CHP appeals for heightened vigilance against invasive Group B Streptococcus
The Centre for Health Protection (CHP) of the Department of Health today (September 13) appealed to members of the public for heightened vigilance against invasive Group B Streptococcus and in particular, urged them to pay attention when touching or handling raw freshwater fish and should wear gloves, as well as not to consume undercooked freshwater fish.
Hong Kong has recorded in 2021 summer (between September and October) a cluster of more than 50 cases of Group B Streptococcus, belonged to serotype III sequence type 283 (ST283). The then investigation found that the infections were associated with contact of raw freshwater fish or consumption of undercooked freshwater fish. The CHP subsequently enhanced surveillance on the relevant cases with the Hospital Authority (HA). The recent surveillance data revealed an upward trend in the number of in-patients tested positive for invasive Group B Streptococcus during last month and September 11. The CHP immediately conducted further laboratory analysis of the cases in collaboration with the HA and the preliminary result showed that 27 of the cases were ST283. The CHP's analysis of some of the samples is still in progress and it cannot rule out that the number of cases will further increase.
The CHP's epidemiological investigations showed that the 27 patients with ST283 infections involved ten males and 17 females, aged between 53 and 88 (median: 70), residing in 18 districts throughout the territory, with no district clustering identified. Among them, 20 patients have underlying illness. The patients mainly presented with sepsis (15 patients), joint abscess (nine patients), meningitis (two patients) and urinary tract infection (one patient). The HA's information showed that among the 27 patients, five have been discharged, 17 hospitalised patients are in stable condition, three in serious condition and the other two passed away. The CHP is obtaining further information on the cause of death from HA.
The CHP also conducted an in-depth investigation on the exposure history of individual patients prior to the onset of the disease in order to identify the possible sources of infection. It was found that about 90 per cent of the patients had contact with or handled raw freshwater fish, prior to the onset of their disease. Seven of them reported that they had wounds on their hands when handling raw freshwater fish, but no infected person reported that they had consumed freshwater fish sashimi. Based on the above information, the CHP considered that the cause of infection was related to the handling of or contact with raw freshwater fish (especially with wound on the hands).
In addition, investigations revealed that 19 patients had been to freshwater fish stalls in markets and contacted freshwater fish, which involved 14 markets located in different districts. The personnel of the CHP had inspected markets where some of the patients had visited and wholesale fish markets supplying live fish to conduct epidemiological investigations. A total of 71 relevant workers have been monitored and no symptomatic worker found. The CHP has provided health education to the workers and will continue to monitor health conditions of workers of other fish stalls. During the investigations, it was identified that the ST283 isolates of environmental and fish samples collected from a retail freshwater fish stall inside the Shek Wu Hui Market is identical to those found in some patients. For prudence's sake, the Food and Environmental Hygiene Department (FEHD) has arranged thorough cleansing and disinfection for all freshwater fish stalls inside Shek Wu Hui Market. The investigations of the CHP are ongoing.
The CHP, the FEHD and the Agriculture, Fisheries and Conservation Department (AFCD) held a joint meeting today to review the relevant situation. The FEHD's personnel will inspect all fish stalls, licensed Fresh Provision Shops and Permitted Premises selling freshwater fishin Hong Kong, provide education on hygiene to relevant workers and request them to strengthen cleaning and disinfection work at the premises. The FEHD conducts thorough cleaning at each public market every day and will pay special attention to the hygiene condition in the vicinity of freshwater fish stalls in the markets. Separately, the AFCD confirmed no abnormality has been observed regarding freshwater fish in wholesale fish markets and will continue to monitor the condition of live fish.
"Literature reported that ST283 exists in freshwater fish, especially in Southeast Asia countries, and with seasonal pattern. Association between invasive Group B Streptococcal infection of ST283 and consumption of raw freshwater fish was also reported in overseas literature," a spokesman for the CHP said.
"Members of the public shall wear gloves when touching or handling raw freshwater fish. If symptoms such as inflamed wound and fever develop, they should seek medical attention promptly. Meanwhile, the public should refrain from consuming undercooked freshwater fish," a spokesman for the CHP reminded.
The CHP will issue a letter to doctors to enhance their alertness for Group B Streptococcus infection cases. The CHP will continue to provide advice to members of the public through different channels to minimise the infection risk and work together with relevant departments to enhance publicity, especially health education related to wound care and consumption of freshwater fish.
A spokesman for the FEHD said that in order to protect public health, freshwater fish sashimi is a prohibited food item under the Food Business Regulation (Cap. 132X) in Hong Kong.
To prevent Group B Streptococcus (ST283) infection, members of the public are reminded to maintain personal, food and environmental hygiene and should keep their hands clean and practice good wound care at all times, especially:
The public may visit the CHP's Invasive Group B Streptococcus Infection associated with Sequence Type 283 (ST283) page for more information.
Source: AI-generated images
CHP reminds public on precautions against cold weather
The Centre for Health Protection (CHP) of the Department of Health (DH) today (December 22) reminded the public, particularly the elderly and people with chronic illnesses, to adopt appropriate measures to protect their health in view of the cold weather.
A spokesman for the CHP said that cold weather can easily trigger or exacerbate diseases, especially among the elderly and persons suffering from heart disease, respiratory illnesses or other chronic illnesses.
"Elderly people have less insulating fat beneath their skin to keep them warm, and their body temperature control mechanisms may be weaker. Their body may not be able to appropriately respond to thecold weather," the spokesman said.
Some senior persons may have decreased mobility, which can impair their ability to generate and conserve body heat. Chronic illnesses, such as hypertension, diabetes and endocrine disorders, may undermine the health of elderly people and lower their metabolic rate, subsequently causing their body to generate less heat. Persons with chronic illnesses, such as chronic respiratory illnesses or heart disease, are vulnerable to disease aggravation due to cold weather.
The CHP reminded the public, in particular the elderly and persons with chronic illnesses, to adopt the following preventive measures:
Take note of the weather forecast. Wear warm clothing, including hats, scarves, gloves and socks, accordingly;
Consume sufficient food to ensure adequate calorie intake;
Perform regular exercise to facilitate blood circulation and heat production;
Stay in a warm environment and avoid prolonged outdoor exposure;
Use heaters with care and maintain adequate indoor ventilation; and
Seek medical advice if feeling unwell.
In addition, the public should avoid alcoholic beverages.
"Drinking alcohol cannot keep you warm. Alcohol accelerates the loss of body heat through dilated blood vessels, resulting in chilling instead," the spokesman said.
"Parents should ensure that babies are sufficiently warm, but it is also important to keep babies relatively lightly clothed to avoid overheating them," the spokesman added.
Parents should observe the following safety measures when putting their children to bed:
Keep the room well ventilated and at a comfortable temperature;
Always place babies on their backs to sleep. Leave their heads, faces and arms uncovered during sleep;
Babies do not need pillows. Place babies on a firm and well-fitted mattress to sleep. Avoid soft objects, pillows and loose bedding;
Let babies sleep in a cot placed near their parents' bed; and
Maintain a smoke-free environment.
In addition, many respiratory pathogens, including influenza and SARS-CoV-2, may have increasing activity and community transmission during winter. Seasonal influenza vaccination is recommended for all persons aged 6 months or above, except those with known contraindications. Persons at higher risk of getting influenza and its complications, including the elderly and children, should receive seasonal influenza vaccinations early. Please see details of the vaccination schemes on theCHP's website.
A person who gets influenza and COVID-19 at the same time may be more seriously ill and would have a higher risk of death. It is important for elderly persons, especially those residing in residential care homes, to receive both a seasonal influenza vaccination and a COVID-19 vaccination. They should also receive an additional booster against COVID-19 according to recommendations as soon as possible. The public should also maintain good personal and environmental hygiene against respiratory illnesses and note the following:
Surgical masks can prevent transmission of respiratory viruses from ill persons. It is essential for persons who are symptomatic (even if having mild symptoms) to wear a surgical mask;
Wear a surgical mask when taking public transport or staying in crowded places. It is important to wear a mask properly, including performing hand hygiene before wearing and after removing a mask;
Avoid touching one's eyes, mouth and nose;
Wash hands with liquid soap and water properly whenever possibly contaminated;
When hands are not visibly soiled, clean them with 70 to 80 per cent alcohol-based handrub;
Cover the mouth and nose with tissue paper when sneezing or coughing. Dispose of soiled tissue paper properly into a lidded rubbish bin and wash hands thoroughly afterwards;
Maintain good indoor ventilation;
When having respiratory symptoms, wear a surgical mask, refrain from work or attending classes at school, avoid going to crowded places and seek medical advice promptly; and
Maintain a balanced diet, exercise regularly, take adequate rest, do not smoke and avoid overstress.
Food-borne diseases, particularly those linked to hotpot cuisine, are also common in cold weather. The following preventive measures should be taken:
Wash hands before handling and consuming food;
Do not patronise unlicensed vendors or those with poor hygienic standards while selecting food;
Wash and cook all food thoroughly;
Vegetables should be washed thoroughly in clean running water before cooking and consumption. When appropriate, scrub vegetables with hard surfaces with a clean brush to remove dirt and substances, including pesticide residues and contaminants, from surfaces and crevices;
Shrimps should be fully cooked until the shells turn red and the flesh turns white and opaque;
For shellfish such as scallops and geoduck, scrub the shells thoroughly and remove internal organs;
Do not eat any undercooked freshwater aquatic products. To ensure that the food is thoroughly cooked, the centre of the food should reach a temperature of at least 75 degrees Celsius so as to destroy pathogen;
Most hotpot ingredients should be stored in a refrigerator at 4 degrees C or below, while frozen food should be stored in a freezer at -18 degrees C or below;
Never use raw eggs as a dipping sauce for hotpot; and
Use different sets of chopsticks to handle raw and cooked food to avoid cross-contamination.
In addition, when using fuel-burning appliances, especially in indoor areas, the public should ensure adequate ventilation to avoid harmful exposure to carbon monoxide (CO) and prevent CO poisoning.
For more health information, the public may call the DH's Health Education Infoline (2833 0111) or visit theCHP's websiteandFacebook Fanpage.
The public may also call Dial-a-Weather (1878 200) or visit thewebsite of the Hong Kong Observatoryfor the latest weather information and forecasts, or itspage on Weather Information for Senior Citizens.
