Encephalitis Breaks Out in China

By ELAINE KURTENBACH : Associated Press Writer
Jun 20, 2003 : 2:45 pm ET

HONG KONG -- An outbreak of encephalitis that flared up in a southern Chinese province just as the SARS epidemic was dying down has prompted calls in Hong Kong for faster and better reporting of infectious diseases on the mainland.

A senior Hong Kong official was meeting with officials in Guangdong province Friday to try to determine the extent of the encephalitis outbreak, as the city tightened precautions against the disease. It is transmitted by mosquitoes and, unlike severe acute respiratory syndrome, not by human-to-human contact.

Guangdong health officials and state-run media reported 211 encephalitis cases, with 18 children killed by Friday. The province has vaccinated 100,000 children in the past week as a precaution.

Hong Kong's recent ordeal with SARS, by far the worst in a series of health scares since this former British colony returned to China rule in 1997, has left residents nervous about health risks from across the border.

"What we need to know is to understand the extent of the outbreak in China and to see whether we need to have additional measures," the territory's health secretary, Yeoh Eng-kiong, told reporters Friday.

Encephalitis kills nearly 10,000 people each year in Asia. Hong Kong reports up to two cases a year, but they usually come from elsewhere. The most recent case of local transmission was in 1996, when the disease killed a 15-year-old boy.

The disease is untreatable and is usually fatal in 30 percent of cases, according to the World Health Organization. It causes mild flu-like symptoms like fever, headache, nausea and fatigue, and can cause the brain to swell.

In some regions, children are routinely vaccinated for the virus, but in big cities like Hong Kong and Beijing, doctors often recommend against the shot unless a family expects to spend much time in rural areas.

So far, nothing indicates that the encephalitis outbreak has spread to this mostly urban territory. But Hong Kong is still worried after the SARS crisis, which killed more people there -- 296 -- than anywhere else except mainland China.

Yeoh said the territory already had stepped up surveillance for encephalitis but was waiting for more information before deciding whether additional precautions, such as mass vaccinations, were needed.

Hong Kong has embarked on an aggressive campaign to eradicate mosquitoes, which also carry dengue fever, another recent worry here. It also stepped up hygiene measures and controls to detect and prevent bird flu after a 1997 outbreak killed six people.

Since its return to Chinese control, Hong Kong has been governed under an autonomy arrangement that ensures press freedoms and greater transparency than found in the communist-ruled mainland.

A lack of information from the mainland early in the SARS crisis is thought to have contributed to the spread of the virus from Guangdong, where SARS is thought to have originated -- first to Hong Kong, and then elsewhere.

Yeoh's comments made it clear that despite vows to improve communication and cooperation across the border, Hong Kong is still trying to figure out how the mainland's system for notification of outbreaks of infectious diseases works.

"First, we need to understand the notification system itself," Yeoh said. "First, we need to talk with our colleagues on the mainland and get information. We really need details."

Yeoh said Hong Kong would like to see "early alerts" from the mainland, but it was unclear if they were available.