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Lee R.L.T.,World Health Organization | Leung C.,Hong Kong Polytechnic University | Tong W.K.,Hospital Authority Infectious Disease Center | Chen H.,Center for Health Protection | Lee P.H.,World Health Organization
American Journal of Infection Control | Year: 2015

Background: Infectious diseases are common among schoolchildren as a result of their poor hand hygiene, especially in those who have developmental disabilities. Methods: A quasi-experimental study using a pre- to post-test design with a control group was used to test the feasibility and sustainability of simplified 5-step handwashing techniques to measure the hand hygiene outcome for students with mild intellectual disability. Sickness-related school absenteeism was compared. Results: The intervention group experienced a significant increase in the rating of their handwashing quality in both hands from pre- to post-test: left dorsum (+1.05, P <.001); right dorsum (+1.00, P <.001); left palm (+0.98, P <.001); and right palm (+1.09, P <.001). The pre- to post-test difference in the intervention group (+1.03, P <.001) was significantly greater than the difference in the control group (+0.34, P =.001). There were no differences between the post-test and the sustainability assessment in the intervention group. The intervention school experienced a significantly lower absenteeism rate (0.0167) than the control group in the same year (0.028, P =.04).Students in this study showed better performance in simplified handwashing techniques and experienced lower absenteeism than those using usual practice in special education school settings. Conclusion: The simplified 5-step hand hygiene technique has been proven effective in reducing the spread of infectious diseases. Copyright © 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. Source


Chan P.K.S.,Chinese University of Hong Kong | Lee N.,Chinese University of Hong Kong | Zaman M.,Khyber Teaching Hospital | Adisasmito W.,University of Indonesia | And 12 more authors.
Journal of Infectious Diseases | Year: 2012

Background. Oseltamivir is widely used as treatment for influenza virus A subtype H5N1 (hereafter, "H5N1") infection but, like any intervention, is not always effective. Methods. We used Avian Influenza Registry data from 10 countries to examine the risk of death in 215 patients with confirmed H5N1 infection who were treated with oseltamivir, according to viral clade, age, respiratory failure, and adjunctive treatment with corticosteroids or antibiotics. Results. The median age of infected individuals was 18 years, and 50 were male. The highest fatality rate occurred in a country with clade 2.1 virus circulation, and the lowest occurred in countries with clade 2.2 virus circulation (P <. 001). In univariate analyses, age of ≤5 years and treatment ≤2 days after symptom onset were protective against fatality. When accounting for all risk factors, early initiation of oseltamivir was found to be particularly effective in individuals without respiratory failure (odds ratio, 0.17; P =. 04). Patients who had advanced respiratory failure requiring ventilatory support at the time of oseltamivir initiation were more likely to die from the episode of H5N1 infection than patients who did not (P <. 001). Adjunctive therapy did not improve the likelihood of surviving the episode. Conclusions. Oseltamivir is especially effective for treating H5N1 infection when given early and before onset of respiratory failure. The effect of viral clade on fatality and treatment response deserves further investigation. © 2012 The Author. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. Source


Oner A.F.,Yuzuncu Yil University | Dogan N.,Ataturk University | Gasimov V.,Azerbaijan Ministry of Health | Adisasmito W.,University of Indonesia | And 10 more authors.
Clinical Infectious Diseases | Year: 2012

Background. Avian influenza continues to pose a threat to humans and maintains the potential for greater transmissibility. Understanding the clinical presentation and prognosis in children will help guide effective diagnosis and treatment.Methods.A global patient registry was created to enable systematic collection of clinical, exposure, treatment, and outcomes data on confirmed cases of H5N1. Bivariate and multivariate statistical tools were used to describe clinical presentation and evaluate factors prognostic of survival.Results.Data were available from 13 countries on 193 children <18 years who were confirmed as having been infected with H5N1; 35.2 of cases were from Egypt. The case fatality rate (CFR) for children was 48.7, with Egypt having a very low pediatric CFR. Overall, children aged ≤5 years had the lowest CFR and were brought to hospitals more quickly and treated sooner than older children. Children who presented for medical care with a complaint of rhinorrhea had a 76 reduction in the likelihood of death compared with those who presented without rhinorrhea, even after statistical adjustment for age, having been infected in Egypt, and oseltamivir treatment (P =. 02). Delayed initiation of treatment with oseltamivir increases the likelihood of death, with an overall 75 increase in the adjusted odds ratio for death for each day of delay.Conclusions.The presence of rhinorrhea appears to indicate a better prognosis for children with H5N1, with most patients surviving regardless of age, country, or treatment. For individuals treated with oseltamivir, early initiation of treatment substantially enhances the chance of survival. © 2012 The Author. Source


Lai P.-C.,University of Hong Kong | Chow C.B.,Hospital Authority Infectious Disease Center | Wong H.T.,Chinese University of Hong Kong | Kwong K.H.,University of Hong Kong | And 5 more authors.
International Journal of Geographical Information Science | Year: 2015

The outbreaks of new and emerging infectious diseases in recent decades have caused widespread social and economic disruptions in the global economy. Various guidelines for pandemic influenza planning are based upon traditional infection control, best practice and evidence. This article describes the development of an early warning system for detecting disease outbreaks in the urban setting of Hong Kong, using 216 confirmed cases of H1N1 influenza from 1 May 2009 to 20 June 2009. The prediction model uses two variables – daily influenza cases and population numbers – as input to the spatio-temporal and stochastic SEIR model to forecast impending disease cases. The fairly encouraging forecast accuracy metrics for the 1- and 2-day advance prediction suggest that the number of impending cases could be estimated with some degree of certainty. Much like a weather forecast system, the procedure combines technical and scientific skills using empirical data but the interpretation requires experience and intuitive reasoning. © 2015 Taylor & Francis. Source


Chan W.M.,Hospital Authority Infectious Disease Center | Kwan Y.W.,Hospital Authority Infectious Disease Center | Leung C.W.,Hospital Authority Infectious Disease Center
Hong Kong Journal of Paediatrics | Year: 2011

Bacillus Calmette-Guérin (BCG) related regional lymphadenitis is not an uncommon complication following BCG vaccination. We present a case series of 11 infants with suppurative BCG lymphadenitis managed in Hospital Authority Infectious Disease Centre of Hong Kong over a 5-year period. All of them presented with isolated left axillary mass which suppurated at a mean of 3.5 months (range 2 to 5 months) after BCG vaccination. The diagnosis of the condition is basically clinical. Five infants who were initially managed with needle aspiration alone showed significant regression in the sizes of their enlarged lymph nodes and surgical excision was spared. Surgical incision and drainage was performed in 5 other infants prior to referral to our centre. They all developed significant irregular scarring and 2 eventually developed keloids over their scars upon healing. We recommend that suppurative BCG lymphadenitis should be managed initially by needle aspiration. Total excision should be considered if aspiration fails or suppuration recurs despite repeated needle aspiration. Incision and drainage is mentioned to be condemned. Source

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