Severe Acute Respiratory Syndrome SARS Introduction Hong Kong

Severe Acute Respiratory Syndrome (SARS) Introduction

Hong Kong situation (on 23 May 2003) 4 No. of cases: 1724 4 No. of death: 260 4 male: female 4. 5: 5. 5

Age distribution 0 -14 15 -24 25 -34 35 -44 45 -54 55 -64 65 -74 75 or above 5% 10% 24% 21% 15% 7% 8% 10%

Occupations 4 Information collected from 90. 3% of cases 4 61% working population 4 39% non-working population

Working Group Health Care Workers 23. 9% Food Handlers 1. 9% Domestic Helpers 1. 9% School Staff 1. 5% Disciplinary Force 0. 6% Others 31. 3% (e. g. drivers, clerical and administrative personnel)

Non-working Group Retired Housewives Students Pre-school Children Visitors/Tourists Others (e. g. unemployed) 12. 9% 10. 1% 8. 7% 0. 6% 0. 3% 6. 6%

Incidence of SARS cases by residential areas 4 Kwun Tong 4 Tai Po 4 Sha Tin 4 Other 15 districts 11. 8 per 10 000 6. 2 4. 1 0. 5 -2. 4

Clinical Presentation 4 Fever is the commonest reported symptom 4 Other symptoms: chills, malaise, cough, headache and muscle ache 4 % of elderly having fever is lower 4 Only 61% have respiratory symptoms, 32% have GI symptoms

General Symptoms Fever Chills Malaise Headache Muscle Ache Rigors Loss of appetite 93. 3% 58% 55. 9% 42. 6% 41. 8% 35. 9% 28%

Respiratory Symptoms Cough Sore throat Shortness of breath Running nose 45. 8% 18. 3% 15. 3% 12. 4%

GI Symptoms Diarrhoea Vomiting Nausea Abdominal pain 17. 5% 11. 3% 10. 2%

Combination of symptoms Fever and chills Fever and malaise Fever and cough 55. 8% 53. 1% 42. 8%

Symptoms of different age groups 0 -14 15 -64 65 and above Fever and cough Fever with general symptoms only 10 to 36% having fever with one other symptom

Home Confinement 4 Household contacts 4 confirmed or suspected cases 4 maximum of 10 days 4 for monitoring and referral for treatment

As at 22 May 4 1219 persons had been affected 4 49 were still under confinement 4 33 had been confirmed to have SARS

Border Checks Health Declaration Post 4 airport, ports and border points 4 incoming travellers to complete a health declaration

Temperature checks 4 All passengers arriving, departing and transit passengers 4 at the HK International Airport 4 temperature checks

Other control points: 4 arriving passengers subjected to screening 4 all departing passengers from Ferry Terminals and Hung Hom Station are required to undergo temperature checks 4 So far, 2 passengers had been confirmed to have SARS

Other Measures Setting up of Designated Medical Centres (DMC) 4 monitor contacts other than household contacts 4 daily reports and monitoring Schools 4 recent return to school 4 daily temperature checks 4 Close school for cleaning once suspected case identified

General Health Education 4 Daily press release for dissemination of information 4 SARS symptoms 4 Hand hygiene, personal and environmental hygiene 4 Cleaning campaigns

Thank You

Background Information 4 Nov 02, reports of cases in Guandong, China 4 Mar 02, professor visited Hong Kong to attend banquet 4 Outbreaks of infection in local hospitals and overseas

Case Definition 4 WHO 4 Probable cases 4 Suspected cases 4 other considerations

Cases worldwide 4 No. of cases 4 No. of deaths

The responsible agent 4 SARS related corona virus 4 co-infection with other agents 4 new recent findings

Mode of transmission 4 Droplets infection 4 close contacts 4 Amoy garden reports 4 superspreaders

Virus behaviour 4 Survival 4 incubation period

Treatment methods 4 Inpatient treatment – ribarivirin – steroids – combination

Treatment methods 4 Inpatient treatment – ribarivirin – steroids – combination 4 Vaccine – no effective vaccine available – need time for development – 1 to 5 years

WHO recommendations 4 Case detection and treatment 4 Contact tracing and isolation 4 Prevention of export of cases by health checks at borders 4 Education of public – symptoms of SARS – hand hygiene, personal and environmental hygiene

WHO information 4 Updates in website 4 affected areas with recent local transmission 4 travel advice to affected areas