?????????????????????? Seminar on Prevention, Investigation and Control of Viral Gastroenteritis and Influenza ????? ?????????

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??????????????????????Seminar on Prevention,
Investigation and Control of Viral
Gastroenteritis and Influenza??????????????
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???? Main Points

• ???????????????
• What is viral gastroenteritis and influenza?
• ?????????????????Under what conditions to notify
  Centre for Health Protection?
• ?????????/???
• How to manage symptomatic staff or students?
• ?????
• Investigation of infectious diseases
• ????
• Other resources

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??????Viral Gastroenteritis

• ??????(???????)?????????????,??????????Gastroente
  ritis is an inflammation of the stomach and
  intestines (both small and large).

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??????Viral Gastroenteritis

• ????????????It is more commonly found during
  cooler months of the year.
• ??????????????,???????????????? Viral
  gastroenteritis is an infection caused by a
  variety of viruses. The most common viruses that
  cause gastroenteritis are Norovirus and rotavirus.

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??????????Viral Gastroenteritis Update

• ??9?15?,????103????????????????,???1142?,?????????
  ??,??????(17)????(5)???(9)???(2) ????(35)?As of
  September 15, there were 103 reported outbreaks
  of viral gastroenteritis caused by Norovirus,
  affecting about 1142 persons and occurring in
  institutions like schools, child care centres and
  homes for the elderly.
• ??????,??113?,??1719??In 2003, there were 113
  reported outbreaks, involving 1719 persons.

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??Symptoms

• ???????????? The main symptoms of viral
  gastroenteritis are
• ?? (diarrhea)
• ??(vomiting)
• ??????????????Other symptoms include headache,
  fever, and abdominal cramps
• ????????????????,???????,???????? In general,
  the symptoms begin 1 to 2 days following
  infection with a virus that causes
  gastroenteritis and may last for 1 to 10 days,
  depending on which virus causes the illness.

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???? Mode of transmission

• ??????????,???????????????,??????????????????????
  ????Viral gastroenteritis is contagious. People
  in any age group may be infected and it is
  particularly easy to occur and spread in
  institutional setting like residential care homes
  for the elderly or schools. It can be transmitted
  via the following means
• ??????????????? By food or water contaminated
  with the viruses
• ??????????? By contact with vomitus or faeces
  from infected persons
• ??????????? By contact with contaminated
  objects or
• ?????? By aerosol spread.

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??Treatment

• ????,??????????,??????????????????????(??)?The
  most important point for both children and adult
  is to prevent severe loss of fluids
  (dehydration).
• ???????,??????????(?????????)?????,??????Medicati
  ons, including antibiotics (which have no effect
  on viruses) and other treatments, should be
  avoided unless specifically recommended by a
  physician.
• ?????????????????????,????????,????????? Most
  people will not be seriously ill by viral
  gastroenteritis. Those who get viral
  gastroenteritis require fluid replacement and
  usually recover completely without any long-term
  problems.

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?? (1) Preventive measures (1)

• ????????????????,?????????,?????????,??????Curre
  ntly, there is no effective vaccination against
  viral gastroenteritis. However, the public is
  advised to reduce their chance of being infected
  by adopting the following measures
• ????????????,?????????????????? Wash hands
  thoroughly before handling food and eating, and
  after going to toilets and handling vomitus or
  faecal matter

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??(2) Preventive measures (2)

• ???149????????????????????? Clean and
  disinfect contaminated areas and items promptly
  and thoroughly with 149 diluted household
  bleach
• ?????????,???? Sick students should rest at
  home and not attend class
• ????????Maintain good indoor ventilation
• ??????????????,?????? Wear gloves while
  cleaning up vomitus and faeces, and wash hands
  afterwards
• ???????????,????????????Eat only thoroughly
  cooked food, particularly seafood and shellfish.

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????? Influenza

• ?????????
• What is influenza?
• ??????????
• Caused by highly infectious viruses
• ??????????
• 3 types of viruses Influenza A, B and C
• ?? (H3N2 H1N1)???????
• Influenza A (H3N2 H1N1) and B more commonly
  seen
• ???????????????? ?
• Higher incidence in February, March and July
  of each year in Hong Kong

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?????????Influenza Update

• ??9?15?,???? 206 ????????,???2395?,???????????,???
  ???(7)????(1)???(26)???(18) ????(116)?As of
  September 15, there were 206 reported outbreaks
  of influenza, affecting about 2395 persons and
  occurring in institutions like schools, child
  care centres and homes for the elderly.
• ??????,??63?,??928??In 2003, there were 63
  reported outbreaks, involving 928 persons.

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??????? Symptoms of Influenza

• ????????????? ???
• Cough, sore throat, runny nose, fever,
  headache
• ????
• Malaise
• ???
• Muscle pain

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????Mode of transmission

• ?????????????????
• Airborne or droplet spread

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????? Influenza

• ???
• Incubation period
• ???????
• usually 1-4 days
• ???
• Period of communicability
• ???????????????7????????
• The viruses may be found in the secretion of
  a patient from a few days before and up to 7 days
  after symptom onset

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????Treatment

• ????????????????
• Majority will recover spontaneously
• ???????????
• Symptoms usually last 3-4 days
• ??????????
• Cough may last for 1-2 weeks
• ??????????
• ???????????????????
• Symptoms can be relieved by medicine such as
  cough suppressant, anti-pyretics, and nasal
  decongestants

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????????When to consult a doctor?

• ????????????
• High fever, sore throat and persistent cough
• ??????
• Purulent sputum
• ???????????
• Chest discomfort, haemoptysis and shortness of
  breath
• ??????????????????????
• Children complain of ear pain, high fever,
  become irritable and scratch the ears

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????Preventive measures

• ????
• Balanced diet
• ????
• Adequate rest
• ??????
• Maintain good ventilation
• ?????????
• Good personal and environmental hygiene

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?????????????????Under what conditions to notify
Centre for Health Protection?

• ???????
• Signs of disease spread
• ????
• Disease conditions
• ??????????
• e.g., vomiting, diarrhea, fever
• ????
• Sick leave absence
• ?????????
• Whole centre vs. same class

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???????Students noted to have disease in centre

• ???????????????????
• If there is a cluster of sickness in same class
  above what is normally expected
• ?? ??????????
• Ex 3 students with diarrhea or fever
• ?????????????????
• Unusual incidents suggestive of infectious
  disease outbreaks in centre
• ????????????????
• Ex multiple vomiting incidents requiring clean
  up in a day

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????Sick leave absence

• ???????
• In whole centre
• ???????????????
• Log sick leave absence of whole centre every day
• ???????????
• Determine baseline range
• ???????????,?????????
• Notify CHP if above baseline range
• ?????
• Within a class
• ??????????
• Find out if absence is due to sickness
• ????????????????????,??????????
• If cluster of sickness absence in same class is
  above what is normally expected, notify CHP
• ??????????????
• Ex 3 students reported to have diarrhea, or
  fever

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????,??????????In case of doubtCall
CHP24772772
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?????????Management of sick staff and students

• ??????,??????
• If onset at centre, stay in isolation room
• ??????????
• Inform parents or guardians immediately
• ????????
• Seek medical advice promptly
• ???
• Sick leave, refrain from school/ work
• ??????48?? (?????)
• Sick leave until 48 hours after recovery
  (Norovirus)

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???????Investigation of infectious diseases

• ???? obtain information
• ???? questionnaire survey
• ???? environmental assessment
• ???? control measures
• ?? communication

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?? Information required

• ???? (?????) leave records (nature of leave)
• ???????????? name list of affected persons,
  contact number
• ???? total number of staff and students
• ????????????? class, activities, timetable,
  sitting plan
• ??? floor plan
• ????/?? meal arrangements/ menu
• ????? staff duty roster

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???? Questionnaire survey

• ???????/ ????
• information from affected persons, or through
  the staff
• ???? onset time
• ?? symptoms
• ?? medical consultation
• ???? food history
• ???? confidentiality

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???? Environmental assessment

• ???? setting
• ???? hygiene
• ???? ventilation
• ?????? Toilet, kitchen facilities
• ???? disinfection techniques
• ???? interview patients
• ???? specimen collection

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???? Control measures

• ??????????? Seek medical treatment and sick leave
• ???? Cohorting
• ????? Disinfection
• ??????? Correct handling of vomitus
• ?????? Suspension of mixing activities
• ???? Surveillance

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?? Communication

• ???????? notify parents or guardian
• ?? telephone
• ?? Memo/ letter
• ????? SWD
• ???? media enquiries

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???? Other resources

• ?????????? ?? 2833 0111
• Central Health Education Unit Hotline
• ?? Website http//www.cheu.gov.hk
• ??????? Food and Environmental Hygiene Department
• ?? Website http//www.fehd.gov.hk

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???? Other resources

• ????????? http//www.chp.gov.hk
• ?? gt ???????? gt ?? gt ?????
• 1.????????????????????????????????????? 
• 2. ????/???/?????????

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??Thank you
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• ??
• Questions??