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BackgroundA range of public health measures have been implemented to delay and reduce local transmission of COVID-19 in Hong Kong, and there have been major changes in behaviours of the general public. We examined the effect of these interventions and behavioral changes on the incidence of COVID-19 as well as on influenza virus infections which may share some aspects of transmission dynamics with COVID-19. MethodsWe reviewed policy interventions and measured changes in population behaviours through two telephone surveys, on January 20-23 and February 11-14. We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (Rt), for COVID-19 and influenza A(H1N1). FindingsCOVID-19 transmissibility has remained at or below 1, indicating successful containment to date. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% confidence interval, CI: 34% to 53%) reduction in transmissibility in the community, and a 33% (95% CI: 24% to 43%) reduction in transmissibility based on paediatric hospitalization rates. In the two surveys we estimated that 74.5% and 97.5% of the general adult population wore masks when going out, and 61.3% and 90.2% avoided going to crowded places, respectively. ImplicationsContainment measures, social distancing measures and changes in population behaviour have successfully prevented spread of COVID-19. The social distancing measures and behavioural changes led to a substantial reduction in influenza transmission in early February 2020. However, it may be challenging to avoid fatigue and sustain these measures and population behaviours as COVID-19 continues to spread globally. FundingHealth and Medical Research Fund, Hong Kong
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Stridor is the main symptom of upper airway obstruction in infants. It can be congenital or acquired, acute or chronic. Pathologies can be located from the nose down to the trachea. Common causes include laryngomalacia, vocal cord palsy, subglottic stenosis, tracheal anomaly, laryngeal cleft, vascular and lymphatic malformation, laryngeal papillomas, craniofacial abnormalities and even head and neck tumours. In this paper, we will discuss our approach to infants with stridor including assessment with flexible and rigid endoscopy and treatments to various conditions in a tertiary centre. Causes of stridor in infants undergoing rigid laryngotracheobronchoscopy in Queen Mary Hospital, University of Hong Kong Medical Centre between 2005 and 2011 will be retrospectively reviewed. Treatments according to various conditions will be discussed. Successful management of these neonates requires accurate diagnosis, early intervention, and multidisciplinary care by ENT surgeons, paediatricians, and paediatric anaesthetists.
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<p><b>OBJECTIVE</b>To evaluate the efficacy of tonsillectomy and adenoidectomy (T & A) in Asian childhood obstructive sleep apnea/hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>The medical data of the OSAHS patients in the Sleep Center of the Duchess Kent Children's Habilitation Institute from May 1999 to May 2003 were retrospectively reviewed. OSAHS was diagnosed according to the abnormal sleep monitoring results. The clinical outcomes were followed up and compared between the Operation and Non-operation groups (Control) in OSAHS children with adenotonsillar hypertrophy (ATH). Sleep endoscopy was performed for those who had residual OSAHS for the purpose of detecting the underlying causes.</p><p><b>RESULTS</b>Sixty-one patients were diagnosed with OSAHS. Among the OSAHS patients, 39 were associated with ATH, and 25 of the 39 patients underwent T & A. The desaturation dip rate and minimum saturation in the Operation group were significantly improved after T & A. Six out of 25 (24%) patients in the Operation group had residual OSAHS whereas 11 out of the 13 (85%) patients in the Control group had unchanged or worsening clinical symptoms (OR=15.4, 95%CI 2.7- 87.5). Residual OSAHS after surgery were attributable to obesity, achondroplasia, upper airway structure anomaly and airway dynamic problems.</p><p><b>CONCLUSIONS</b>T & A was effective in the majority of Asian childhood OSAHS associated with ATH. Upper airway structure or dynamic abnormalities can result in residual OSAHS in parts of children. Further investigation is required to detect the underlying problems.</p>