The Centre for Health Protection (CHP) of the Department of Health (DH) announced that as of 8pm today (February 18), the CHP is investigating two additional cases of novel coronavirus infection, taking to 62 the number of confirmed cases so far in Hong Kong.
 
     The first case involves a 32-year-old woman (the 61st case) who is the domestic helper of the 67-year-old female patient of the 52nd case confirmed on February 13. The patient has good past health who lives in Block D, Mount Parker Lodge in Quarry Bay. She developed fever and cough since February 2. Her symptoms subsided after self-medication and she did not consult a private doctor. She was transferred to Pamela Youde Nethersole Eastern Hospital where she was admitted for isolation and management by the CHP during its epidemiological investigation on February 14. Her respiratory samples were initially tested negative for novel coronavirus. The patient has undergone further check-ups owing to persistent clinical symptoms and her respiratory samples were tested positive for novel coronavirus today. She is now in a stable condition. The patient had no travel history during the incubation period. She also did not attend the family dinner of her employer held in North Point on January 26. Her close contacts (except the case 52), namely her employers and their kids, have already been arranged for quarantine earlier on.
 
     The second case involves a 58-year-old man (the 62nd case) with good past health who lives alone in Cambridge Building, 25-41 Hong Ning Road, Kwun Tong. He developed fever and chills since February 11, and cough since February 15. He consulted the same private doctor on February 11 and 13 respectively. He sought medical attention at United Christian Hospital yesterday and was admitted for treatment. His respiratory sample was tested positive for novel coronavirus and he is now in a stable condition. The patient travelled to Zhongshan (from January 23 to February 2) and Macao (February 5) during the incubation period.
 
     Relevant contract tracing by the CHP is ongoing.

     A spokesman for the CHP said, "According to our preliminary epidemiological investigations, some of the confirmed cases are locally infected. The CHP strongly urged the public to maintain at all times strict personal and environmental hygiene which is key to personal protection against infection and prevention of the spread of the disease in the community."

     The spokesman said, "On the personal level, members of the public should wear a surgical mask when having respiratory symptoms, taking public transport or staying in crowded places. They should also perform hand hygiene frequently, especially before touching the mouth, nose or eyes. The public should go out less and reduce social activities, and maintain appropriate social distance with other people as far as possible."

     "As for household environmental hygiene, members of the public are advised to maintain drainage pipes properly and regularly pour water into drain outlets (U-traps); after using the toilet, they should put the toilet lid down before flushing to avoid spreading germs."

     The CHP will report the case to the World Health Organization, National Health Commission, Health Commission of Guangdong Province and Health Bureau of Macao.
       
     The CHP's epidemiological investigations and relevant contact tracing on the confirmed cases are ongoing. Quarantine will be arranged for close contacts while medical surveillance will be arranged for other contacts. For the progress on the contact tracing of the cases, please see annex.

     The CHP has set up a hotline (2125 1122) for public enquiries. The hotline operates from 8am to midnight daily. As at 4pm today, a total of 16 044 calls were received.

     A dedicated webpage (www.gov.hk/ncv) has been set up by the CHP. Information including the latest local situation, list of buildings and list of flights/trains/ships relevant to the confirmed cases, countries/areas with reported cases as well as health advice and a "Novel Coronavirus Infection Local Situation Interactive Map Dashboard" are available on the webpage to help the public grasp the latest updates.

     To prevent pneumonia and respiratory tract infection, members of the public should always maintain good personal and environmental hygiene. They are advised to:

• Wear a surgical mask when taking public transport or staying in crowded places. It is important to wear a mask properly, including hand hygiene before wearing and after removing a mask;
• Perform hand hygiene frequently, especially before touching the mouth, nose or eyes; after touching public installations such as handrails or door knobs; or when hands are contaminated by respiratory secretions after coughing or sneezing;
• Maintain drainage pipes properly and regularly (about once a week) pour about half a liter of water into each drain outlet (U-traps) to ensure environmental hygiene;
• After using the toilet, put the toilet lid down before flushing to avoid spreading germs;
• Wash hands with liquid soap and water, and rub for at least 20 seconds. Then rinse with water and dry with a disposable paper towel. If hand washing facilities are not available, or when hands are not visibly soiled, performing hand hygiene with 70 to 80 per cent alcohol-based handrub is an effective alternative;
• Cover your mouth and nose with tissue paper when sneezing or coughing. Dispose of soiled tissues into a lidded rubbish bin, then wash hands thoroughly; and
• When having respiratory symptoms, wear a surgical mask, refrain from work or attending class at school, avoid going to crowded places and seek medical advice promptly.

     The public should take heed of the health advice below when travelling outside Hong Kong:

• Do not travel to Hubei Province where community transmission of novel coronavirus is occurring;
• Avoid close contact with persons with fever or respiratory symptoms in countries/areas with possible community transmission of novel coronavirus infection. If it is unavoidable to come into contact with them, put on a surgical mask and continue to do so until 14 days after returning to Hong Kong;
• Avoid visiting hospitals. If it is necessary to visit a hospital, put on a surgical mask and observe strict personal and hand hygiene;
• Avoid touching animals (including game), poultry/birds or their droppings;
• Avoid visiting wet markets, live poultry markets or farms;
• Avoid making close contact with patients, especially those with symptoms of acute respiratory infections;
• Do not consume game meat and do not patronise food premises where game meat is served;
• Adhere to food safety and hygiene rules such as avoiding consuming raw or undercooked animal products, including milk, eggs and meat, or foods which may be contaminated by animal secretions, excretions (such as urine) or contaminated products, unless they have been properly cooked, washed or peeled;
• If feeling unwell when outside Hong Kong, especially if experiencing a fever or cough, wear a surgical mask, inform the hotel staff or tour escort and seek medical advice at once; and
• After returning to Hong Kong, consult a doctor promptly if experiencing a fever or other symptoms, take the initiative to inform the doctor of any recent travel history and any exposure to animals, and wear a surgical mask to help prevent spread of the disease. 

The following is issued on behalf of the Hospital Authority:

　　The Hospital Authority (HA) today (February 18) announced the further extension of the Enhanced Laboratory Surveillance Programme to further advance the identification of novel coronavirus infected patients to minimise the risk of community transmission.
 
     "To combat the novel coronavirus epidemic, the HA has widened the coverage of the Enhanced Laboratory Surveillance Programme several times in the past so as to identify more cases as early as possible," the HA spokesperson said.
 
     "The current Enhanced Laboratory Surveillance Programme covers all inpatient pneumonia cases. Around 700 to 800 tests are being conducted each day in all public hospitals. Around 20 cases which have no travel nor contact history with confirmed cases have been identified through the Programme, which is about one-third of the confirmed cases."
 
     The spokesperson said that there were increasing number of cases in the community and some patients presented with mild symptoms only. Many patients were diagnosed as common upper respiratory infections until their conditions deteriorated.
 
     "After prudent consideration of the current capacity of isolation facilities in public hospitals, the HA decided to dovetail with the recommendations of the Scientific Committees of the Centre for Health Protection (CHP) to extend the surveillance to outpatients.  This will help detect mild cases in the community and to have a better understanding of the epidemiological situation."
 
     Starting from tomorrow (February 19), Accident and Emergency Department (AED) or General Out-patient Clinic (GOPC) patients aged 18 or above, presented with fever and respiratory symptoms or mild chest infection, will be given a specimen bottle for the collection of deep throat saliva in the early morning of the following day, if hospital admission is considered unnecessary according to clinical assessment.  Patients are required to return the specimens to the AED or GOPC for novel coronavirus laboratory testing.
 
     "The HA will send the specimen to the Public Health Laboratory Centre (PHLC) of the Department of Health (DH).  Patients do not need to stay in hospital to wait for test result. The HA will inform the patient via SMS if the test result is negative to novel coronavirus while the CHP will contact the patient for hospital admission for isolation and other follow-up if the test result is positive."
 
     Under the current containment strategy to manage the epidemic, 17 AEDs and over 50 GOPCs of the HA will launch this trial programme in the coming week with a view to advance the detection of infected patients and to minimise the risk of community outbreak.
 
     "Data collected from the Programme can help ascertain the proportion of infected patients in the community and support the upcoming epidemic management strategy formulation," the spokesperson added.
 
     The HA and CHP will closely monitor the implementation and the outcome of the Programme to make adjustments as required.

     The Government today (February 18) announced that the "Enhanced Laboratory Surveillance Programme" by the Hospital Authority (HA) would be expanded from tomorrow (February 19) to cover the patients attending the General Out-patient Clinics (GOPCs) as well as Accident and Emergency Departments (AEDs), with a view to further enhancing the current surveillance, prevention and control strategy in Hong Kong.

     On a trial basis, the HA will arrange testing on deep throat saliva specimen for outpatients attending GOPCs and AEDs with fever and respiratory symptoms, and without epidemiological links with confirmed cases of novel coronavirus infection. Infection control advice will be given to outpatients awaiting test result.

     A spokesman for the Food and Health Bureau (FHB) said, "After reviewing the measures in light of the latest situation of novel coronavirus infection in Hong Kong, the Scientific Committee on Emerging and Zoonotic Diseases and the Scientific Committee on Infection Control under the Centre for Health Protection of the Department of Health (DH) also recommended that the enhanced surveillance be expanded from inpatient to outpatient settings. We believe that the aforesaid measure helps detect mild cases in the community and provide a better understanding of the epidemiological situation."

     Under the Preparedness and Response Plan for Novel Infectious Disease of Public Health Significance, the FHB, the DH and the HA have taken into account risk assessment and the development of the disease to expand the "Enhanced Laboratory Surveillance" programme in phases. The scheme was implemented in mid-January to conduct tests for novel coronavirus infection on pneumonia patients meeting the relevant criteria, and has been further expanded in late January to cover all in-patient pneumonia cases.

     The FHB, the DH and the HA will continue to closely monitor the latest development of the disease.

  

     Police today (February 18) appealed to the public for information on a man who went missing in Wong Tai Sin.

     Wong Man-tak, aged 58, went missing after he was last seen at Chuk Yuen (North) Estate in the small hours of January 22. His family made a report to Police yesterday (February 17).
         
     He is about 1.73 metres tall, 65 kilograms in weight and of medium build. He has a square face with yellow complexion and short black hair. He was last seen wearing a grey jacket, black trousers, slippers and a pair of gold-framed glasses.
      
     Anyone who knows the whereabouts of the missing man or may have seen him is urged to contact the Regional Missing Person Unit of Kowloon East on 3661 0316 or 9886 0060 or email to rmpu-ke-2@police.gov.hk, or contact any police station.

  

     The Centre for Health Protection (CHP) of the Department of Health is today (February 18) investigating a cluster of Legionnaires' disease (LD) cases involving 14 patients and stressed the importance of using and maintaining properly designed man-made water systems and that susceptible groups should strictly observe relevant precautions.
      
     Further to the CHP's announcements on a cluster of LD cases on February 1, 3, 6, 7, 10, 11, 13 and 17, two additional LD cases relevant to the cluster has been recorded today, accumulating a total of 11 male and three female patients aged 52 to 94.

     Details of the two LD cases are as follows:
 
1. A male patient, aged 94 with underlying illness, who lives in Hung Shek House, Ping Shek Estate, Kwun Tong;

2. A female patient, aged 52 with underlying illness, who lives in Block 2, 22 Wing Ting Road, Ngau Chi Wan.

     Patients' samples tested positive for Legionella pneumophila.

     "Epidemiological investigations revealed that the male and the female patient developed symptoms on February 6 and January 28 respectively. They had no travel history in the incubation period (IP). The CHP is following up on the collection of environmental and water samples and continuing its investigation. Investigations are ongoing," a spokesman for the CHP said.

     "Men, people aged over 50, smokers, alcoholics and persons with weakened immunity are more susceptible to LD. Some situations may also increase the risk of infection including poor maintenance of water systems leading to stagnant water; living in areas with old water systems, cooling towers or fountains; using electric water heaters, whirlpools and spas or hot water spring spas; and recent stays in hotels or vessels," the spokesman said.
      
     Legionellae are found in various environmental settings and grow well in warm water (20 to 45 degrees Celsius). They can be found in aqueous environments such as water tanks, hot and cold water systems, cooling towers, whirlpools and spas, water fountains and home apparatus which support breathing. People may become infected when they breathe in contaminated droplets (aerosols) and mist generated by artificial water systems, or when handling garden soil, compost and potting mixes.
           
     Immunocompromised persons should:

• Use sterile or boiled water for drinking, tooth brushing and mouth rinsing;
• Avoid using humidifiers, or other mist- or aerosol-generating devices. A shower may also generate small aerosols; and
• If using humidifiers, or other mist- or aerosol-generating devices, fill the water tank with only sterile or cooled freshly boiled water, and not water directly from the tap. Also, clean and maintain humidifiers/devices regularly according to manufacturers' instructions. Never leave stagnant water in a humidifier/device. Empty the water tank, wipe all surfaces dry, and change the water daily.
 
     The public should observe the health advice below:
 
• Observe personal hygiene;
• Do not smoke and avoid alcohol consumption;
• Strainers in water taps and shower heads should be inspected, cleaned, descaled and disinfected regularly or at a frequency recommended by the manufacturer;
• If a fresh water plumbing system is properly maintained, it is not necessary to install domestic water filters. Use of water filters is not encouraged as clogging occurs easily, which can promote growth of micro-organisms. In case water filters are used, the pore size should be 0.2 micrometres (µm) and the filter needs to be changed periodically according to the manufacturer's recommendations;
• Drain and clean water tanks of buildings at least quarterly;
• Drain or purge for at least one minute infrequently used water outlets (e.g. water taps, shower heads and hot water outlets) and stagnant points of the pipework weekly or before use;
• Seek and follow doctors' professional advice regarding the use and maintenance of home respiratory devices and use only sterile water (not distilled or tap water) to clean and fill the reservoir. Clean and maintain the device regularly according to the manufacturer's instructions. After cleaning/disinfection, rinse the device with sterile water, cooled freshly boiled water or water filtered with 0.2 µm filters. Never leave stagnant water in the device. Empty the water tank, keep all surfaces dry, and change the water daily; and
• When handling garden soil, compost and potting mixes:
    1. Wear gloves and a face mask;
    2. Water gardens and compost gently using low pressure;
    3. Open composted potting mixes slowly and make sure the opening is directed away from the face;
    4. Wet the soil to reduce dust when potting plants; and
    5. Avoid working in poorly ventilated places such as enclosed greenhouses.

     The public may visit the CHP's LD page, the Code of Practice for Prevention of LD and the Housekeeping Guidelines for Cold and Hot Water Systems for Building Management of the Prevention of LD Committee, and the CHP's risk-based strategy for prevention and control of LD.