Public Health Situation in Hong Kong Dr Regina Ching Department of Health

Balance between viral diseases of public concern and the public health situation in Hong Kong

Presentation overview Population & health indices Population & health indices Top 10 killer diseases Top 10 killer diseases Top 10 conditions cared in hospitals Top 10 conditions cared in hospitals Top 5 notifiable infections Top 5 notifiable infections Top 5 CDs most talked about Top 5 CDs most talked about Challenges Challenges Control strategies Control strategies

Population profile (2002) Population ( ‘ 000) 6787 increasing Natural increase ( ‘ 000) 13.4 decreasing Net movement ( ‘ 000) 48.7 increasing Population growth 0.9% increasing Pop. density (per sq m) 6300 increasing Education (primary or above) 93% increasing Arrivals ( ‘ 000) increasing

Health indices (2002) IMR 2.4/1000 registered LB MMR 4.2/ LB LE at birth (female) LE at birth (male) 84.7 years 78.7 years

Leading causes of death (2002) 1.Malignant neoplasms 6.External causes 2.Heart diseases 7.Nephritis, nephrosis & nephrotic syndrome 3.Cerebrovascular disease 8.Diabetes Mellitus 4.Pneumonia9.Septicaemia 5.Chronic lower respiratory diseases 10.Aortic aneurysm & dissection

Leading causes of hospitalization (2001) 1.Genitourinary system 6.Circulatory system 2.Respiratory system 7.Pregnancy related 3.Digestive system 8.Mental & nervous system 4.Not elsewhere classified 9.Injury & poisoning 5.Endocrine & metabolic 10.Skin, musculoskeletal & connective tissue

Hospital discharges (2001) Certain infectious and parasitic diseases (A00-B99) Certain infectious and parasitic diseases (A00-B99) 2.3% of all discharges 2.3% of all discharges

The SARS epidemic Feb7 Feb 10 Feb13 Feb16 Feb19 Feb22 Feb25 Feb28 Feb 3 Mar6 Mar9 Mar 12 Mar15 Mar18 Mar21 Mar24 Mar27 Mar30 Mar 2 Apr5 Apr8 Apr 11 Apr14 Apr17 Apr20 Apr23 Apr 26 Apr29 Apr 2 May5 May 8 May 11 May14 May17 May20 May23 May26 May29 May Number of cases Amoy PWH

HK in the limelight (2003) ML China HKSAR Taiwan Canada25141 Singapore23833

Notifiable diseases under Cap 141 Cholera Cholera Plague Plague Yellow fever Yellow fever Acute poliomyelitis Acute poliomyelitis Amoebic dysentery Amoebic dysentery Bacillary dysentery Bacillary dysentery Chickenpox Chickenpox Dengue fever Dengue fever Diphtheria Diphtheria Food poisoning Food poisoning Influenza A (H5) Influenza A (H5) Legionnaires’ Disease Legionnaires’ Disease Leprosy Leprosy Malaria Malaria Measles Measles Meningococcal infections Meningococcal infections Mumps Mumps Paratyphoid fever Paratyphoid fever Rabies Rabies Relapsing fever Relapsing fever Rubella Rubella Scarlet fever Scarlet fever SARS SARS Tetanus Tetanus Tuberculosis Tuberculosis Typhoid fever Typhoid fever Typhus fever Typhus fever Viral hepatitis Viral hepatitis Whooping cough Whooping cough

Top 5 CDs by notification Chickenpox 2. Tuberculosis 3. Food poisoning 4. V hep Rubella V hep SARS 5. B dysen V hep Measles B dysen V hep

Heavy involvement in CD prevention and control ‘ Press release ’ as proxy ‘ Press release ’ as proxy From to From to of 152 PR related to CD 130 of 152 PR related to CD About 1 PR on CD every other day About 1 PR on CD every other day

Top 5 CDs most talked about SARS4328% Norovirus infections 2517% Dengue fever 2013% Influenza incl. H9, H5 1711% Cholera85% Subtotal74%

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Challenges P opulation density P opulation density P eople movement P eople movement P roximity to health threats P roximity to health threats P eace for too long P eace for too long

Control strategies S top importation S top importation S urveillance S urveillance S ystem & response S ystem & response S hare information S hare information S upport from the community S upport from the community

Port health measures

Temperature checks for SARS identification

Temperature checks at border control points

Control strategies S top importation S top importation S urveillance S urveillance S ystem & response S ystem & response S hare information S hare information S upport from the community S upport from the community

Enhanced surveillance Global Global Regional Regional Pearl River Delta Region Pearl River Delta Region Local Local –Public and private sectors –Hospital and community-based

Control strategies S top importation S top importation S urveillance S urveillance S ystem & response S ystem & response S hare information S hare information S upport from the community S upport from the community

System & response Timely diagnosis Timely diagnosis Treatment & isolation Treatment & isolation Contact management Contact management Emergency response Emergency response Professional training Professional training Service planning Service planning Resource allocation Resource allocation

Control strategies S top importation S top importation S urveillance S urveillance S ystem & response S ystem & response S hare information S hare information S upport from the community S upport from the community

Share information Open communication Open communication –With international authorities –Within the organization –With stakeholders –With the public Public education Public education Publicity Publicity

Control strategies S top importation S top importation S urveillance S urveillance S ystem & response S ystem & response S hare information S hare information S upport from the community S upport from the community

Engaging the community Team Clean, the special task force chaired by the Chief Secretary for Administration, is established to promote a sustainable, cross-sectoral approach to improve environmental hygiene in Hong Kong Team Clean, the special task force chaired by the Chief Secretary for Administration, is established to promote a sustainable, cross-sectoral approach to improve environmental hygiene in Hong Kong Zero-tolerance of littering, spitting and other unhygienic behaviour Zero-tolerance of littering, spitting and other unhygienic behaviour

Engaging the community In partnership with schools & community sectors

“… Reducing risks to health remains a vital preoccupation of all people, in all populations, and of all those who serve them.” - Dr Gro Harlem Brundtland Former DG WHO

Thank you