The Hong Kong government closed all the territory’s primary schools, special schools, kindergartens, and day nurseries for two weeks on 13 March to try to minimise infection during the peak of the flu season and to calm the nerves of anxious parents. The government has not taken such a drastic public health measure since the outbreak of severe acute respiratory syndrome in 2003, when all school classes were suspended for seven weeks.
Although Hong Kong is experiencing its expected seasonal peak for flu, two deaths have unexpectedly occurred. On 1 March a 3 year old girl died of respiratory causes and tested positive for influenza A (H3). A 7 year old boy died on 11 March, and laboratory tests gave positive results for influenza A (H1N1). Both patients had been discharged from Tuen Mun Hospital and then readmitted after their condition deteriorated. A preliminary investigation has found that there were other underlying causes in both cases. The 3 year old may have had a metabolic defect that increased the severity of her disease, and the 7 year old had taken steroids for asthma, which may have suppressed his immune system. Officials say that the cases do not signify a significant public health threat.
A third child, a 3 year old boy, was hospitalised on 11 March with persistent fever, cough, and shortness of breath and transferred to intensive care on 12 March. He also tested positive for influenza A (H1N1). By that date outbreaks of flu-like illness had occurred in 23 schools, affecting 184 people.
Unusually, five different flu strains are circulating in Hong Kong at the moment, whereas normally one strain accounts for 70% of infections, said Ho Pak-leung, associate professor at the University of Hong Kong’s Department of Microbiology. He said, “Half of the cases have been caused by two strains of influenza B (Malaysia and Yamagata), and the other half have been caused by three influenza A strains, split equally between H1 (Solomon Islands) H1 (Brisbane), and H3 (Brisbane).”
“It’s difficult to predict the peak, because there are so many strains that are new to the population, and the winter has been unusually long here—so it may not decline at the end of March as usual and may continue through to April,” he said.
Hong Kong’s public hospitals have been grappling with more than 110% occupancy since early February, and the daily rate of medical admissions was 16% higher last month than in February 2007. The Hong Kong Hospital Authority has since allocated an additional $HK20m (£1.3m; €1.6m; $2.6m) to compensate staff for an estimated 40 000 hours of overtime accumulated since the beginning of February and to fund other measures to cope with the flu season until the end of April.
How well Hong Kong copes with the upsurge in cases, the demand for hospital beds, and the social consequences of the current outbreak will be a measure of how well it would cope with an outbreak of pandemic flu. “It’s up to the international medical community to judge how well we do, but I hope the results will speak for themselves,” said Thomas Tsang, controller of the Department of Health’s Centre for Health Protection.