The Centre for Health Protection (CHP) of the Department of Health (DH) announced today (March 4) that in view of an increasing number of pertussis cases locally in recent years, the Scientific Committee on Vaccine Preventable Diseases (SCVPD) under the CHP has recommended that pregnant women receive one dose of acellular pertussis-containing vaccine during each pregnancy as part of routine antenatal care regardless of previous vaccination and natural infection history against pertussis, as a measure to provide direct protection for infants against pertussis.
 
     The SCVPD recommends that the vaccination can be conducted at any time in the second or third trimester, preferably before 35 weeks of gestation, for transplacental transfer of maternal vaccine-induced antibodies to the baby. Diphtheria (reduced dose), tetanus and acellular pertussis (reduced dose) (dTap) vaccine is recommended to be used while diphtheria (reduced dose), tetanus, acellular pertussis (reduced dose) and inactivated poliovirus (dTap-IPV) vaccine can also be used if available.
 
     As for women who have not received any pertussis-containing vaccine during pregnancy, they would still benefit by receiving one dose of a dTap or dTap-IPV vaccine as early as possible after delivery, preferably before discharge from the hospital, for indirect protection to infants. Of note, it requires about two weeks for antibodies to develop after the vaccination and the World Health Organization (WHO) recommends that the vaccine be given preferably at least 15 days before the end of pregnancy.
 
     Moreover, pregnant women are recommended to receive the annual inactivated seasonal influenza vaccine available for the season, which can be administered with a pertussis-containing vaccine during the same visit.
 
     In a meeting held earlier, the SCVPD reviewed the local epidemiology of pertussis, recommendations of the WHO, overseas practices, and scientific evidence on the effectiveness and safety of maternal pertussis vaccination and thus made the above recommendations.
 
     The SCVPD noted that substantial evidence supporting the effectiveness and safety of dTap vaccination in pregnancy has been documented in countries where maternal pertussis vaccination was implemented. Furthermore, there has been an increasing amount of evidence on the safety of maternal pertussis immunisation from different countries in recent years, and available evidence so far has not suggested an increase in adverse events in both mothers and infants.
 
     Pertussis is an acute, highly contagious respiratory infection spread by droplets when an infected person coughs or sneezes, or via direct contact with respiratory secretions of the infected. The disease affects people of all ages, and infants who are too young to be vaccinated are most vulnerable. Young children and particularly infants have a much higher risk of severe complications from the infection and the disease may be fatal.
 
     A pertussis-containing vaccine was first introduced in Hong Kong in 1957. Under the current Hong Kong Childhood Immunisation Programme, children receive a total of six doses of pertussis-containing vaccines, including three primary doses at 2, 4 and 6 months old and three booster doses at 18 months, Primary One and Primary Six. The immunisation coverage rate of pertussis has been maintained at a very high level of over 95 per cent for many years.
 
     In recent years, resurgence of pertussis has been observed in countries with high vaccination coverage, such as Australia, Japan, the United States and a number of European countries including Portugal and the United Kingdom. Regionally, there have also been significant increases in the number of reported pertussis cases in the Mainland including Guangdong Province.
　　
     Locally, there has been a surge in the notified pertussis cases since 2017 and the increasing trend continued through 2018. The number of pertussis cases recorded by the CHP has increased from 20 to 50 per year during 2011-16 to 69 cases in 2017, and further to 110 cases in 2018.
 
     Among the 179 cases recorded in 2017 and 2018, about 40 per cent (72 cases) affected infants aged below 6 months and all had not completed the primary series of pertussis vaccination. About 20 per cent (35 cases) were infants aged below 2 months who were not yet due for the first dose of pertussis-containing vaccine. Among the 93 adult cases recorded in the same period, about 83 per cent (77 cases) had no or unknown history of pertussis vaccination and about 48 per cent (45 cases) were not born in Hong Kong and might not have received a pertussis vaccine during their childhood.
 
     The CHP has issued a letter to doctors and hospitals to inform them of the recommendations. Meanwhile, the DH has been actively planning the implementation of the recommendations in collaboration with the Hospital Authority, details of which will be announced in due course. The Consensus Recommendation has been uploaded to the CHP website (www.chp.gov.hk/en/static/24008.html) for reference by healthcare professionals.

     The effective exchange rate index for the Hong Kong dollar on Monday, March 4, 2019 is 103.1 (down 0.2 against last Saturday's index).

     The effective exchange rate index for the Hong Kong dollar on Saturday, March 2, 2019 was 103.3 (up 0.1 against last Friday's index).

     Police are investigating a fatal traffic accident in Yau Ma Tei today (March 4) in which two men aged 54 and 59 died, while 11 women and five men were injured.

     At about 10.25am, a bus driven by the 59-year-old man was travelling along West Kowloon Highway towards Hong Kong. When approaching Yau Ma Tei Interchange, it reportedly collided with a light goods vehicle (LGV) that was stopped on the highway suspectedly due to breakdown.

     In the accident, the 59-year-old bus driver fell out from the bus and was certified dead at scene, while the 54-year-old LGV driver, who was located at the back of the LGV, was seriously injured and sent to Queen Elizabeth Hospital unconsciously where he was certified dead at 11.11am. A 39-year-old female LGV passenger, ten female bus passengers and five male bus passengers aged between 23 and 69 were injured and sent to Queen Elizabeth Hospital and Kwong Wah Hospital for medical treatment.

     Investigation by the Special Investigation Team of Traffic, Kowloon West is underway.

     Anyone who witnessed the accident or has any information to offer is urged to contact the investigating officers on 3661 9023 or 3661 9188.

     The Land Registry today (March 4) released its statistics for February 2019.
 
Land registration
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* The number of sale and purchase agreements for all building units received for registration in February was 4,999 (-10.6 per cent compared with January 2019 and -33.0 per cent compared with February 2018)

* The 12-month moving average for February was 6,259 (3.2 per cent below the 12-month moving average for January 2019 and 14.3 per cent below that for February 2018)

* The total consideration for sale and purchase agreements in February was $41.7 billion (-42.1 per cent compared with January 2019 and -33.4 per cent compared with February 2018)

* Among the sale and purchase agreements, 4,089 were for residential units (-10.0 per cent compared with January 2019 and -25.4 per cent compared with February 2018)

* The total consideration for sale and purchase agreements in respect of residential units was $36.1 billion (-19.7 per cent compared with January 2019 and -29.1 per cent compared with February 2018)

     Statistics on sales of residential units do not include sale and purchase agreements relating to sales of units under the Home Ownership Scheme, the Private Sector Participation Scheme and the Tenants Purchase Scheme unless the premium of the unit concerned has been paid after the sale restriction period.

     Figures on sale and purchase agreements received for the past 12 months, the year-on-year rate of change and breakdown figures on residential sales have also been released.

     As deeds may not be lodged with the Land Registry until up to 30 days after the transaction, these statistics generally relate to land transactions in the previous month.
 
Land search
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* The number of searches of land registers made by the public in February was 312,119 (-26.4 per cent compared with January 2019 and -9.7 per cent compared with February 2018)

     The statistics cover searches made at the counter, through the self-service terminals and via the Integrated Registration Information System Online Services.

     The Centre for Health Protection (CHP) of the Department of Health today (March 4) reported the latest number of cases of Legionnaires' disease (LD), and stressed the importance of using and maintaining properly designed man-made water systems, and that susceptible groups should strictly observe relevant precautions.
 
     From February 24 to March 2, one community-acquired LD case was reported. The male patient, aged 76 with underlying illnesses, lives in Tower 19, Laguna Verde, 8 Laguna Verde Avenue, Hung Hom.

     "Epidemiological investigations are ongoing to identify potential sources of infection, high-risk exposure and clusters, if any," a spokesman for the CHP said.

     As of March 2, six LD cases had been reported in 2019. In 2018 and 2017, there were 105 and 72 cases respectively.
 
     "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 get 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 the 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.