

Influenza A (H9N2) infection in a 5-year-old boy



Late afternoon today (Dec 9), the DH Public Health Laboratory Center (PHLC)
reported a preliminary test result on a nasopharyngeal aspirate specimen
that was positive for influenza A (H9N2).   Further tests are being
conducted to sequence the virus to confirm its identity.   

The patient is a 5-year-old boy with good past health living in Kwun Tong
district.  On Nov 27, he was admitted to United Christian Hospital (UCH)
with a 2-day history of fever, cough, and runny nose (onset on 25 Nov).  He
made a complete recovery and was discharged on Nov 29.  He did not travel
recently outside Hong Kong. 

This evening, DH contacted 4 family members of the patient.  Three of them
were suffering from upper respiratory tract symptoms (cough, runny nose,
afebrile) with onset dates on 26 November, 6 December and 8 December 03
respectively.  DH is giving them health advice and have taken clinical
specimens (three serum and three throat swabs) from them.  DH will also
investigate the kindergarten that the child is studying at. 

Genetic sequencing is being performed to confirm the identity of the virus,
and determine whether it is completely of avian origin.   

DH operates a sentinel surveillance system on influenza-like-illness
covering more than 100 doctors in Hong Kong.  Every week DH reports the
trend of influenza-like-illness on its website.  During recent weeks, there
has been no abnormal rise in influenza-like-illness detected in the
community.  There is no other influenza strain now in DH's PHLC that is
suggestive of H9N2. 

We have a comprehensive avian influenza surveillance programme that cover
local chicken farms, imported poultry, the wholesale market, retail outlets,
wild birds, waterfowls in recreational parks and pet birds in the market.
Since March 2003, we have been implementing two rest days per month on a
regular basis in all retail outlets.   

We will inform you of the laboratory results and further epidemiological
investigation findings in due course. 

Cases in 1999 

In March 1999, there were two cases of H9N2 in two girls, aged four years
and 13 months respectively, who suffered from influenza-like illnesses.
Both girls recovered uneventfully.  Since then, no further human case of
H9N2 infections was discovered in the local population. 

During that investigation, antibody to H9N2 virus was only found one (0.4%)
out of the 233 persons tested. This seropositive person was a health care
worker who had no history of exposure to the two H9N2 patients nor poultry.
None of the contacts at home and school and the hospital staff who had taken
care of the patients had tested positive. 

In a prevalence study, one out of the 200 blood donors, two out of the 100
poultry workers and none of the 200 hospital staff and patients had tested
positive. 

Serology tests conducted by the then AFD indicated that over 70% of the
batches of poultry tested had evidence of exposure to H9 virus.  It was
noted that the virus usually causes mild symptoms, if any, among birds and
poultry. 

The evidence suggested that poultry was the source of infection and the main
mode of H9N2 transmission was from bird-to-human. However, the possibility
of person-to-person transmission remained open.  The overall low prevalence
of antibody among the various groups tested indicated that the transmission
of the isolated H9N2 virus among the local population was relatively rare
and inefficient. 


Dr Ronald LAM 
for Director of Health 
Hong Kong SAR, China 

 
 
 
 
weitere aktuelle Links
 
Homepage der AGI (Arbeitsgemeinschaft Influenza)
http://influenza.rki.de/agi <http://influenza.rki.de/agi> 
 
 
Die aktuelle Grippe-Informationsseite der Firma Roche:
http://www.roche.de/pharma/indikation/grippe/realflu/report_ge.pdf
<http://www.roche.de/pharma/indikation/grippe/realflu/report_ge.pdf> 
 
 

 

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[influenza] DGVI Nachricht H9N2 in Hongkong

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