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

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4 F

eb7

Feb

10 F

eb13

Feb

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eb19

Feb

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eb25

Feb

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eb3

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6 M

ar9

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ar15

Mar

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ar21

Mar

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ar27

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ar2

Apr

5 A

pr8

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pr14

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pr20

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pr26

Apr

29 A

pr2

May

5 M

ay8

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11 M

ay14

May

17 M

ay20

May

23 M

ay26

May

29 M

ay

Num

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of c

ases

Amoy

PWH

Date of onset of Severe Acute Respiratory Syndrome Cases

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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

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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