Legionnaires' Disease Reported: One New Case, Emphasis on Water System Maintenance and Precautions for Vulnerable Groups.

Update on cases of Legionnaires' disease

The Centre for Health Protection (CHP) of the Department of Health today (October 21) reported the latest number of cases of Legionnaires' disease (LD), and stressed the importance of using and maintaining properly designed man-made water systems, adding that susceptible groups should strictly observe relevant precautions.

From October 13 to 19, the CHP recorded one community-acquired LD case, involvinga female patient, aged 88 with underlying illnesses, who lives in North District.

"Epidemiological investigations are ongoing to identify potential sources of infection, high-risk exposure and clusters, if any," a spokesman for the CHP said.

As of October 19, 91 LD cases had been recorded this year. In 2023 and 2022, there were 121 and 80 cases respectively.

"Men, people aged over 50, smokers, alcoholics and persons with weakened immunity are more susceptible to LD. Some situations may also increase the risk of infection, including poor maintenance of water systems; living in areas with old water systems, cooling towers or fountains; using electric water heaters, whirlpools and spas or hot water spring spas; and recent stays in hotels or vessels," the spokesman said.

Legionellae are found in various environmental settings and grow well in warm water (20 to 45 degrees Celsius). They can be found in aqueous environments such as water tanks, hot and cold water systems, cooling towers, whirlpools and spas, water fountains and home apparatus that support breathing. People may become infected when they breathe in contaminated droplets (aerosols) and mist generated by artificial water systems, or when handling garden soil, compost and potting mixes.

Immunocompromised persons should:

Use sterile or boiled water for drinking, tooth brushing and mouth rinsing;

Avoid using humidifiers, or other mist- or aerosol-generating devices; and

If using humidifiers, or other mist- or aerosol-generating devices, fill the water tank with only sterile or cooled freshly boiled water, and not water directly from the tap. Also, clean and maintain humidifiers/devices regularly according to manufacturers' instructions. Never leave stagnant water in a humidifier/device. Empty the water tank, wipe all surfaces dry, and change the water daily.

​ The public should observe the health advice below:

Observe personal hygiene;

Do not smoke and avoid alcohol consumption;

Strainers in water taps and shower heads should be inspected, cleaned, descaled and disinfected regularly or at a frequency recommended by the manufacturer;

If a fresh-water plumbing system is properly maintained, it is not necessary to install domestic water filters. Use of water filters is not encouraged as clogging occurs easily, which can promote growth of micro-organisms. In case water filters are used, the pore size should be 0.2 micrometres (µm) and the filter needs to be changed periodically according to the manufacturer's recommendations;

Drain and clean water tanks of buildings at least quarterly;

Drain or purge for at least one minute infrequently used water outlets (e.g. water taps, shower heads and hot water outlets) and stagnant points of the pipework weekly or before use;

Seek and follow doctors' professional advice regarding the use and maintenance of home respiratory devices and use only sterile water (not distilled or tap water) to clean and fill the reservoir. Clean and maintain the device regularly according to the manufacturer's instructions. After cleaning/disinfection, rinse the device with sterile water, cooled freshly boiled water or water filtered with 0.2 µm filters. Never leave stagnant water in the device. Empty the water tank, keep all surfaces dry, and change the water daily; and

When handling garden soil, compost and potting mixes:

Wear gloves and a face mask;

Water gardens and compost gently using low pressure;

Open composted potting mixes slowly and make sure the opening is directed away from the face;

Wet the soil to reduce dust when potting plants; and

Avoid working in poorly ventilated places such as enclosed greenhouses.

​​The public may visit the CHP'sLD page, theCode of Practice for Prevention of LDand theHousekeeping Guidelines for Cold and Hot Water Systems for Building Managementof the Prevention of LD Committee, and the CHP'srisk-based strategyfor prevention and control of LD.

HKSAR Government's response to 2024 World Justice Project Rule of Law Index

In response to media enquiries on 2024 World Justice Project Rule of Law Index (Index), a Hong Kong Special Administrative Region (HKSAR) Government spokesman made the following reply today (October 23):

Hong Kong's ranking in the Index remains unchanged, continuing to rank the 6th in East Asia and the Pacific, and the 23rd out of 142 countries and jurisdictions globally. Hong Kong remains high in the overall ranking and continues to be ahead of some European and American countries which often unreasonably criticise the rule of law and human rights situation of Hong Kong.

Hong Kong climbs one place in the global rankings in respect of "Regulatory Enforcement" and "Civil Justice". In respect of "Open Government", Hong Kong continues to maintain last year's score and global ranking, which clearly demonstrates that Hong Kong has a comprehensive regulatory enforcement mechanism and civil justice system under "one country, two systems". The continuous improvements in these areas are conducive to the construction of the rule of law and the business environment, which consolidate and enhance Hong Kong's "eight centres" positioning under the National 14th Five-Year Plan.

Hong Kong's score in respect of "Absence of Corruption" is higher than last year and ranks the 10th globally. This shows that Hong Kong remains to be one of the most corruption-free places in the world and that the effectiveness of its anti-corruption efforts has been recognised internationally. The Government will continue to promote the exchange of anti-corruption experience among experts and scholars from Hong Kong, the Mainland and overseas, thereby strengthening Hong Kong's international status in integrity building and further contributing to the national and global anti-corruption cause.

Hong Kong's scores and global rankings slightly drop in relation to "Constraints on Government Powers", "Fundamental Rights", "Order and Security" and "Criminal Justice". However, Hong Kong's rankings in East Asia and the Pacific remain almost unchanged, reflecting the successful implementation of the "one country, two systems" principle in Hong Kong, as well as the effectiveness of the Hong Kong National Security Law, the Safeguarding National Security Ordinance and other relevant laws of the HKSAR in safeguarding national security and maintaining long-term prosperity and stability in Hong Kong. The minor drop in the scores does not seem to fully reflect the institutional strengths of Hong Kong's rule of law. For example, in respect of "Criminal Justice", Hong Kong has a fair and comprehensive criminal justice system as well as a criminal legislative framework that keeps up with the times, fully protecting the rights of the parties involved. Hong Kong's comprehensive, robust and well-funded legal aid system also plays a pivotal role in safeguarding the rule of law. In addition, Hong Kong residents enjoy fundamental rights to commence legal proceedings and seek judicial remedies before the courts, which are protected by the Basic Law and the Hong Kong Bill of Rights Ordinance.

All in all, Hong Kong's overall score (0.72) is the same as the countries ranked the 22nd and the 24th globally. The scores in most of the aspects have only been slightly adjusted.

Hong Kong has maintained a trusted legal system under "one country, two systems", its rule of law is also widely recognised and respected by the community. The HKSAR Government will continue to be steadfast in safeguarding national sovereignty, security and development interests, as well as fully and faithfully implementing the "one country, two systems" principle and upholding the rule of law in the HKSAR.