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Public Health Situation Public Health Situation in Hong Kongin Hong Kong
Dr Regina ChingDr Regina Ching
Department of HealthDepartment of Health
5.3.20045.3.2004
Balance Balance betweenbetween viral diseases of viral diseases of public concern public concern andand the public health the public health situation in Hong situation in Hong KongKong
Presentation overviewPresentation overview
Population & health indicesPopulation & health indices Top 10 killer diseasesTop 10 killer diseases Top 10 conditions cared in hospitalsTop 10 conditions cared in hospitals Top 5 notifiable infectionsTop 5 notifiable infections Top 5 CDs most talked aboutTop 5 CDs most talked about Challenges Challenges Control strategiesControl strategies
Population profile Population profile (2002)(2002)
Population (‘000)Population (‘000) 67876787 increasingincreasing
Natural increase Natural increase (‘000)(‘000) 13.413.4 decreasindecreasin
gg
Net movement (‘000)Net movement (‘000) 48.748.7 increasingincreasing
Population growthPopulation growth 0.9%0.9% increasingincreasing
Pop. density (per sq Pop. density (per sq m)m) 63006300 increasingincreasing
Education (primary or Education (primary or above) above) 93%93% increasingincreasing
Arrivals (‘000)Arrivals (‘000) 8112281122 increasingincreasing
Health indices (2002)Health indices (2002)
IMRIMR 2.4/1000 registered 2.4/1000 registered LBLB
MMRMMR 4.2/100 000 LB4.2/100 000 LB
LE at birth LE at birth (female)(female)
LE at birth (male)LE at birth (male)
84.7 years84.7 years
78.7 years78.7 years
Leading causes of Leading causes of death (2002)death (2002)
1.Malignant neoplasms1.Malignant neoplasms 6.External causes6.External causes
2.Heart diseases2.Heart diseases 7.Nephritis, nephrosis & 7.Nephritis, nephrosis & nephrotic syndromenephrotic syndrome
3.Cerebrovascular 3.Cerebrovascular diseasedisease 8.Diabetes Mellitus8.Diabetes Mellitus
4.Pneumonia4.Pneumonia 9.Septicaemia9.Septicaemia
5.Chronic lower 5.Chronic lower respiratory diseasesrespiratory diseases
10.Aortic aneurysm & 10.Aortic aneurysm & dissectiondissection
Leading causes of Leading causes of hospitalization (2001)hospitalization (2001)
1.Genitourinary system1.Genitourinary system 6.Circulatory system6.Circulatory system
2.Respiratory system2.Respiratory system 7.Pregnancy related7.Pregnancy related
3.Digestive system3.Digestive system 8.Mental & nervous 8.Mental & nervous systemsystem
4.Not elsewhere 4.Not elsewhere classifiedclassified 9.Injury & poisoning9.Injury & poisoning
5.Endocrine & metabolic5.Endocrine & metabolic10.Skin, 10.Skin, musculoskeletal & musculoskeletal & connective tissueconnective tissue
Hospital discharges Hospital discharges (2001)(2001)
Certain infectious and parasitic Certain infectious and parasitic diseases (A00-B99)diseases (A00-B99)
2.3% of all discharges2.3% of all discharges
The SARS epidemicThe SARS epidemic
0
20
40
60
80
100
120
4 F
eb7
Feb
10 F
eb13
Feb
16 F
eb19
Feb
22 F
eb25
Feb
28 F
eb3
Mar
6 M
ar9
Mar
12 M
ar15
Mar
18 M
ar21
Mar
24 M
ar27
Mar
30 M
ar2
Apr
5 A
pr8
Apr
11 A
pr14
Apr
17 A
pr20
Apr
23 A
pr26
Apr
29 A
pr2
May
5 M
ay8
May
11 M
ay14
May
17 M
ay20
May
23 M
ay26
May
29 M
ay
Num
ber
of c
ases
Amoy
PWH
Date of onset of Severe Acute Respiratory Syndrome Cases
0
10
20
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60
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80
90
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120
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/2/2
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/2/2
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/2/2
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/2/2
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1/3
/20
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3/3
/20
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5/3
/20
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7/3
/20
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9/3
/20
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/3/2
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/3/2
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/3/2
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/3/2
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/3/2
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2/4
/20
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/20
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6/4
/20
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8/4
/20
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10
/4/2
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/4/2
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/4/2
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/4/2
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/4/2
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/4/2
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30
/4/2
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2/5
/20
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4/5
/20
03
6/5
/20
03
8/5
/20
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/5/2
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/5/2
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/5/2
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1/6
/20
03
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/20
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/20
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7/6
/20
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9/6
/20
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O nset date
No
. o
f P
ati
ents
Others
Health Care Worker
HK in the limelight HK in the limelight (2003)(2003)Areas Areas No. probable No. probable
casescasesNo. deathsNo. deaths
ML ChinaML China 53275327 349349
HKSARHKSAR 17551755 299299
TaiwanTaiwan 665665 180180
CanadaCanada 251251 4141
SingaporSingaporee
238238 3333
Notifiable diseases Notifiable diseases under Cap 141under Cap 141 CholeraCholera PlaguePlague Yellow feverYellow fever Acute poliomyelitisAcute poliomyelitis Amoebic dysenteryAmoebic dysentery Bacillary dysenteryBacillary dysentery ChickenpoxChickenpox Dengue feverDengue fever DiphtheriaDiphtheria Food poisoningFood poisoning Influenza A (H5) Influenza A (H5) Legionnaires’ DiseaseLegionnaires’ Disease LeprosyLeprosy MalariaMalaria MeaslesMeasles
Meningococcal infectionsMeningococcal infections MumpsMumps Paratyphoid feverParatyphoid fever RabiesRabies Relapsing feverRelapsing fever RubellaRubella Scarlet feverScarlet fever SARSSARS TetanusTetanus TuberculosisTuberculosis Typhoid feverTyphoid fever Typhus feverTyphus fever Viral hepatitisViral hepatitis Whooping coughWhooping cough
Top 5 CDs by Top 5 CDs by notificationnotification
19991999 20002000 20012001 20022002 20032003
1. Chickenpox1. Chickenpox
2. Tuberculosis2. Tuberculosis
3. Food poisoning 3. Food poisoning
4. V hep4. V hep RubellaRubella V hepV hep V hepV hep SARSSARS
5. B 5. B dysendysen
V hepV hep MeaslesMeasles B dysenB dysen V hepV hep
Heavy involvement in Heavy involvement in CD prevention and CD prevention and controlcontrol
‘‘Press release’ as proxy Press release’ as proxy From 24.6.2003 to 20.2.2004From 24.6.2003 to 20.2.2004 130 of 152 PR related to CD130 of 152 PR related to CD About 1 PR on CD every other dayAbout 1 PR on CD every other day
Top 5 CDs most talked Top 5 CDs most talked aboutaboutSARSSARS 4343 28%28%
Norovirus infectionsNorovirus infections 2525 17%17%
Dengue feverDengue fever 2020 13%13%
Influenza incl. H9, Influenza incl. H9, H5H5
1717 11%11%
CholeraCholera 88 5%5%
SubtotalSubtotal 74%74%
1717
Norovirus Outbreaks Reported, 2001-03
0
10
20
30
40
50
60
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Month
No.
of o
utbr
eaks
2001
2002
2003
1818
Dengue Fever Notifications, 1999-2003
0
10
20
30
40
50
60
1999 2000 2001 2002 * 2003 *
Year
No.
of c
ases
Imported
Local
Total
1919
ILI outbreaks reported, 2001-03
0
5
10
15
20
25
30
35
40
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Month
No.
of o
utbr
eaks
200120022003
2020
Number of TB Notifications by Sex, 1994-2003
1 000
2 000
3 000
4 000
5 000
6 000
7 000
8 000
9 000
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 *
Year
Not
ifica
tions Male
Female
Total
2121
Number of Viral Hepatitis Notifications by type, 1994-2003
0
100
200
300
400
500
600
700
800
900
1994 1995 1996 1997 1998 1999 2000 2001 2002 † 2003 †
Year
Not
ifica
tions A
BTotal
2222
Number of New HIV Cases by Sex, 1994-2003
0
50
100
150
200
250
300
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Year
No.
of c
ases
Male
Female
Total
2323
Number of New AIDS Cases, 1994-2003
0
10
20
30
40
50
60
70
80
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Year
No.
of c
ases
Male
Female
Total
2424
Number of New Cases Attending DH Social Hygiene Clinics,1994-2003
0
10 000
20 000
30 000
40 000
50 000
60 000
70 000
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Year
No.
of c
ases Male
Female
Total
ChallengesChallenges
PPopulation densityopulation density
PPeople movementeople movement
PProximity to health threatsroximity to health threats
PPeace for too longeace for too long
Control strategiesControl strategies
SStop importationtop importation SSurveillanceurveillance SSystem & response ystem & response SShare informationhare information SSupport from the communityupport from the community
Port health measures
Temperature checks for SARS Temperature checks for SARS identificationidentification
Temperature checks at border Temperature checks at border control pointscontrol points
Control strategiesControl strategies
SStop importationtop importation SSurveillanceurveillance SSystem & response ystem & response SShare informationhare information SSupport from the communityupport from the community
Enhanced surveillanceEnhanced surveillance
Global Global RegionalRegional Pearl River Delta RegionPearl River Delta Region Local Local
– Public and private sectorsPublic and private sectors– Hospital and community-basedHospital and community-based
Control strategiesControl strategies
SStop importationtop importation SSurveillanceurveillance SSystem & response ystem & response SShare informationhare information SSupport from the communityupport from the community
System & responseSystem & response
Timely diagnosis Timely diagnosis Treatment & isolationTreatment & isolation Contact managementContact management Emergency responseEmergency response Professional trainingProfessional training Service planningService planning Resource allocationResource allocation
Control strategiesControl strategies
SStop importationtop importation SSurveillanceurveillance SSystem & responseystem & response SShare informationhare information SSupport from the communityupport from the community
Share informationShare information
Open communication Open communication – With international authoritiesWith international authorities– Within the organizationWithin the organization– With stakeholdersWith stakeholders– With the publicWith the public
Public educationPublic education PublicityPublicity
Control strategiesControl strategies
SStop importationtop importation SSurveillanceurveillance SSystem & response ystem & response SShare informationhare information SSupport from the communityupport from the community
Engaging the communityEngaging the community
Team Clean, the special task force chaired by the Team Clean, the special task force chaired by the Chief Secretary for Administration, is established Chief Secretary for Administration, is established to promote a sustainable, cross-sectoral approach to promote a sustainable, cross-sectoral approach to improve environmental hygiene in Hong Kong to improve environmental hygiene in Hong Kong
Zero-tolerance of littering, spitting and other Zero-tolerance of littering, spitting and other unhygienic behaviourunhygienic behaviour
Engaging the communityEngaging the community
In partnership with schools & communiIn partnership with schools & community sectorsty sectors
“…“…Reducing risks to health remains a Reducing risks to health remains a vital preoccupation of all people, in vital preoccupation of all people, in all populations, and of all those all populations, and of all those who serve themwho serve them.”.”
- Dr Gro Harlem Brundtland- Dr Gro Harlem Brundtland
Former DG WHOFormer DG WHO
Thank youThank you