scholarly journals Temporal and gene reassortment analysis of influenza C outbreaks in Hong Kong SAR, China

2021 ◽  
Author(s):  
Rodney S. Daniels ◽  
Monica Galiano ◽  
Burcu Ermetal ◽  
Jasmine Kwong ◽  
Chi S. Lau ◽  
...  
Keyword(s):  
Hong Kong ◽  
Severe Disease ◽  
Disease Outbreaks ◽  
Great Majority ◽  
Antigenic Drift ◽  
Similar Time ◽  
Hong Kong Sar ◽  
Influenza C Virus ◽  
Time Frames ◽  
The Impact

From 2014 to week 07/2020 the Centre for Health Protection in Hong Kong conducted screening for influenza C virus (ICV). A retrospective analysis of ICV detections to week 26/2019 revealed persistent low-level circulation with outbreaks occurring biennially in the winters of 2015-16 and 2017-18 (1). Here we report on an outbreak occurring in 2019-20, reinforcing the observation of biennial seasonality in Hong Kong. All three outbreaks occurred in similar time-frames, were subsequently dwarfed by seasonal epidemics of influenza types A and B, and were caused by similar proportions of C/Kanagawa/1/76 (K-)lineage and C/São Paulo/378/82 S1- and S2-sublineage viruses. Ongoing genetic drift was observed in all genes, with some evidence of amino acid substitution in the HEF glycoprotein possibly associated with antigenic drift. A total of 61 ICV genomes covering the three outbreaks were analysed for reassortment and nine different reassortant constellations were identified, one K-lineage, four S1-sublineage and four S2-sublineage, with six of these being identified first in the 2019-20 outbreak (two S2-lineage and four S1-lineage). The roles that virus interference/enhancement, ICV persistent infection, genome evolution and reassortment might play in the observed seasonality of ICV in Hong Kong are discussed. Importance Influenza C virus (ICV) infection of humans is common with the great majority of people being infected during childhood, though re-infection can occur throughout life. While infection normally results in ‘cold-like’ symptoms, severe disease cases have been reported in recent years. However, knowledge of ICV is limited due to poor systematic surveillance and an inability to propagate the virus in large amounts in the laboratory. Following recent systematic surveillance in Hong Kong SAR, China and direct ICV gene sequencing from clinical specimens a two-year cycle of disease outbreaks (epidemics) has been identified with gene mixing playing a significant role in ICV evolution. Studies like those reported here are key to developing an understanding of the impact of influenza C virus infection in humans, notably where comorbidities exist and severe respiratory disease can develop.

scholarly journals Molecular Characterization of Influenza C Viruses from Outbreaks in Hong Kong SAR, China

2020 ◽  
Vol 94 (21) ◽  
Author(s):  
Rodney S. Daniels ◽  
Herman Tse ◽  
Burcu Ermetal ◽  
Zheng Xiang ◽  
Deborah J. Jackson ◽  
...  
Keyword(s):  
Hong Kong ◽  
Virus Infection ◽  
Severe Disease ◽  
Gene Sequencing ◽  
Virus Evolution ◽  
Antigenic Drift ◽  
Genetic Lineages ◽  
Hong Kong Sar ◽  
Influenza C Virus ◽  
The Impact

ABSTRACT In 2014, the Centre for Health Protection in Hong Kong introduced screening for influenza C virus (ICV) as part of its routine surveillance for infectious agents in specimens collected from patients presenting with symptoms of respiratory viral infection, including influenza-like illness (ILI). A retrospective analysis of ICV detections up to week 26 of 2019 revealed persistent low-level circulation, with two outbreaks having occurred in the winters of 2015 to 2016 and 2017 to 2018. These outbreaks occurred at the same time as, and were dwarfed by, seasonal epidemics of influenza types A and B. Gene sequencing studies on stored ICV-positive clinical specimens from the two outbreaks have shown that the hemagglutinin-esterase (HE) genes of the viruses fall into two of the six recognized genetic lineages (represented by C/Kanagawa/1/76 and C/São Paulo/378/82), with there being significant genetic drift compared to earlier circulating viruses within both lineages. The location of a number of encoded amino acid substitutions in hemagglutinin-esterase fusion (HEF) glycoproteins suggests that antigenic drift may also have occurred. Observations of ICV outbreaks in other countries, with some of the infections being associated with severe disease, indicates that ICV infection has the potential to have significant clinical and health care impacts in humans. IMPORTANCE Influenza C virus infection of humans is common, and reinfection can occur throughout life. While symptoms are generally mild, severe disease cases have been reported, but knowledge of the virus is limited, as little systematic surveillance for influenza C virus is conducted and the virus cannot be studied by classical virologic methods because it cannot be readily isolated in laboratories. A combination of systematic surveillance in Hong Kong SAR, China, and new gene sequencing methods has been used in this study to assess influenza C virus evolution and provides evidence for a 2-year cycle of disease outbreaks. The results of studies like that reported here are key to developing an understanding of the impact of influenza C virus infection in humans and how virus evolution might be associated with epidemics.

scholarly journals Comparing Public Perceptions and Preventive Behaviors During the Early Phase of the COVID-19 Pandemic in Hong Kong and the United Kingdom: Cross-sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Leigh Bowman ◽  
Kin On Kwok ◽  
Rozlyn Redd ◽  
Yuanyuan Yi ◽  
Helen Ward ◽  
...  
Keyword(s):  
Hong Kong ◽  
United Kingdom ◽  
Risk Perception ◽  
Early Phase ◽  
Disease Outbreaks ◽  
Cross Sectional ◽  
Social Distancing ◽  
Explanatory Variables ◽  
The United Kingdom ◽  
The Impact

BACKGROUND Given the public health responses to previous respiratory disease pandemics, and in the absence of treatments and vaccines, the mitigation of the COVID-19 pandemic relies on population engagement in nonpharmaceutical interventions. This engagement is largely driven by risk perception, anxiety levels, and knowledge, as well as by historical exposure to disease outbreaks, government responses, and cultural factors. OBJECTIVE The aim of this study is to compare psychobehavioral responses in Hong Kong and the United Kingdom during the early phase of the COVID-19 pandemic. METHODS Comparable cross-sectional surveys were administered to adults in Hong Kong and the United Kingdom during the early phase of the epidemic in each setting. Explanatory variables included demographics, risk perception, knowledge of COVID-19, anxiety level, and preventive behaviors. Responses were weighted according to census data. Logistic regression models, including effect modification to quantify setting differences, were used to assess the association between the explanatory variables and the adoption of social distancing measures. RESULTS Data from 3431 complete responses (Hong Kong, 1663; United Kingdom, 1768) were analyzed. Perceived severity of symptoms differed by setting, with weighted percentages of 96.8% for Hong Kong (1621/1663) and 19.9% for the United Kingdom (366/1768). A large proportion of respondents were abnormally or borderline anxious (Hong Kong: 1077/1603, 60.0%; United Kingdom: 812/1768, 46.5%) and regarded direct contact with infected individuals as the transmission route of COVID-19 (Hong Kong: 94.0%-98.5%; United Kingdom: 69.2%-93.5%; all percentages weighted), with Hong Kong identifying additional routes. Hong Kong reported high levels of adoption of various social distancing measures (Hong Kong: 32.6%-93.7%; United Kingdom: 17.6%-59.0%) and mask-wearing (Hong Kong: 98.8% (1647/1663); United Kingdom: 3.1% (53/1768)). The impact of perceived severity of symptoms and perceived ease of transmission of COVID-19 on the adoption of social distancing measures varied by setting. In Hong Kong, these factors had no impact, whereas in the United Kingdom, those who perceived their symptom severity as “high” were more likely to adopt social distancing (adjusted odds ratios [aORs] 1.58-3.01), and those who perceived transmission as “easy” were prone to adopt both general social distancing (aOR 2.00, 95% CI 1.57-2.55) and contact avoidance (aOR 1.80, 95% CI 1.41-2.30). The impact of anxiety on adopting social distancing did not vary by setting. CONCLUSIONS Our results suggest that health officials should ascertain baseline levels of risk perception and knowledge in populations, as well as prior sensitization to infectious disease outbreaks, during the development of mitigation strategies. Risk should be communicated through suitable media channels—and trust should be maintained—while early intervention remains the cornerstone of effective outbreak response.

scholarly journals Public perceptions and preventive behaviours during the early phase of the COVID-19 pandemic: a comparative study between Hong Kong and the United Kingdom

2020 ◽  
Author(s):  
Leigh Bowman ◽  
Kin On Kwok ◽  
Rozlyn Redd ◽  
Yuanyuan Yi ◽  
Helen Ward ◽  
...  
Keyword(s):  
Hong Kong ◽  
United Kingdom ◽  
Risk Perception ◽  
Early Phase ◽  
Disease Outbreaks ◽  
Perceived Severity ◽  
Social Distancing ◽  
Explanatory Variables ◽  
The United Kingdom ◽  
The Impact

Background: In the absence of treatments and vaccines, the mitigation of COVID-19 relies on population engagement in non-pharmaceutical interventions, which is driven by their risk perception, anxiety level and knowledge. There may also be regional discrepancies in these drivers due to different historical exposure to disease outbreaks, government responses and cultures. As such, this study compared psycho-behavioral responses in two regions during the early phase of the pandemic. Methods: Comparable cross-sectional surveys were administered among adults in Hong Kong (HK) and the United Kingdom (UK) during the early phase of each respective epidemic. Explanatory variables included demographics, risk perception and knowledge of COVID-19, anxiety level and preventive behaviors. Responses were weighted according to census data. Logistic regression models, including interaction terms to quantify regional differences, were used to assess the association between explanatory variables and the adoption of social-distancing measures. Results: Data of 3431 complete responses (HK:1663; UK:1768) were analysed. Perceived severity differed by region (HK: 97.5%; UK: 20.7%). A large proportion of respondents were abnormally/borderline anxious (HK:64.8%; UK:45.9%) and regarded direct contact with infected individuals as the transmission route of COVID-19 (HK:94.0-98.5%; UK:69.2-93.5%), with HK identifying additional routes. HK reported high levels of adoption of social-distancing (HK:32.4-93.7%; UK:17.6-59.0%) and mask-wearing (HK:98.8%; UK:3.1%). The impact of perceived severity and perceived ease of transmission on the adoption of social-distancing varied by region. In HK, they had no impact, whereas in the UK, those who perceived severity as 'high' were more likely to adopt social-distancing (aOR:1.58-3.01), and those who perceived transmission as 'easy' were prone to both general social-distancing (aOR:2.00, 95% CI:1.57, 2.55) and contact avoidance (aOR:1.80, 95% CI: 1.41, 2.30). The impact of anxiety on adopting social-distancing did not vary by region. Discussion: These results suggest that health officials should ascertain and consider baseline levels of risk perception and knowledge in the populations, as well as prior sensitisation to infectious disease outbreaks, during the development of mitigation strategies. Risk communication should be done through suitable media channels - and trust should be maintained - while early intervention remains the cornerstone of effective outbreak response.

Enforcement of Hong Kong Sar Court Judgments in the People's Republic of China

2000 ◽  
Vol 49 (4) ◽  
pp. 867-875
Author(s):  
Qingjiang Kong
Keyword(s):  
Hong Kong ◽  
People’S Republic Of China ◽  
Special Administrative Region ◽  
People's Republic Of China ◽  
New Era ◽  
Republic Of China ◽  
Administrative Region ◽  
British Colony ◽  
Hong Kong Sar ◽  
The Impact

On 1 July 1997 Hong Kong entered a new era when it was transformed from a British colony into a Special Administrative Region (SAR) of the People's Republic of China (PRC). The impact of the handover of Hong Kong cannot be overstated but, for the time being perhaps, may lie more in the sphere of ideology than in institutions.

scholarly journals A Randomized, Single-Blind, Crossover Study Evaluating the Impact of OnabotulinumtoxinA Treatment on Mood and Appearance During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Robert T Cristel ◽  
Nimit D Gandhi ◽  
Tariq Z Issa ◽  
Eljona Kola ◽  
Daniel Demesh ◽  
...  
Keyword(s):  
Placebo Group ◽  
Treatment Satisfaction ◽  
Severe Disease ◽  
Disease Outbreaks ◽  
Time Period ◽  
The Face ◽  
Upper Face ◽  
The Impact ◽  
Upper Third ◽  
Single Blind

Abstract Background The emergence of Coronavirus disease of 2019 (COVID-19), quickly became one of the most severe disease outbreaks in modern history. This caused many aesthetic practices around the country to close temporarily and led to a unique time period to evaluate the impact neurotoxin has in the setting of an ongoing pandemic. Objectives To examine whether the administration of onabotulinumtoxinA (BOTOX Cosmetic, Allergan plc, Coolock, Ireland), in regular users, synergistically amplifies the elevation in mood/happiness, self-satisfaction with appearance and overall satisfaction, in the context of the ongoing pandemic. Methods A randomized single-blind cross-over study was designed to evaluate the impact of neurotoxin treatment in the upper third of the face on mood, self-satisfaction with appearance, and overall satisfaction. The placebo group crossed over to treatment after 1 month. Surveys evaluating patient happiness, self-satisfaction with appearance and overall efficacy were completed among both groups, and again to the placebo group again following crossover to treatment. Results Forty-five subjects were enrolled with 30 in the treatment and 15 in the control/cross-over group. The placebo group demonstrated no change in happiness or self-satisfaction in appearance until cross-over to the treatment group. Both groups, once receiving, onabotulinumtoxinA reported increased happiness, self-satisfaction with appearance and overall treatment satisfaction. Conclusions OnabotulinumtoxinA treatment to the upper face in the midst of the COVID-19 pandemic was found to increase patient happiness, self-satisfaction with appearance, and overall treatment satisfaction.

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