Author: SHEA
Date Published:1/5/2015 11:04:00 AM
Publication Format:

For Immediate Release: January 5, 2015
Society for Healthcare Epidemiology of America
Contact: Tamara Moore / 202-745-5114
Author contact: K.Y. Yuen /

Infection Control Preparedness Measures Control Avian Flu in Hong Kong Hospital

NEW YORK  (January 5, 2015) – A proactive infection prevention plan implemented widely in a Hong Kong healthcare system was a significant factor preventing the spread of influenza strain A H7N9, otherwise known as Avian flu. The study was published in the January issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

"The emergence of A H7N9 influenza in March 2013 posed a public health threat both locally and internationally because of the risk for airborne transmission," said K.Y. Yuen, MD, FRCPath, a lead author of the study. "Despite the delay in airborne precaution implementation, we suspect that high hand hygiene compliance, as a result of continuous implementation of proactive control measures against various viruses and multidrug-resistant organisms, protected frontline healthcare workers against many challenges of emerging infectious diseases."

Risk for person-to-person transmission in A H7N9 is lower compared to other viruses including certain influenza strains, but some cases were identified as being spread between relatives. The strain is associated with high mortality and morbidity.

Researchers examined the effectiveness of preparedness measures in controlling the spread of the virus at Queen Mary Hospital in Hong Kong for 13 months (April 2013-May 2014). Infection control staff implemented an integrated approach, utilizing active and enhanced surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and extensive tracing for healthcare workers with unprotected exposure. Additionally, open forum sessions were conducted to brief frontline staff on proper protocols.

During the study period, 126 of 163,456 admitted patients were tested for the strain and two cases tested positive for A H7N9 influenza.  Seventy healthcare workers had unprotected exposure during patient care activities by not wearing an N95 respirator during aerosol-generating procedures. However, most of the healthcare workers exposed complied with standard precautions, including wearing a surgical mask and performing hand hygiene. No staff tested positive for the strain.

"As we look at lessons learned from this outbreak, the high false-positive screening rate and other delays in diagnosis may have resulted in unprotected exposure of frontline staff. However, enhanced surveillance methods appeared to be an important safety net for the detection of A H7N9," said Yuen.


Vincent C. C. Cheng, Josepha W. M. Tai, W. M. Lee, W. M. Chan, Sally C. Y. Wong, Jonathan H. K. Chen, Rosana W. S. Poon, Kelvin K. W. To, Jasper F. W. Chan, P. L. Ho, K. H. Chan, K. Y. Yuen. "Infection Control Preparedness for Human Infection With Influenza A H7N9 in Hong Kong." Infection Control and Hospital Epidemiology (January 2015).

Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control &  Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13 out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

SHEA is a global professional society representing more than 2,000 physicians and other healthcare professionals with expertise and passion for healthcare epidemiology and infection prevention to improve patient care in all healthcare settings. SHEA's mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology. The society advances its mission through advocacy, science and research, expert guidelines and guidance on key issues, the exchange of knowledge, and high-quality education.  SHEA focuses resources on promoting antimicrobial stewardship, ensuring a safe healthcare environment, encouraging transparency in public reporting related to HAIs, focused efforts on prevention and more. Visit SHEA online at, and @SHEA_Epi.