Hong Kong bird flu
concerns isle officials

There's no vaccine
for the virus that's caused three
Hong Kong deaths

By Helen Altonn
Star-Bulletin

With Hawaii a gateway for Far East visitors and viruses, state health officials are closely monitoring Hong Kong's bird flu.

Today the Hong Kong government reported that four more suspected cases of the flu have surfaced.

So far, nine cases have been confirmed and three people have died.

There is no vaccine for the virus, which until this year was found only in birds.

Some chickens on sale in Hong Kong, believed to be from China, were found to carry the H5NI virus strain.

"A few things are reassuring despite the fact that it seems to be a new virus," said Dr. Paul V. Effler, Hawaii's state epidemiologist and acting Communicable Disease Division chief.

Although Hong Kong has a population of several million, few cases have been identified to date, he pointed out.

"This would lead one to believe it is not easily transmitted from person to person, if transmitted at all. I don't think the mode of transportation has been clearly identified."

Effler said the H5NI virus was first detected in terns in South Africa in the 1960s. "So it has been around."

There were no outbreaks in the past, he said, "but that doesn't mean we can let our guard down and not be careful. Development of a dozen or so cases in Hong Kong is concerning."

Effler said Hawaii has a three-pronged annual influenza surveillance program:

Doctors report weekly whether they have cases or not.

Schools report any absenteeism of more than 10 percent in the school and more than 20 percent in a class.

Nursing homes report any flu cases.

So far this season, Effler said, doctors have reported few cases; the schools have had no outbreaks, and nursing homes haven't reported any cases other than one outbreak in September.

Physicians who see a lot of tourists also say compared with last year the number of people with flulike illnesses is very low, Effler said.

But things could change, he warned.

Anyone at risk for serious complications, such as the elderly and people with medical conditions, should be vaccinated if they haven't already, Effler said.

"It won't protect them from Hong Kong avian flu, but most likely they would be infected with a strain covered by the vaccine," he said.

Physicians seeing people who might have influenza also are asked to submit islets or swabs to the Health Department to determine if it is flu and what type.

Cases this year have mostly been influenza A strains, Effler said.

A few respiratory viruses have been reported, which are expected, especially in the winter season, he said.

He said the absence of a more severe outbreak of bird flu in Hong Kong is reassuring. "But that's not the kind of reassurance I really like."

He would be less concerned if it's shown that the flu is transmitted only from birds and not from person to person, Effler said.

"If it turned out that it is person-to-person transmission, the potential for a large outbreak is greater," he said.

Even so, he said, perhaps substantial contact would be needed to acquire the flu.

There may be more cases in Hong Kong that are very mild and aren't getting medical attention, Effler said.

"They may not be cultured and we'd never know."