Severe Acute Respiratory Syndrome (SARS) Introduction

Hong Kong situation (on 23 May 2003) 4 No. of cases: No. of death: male: female 4.5:5.5

Age distribution 0-145% % % % % % % 75 or above10%

Occupations 4 Information collected from 90.3% of cases 4 61% working population 4 39% non-working population

Working Group Health Care Workers23.9% Food Handlers1.9% Domestic Helpers1.9% School Staff1.5% Disciplinary Force0.6% Others 31.3% (e.g. drivers, clerical and administrative personnel)

Non-working Group Retired12.9% Housewives10.1% Students8.7% Pre-school Children0.6% Visitors/Tourists0.3% Others6.6% (e.g. unemployed)

Incidence of SARS cases by residential areas 4 Kwun Tong11.8 per Tai Po6.2 4 Sha Tin4.1 4 Other 15 districts

Clinical Presentation 4 Fever is the commonest reported symptom 4 Other symptoms: chills, malaise, cough, headache and muscle ache 4 % of elderly having fever is lower 4 Only 61% have respiratory symptoms, 32% have GI symptoms

General Symptoms Fever93.3% Chills58% Malaise55.9% Headache42.6% Muscle Ache41.8% Rigors35.9% Loss of appetite28%

Respiratory Symptoms Cough45.8% Sore throat18.3% Shortness of breath15.3% Running nose12.4%

GI Symptoms Diarrhoea17.5% Vomiting11.5% Nausea11.3% Abdominal pain10.2%

Combination of symptoms Fever and chills55.8% Fever and malaise53.1% Fever and cough42.8%

Symptoms of different age groups 0-14Fever and cough 15-64Fever with general symptoms 65 and aboveonly 10 to 36% having fever with one other symptom

Home Confinement 4 Household contacts 4 confirmed or suspected cases 4 maximum of 10 days 4 for monitoring and referral for treatment

As at 22 May persons had been affected 4 49 were still under confinement 4 33 had been confirmed to have SARS

Border Checks Health Declaration Post 4 airport, ports and border points 4 incoming travellers to complete a health declaration

Temperature checks 4 All passengers arriving, departing and transit passengers 4 at the HK International Airport 4 temperature checks

Other control points: 4 arriving passengers subjected to screening 4 all departing passengers from Ferry Terminals and Hung Hom Station are required to undergo temperature checks 4 So far, 2 passengers had been confirmed to have SARS

Other Measures Setting up of Designated Medical Centres (DMC) 4 monitor contacts other than household contacts 4 daily reports and monitoring Schools 4 recent return to school 4 daily temperature checks 4 Close school for cleaning once suspected case identified

General Health Education 4 Daily press release for dissemination of information 4 SARS symptoms 4 Hand hygiene, personal and environmental hygiene 4 Cleaning campaigns

Thank You

Background Information 4 Nov 02, reports of cases in Guandong, China 4 Mar 02, professor visited Hong Kong to attend banquet 4 Outbreaks of infection in local hospitals and overseas

Case Definition 4 WHO 4 Probable cases 4 Suspected cases 4 other considerations

Cases worldwide 4 No. of cases 4 No. of deaths

The responsible agent 4 SARS related corona virus 4 co-infection with other agents 4 new recent findings

Mode of transmission 4 Droplets infection 4 close contacts 4 Amoy garden reports 4 superspreaders

Virus behaviour 4 Survival 4 incubation period

Treatment methods 4 Inpatient treatment –ribarivirin –steroids –combination

Treatment methods 4 Inpatient treatment –ribarivirin –steroids –combination 4 Vaccine –no effective vaccine available –need time for development –1 to 5 years

WHO recommendations 4 Case detection and treatment 4 Contact tracing and isolation 4 Prevention of export of cases by health checks at borders 4 Education of public –symptoms of SARS –hand hygiene, personal and environmental hygiene

WHO information 4 Updates in website 4 affected areas with recent local transmission 4 travel advice to affected areas