Public Health Situation in Hong Kong

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Public Health Situation in Hong Kong

• Dr Regina Ching
• Department of Health
• 5.3.2004

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

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

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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
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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
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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.Pneumonia 9.Septicaemia
5.Chronic lower respiratory diseases 10.Aortic aneurysm dissection
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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
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Hospital discharges (2001)

• Certain infectious and parasitic diseases
  (A00-B99)
• 2.3 of all discharges

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The SARS epidemic
120
100
80
60
Number of cases
40
20
0
4 Feb
7 Feb
2 Apr
5 Apr
8 Apr
3 Mar
6 Mar
9 Mar
10 Feb
13 Feb
16 Feb
19 Feb
22 Feb
25 Feb
28 Feb
2 May
5 May
8 May
12 Mar
15 Mar
18 Mar
21 Mar
24 Mar
27 Mar
30 Mar
11 Apr
14 Apr
17 Apr
20 Apr
23 Apr
26 Apr
29 Apr
11 May
14 May
17 May
20 May
23 May
26 May
29 May
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HK in the limelight (2003)
Areas No. probable cases No. deaths
ML China 5327 349
HKSAR 1755 299
Taiwan 665 180
Canada 251 41
Singapore 238 33
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Notifiable diseases under Cap 141

• Cholera
• Plague
• Yellow fever
• Acute poliomyelitis
• Amoebic dysentery
• Bacillary dysentery
• Chickenpox
• Dengue fever
• Diphtheria
• Food poisoning
• Influenza A (H5)
• Legionnaires Disease
• Leprosy
• Malaria
• Measles

• Meningococcal infections
• Mumps
• Paratyphoid fever
• Rabies
• Relapsing fever
• Rubella
• Scarlet fever
• SARS
• Tetanus
• Tuberculosis
• Typhoid fever
• Typhus fever
• Viral hepatitis
• Whooping cough

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Top 5 CDs by notification
1999 2000 2001 2002 2003
1. Chickenpox 1. Chickenpox 1. Chickenpox 1. Chickenpox 1. Chickenpox
2. Tuberculosis 2. Tuberculosis 2. Tuberculosis 2. Tuberculosis 2. Tuberculosis
3. Food poisoning 3. Food poisoning 3. Food poisoning 3. Food poisoning 3. Food poisoning
4. V hep Rubella V hep V hep SARS
5. B dysen V hep Measles B dysen V hep
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Heavy involvement in CD prevention and control

• Press release as proxy
• From 24.6.2003 to 20.2.2004
• 130 of 152 PR related to CD
• About 1 PR on CD every other day

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Top 5 CDs most talked about
SARS 43 28
Norovirus infections 25 17
Dengue fever 20 13
Influenza incl. H9, H5 17 11
Cholera 8 5
Subtotal 74
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Challenges

• Population density
• People movement
• Proximity to health threats
• Peace for too long

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Control strategies

• Stop importation
• Surveillance
• System response
• Share information
• Support from the community

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Port health measures
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• Temperature checks for SARS identification

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Temperature checks at border control points
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Control strategies

• Stop importation
• Surveillance
• System response
• Share information
• Support from the community

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Enhanced surveillance

• Global
• Regional
• Pearl River Delta Region
• Local
• Public and private sectors
• Hospital and community-based

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Control strategies

• Stop importation
• Surveillance
• System response
• Share information
• Support from the community

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System response

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

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Control strategies

• Stop importation
• Surveillance
• System response
• Share information
• Support from the community

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Share information

• Open communication
• With international authorities
• Within the organization
• With stakeholders
• With the public
• Public education
• Publicity

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Control strategies

• Stop importation
• Surveillance
• System response
• Share information
• Support from the community

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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
• Zero-tolerance of littering, spitting and other
  unhygienic behaviour

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Engaging the community
In partnership with schools community sectors
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• 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

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Thank you