Health Authorities Warn Public: Protect Against Invasive Group B Streptococcus from Handling Raw Freshwater Fish

CHP updates on latest situation of invasive Group B Streptococcus infection

The Centre for Health Protection (CHP) of the Department of Health today (September 16) continued its investigation into the latest situation of invasive Group B Streptococcus infection. The CHP appealed to members of the public for heightened vigilance and in particular, to pay attention when touching or handling raw freshwater fish and should wear gloves, as well as not to consume undercooked freshwater fish.

The CHP has been monitoring with the Hospital Authority (HA) the admission figures in relation to invasive Group B Streptococcus infection cases. Since the announcement of the situation of Group B Streptococcus infection belonged to serotype III sequence type 283 (ST283) on September 13, the CHP has today confirmed 13 additional ST283 cases involving patients recently admitted with invasive Group B Streptococcus infection. The CHP's epidemiological investigations showed that the 13 patients with ST283 infections involved seven males and six females, aged between 35 and 94. The patients mainly presented with sepsis (eight patients) and joint abscess (five patients). Together with the 27 cases of ST283 infection announced on September 13, this cluster involved a cumulative total of 40 patients residing in 18 districts throughout the territory. Their onset date of the disease were between August 8 and September 5, and 30 of them have underlying illnesses. The HA's information showed that among the 40 patients, 10 have been discharged, 25 hospitalised patients are in stable condition, three in serious condition and the other two with underlying illness passed away.

The CHP's analysis of samples of other recently admittedpatients is still in progress and it cannot rule out that the number of cases will further increase.

The CHP's epidemiological investigations revealed that 31 patients have contacted with or handled raw freshwater fish before onset of symptoms (five of them reported that they had wounds on their hands when handling raw freshwater fish), six patients cannot rule out that they have consumed undercooked freshwater fish (not freshwater fish sashimi), and the exposure history of the remaining three patients is under investigation.

Furthermore, none of the 40 patients were fishmongers or engaged in fish culture related jobs. As the patients resided in various districts throughout the territory, and the freshwater fishes concerned were bought from 23 markets in 11 districts respectively, the CHP considered that the affected freshwater fish may involve the wholesale level. After knowing that the genetic sequence of samples collected from a retail freshwater fish stall matched those found in some patients, the CHP immediately teamed up with the Agriculture, Fisheries and Conservation Department (AFCD) to conduct an inspection in the Freshwater Fish Market under the Cheung Sha Wan Wholesale Food Market, and collect environmental samples for testing and analysis. The laboratory analysis is still in progress. So far, no abnormality has been observed regarding the freshwater fish in the wholesale fish markets. Besides, the CHP and the Food and Environmental Hygiene Department (FEHD) have conducted medical surveillance on over 200 workers and no symptomatic worker identified. The FEHD have strengthened the cleansing and disinfection of the relevant markets.

The CHP has issued a letter to doctors to enhance their alertness for Group B Streptococcus infection cases. The CHP's investigations, as well as prevention and control works, which include closely monitoring the admission cases, conducting genetic analysis of patients' bacterial samples, testing environmental samples, and strengthening health education to workers and the public, especially the education related to wound care and consumption of freshwater fish, are still ongoing. The AFCD will continue to monitor the health condition of freshwater fish supplied to Hong Kong and ensure that there are no abnormalities and to implement feasible measures to reduce proliferation of bacteria.

"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.

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'sInvasive Group B Streptococcus Infection associated with Sequence Type 283 (ST283)page for more information.

CHP reminds public on precautions against heat stroke during very hot weather

The Centre for Health Protection (CHP) of the Department of Health (DH) today (September 19) reminded members of the public, particularly those undertaking outdoor activities, to take heed of necessary measures against heat stroke and sunburn in very hot weather.

"The public should carry and drink plenty of water to prevent dehydration while engaging in outdoor activities," a spokesman for the CHP said.

"Those engaged in strenuous outdoor activities should avoid beverages containing caffeine, such as coffee and tea, as well as alcohol, as they speed up water loss through the urinary system," the spokesman explained.

"Infants and children, the elderly, pregnant women, those with chronic illnesses such as heart disease or high blood pressure, outdoor/manual workers, and individuals who are overweight are more vulnerable to heat stroke. They should pay special attention," the spokesman added.

The public should adopt the following precautions:

Wear loose and light-coloured clothing to reduce heat absorption and facilitate sweat evaporation and heat dissipation;

Avoid vigorous exercise and prolonged activities like hiking or trekking as heat, sweating and exhaustion can place additional demands on the physique;

Perform outdoor activities in the morning or the late afternoon, if possible;

For indoor activities, open all windows, use a fan or use air-conditioning to maintain good ventilation;

Do not stay inside a parked vehicle; and

Reschedule work to cooler times of the day if feasible. If working in a hot environment is inevitable, introduce shade in the workplace where practicable. Start work slowly and pick up the pace gradually. Move to a cool area for rest at regular intervals to allow the body to recuperate.

​The public should also note the latest and the forecast Ultraviolet (UV) Index released by the Hong Kong Observatory (HKO). When the UV Index is high (6 or above):

Minimise direct exposure of the skin and the eyes to sunlight;

Wear long-sleeved and loose-fitting clothes;

Wear a wide-brimmed hat or use an umbrella;

Seek a shaded area or put on UV-blocking sunglasses;

Apply a broad-spectrum sunscreen lotion with a minimum sun protection factor (SPF) of 15, preferably higher. Reapply every two hours if you stay out in the sun, and after swimming, sweating or towelling off; and

While using DEET-containing insect repellents for personal protection against mosquito-borne diseases, apply sunscreen first, then insect repellent.

​If symptoms develop, such as dizziness, headache, nausea, shortness of breath or confusion, rest and seek help immediately, and seek medical advice as soon as possible.

​The public may obtain more information from the DH's Health Education Infoline (2833 0111),heat strokepage andUV radiationpage; the HKO's Dial-a-Weather (1878 200),latestweather report and forecast,UV Indexand weather information forhiking and mountaineering; andpress releasesof the Labour Departmenton precautions against heat stroke for outdoor workers and their employers when the Very Hot Weather Warning is in force.