Follow-up: Hong Kong melioidosis investigation

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in Follow the increase in melasma cases in Hong Kong this year, and Center for Health Protection (CHP) According to the health department reports as of yesterday (October 17), the CHP has recorded a total of 29 cases of chlamydia this year so far, involving 21 males and eight females, aged between 42 and 93, of whom 20 live in Sham Shui. Bo (17 of which were recorded in or after August). Preliminary epidemiological investigations revealed that the majority of patients had underlying disease or immunodeficiency while none of their home contacts showed any symptoms. The patients had not visited any common premises before their appearance and did not drink unboiled water. Transmission through food or produce can be ruled out at this stage.

Scanning electron micrograph of Burkholderia cepacia/CDC

The CHP collected a total of 107 environmental samples in Sham Shui Po (including 16 soil samples from nearby parks and construction sites; 90 water samples and environmental exchange samples taken from 16 buildings where confirmed cases have been established since August; and one ash sample from a family). All PCR tested samples are negative for Burkholderia pseudomallei.

Meanwhile, the CHP invited the head of the Department of Microbiology at the University of Hong Kong (HKU), Professor Yuen Kwok Young and his team to join the environmental investigation. The University of Hong Kong team collected 31 environmental samples from the residences of some confirmed cases, among which two swab samples (one taken from a bathroom faucet and one from the inner surface of a utensil) from a home PCR test that tested positive for Burkholderia pseudomallei. The CHP learned that the polymerase chain reaction (PCR) test method published by the HKU team has a very high sensitivity and that the two positive samples carried a very small amount of bacteria, which could be the remaining genetic part of the bacteria. The possibility that the relevant environment was contaminated with bacteria introduced by the patient cannot be excluded.

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After examining the results of the environmental investigation, the CHP considered that there is currently no evidence to suggest that the source of the cases came from tap water. However, in view of the positive results of the Hong Kong Federation, as a precaution, the CHP notified the Water Supply Department (WSD) to check the area’s water supply system as well as maintenance records for the past three months. WSD has found no occurrences of foreign body contamination of the water supply system in the area during the past 3 months. No abnormalities were found in the testing of water samples in the service tank and related area, and the test results fully meet the standards of Hong Kong drinking water.

After the details of the case were announced on October 12, the CHP had not received notifications from the Hospital Authority (HA) regarding the registration of new cases so far. Meanwhile, the CHP informed all doctors and private hospitals in Hong Kong of the relevant situation message On October 14, he reminded them to take note of suspected cases. The CHP also strengthened its surveillance of HA along with HA.

A spokesman for the CHP said that the bacteria can live in the local environment, and that every year cases of kalama were recorded in Hong Kong. According to the literature, cases of infection are more common after hurricanes or storms. Burkholderia pseudomallei bacteria may be exposed in soil and muddy water to the ground after hurricanes or storms, and the bacteria will spread easily with strong winds or storms. As such, the number of cases of melioidosis may increase. The CHP cannot rule out the possibility that the cases in the past few months are weather-related.

The CHP is again reminding members of the public, especially high-risk groups such as people with underlying diseases, to avoid contact with muddy soil or water after storms and heavy rains to prevent chlamydia. The infection is rarely transmitted from person to person and from animal to human. Members of the public should seek medical advice immediately if they develop symptoms.

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