Invasive Group B Streptococcus Cases – Avoid handling raw freshwater fish or seafood with hand wounds 侵入性乙型鏈球菌感染個案 – 手部有傷口應避免徒手接觸淡水魚或海鮮

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The Centre for Health Protection of Deparment of Health (CHP), HKSAR has received reports by the Hospital Authority that 58 & 21 in-patients had tested positive for invasive Group B Streptococcus from Sep to Oct 10, 2021,  a surge as compared with a range of 9-26 cases per month over the past three years.   The paitient mainly presented with septicaemia, meningitis, pyogenic arthritis or abscess/cellulitis.

Investigations show that some of the patients have history of handling freshwater fish, including grass carp, before onset. Some of them had reported handling of raw freshwater fish with hand wounds.

Laboratory analysis has shown that at least 32 cases belonged to serotype III sequence type 283 (ST283) which was of identical genetic sequencing to the fish and environmental samples taken in markets visited by some of the cases. The CHP considers that handling raw freshwater fish with hand wounds or consumption of undercooked freshwater fish may be associated with the infection. In fact, association between consumption of raw freshwater fish and invasive Group B Streptococcus of ST283 has been reported previously in overseas literature. Presence of Group B Streptococcus of ST283 was also reported in freshwater fish in southeast Asia countries.

To prevent Group B Streptococcus infection, members of the public are reminded to maintain personal, food and environmental hygiene and should keep their hands clean and practice good wound care at all times, especially:

•Wear gloves while handling raw freshwater fish or seafood and avoid having wounds coming in contact with raw freshwater fish or seafood;

•Avoid eating raw freshwater fish or seafood; and

•Avoid skin contact with dirty water when visiting a wet market and maintain good hand hygiene.

Official Press Releases from CHP, HKSAR:

https://www.info.gov.hk/gia/general/202110/18/P2021101800707.htm?fontSize=1

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衞生署衞生防護中心接獲醫院管理局通報，2021年9月截至10月10日，分別有58名和21名住院病人經檢測後證實感染侵入性乙型鏈球菌，較過去三年（二○一九至二○二一年八月）錄得每月介乎九至26宗個案有所增加。該79宗個案涉及42男、37女，年齡介乎一個月大至96歲。他們主要出現敗血症、腦膜炎、化膿性關節炎或膿腫／蜂窩組織炎等。

調查顯示，部分病人病發前曾接觸淡水魚，包括鯇魚，當中部分人報稱處理未經烹煮的淡水魚時手部帶有傷口。

化驗分析顯示其中最少32宗個案屬於血清三型基因序列型283（ST283），與部分個案曾到訪的街市內採集的環境樣本和魚樣本的基因排序吻合。中心認為病人感染可能與處理未經烹煮的淡水魚時手部帶有傷口或食用未煮熟的淡水魚有關。事實上，海外亦有文獻指出ST283的侵入性乙型鏈球菌感染與食用未經烹煮的淡水魚有關，東南亞國家亦曾報告在淡水魚發現ST283的乙型鏈球菌。

要預防感染乙型鏈球菌，市民應經常保持個人、食物及環境衞生，並經常保持手部清潔和適當處理傷口，尤其是：

•  處理未經烹煮的淡水魚或海產時應使用手套，並避免傷口接觸未經烹煮的淡水魚或海產；

•  避免進食未經烹煮的淡水魚或海產；及

•  到訪濕貨街市時避免皮膚接觸污水，並應保持手部清潔。

新聞公報原址:

https://www.info.gov.hk/gia/general/202110/18/P2021101800708.htm?fontSize=1