All notified malaria cases were thoroughly investigated and followed up by regional health staff. This active surveillance programme was undertaken to minimize the possibility of a build-up of parasite density in the local community and to ensure that all practicable prevention and treatment programmes were being instituted effectively. With the establishment of the Central Reference Laboratory for malaria, all positive slides as well as 10 percent of negative slides were routinely cross-checked for the presence of the parasite.
Malaria control in the territory is concentrated on early case detection and notification, vector control and health education.
Health talks, film shows, posters, pamphlets, press releases, radio and television interviews are used to remind the general public to eliminate mosquito breeding sites and to urge picnickers and international travellers to protect themselves against mosquito bites.
Immunisation programmes were carried out in schools as well as Family Health Service clinics. Primary 1 & 6 children receive booster vaccination for protection against diphtheria, tetanus and poliomyelitis. In addition, girls in primary 6 are given rubella vaccination. The coverage was up to 97.9%.
To increase the protection of the at-risk group, namely women at child-bearing age, rubella vaccination is made available to nurses, teachers and social workers who are in constant contact with children. The vaccination is also given to eligible women attending the various Family Health Services centres.
Both virus hepatitis A and hepatitis B remain prevalent in the community with 1 425 notified cases and 19 deaths reported during the year. Because of the public health implications of hepatitis, which usually leads to long-term liver complications such as cirrhosis and liver cancers, a hepatitis B vaccination programme was introducted as a prevention against the disease.
Based on the recommendation of the World Health Organisation, the present strategy is to provide immunization against hepatitis B to certain high-risk groups in the community. The first group comprises babies bora to mothers who are carriers of the disease. The second group comprises health care workers who are in frequent contact with blood and blood products or tissue fluids.
The Medical and Health Department continued to administer a combined neo-natal screening programme for glucose-6-phosphatase dehydrogenase deficiency and congenital hypothyroidism to facilitate early diagnosis and treatment of infants who may otherwise develop disabilities or mental retardation. The programne managed to cover all babies born in government and subvented hospitals. Based on the result of the screening programme so far, the prevalence of G-6-PD deficiency in local male babies is 4.5 per cent whereas the frequency of congenital hypothyroidism disorder is one in 3 200 live births. Prompt follow-up and remedial measures were instituted and the development of permanent disabilities in these children was therefore avoided. In 1986, the programme was extended to cover babies born in private hospitals as well.
In November 1984, an Advisory Committee on AIDS (Acquired Immune Deficiency Syndrome) consisting of medical experts from the Medical and Health Department and the two universities was established to monitor the global development of this disease. The Committee, in the light of available scientific data and knowledge and in line with the recommendations from Centre for Disease Control in the United States and the World Health Organization, set up guidelines to medical, nursing and laboratory personnel on the diagnosis and handling of AIDS cases. Laboratory facilities and clinical expertise for the screening, diagnosis, counselling and management of the disease were also set up.
To prevent the possible transmission of the disease through blood transfusion, the Hong Kong Red Cross Blood Transfusion Service introduced a blood screening programme in August 1985. All blood and blood products in the blood transfusion service were screened for the presence of any antibody to the AIDS virus before use.
Health educational activities on the subject were stepped up to educate the public on the facts of the disease and to allay any misconception and undue anxiety. The Department's Central Health Education Unit produced special leaflets on the subject, and a 24-hour telephone service was set up for those wanting to know more about the subject. Emphasis was placed on reaching the special at-risk group in the community. A speical AIDS counselling and consultative clinic service was also established in November 1985.
An active surveillance programme was set up in 1985 to monitor the likely occurrence of the disease in many of the high-risk groups.
Up to 1986 only three confirmed cases of AIDS have been reported. Follow-up investigations had revealed previous history of contacts with the risk factors and carriers while they were abroad. All three cases had died in the later part of 1985.
Castrointestinal diseases are endemic in the territory and small outbreaks occur from time to time. There were 223 outbreaks of food poisoning involving 1 076 persons. Organisms responsible for these outbreaks include salmonella, E. Coli, Staphylococcus and Vibrio parahemolyticus. There were also 198 cases of enteric fever, and 344 cases of bacterial dysentery. Active case finding, contact tracing and health education on food and personal hygiene by the regional health staff helped to limit the spread of these diseases in the community.
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