More measles cases likely to hit Hong Kong, disease expert warns

Sum Lok-kei
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More measles cases likely to hit Hong Kong, disease expert warns

Hong Kong could face a second wave of measles infections, a top disease expert warned on Monday, as health authorities stepped up vaccinations of workers at the city’s airport.

The Centre for Health Protection has recorded 20 measles infections so far this year – against 15 in all of 2018 – five of them involving airport and airline staff.

The outbreak started early this month, when a Cathay Pacific Airways flight attendant displayed symptoms such as a fever and a rash.

University of Hong Kong microbiologist Dr Ho Pak-leung said the attendant, who had travelled to Japan, was probably the source of the outbreak at Hong Kong International Airport.

Ho noted the 23 year-old man was the first to become ill, and that a 41-year-old pilot working on the same airline also got sick during the incubation period of seven to 21 days.

The pilot, despite becoming ill on March 12, took seven flights between March 13 and 16.

Health officials, meanwhile, met representatives from the Hong Kong Airport Authority, airlines and other airport-based firms and briefed attendees on the latest cases and offered advice on infection control on Monday morning.

Due to a generally high level of measles immunity among the city’s population, the scale of the current outbreak had been small, Ho told a radio programme.

“But I expect more cases to surface, and there could be a second round of infections,” he said.

I expect more cases to surface, and there could be a second round of infections

Ho Pak-leung, HKU

In 2016, the World Health Organisation declared that Hong Kong’s local transmission of measles – a highly infectious disease that can be spread through coughing and sneezing – had been eliminated for at least 36 months. But imported cases are still recorded.

Ho said local measles outbreaks in recent years had been limited to households and hospitals, and that a case at the airport had not been seen in the past decade.

“I believe the outbreak at the airport and overall increase in the number of cases is due to more people getting sick in Japan and the Philippines and bringing the disease home,” Ho said, noting the number of measles cases in the two countries had shot up recently.

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To tighten the grip on the outbreak, Ho suggested health authorities vaccinate airport workers not born in Hong Kong and who have unclear vaccination histories.

Speaking on two radio programmes on Monday morning, Dr Wong Ka-hing, who heads the Centre for Health Protection, said the centre had set up a vaccination station in the non-restricted part of the airport. This came after some airport workers complained about not being able to get vaccinated on Sunday, as the booth was inside a restricted zone.

Some also complained about long queues and waiting times, according to the Staffs and Workers Union of Hong Kong Civil Airlines.

The union’s secretary general, Ip Wai-ming, said workers had to sit through a lengthy health talk before medical staff checked their suitability for the vaccine.

“It took at least three hours [to get vaccinated],” Ip said.

He said at least 20 complaints were lodged on Sunday, and that more than 100 workers had failed to get vaccinated, despite joining the queue.

Wong said about 400 workers were vaccinated since last Friday, and that authorities would try to speed up the process.

He also said nine of the current cases were confirmed to have been imported, but did not give further details.

According to the health authority, most of the city’s residents are immunised against measles, especially young people.

Those born in 1985 and after, and who went to primary school in Hong Kong, were likely to have had both doses of the vaccine. In addition, most older people, such as those born in the early 1960s, would have already had the disease and developed immunity.

The Airport Authority has also launched its own infection control scheme, according to Chapman Fong Sui-man, general manager of terminal one, who attended the meeting on Monday.

Asked if it was too late to launch the vaccination programme for airport employees, Fong said: “After receiving the notice on Friday, we immediately made arrangements, we think it is timely.”

The union said that after the second vaccination station opened the waiting time had been slashed by about 30 to 40 minutes. The quota for getting vaccinated in the morning, however, was quickly used up, it said.

The Hospital Authority, meanwhile, convened an ad hoc meeting on Monday to look at measures in public hospitals. The authority will start to offer measles vaccination to necessary staff from next week.

In the first phase, vaccinations would be provided to those working in high-risk departments, such as paediatric, obstetrics and gynaecology, intensive care units and isolation wards.

According to the authorities, there are people who have never been vaccinated, while local residents born between 1967 and 1978 do not have sufficient immunity against measles due to their single dose vaccination.

Ho recently posted online a list of the kinds of person most susceptible to measles infection. They were:

  • People who visit Japan, particularly areas with more measles cases, such as Tokyo, Osaka and Aichi prefectures
  • Airline workers who visit places with measles outbreaks, and those who might come into close contact with them
  • New arrivals from countries with poor measles vaccination programmes
  • Children under the age of one, and those who have not been vaccinated
  • Adults who have only had one shot of the measles vaccine, such as those who went to primary school before 1996
  • People with impaired immunity, such as those with Aids, or people who have had transplants or cancer treatment

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