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Background: COVID-19 outbreaks in residential care homes for the elderly (RCHEs) and for persons with disability (RCHDs) have caused significant morbidity and mortality during 5th epidemic in Hong Kong. This article reviewed COVID-19 outbreaks situation and estimated the effectiveness of receiving at least two-dose of COVID-19 vaccine in preventing severe outcomes. Methods: To estimate attack rates and vaccination coverage, documentation on COVID-19 infection and their vaccination records of residential care homes (RCH) residents reported between December 31, 2021 and May 31, 2022 were reviewed, and infected cases were follow-up for 4 weeks for severe outcomes or death. Correlation between vaccination coverage against attack rate by types of homes was examined. Infected RCH residents with available information were included in the analysis of vaccine effectiveness against severe outcomes and death. Results: COVID-19 vaccination coverage was low in RCHDs (median 0.46, IQR: 0.24-0.76) and very low in RCHEs (median 0.08, IQR: 0.00-0.19). Higher attack rates were recorded among RCHE residents (median 0.84, IQR: 0.64-0.93) and higher case fatality rate (CFR: 28.1%) than in RCHDs (median 0.58, IQR: 0.31-0.84; CFR: 3.9%). The attack rate decreased when vaccination coverage increased for both RCHEs (ρ = -0.131, p < 0.001) and RCHDs (ρ = -0.333, p < 0.001). Comparing with infected residents who were unvaccinated/vaccinated with one-dose, receiving at least two-dose was estimated to be effective in reducing severe outcomes in 31% and 36% of infected RCHE and RCHD residents respectively; with greater reduction in mortality among RCHD than RCHE residents (54% and 38%, respectively). Vaccine effectiveness of two-dose of BNT162b2 against severe outcomes and death are higher than that of CoronaVac. Conclusions: Increasing COVID-19 vaccination could have significant impact on reducing the risk of COVID-19 outbreaks in RCHs. At least two-dose of COVID-19 vaccine is still effective in reducing severe outcomes and death among infected residents in RCHs during Omicron epidemic.

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BACKGROUND: With the rapid expansion of pet animal populations worldwide, pet-related zoonotic diseases are becoming an important issue in public health. Hong Kong (HK), located in southern China, is one of the most crowded urban centres in the world. The population of pets, especially exotic pets, in HK has grown significantly in recent decades, potentially elevating the risk of pet-related zoonotic diseases. However, no studies have been conducted to explore the knowledge of HK public towards pet-related zoonotic diseases and animal husbandry practices. OBJECTIVES: To evaluate the level of awareness among the HK public of pet-related zoonotic diseases and their understanding of proper animal husbandry practices. METHODS: The study was carried out in HK from June-August 2019 using both online and paper versions of a questionnaire. A total of 362 completed questionnaires (74.3% return rate) were collected and the responses analysed. RESULTS: Sixty percent of the participants were current or past pet owners or planned on becoming pet owners in the coming 2 years, irrespective of their income or size of their living space. Among the participants, pet owners (including those who planned pet ownership) had a relatively higher level of awareness of pet-related zoonotic disease. However, the overall awareness of zoonotic diseases among both pet and non-pet owners was low with a knowledge score of <50%. A similar trend was observed for knowledge about proper animal husbandry practices. CONCLUSIONS: This study showed that the HK public was generally not familiar with pet-related zoonotic diseases and proper pet care. These knowledge gaps could potentially increase the risk of disease transmission. Further studies focusing on specific pet species and on people of different social-economic backgrounds are needed to provide future direction of efforts to reduce the risk of pet-related zoonotic diseases and to enhance pet-related animal and human welfare.

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Whether Burkholderia cepacia complex should be an objectionable organism in antiseptic solutions with acceptable total bacterial counts is controversial. By using next-generation sequencing, we documented a polyclonal B. cepacia complex outbreak affecting peritoneal dialysis patients in Hong Kong that was caused by contaminated chlorhexidine solutions. Epidemiologic investigations at a manufacturing site identified a semiautomated packaging machine as the probable source of contamination in some of the brands. Use of whole-genome sequencing differentiated the isolates into 3 brand-specific clonal types. Changes in exit site care recommendations, rapid recall of affected products, and tightening of regulatory control for chlorhexidine-containing skin antiseptics could prevent future similar outbreaks. Environmental opportunistic pathogens, including B. cepacia complex, might be included in regular surveillance as indicator organisms for monitoring environmental contamination.

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BACKGROUND: The effects of smoking cessation might be different in different populations. Proportional mortality studies of all deaths, relating the certified cause to retrospectively determined smoking habits, have helped assess the hazards of smoking in Hong Kong, and further analyses can help assess the effects of prolonged cessation (although not of recent cessation, as life-threatening disease can itself cause cessation, particularly in old age). METHODS: The LIMOR study sought the certified causes of all deaths in 1998, and interviewed 81% of families at death registries to determine the decedent's smoking history. Cases were deaths from pre-defined diseases of interest (N = 15 356); controls were deaths from pre-defined non-smoking-related diseases (N = 5023). Case vs control odds ratios for ex-smokers vs smokers were calculated by age-, sex- and education-standardized logistic regression. These are described as mortality rate ratios (RRs), with a group-specific confidence interval (CI). RESULTS: For the aggregate of all deaths from any of the diseases of interest at ages 35-69 years, the RRs for current smoking, quitting 0-4, 5-9 or 10+ years ago and never-smoking were, respectively, RR = 1 (95% CI 0.86-1.17), 0.91 (0.73-1.14), 0.71 (0.49-1.02), 0.66 (0.50-0.87) and 0.43 (0.37-0.48). Younger age of quitting (25-44 or 45-64) appeared to be associated with greater protection: RR = 0.58 (0.38-0.88) and 0.71 (0.54-0.93), respectively. These patterns were less clear at older ages, particularly for death from emphysema. CONCLUSIONS: Longer durations of smoking cessation are associated with progressively lower mortality rates from the diseases of interest. For sustainable monitoring of tobacco-attributed mortality, approximate years since last smoked should be recorded during death registration.

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We conducted a study to explore how people diagnosed with first-episode psychosis experienced their contact with early intervention services for psychosis and the way these experiences relate to their recovery processes. Our aim was to integrate and describe the service users' experiences in a rigorous and comprehensive way. A broad literature search was performed in June and July 2016. After screening, 17 qualitative studies were included. We analyzed the findings in two main steps: (a) translating studies into one another and (b) synthesizing the findings from the studies. Through these interpretative processes, we found five new and overarching themes: (a) something is wrong, (b) do for myself, (c) it's about people, (d) a price to pay, and (e) ongoing vulnerability. We describe these themes as a process that service users' maneuver through in their contact with the services. Our findings are discussed in light of relevant research.

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Grief in dementia caregiving is underexplored in research studies in the Chinese context, yet social workers often work with caregivers of people with dementia (PWD) and who experience grief. Having a valid assessment tool can help social workers better identify the grief of caregivers and facilitate caregivers' articulation of grief. This article describes a study aimed to validate the Marwit-Meuser Caregiver Grief Inventory-Short Form (C-MM-CGI-SF) among Hong Kong Chinese caregivers of PWD. One hundred and twenty caregivers participated in this study. They were recruited from day care centers and a memory clinic. The short version of MM-CGI was translated into Chinese, and participants were asked to complete a questionnaire that included this scale and other scales validating it. Reliability and validity were examined. C-MM-CGI-SF was found to be a reliable and valid measure in the Hong Kong context. Its construct validity was demonstrated by the positive correlations with caregiving strain and depression, and negative correlations with presence of meaning and life satisfaction. The discriminant validity was supported by showing that spousal caregivers' grief level was significantly higher than that of nonspousal caregivers. Authors recommend social workers using the C-MM-CGI-SF to assess the grief of Chinese caregivers caring for people suffering from dementia.

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