CHP investigates three cases of severe paediatric influenza B infection
***********************************************************************
The first case involves a 5-year-old boy with good past health. He has presented with fever, runny nose, cough, vomiting and abdominal pain since January 23. He attended Union Hospital yesterday (January 24) due to persistent symptoms and was admitted for management. His condition deteriorated after admission and he passed away this morning.
His nasopharyngeal swab tested positive for influenza B virus upon laboratory testing. The clinical diagnosis was influenza B infection complicated with encephalopathy.
Initial enquiries revealed that the patient did not receive seasonal influenza vaccination (SIV) for the current season and had no recent travel history. His mother had developed fever and cough recently and is in a stable condition. His father was asymptomatic.
Epidemiological investigations revealed that there was an influenza-like illness (ILI) outbreak in the kindergarten-cum-child care centre which the patient attended. Apart from the patient, three pupils (two boys and one girl) aged 2 to 4 have developed upper respiratory tract infection (URI) symptoms since January 19. All of them sought medical attention and none required hospitalisation. They are now in a stable condition.
Officers of the CHP have conducted a site visit and advised the kindergarten-cum-child care centre to adopt necessary infection control measures against respiratory infections.
As a precautionary measure, the CHP advised the kindergarten to suspend classes for a week from tomorrow (January 26) for thorough cleansing and disinfection.
The second case is a 6-year-old girl with good past health. She has presented with fever, cough, vomiting and shortness of breath since January 13. She was admitted to Kwong Wah Hospital (KWH) on January 20 and was subsequently transferred to the paediatric intensive care unit (PICU) for further management. Her nasopharyngeal aspirate (NPA) tested positive for influenza B virus. The clinical diagnosis was influenza B infection complicated with severe pneumonia. She is in a stable condition.
She had no recent travel history and did not receive SIV. Her younger brother had recent URI symptoms and is in a stable condition while her other home contacts have been asymptomatic.
Epidemiological investigations revealed that there was an influenza B outbreak in the primary school which the patient attended. Apart from the patient, 10 students (four boys and six girls) aged 6 to 7 have developed influenza-like illness (ILI) symptoms since January 10. All of them sought medical attention and none required hospitalisation. They are now in a stable condition. Among them, the respiratory specimens of two affected students tested positive for influenza B virus.
The third case involves another 5-year-boy with good past health. He has developed fever and cough since January 19. He was brought to the Accident and Emergency Department of KWH on January 22 and was admitted for management on the same day. Upon admission, he developed shortness of breath, confusion and drowsiness and was transferred to the PICU for further management.
His NPA tested positive for influenza B virus and blood culture collected grew Streptococcus pneumoniae. The clinical diagnoses were influenza B infection complicated with encephalopathy and invasive pneumococcal disease. The patient is now in serious condition.
He had no recent travel history and did not receive SIV. His home contacts have been asymptomatic.
A spokesman for the CHP said, "The local seasonal influenza activity has been rising markedly in the past two weeks to a high level. The influenza activity may increase further in the coming few weeks and will remain at an elevated level for some time. We strongly urge the public, particularly children, the elderly and chronic disease patients, to observe strict personal, hand and environmental hygiene for better personal protection against seasonal influenza and other respiratory illnesses in view of the expected arrival of a cold front next week as cold weather can easily trigger or exacerbate diseases especially among such high-risk groups. In particular, high-risk individuals should avoid going to crowded or poorly ventilated public places and put on surgical masks if they visit such places."
In 2018, a total of seven cases of paediatric influenza-associated severe complication/death cases (including two deaths) were recorded so far.
Meanwhile, the CHP recorded a significant increase in institutional ILI outbreaks from 26 (affecting 190 persons) in the week ending January 13 to 82 (affecting 557 persons) last week. In the first four days of this week, 72 ILI outbreaks (affecting 364 persons) have been recorded. Majority of the outbreaks reported in the past two weeks occurred in primary schools (45 per cent), followed by kindergartens/child care centres (38 per cent).
"To prevent influenza outbreaks in schools, it is very important that children with fever and respiratory symptoms should not attend schools till 48 hours after the fever has subsided. Schools and institutions are reminded to follow the Guidelines on Prevention of Communicable Diseases on preventive and control measures as well as management of outbreaks, which should be reported to the CHP for prompt follow-up," the spokesman said.
"Children, the elderly and those with underlying illnesses are recommended to get vaccinated against seasonal influenza for better personal protection. People should promptly seek medical advice if influenza-like symptoms develop so that appropriate treatment can be initiated as early as possible to prevent potential complications. Parents and carers are reminded to render assistance in prevention, care and control for vulnerable people," the spokesman added.
Besides receiving SIV for personal protection, the public should maintain good personal and environmental hygiene for protection against influenza and other respiratory illnesses. For more information, please visit the CHP's influenza page and weekly Flu Express for more information.
Ends/Thursday, January 25, 2018
Issued at HKT 20:56
Issued at HKT 20:56
NNNN