OUTBREAKS OF COMMON INFECTIONS IN THE ELDERLY HOMES IN HONG KONG

Background: Hong Kong is one of the most densely populated cities in the world.  About 60,000 of the territory’s 0.9 million people (12.8% of the population) aged 65 and above reside in some 770 residential care homes for the elderly (RCHEs).  Elderly people living in RCHEs are at considerable risk of developing infections, in particular when the living environment is crowded.

Objective: In Hong Kong, suspected outbreaks of infections in RCHEs are reported to the Centre for Health Protection of the Department of Health and field investigations will be carried out for each and every reported outbreak.

Methods: We reviewed the number and types of infectious disease outbreaks in RCHEs recorded by the CHP in the past 3.75 years from January 2006 to September 2009.

Results: Influenza-like-illness accounted for 21% of all the outbreaks notified to the CHP, which ranged from 13 to 121 per year, affecting a total of 1,366 people with 899 hospitalised.  Forty to 218 gastroenteritis outbreaks were recorded every year involving a total of 4,362 residents with 1,219 hospitalised, more than 80% of the outbreaks was caused by noroviruses.  With high vigilance and care on the menu and choices of food in RCHEs, food poisoning was relatively uncommon with only 4 outbreaks recorded in the past few years affecting 67 people, while none required hospitalisation.  On the other hand, scabies was the most common skin infestation noted in elderly homes with 66 to 105 outbreaks reported to the CHP every year; a total of 1,463 residents were affected.

Conclusions: Surveillance for infections is the key to all infection control programmes. Early detection, notification and implementation of control measures not only safeguards the health of the residents and staff by minimizing the harm caused by the disease, it also prevents the spread of infections, reduces the chance of hospitalization of the residents and helps save community resources. The outbreak reporting system set up with RCHEs has been important for the above purposes.