Neurological sequelae of acute otitis media in a six-month-old baby - facial nerve palsy: a case report

Acute Otitis Media (AOM) is common among children. It almost always resolves completely with no sequelae. In unusual cases, however, bacterial resistance to antibiotics, disordered host immunity or anatomical deficits may lead to severe complications including facial nerve palsy. Prompt treatment by drainage and appropriate antibiotics is required for recovery from facial nerve palsy.published_or_final_versio

Changing epidemiology of measles in Hong Kong from 1961 to 1990 - Impact of a measles vaccination program

With the use of measles vaccine since 1967, Hong Kong has experienced a low incidence of measles until a major outbreak in 1988. A shift in the distribution of susceptible children to older age groups was suddenly accelerated in the 1988 outbreak. The attack rate increased by 18.9-fold for children >10 years old, while that for those in the best-protected age group of 1-4 years was only 2.2-fold. Of the cases during that outbreak, 56.3% would have been considered preventable with the present vaccination regimen, and vaccine failures accounted for only 20.4% of the cases. Present control strategies aim at increasing the coverage rate rather than introducing a two- dose regimen, which may be necessary when vaccine failures account for a larger proportion of measles cases.published_or_final_versio

Changes in nasopharyngeal carriage and serotype distribution of antibiotic-resistant Streptococcus pneumoniae before and after the introduction of 7-valent pneumococcal conjugate vaccine in Hong Kong

This study assessed the changes in serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates in children before and after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in Hong Kong. Nasopharyngeal specimens were collected from 1978 and 2211 children (ages, 2 to 6 years) attending day care centers or kindergartens in period 1 (1999-2000) and period 2 (2009-2010), respectively. Carriage of PCV7 serotypes decreased from 12.8% to 8.6% (P < 0.01). The relative contribution of PCV7 serotypes 14 and 18C had decreased, whereas that for non-PCV7 serotypes 19A, 6A, 6C, 23A, and 15B had increased. In period 2, PCV7 penetration rate (at least 1 dose) for children aged 2, 3, 4, and 5 years was 43%, 35.7%, 26.7%, and 20.4%, respectively. In multivariate analysis, PCV7 use was the only independent variable associated with fewer PCV7 serotype carriages (odds ratio 0.5; P = 0.001). In period 2, high rates of dual penicillin/erythromycin nonsusceptibility were found in serotypes 6B (77.3%), 14 (100%), 19F (100%), 23F (78%), 19A (75%), 6A (87.8%), 6C (59.3%), and 23A (78.9%).postprin

Policy brief: Children left unattended at home in Hong Kong

Recommendations on Childhood Injury in Hong Kong, in response to the Child Fatality Review for the Legislative Council Welfare Services Panel Meetingpublished_or_final_versio

Molecular epidemiology and nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus among young children attending day care centers and kindergartens in Hong Kong

OBJECTIVES: To investigate the prevalence and molecular epidemiology of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) nasal carriage in children. METHODS: We collected nasal and nasopharyngeal swabs from 2211 children aged 2-5 years attending 79 day care centers (DCCs) and 113 kindergartens (KGs) in all 18 geographical districts in Hong Kong. RESULTS: The overall carriage rates of S. aureus and MRSA were 27.6% (95% confidence interval [CI], 24.8-28.5%) and 1.3% (95% CI, 0.8-1.8%), respectively. Molecular typing (staphylococcal cassette chromosome mec [SCCmec], sequence type [ST], clonal cluster [CC]) showed that all the 28 MRSA isolates had SCCmec IV (n = 13) or V (n = 15) including 12 isolates with community-associated-MRSA genotypes (ST59-IV/V, ST30-IV and ST88-V), 10 isolates with healthcare-associated-MRSA genotypes (ST45-IV/V, CC5-IV and ST630-V) and six isolates with novel genotypes (ST10-V and CC1-IV). Spa typing indicated that there was some within and between DCCs/KGs transmission of certain MRSA and methicillin-sensitive S. aureus strains but this was not extensive. CONCLUSION: Our findings indicate the potential for DCCs to be a reservoir for emerging MRSA genotypes and highlight the need to enhance education and infection control measures to reduce their cross-transmission in this population.postprin

Live birth following double-factor pre-implantation genetic diagnosis for both reciprocal translocation and alpha-thalassaemia

published_or_final_versio

The need of policies and legislative changes for tobacco control in Hong Kong: Letter of recommendations to Hong Kong Legislative Council

Recommendations on Anti-smoking Policy in Hong Kong, in response to the discussion on increasing tobacco taxation for the Legislative Council Subcommittee on Public Revenue Protection (Dutiable Commodities) Order 2011published_or_final_versio

Two Chinese patients with Loeys-Dietz Syndrome due to TGFBR2 mutations

Poster Presentation (Doctor’s Session)This journal issue contain Proceedings of the CongressBACKGROUND: We previously reported 6 patients with Marfan-like phenotype due to transforming growth factor b-receptor 2 (TGFBR2) mutations (Am J Med Genet Part A 149A:1452-1459). Loeys-Dietz syndrome (LDS) is a recently described autosomal dominant connective tissue disorder characterized by facial dysmorphism, cleft palate, aortic dilatation, blood vessel tortuosity and a high risk of aortic dissection. It is caused by mutations in the TGFBR1 and 2 genes. Two of the 6 patients reported in 2009 were re-assessed and confirmed to have phenotypic features of ...postprin

Molecular epidemiology and nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus among young children attending day care centers and kindergartens in Hong Kong

OBJECTIVES: To investigate the prevalence and molecular epidemiology of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) nasal carriage in children. METHODS: We collected nasal and nasopharyngeal swabs from 2211 children aged 2-5 years attending 79 day care centers (DCCs) and 113 kindergartens (KGs) in all 18 geographical districts in Hong Kong. RESULTS: The overall carriage rates of S. aureus and MRSA were 27.6% (95% confidence interval [CI], 24.8-28.5%) and 1.3% (95% CI, 0.8-1.8%), respectively. Molecular typing (staphylococcal cassette chromosome mec [SCCmec], sequence type [ST], clonal cluster [CC]) showed that all the 28 MRSA isolates had SCCmec IV (n = 13) or V (n = 15) including 12 isolates with community-associated-MRSA genotypes (ST59-IV/V, ST30-IV and ST88-V), 10 isolates with healthcare-associated-MRSA genotypes (ST45-IV/V, CC5-IV and ST630-V) and six isolates with novel genotypes (ST10-V and CC1-IV). Spa typing indicated that there was some within and between DCCs/KGs transmission of certain MRSA and methicillin-sensitive S. aureus strains but this was not extensive. CONCLUSION: Our findings indicate the potential for DCCs to be a reservoir for emerging MRSA genotypes and highlight the need to enhance education and infection control measures to reduce their cross-transmission in this population.postprin

'Everybody Else Got To Have This Cookie': The Effects of Food Allergen Labels On the Well-Being of Canadians

The Canadian prevalence for all food allergies is estimated to be 7.5%. The only management strategy for an allergic individual is a strict avoidance diet, which is heavily reliant on the effectiveness of food labels used on commercial food products. This thesis explores the effects of food allergen labels on the well-being of affected Canadians, using a social constructionist framework and a mixed methods approach. The quantitative portion of this study drew upon primary survey data. Respondents were asked to self-report household allergic status, as well as purchasing behavior and attitudes towards precautionary statements (n=1380). Results from the quantitative analysis were used to inform and develop the qualitative interview schedule for the second phase of this thesis. Qualitative interviews in a grocery store setting were conducted with 12 anaphylactic individuals, or parents of anaphylactic children.Respondents were observed during the course of product selection and questioned about their shopping habits, perceptions of and preferences for allergen labels. Results indicate that current Canadian allergen labels are not as effective as expected, since affected consumers reported not heeding precautionary statements. Allergic families were found to be less diligent than indirectly affected families, and also less likely to find precautionary statements helpful. Through qualitative interviews, it was found that prior experience, not allergen information, is the primary factor guiding purchasing decisions. Even though precautionary statements were found to be easy to understand, terminology, font sizes, and contrast issues on labels were reported to be key areas of improvement. Results from the two phases reflect differences in individuals‟ social constructions of risk, which ultimately shape purchasing and consumption behaviors. This research is the first to explore the effects of allergen labels on affected Canadians, using a social constructionist approach. Ultimately, results will help effective policy change in Canada and help affected consumers make safe consumption choices. This research contributes to the number of health studies that utilized a mixed methods approach, which is an emerging paradigm. The use of mixed methods allowed for extension and refinement of results. Future research directions identified in this research include the need for pharmaceutical labeling in Canada, as well as the need to explore purchasing behaviors of indirectly affected families, as they also utilize allergen labels to guide consumption choices when shopping for allergy-controlled environments.Master of Arts (MA