3. Public Health Situation in Hong Kong Dr Regina Ching Department of Health 5.3.2004

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

5. 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

6. 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) 81122 increasing

7. Health indices (2002) IMR 2.4/1000 registered LB MMR 4.2/100 000 LB LE at birth (female) LE at birth (male) 84.7 years 78.7 years

8. 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

9. 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

10. 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

11. The SARS epidemic 0 20 40 60 80 100 120 4 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

12. HK in the limelight (2003) ML China 5327349 HKSAR1755299 Taiwan665180 Canada25141 Singapore23833

13. 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

14. Top 5 CDs by notification 19992000200120022003 1. Chickenpox 2. Tuberculosis 3. Food poisoning 4. V hep Rubella V hep SARS 5. B dysen V hep Measles B dysen V hep

15. Heavy involvement in CD prevention and control ‘ Press release ’ as proxy ‘ Press release ’ as proxy From 24.6.2003 to 20.2.2004 From 24.6.2003 to 20.2.2004 130 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

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

17. 17

18. 18

19. 19

20. 20

21. 21

22. 22

23. 23

24. 24

25. 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

26. 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

27. Port health measures

28. Temperature checks for SARS identification

29. Temperature checks at border control points

30. 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

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

32. 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

33. 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

34. 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

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

36. 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

37. 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

38. Engaging the community In partnership with schools & community sectors

39. “… 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

40. Thank you