Public Urged to Take Precautions Against Heat-Related Illnesses During Extreme Heat Conditions

DH reminds public to take precautions against heat-related illnesses during very hot weather

The Centre for Health Protection (CHP) of the Department of Health (DH) today (August 5) reminded members of the public to take appropriate precautions against heat-related illnesses, such as heat cramps, heat exhaustion and heat stroke, during very hot weather.

In a high-temperature environment, excessive sweating and difficulty in heat dissipation can cause stress to the body. Members of the public should take the following precautions:

• Hydrate in a timely manner to prevent dehydration;
• Wear light-coloured, loose-fitting and breathable clothing to minimise heat absorption and facilitate perspiration and heat dissipation;
• Keep indoor areas well ventilated and maintain appropriate temperature and humidity, e.g. by opening windows or using a fan or air-conditioning;
• Avoid strenuous exercise and prolonged activities such as hiking or trekking;
• Arrange outdoor activities in the morning or the late afternoon, if possible, and bring enough water; and
• Avoid beverages containing caffeine, such as coffee and tea, as well as alcoholic beverages, which may speed up water loss through the urinary system.

In addition, infants and children, the elderly, pregnant women, individuals with chronic illnesses such as heart disease or high blood pressure, overweight people and outdoor/manual workers are more susceptible to heat stroke. These groups should pay special attention to the following:

• Infants and young children: Avoid going outside when the temperature is high. If they must go outside, adults should ensure they stay in places with moderate temperatures and good ventilation or air-conditioning. Infants and young children should never be left unattended in a confined space such as a vehicle;
• The elderly, pregnant women, individuals with chronic illnesses and overweight people: Pay close attention to health conditions and seek help as soon as possible if experiencing any abnormalities in health indicators such as blood pressure, heart rate, etc or if there are fluctuations in health conditions. Avoid going out when the temperature is high. Make sure there is good ventilation, or turn on a fan or air-conditioner to keep an appropriate temperature indoors. High temperatures can also worsen the condition of people with chronic illnesses (such as cardiovascular and respiratory diseases). Therefore, they should have an ample supply of their usual medication and keep in contact with family members, neighbours and the community. People should seek immediate help if they feel unwell.
• Outdoor/manual workers: Reschedule work to cooler hours as far as feasible. If working in a hot environment is unavoidable, provide shade where practicable and use ventilation and heat dissipation equipment. Once work has begun, gradually adjust the pace of work and take breaks in the shade to regain strength.

The DH reminded the public that heat stroke is one of the most common health risks in hot weather. Over the past five years, there have been over 200 hospital admissions due to heat stroke each year in Hong Kong, with two to five fatal cases occurring mainly during the summer months from May to September. Vulnerable groups are more susceptible to heat stroke. Symptoms include dizziness, headache, nausea, shortness of breath or confusion. In severe cases, patients may suffer from convulsions or become unconscious, which can be life-threatening if they are not cooled down and resuscitated in a timely manner.

Members of the public are also advised to pay attention to the latest weather, as well as the real-time and forecasted ultraviolet (UV) index released by the Hong Kong Observatory (HKO). When the UV index is high (6 or above), the public should note the following:

• Avoid direct sunlight exposure to the skin and the eyes;
• Apply broad-spectrum, water-resistant sunscreen liberally, with a sun protection factor (SPF) of at least 30 or higher, when participating in outdoor activities. Reapply every two hours if staying outdoors for long periods, or after swimming, sweating or towelling off;
• While using DEET-containing insect repellents for personal protection against mosquito-borne diseases, apply sunscreen before insect repellent;
• Seek shade;
• Wear UV-blocking sunglasses;
• Wear loose-fitting clothing with long-sleeves; and
• Wear a wide-brimmed hat or use an umbrella.

If symptoms develop, such as dizziness, headache, nausea, shortness of breath or confusion, rest and seek help immediately, and seek medical advice as soon as possible.

For more health information, the public may visit theCHP's heat strokepage andUV radiation page; the HKO's Dial-a-Weather (1878 200),latestweather report and forecast,UV Indexand weather information forhiking and mountaineering; andpress releasesof the Labour Departmenton precautions against heat stroke for outdoor workers and their employers when the Heat Stress at Work Warning is in force.

Source: AI-found images

DH continue to actively follow up on hospital-acquired case of Legionnaires' disease

Regarding a patient contracted Legionnaires' disease (LD) during hospitalisation at Hong Kong Sanatorium & Hospital (HKSH), the Centre for Health Protection (CHP) of the Department of Health (DH) today (August 4) announced that water samples taken from devices dispensing cooled boiled water within the hospital had tested positive for Legionella pneumophila (non-serogroup 1) at a concentration exceeding the action level for water supply systems in high-risk areas of hospitals. Sequence-based typing showed that the strain was the same as that found in the patient's respiratory specimen. The CHP considered that it is highly likely that the patient contracted LD by drinking water supplied by the affected water dispensing device. HKSH has completely discontinued the use of the water dispensing devices in question. A total of 137 patients who were hospitalised on the same floor as the patient has been put under medical surveillance. So far, none of them have contracted LD.

The water dispensing device in question was supplied by Aqua Vital Water Filtration Systems Ltd. The product is named the "BC-Tap Classic BA-Heat Exchange". According to the information provided by the supplier, this specific model was supplied exclusively to HKSH but not other hospitals. As a precaution, the DH today issued another letter reminding all private hospitals in Hong Kong to strictly adhere to the "Code of Practice for Prevention of LD" when providing drinking water to patients.

Upon receiving notification of the abovementioned nosocomial LD case last month, the CHP immediately sent personnel to the hospital to conduct an environmental investigation to identify the source of the infection. During the investigation, 10 water samples and six environmental samples were collected from the water tanks of the hospital building and the floor where the patient had been admitted. Test results from the CHP's Public Health Laboratory Services Branch (PHLSB) revealed that two water samples from the outlet of the device dispensing cooled boiled water in the pantry on that floor tested positive for Legionella pneumophila (non-serogroup 1) at levels ranging from 3 to 16.6 colony-forming units per millilitre (cfu/ml), far exceeding the action level for water supply systems in high-risk areas of hospitals (i.e. 0.1 cfu/ml or above). Sequence-based typing showed that the Legionella pneumophila (non-serogroup 1) isolated from the water samples and the patient's respiratory specimen belonged to the same sequence type. The remaining samples, including two water samples collected from the water tanks, six water samples collected from the single room where the patient had been admitted and six environmental samples, tested negative for Legionella pneumophila.

HKSH has since disinfected the relevant ward's water supply system according to the CHPs instructions. HKSH has also suspended the use of the water dispensing devices and is now providing bottled water for patients' consumption.

To assist in assessing the risk posed by the water dispensing device in question, the CHP collected 19 water samples and one environmental sample from the same model of water dispensing devices within the hospital for further testing. The PHLSB's testing results revealed that one environmental sample and four water samples tested positive for Legionella pneumophila at levels ranging from 0.3 to 12.9 cfu/ml. Testing is still underway for two additional water samples.

An in-depth investigation by the CHP and the Electrical and Mechanical Services Department found that the water dispensing device contains a built-in cooling system with a long, coiled metallic water conduit. When the device is not in use, stagnant warm water accumulates inside it. The temperature remains within a range conducive to the growth of Legionella bacteria for an extended period. This stagnant water, which may be contaminated with Legionella, is dispensed for direct consumption. Additionally, the metallic water conduit was not regularly disinfected or cleaned. HKSH has agreed to suspend use of the devices entirely and is currently providing patients with bottled water as a temporary measure.

The CHP will continue to investigate and follow up on the case. A meeting of the Prevention of Legionnaires' Disease Committee (PLDC) will be convened to report on the epidemiological investigation and the cause of the infection.

The PLDC was set up in 1985 to advise the Government from the public health, microbiology and engineering services perspectives on the minimisation of the risk of LD, and the promotion of good practices to building owners and associated practitioners to prevent the outbreak of LD.

Men, people aged over 50, smokers, alcoholics and persons with weakened immunity are more susceptible to LD. Some situations may also increase the risk of infection, including poor maintenance of water systems; living in areas with old water systems, cooling towers or fountains; using electric water heaters, whirlpool spas or hot water spring spas; and recent stays in hotels or ships.

Legionellae are found in various environmental settings and grow well in warm water (20 to 45 degrees Celsius). They can be found in aqueous environments such as water tanks, hot and cold water systems, cooling towers, whirlpool spas, water fountains, humidifiers and home respiratory devices that support breathing. People may become infected when they breathe in contaminated droplets (aerosols) and mist generated by artificial water systems, or when handling garden soil, compost and potting mixes.

The public may visit the CHP's LD page, the Code of Practice for Prevention of LD and the Housekeeping Guidelines for Cold and Hot Water Systems for Building Management of the Prevention of LD Committee, and the CHP's risk-based strategy for prevention and control of LD.

Additionally, as smokers and alcoholics are more susceptible to LD, the Government urges members of the public to quit smoking and avoid drinking. Members of the public may call the DH Integrated Smoking Cessation Hotline at 1833 183, which is answered by registered nurses who provide professional counselling and referral to a wide range of free smoking cessation services. The public may also visit the smoking cessation thematic website (www.livetobaccofree.hk) for more information on smoking cessation. The DH has also developed and promulgated the Alcohol Screening and Brief Intervention tool to primary healthcare service providers to facilitate the early identification and management of at-risk drinkers. For information on alcohol-related harm, please visi the DH's Change for Health website.

Source: AI-found images