Indoor Air Quality in Hong Kong

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?????? HOW TO PREVENT INFLUENZA
?????????? Central Health Education
Unit DEPARTMENT OF HEALTH September 2007
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What is Influenza?

• Influenza (flu)
• is a highly infectious viral disease
• caused by various types of influenza viral
  strains

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Seasonal Influenza
In Hong Kong, the disease is more common in
periods from January to March and from July to
August.
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Consultation rate of influenza-like illness and
number of influenza isolates in 2006
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Influenza Pandemic

• Pre-requisites for the start of an Influenza
  Pandemic
• A novel influenza virus subtype emerge or an old
  subtype re-emerge
• The new virus must be able to replicate in humans
  and cause serious illness
• The new virus must be efficiently transmitted
  from one human to another

Photo source from CDC
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Pandemic Influenza vs Seasonal Influenza

• When compared to localised seasonal influenza
  epidemic, the influenza pandemic
• Spreads quicker and broader
• Usually associates with higher severity of
  illness and a higher death toll
• Has more serious consequences, greater social and
  economic impact

Photo source from CDC
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The relationship with Avian Influenza

• The Hong Kong 1997 experience and the recent
  situation in some parts of the world have
  demonstrated the pandemic potential of H5N1
• The threat of H5N1 to human health is closely
  related to the outbreaks of HPAI (Highly
  Pathogenic Avian Influenza) in poultry
• The surveillance of potential virus responsible
  for pandemic influenza is an important part of
  contingency preparedness

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Preparedness Plan for Influenza Pandemic

• The Government's 3-tier response system for
  handling major infectious disease outbreaks
• Alert Response Level
• Serious Response Level
• Emergency Response Level

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Alert Response Level

• Scenarios
• Confirmation of highly pathogenic avian influenza
  (HPAI) outbreaks in poultry populations outside
  Hong Kong
• Confirmation of HPAI in Hong Kong in imported
  birds in quarantine, in wild birds, in
  recreational parks, in pet bird shops or in the
  natural environment
• Confirmation of human case(s) of avian influenza
  outside Hong Kong

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Actions from Public Alert Level

• Maintain normal way of life
• Pay attention to further announcements
• from the Government

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Serious Response Level

• Scenarios
• Confirmation of HPAI outbreaks in the environment
  of or among poultry population in retail markets,
  wholesale markets, farms in Hong Kong due to a
  strain with known human health impact
• Confirmation of human case(s) of avian influenza
  in Hong Kong without evidence of efficient
  human-to-human transmission

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Actions from Public - Serious Level

• Maintain normal way of life
• Prepare enough masks for possible
• exigencies
• Pay attention to and comply with
• guidelines issued by the Government

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Emergency Response Level

• Scenarios
• Evidence of efficient human-to-human transmission
  of novel influenza overseas or in Hong Kong
• Pandemic influenza

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Actions from Public - Emergency Level

• Use mask appropriately
• Pay attention to and comply with
• guidelines issued by the Government

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Current level ?
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How to Prevent

• Avoid touching live birds and poultry and their
  droppings
• After contact with live birds and poultry, wash
  hands thoroughly with liquid soap and water
  immediately
• Poultry and eggs should be thoroughly cooked
  before eating
• Travellers returning from endemic areas should
  consult doctors promptly if they have symptoms of
  influenza after the trip. Let the doctors know
  the travel history and wear a mask to prevent
  spread of the disease

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How to Prevent

• Keep the environment clean
• - Ensure good ventilation
• - Avoid visiting crowded places with poor
  ventilation
• - Prevent the trap from drying, pour half a
  litre of water
• into each drain outlet once a week
• - Keep your home clean, wipe furniture and
  toilets with a
• diluted household bleach solution in the
  ratio of 1 in 99
• once a day

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How to Prevent

• 8 Steps to Protect Yourself
• Individual preparedness
• Before the pandemic comes
• When the pandemic comes

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Why Should We Prevent Influenza

• Changeable surface antigens of
  influenza viruses
• Potential threat
• Antigenic drift
• (minor changes)
• Seasonal influenza
• 
  

Antigenic shift (major changes)
Emergence of pandemic strain
Influenza pandemic
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8 Steps To Protect Yourself
Step 1 Be prepared Step 2 Get
vaccinated Step 3 Keep hands clean Step 4
Use mask properly
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8 Steps To Protect Yourself
Step 5 Know how influenza presents Step 6
Manage fever well Step 7 Practise healthy
lifestyle Step 8 Be resourceful
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Step 1 Be Prepared
Follow a healthy lifestyle Consult a doctor for influenza vaccination
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Step 1 Be Prepared

• Build up good personal hygiene
• wash hands frequently
• cover mouth and nose with tissue
• paper when coughing or sneezing
• and dispose of soiled tissue paper
• properly in a lidded rubbish bin
• avoid touching eyes, mouth or nose
• wear mask when symptoms of
• respiratory tract infection develop

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Step 1 Be Prepared
Keep at home Masks Anti-pyretics for use when necessary Thermometer Liquid soap Tissue paper Be always ready with information of family doctor other useful information
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Step 2 Get Vaccinated

• Seasonal peaks Jan - Mar / Jul Aug
• Influenza vaccination
• one of the effective means in preventing
  influenza and its complications
• Influenza vaccination to special groups is
  recommended

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Step 2 Get Vaccinated
People who should receive influenza vaccination Elderly persons living in residential care homes Long-stay residents of institutions for the disabled Elderly persons aged 65 years or above Persons with chronic illnesses Health care workers Poultry workers Children aged 6 to 23 months Pregnant women Influenza vaccine can be given on the same day as other types of vaccines
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Step 2 Get Vaccinated

• People not suitable to
• receive influenza vaccination
• Allergic to eggs, neomycin, etc
• Allergic to previous dose of influenza vaccine
• With bleeding disorders or on warfarin
• ? deep subcutaneous injection
• Suffer from acute febrile illness
• ? receive when recover

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Step 2 Get Vaccinated

• Two weeks after vaccination
• ? antibodies develop and
• provide protection
• Immunity decline over time

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Step 2 Get Vaccinated
Yearly influenza vaccine is targeted on seasonal influenza only Development of a new vaccine which matches the pandemic viral strain will probably take several months to complete
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Step 3 Keep Hands Clean
When Should We Wash Our Hands? Before touching eyes, mouth nose When hands are contaminated by respiratory secretion e.g. after coughing / sneezing After touching public installations or equipment e.g. escalator handrails, elevator control panels, door knobs Before handling food or eating After going to toilet
When Should We Wash Our Hands? Before touching eyes, mouth nose When hands are contaminated by respiratory secretion e.g. after coughing / sneezing After touching public installations or equipment e.g. escalator handrails, elevator control panels, door knobs Before handling food or eating After going to toilet
When Should We Wash Our Hands? Before touching eyes, mouth nose When hands are contaminated by respiratory secretion e.g. after coughing / sneezing After touching public installations or equipment e.g. escalator handrails, elevator control panels, door knobs Before handling food or eating After going to toilet
When Should We Wash Our Hands? Before touching eyes, mouth nose When hands are contaminated by respiratory secretion e.g. after coughing / sneezing After touching public installations or equipment e.g. escalator handrails, elevator control panels, door knobs Before handling food or eating After going to toilet
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Step 3 Keep Hands Clean
Steps to Good Handwashing Wet hands under running water Apply liquid soup and rub hands together to make a soapy lather Massage all the finger tips properly for at least 20 seconds Rinse hands thoroughly under running water
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Step 3 Keep Hands Clean
Dry hands thoroughly with clean cotton towel / paper towel / hand dryer The tap may be turned off by using the towel wrapping the faucet Note Rub hands with 70-80 alcohol solution to disinfect them when hand washing facilities are not available
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Step 4 Use Mask Properly
A way to prevent spread of respiratory tract infections Surgical masks ? prevent spread of droplet infections
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Step 4 Use Mask Properly
People who should wear mask Patients with respiratory infection symptoms Caregivers of patients with respiratory infection symptoms Visitors of clinics or hospitals
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Step 4 Use Mask Properly

• Points to note about wearing a surgical mask
• The mask should fit snugly over the face
• Try not to touch the mask once it is secured on
  your face. If you must do so, wash your hands
  before and after touching the mask
• When taking off the mask, avoid touching the
  outside of the mask

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Step 4 Use Mask Properly

• Points to note about wearing a surgical mask
• After taking off the mask, put the mask into a
  plastic or paper bag before putting it into a
  rubbish bin with a lid
• A surgical mask should be changed at least daily
• Replace the mask immediately if it is damaged or
  soiled

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Step 5 Know How Influenza Presents
Incubation period about 1-3 days Signs and symptoms of influenza Fever Headache Muscle ache Cough Sore throat Runny nose
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Step 6 Manage Fever Well
FEVER - Symptom of underlying illness (should concern about specific illness that causes fever) Normal body temperature 37? / 98.6? can vary 1?- 1.5? normally Readings taken as reference under different methods of measurement Rectal temperature (38?) Oral or tympanic temperature (37.5 ?) Axillary temperature (37.0 ?, less reliable)
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Step 6 Manage Fever Well
Self-care tips of fever Dressing in lightweight clothing and using light blanket ? facilitate escape of body heat Maintaining good ventilation of indoor areas ? facilitate escape of body heat Drink adequate amount of water Consume nutritious and easily digestible food Have adequate rest
Self-care tips of fever Dressing in lightweight clothing and using light blanket ? facilitate escape of body heat Maintaining good ventilation of indoor areas ? facilitate escape of body heat Drink adequate amount of water Consume nutritious and easily digestible food Have adequate rest
Self-care tips of fever Dressing in lightweight clothing and using light blanket ? facilitate escape of body heat Maintaining good ventilation of indoor areas ? facilitate escape of body heat Drink adequate amount of water Consume nutritious and easily digestible food Have adequate rest
Self-care tips of fever Dressing in lightweight clothing and using light blanket ? facilitate escape of body heat Maintaining good ventilation of indoor areas ? facilitate escape of body heat Drink adequate amount of water Consume nutritious and easily digestible food Have adequate rest
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Step 6 Manage Fever Well
Self-care tips of fever Check body temperature regularly When taking antipyretics, one should follow the instructions on the package of the medication or follow the doctors advice Consult a doctor especially if symptoms are persistent, severe or getting worse Note General households should maintain about one weeks supply of antipyretics for use when necessary
Self-care tips of fever Check body temperature regularly When taking antipyretics, one should follow the instructions on the package of the medication or follow the doctors advice Consult a doctor especially if symptoms are persistent, severe or getting worse Note General households should maintain about one weeks supply of antipyretics for use when necessary
Self-care tips of fever Check body temperature regularly When taking antipyretics, one should follow the instructions on the package of the medication or follow the doctors advice Consult a doctor especially if symptoms are persistent, severe or getting worse Note General households should maintain about one weeks supply of antipyretics for use when necessary
Self-care tips of fever Check body temperature regularly When taking antipyretics, one should follow the instructions on the package of the medication or follow the doctors advice Consult a doctor especially if symptoms are persistent, severe or getting worse Note General households should maintain about one weeks supply of antipyretics for use when necessary
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Step 7 Practise Healthy Lifestyle

• Is one of the most effective ways to prevent
  communicable diseases
• Consisting
• Eat a balanced diet
• Get regular exercise
• Do not smoke
• Have adequate rest
• ? build up body resistance

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Step 7 Practise Healthy Lifestyle

• Major components of
• a balanced diet
• A variety of food
• Whole grains as the major component of each meal
• Plenty of fruits and vegetables
• Adequate amounts of fluids

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Step 7 Practise Healthy Lifestyle

• Eat adequate amount of lean meat or beans, and
  reduced fat dairy products
• Avoid processed or preserved food and food that
  is rich in fat, cholesterol, salt and sugar
• Have regular meals

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Step 7 Practise Healthy Lifestyle

• Regular exercise
• 30 minutes every day /
• accumulate exercise time in multiple sessions
  not less than 10 minutes each
• Physical activity of moderate intensity
• ? build up cardiovascular endurance
• ? enhance heart and lung functions
• ? improve health

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Step 8 Be Resourceful
Useful websites Department of Health www.dh.gov.hk Centre for Health Protection www.chp.gov.hk Medical organization hotlines 24-Hour Health Education Hotline of the DH 2833 0111 Influenza Pandemic Hotline of the DH 2125 1111 Tel nos. of hospitals under the HA having 24-hour emergency services Tel nos. of private hospitals having 24- hour emergency services
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Knowledge can alleviate fear

• Before crisis comes Go through Influenza
  Pandemic Preparedness Kit
• During the pandemic Information government
  advice available through pamphlets, posters,
  websites, hotlines the media

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• Take Preventive Actions in
• Peace Time
• Understand Influenza
• Work Together
• Prevent the PANDEMIC

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?? THANK YOU