X1000306-1985-86_Part01 — Page 5

III Communicable Diseases

Two isolated local cases of cholera were reported in July and September. The disease affected a 71 years old woman and a 44 years old man; both recovered after treatment and no secondary case was reported. Hong Kong remains free from other quarantinable diseases. The commON communicable childhood diseases such as diphtheria, whooping cough and poliomyelitis have largely been under control. No human or animal rabies cases was reported in the year.

During the year, a total of 168 cases of malaria were notified. The trend of imported cases was still on the increase while the number of indigenous cases was reduced to 3 for the year 1985. The indigenous cases were confined to North-west New Territories and along the border areas.

All notified malaria cases were thoroughly investigated and followed up by the regional health staff. This active surveillance programme was to minimise the possibility of a built up parasite density in the local community and to ensure that all practicable prevention and treatment programmes were being instituted effectively.

Since the establishment of the Central Reference Laboratory for the detection of malaria parasites, all positive slides as well as 10% of all initially negative slides were cross-checked for quality control.

Malaria control in the territory was concentrated on early case detection and notification, vector control and health education. Health talks, film shows, posters, pamphlets, press release, radio and TV interviews were utilised to remind the general public to eliminate mosquito breeding sites and picnickers and international travellers to protect themselves against mosquito bitea.

Measles and rubella vaccination programmes were carried out in family health clinics and schools. Measles vaccinations were given to one- year-old babies and rubella vaccinations to girls in Primary 6 classes. The coverage were in the region of 701 and 97% (1985 programme) respectively.

To increase the protection of the at-risk group, namely women at child-bearing age the rubella vaccinations were made available to the nurses, teachers, social workers who are in constant contact with children. The vaccination is also given to eligible women attending the various family health services clinics.

Both virus hepatitis A and hepatitis B remain prevalent in the community with 1 601 notified coses and 13 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, the department had introduced a Hepatitis B Vaccination Programme 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 of those babies born to mothers who are carriers of the disease.

The second group comprises of health care workers who are in frequent contact with blood and blood products or tissue fluids.

The Medical and Health Department continues to administer a combined neo-natal screening programme for glucose-6-phosphatase dehydrogenose deficiency and congenital hypothyroidism to facilitate early diagnosis and treatment of infants who may otherwise develop disabilities or mental retardation. The programme managed to cover all babies born in government and subvented hospitals. Based on the result of the present screening programme so far, the prevalence of G-6-PD deficiency in local male babies is 4.5% whereas the frequency of congenital hypothyroidism disorder is 1 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.

Since November 1984, an Advisory Committee on AIDS consisting of medical experts from the Medical and Health Department and the 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 Centres for Disease Control USA and the World Health Organization, had set up guidelines to medical, nursing and laboratory personnel on the diagnosis and handling of AIDS cases, The department has also established the necessary laboratory facilities and clinical expertise for the screening, diagnosis, counselling and management of the disease.

In order to prevent the possible transmission of the disease through the blood transfusion process, the Hong Kong Red Cross Blood Transfusion Service had introduced a blood screening programme against the disease since August 1985. All blood and blood products in the blood transfusion service were screened for the presence of an antibody to the AIDS virus before use.

Health educational activities on the subject have been stepped up to educate the public on the facts of the disease and to allay any misconception and undue anxiety that might have arisen. The Department's Central Health Education Unit has also produced special leaflets on the subject. A 24-hour telephone service has also been set up for those who are interested in the subject. Emphasis has also been made to reach the special at risk group in the community. A speical AIDS counselling and consultative clinic service was also established in November 1985 to handle persons or patients who might need advice or service.

Active surveillance programme was also set up since 1985 to monitor the likely occurrence of the disease in many of the high risk groups. So far only three confirmed cases of AIDS have been detected. 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 later part of 1985.

Many gastroenteritis diseases were still endemic in the region and they occurred from time to time in small outbreaks. There were 278 outbreaks of acute food poisoning involving some 958 persons. The common organisms responsible for these outbreaks included salmonella, E. coli, staphylococcus and vibrio-parahaemolyticus. Active case finding and contact tracing were carried out by the regional health teams. Their efforts helped in limiting the spread of the disease within the community.

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