Common factors are yet to be identified in the recent deaths of three children with flu-like symptoms in Hong Kong, said HK Secretary for Food & Health York Chow, citing initial results of an expert investigation.

Dr Chow pledged yesterday that the HK government would continue to monitor developments closely and conduct more flu tests to gain a clear picture of the outbreaks and determine whether they were spreading.

The three young victims had all exhibited flu-like symptoms including running fever and coughing, according to Chow. Two of them, however, had tested negative to influenza A and B.

The HK government is yet to reveal the causes of the deaths, but is seeking special permission for early disclosure - for the sake of public health and safety, Chow noted.

On March 10, nine new reports of institutional outbreaks of flu-like illness surfaced involving 52 people at three kindergartens and six schools.

All local schools must report to the HK Education Bureau the number of students sick with the flu and the number subsequently admitted to hospital, said a notice on the HK government website.

It also stated that the Hospital Authority (HA), which manages HK's 42 public hospitals, must provide relevant figures and information to the Department of Health for follow-up.

When asked if schools would be closed, Chow said more justification was needed, as case numbers this flu season had reflected the previous two, but did not rule out the possibility of closing a particular school.

"It would depend on the outbreak situation, the severity of the illness, its infectiousness and social concern," he added.

Hu Dingxu, chairman of the HA, told China Daily yesterday special fever outpatient sections had been set up in hospitals to cut possible cross infections.

The number of emergency ward visitors is currently rising and the HA is deploying more resources to cope with the surge.

If necessary, the government will ramp up measures even further, Hu said.

In neighboring Guangdong province, more than 100 people in the capital city of Guangzhou came down with flu-like symptoms in the first 10 days of the month, a majority of whom tested positive to influenza, the municipal health bureau said yesterday.

Although no deaths have recorded there so far, the city's flu surveillance report confirmed the presence of the health menace.

"Nearly all patients are school children," Wang Yulin, a researcher with Guangzhou center for disease control and prevention (CDC), told China Daily yesterday.

"Due to the peak flu season, more people probably will contract influenza in the second half of March," Wang said. "(And) the surveillance and prevention of influenza would be strengthened."

The bureau requires all schools in the city to check for the presence of flu among students every morning. Outbreaks of more than five students have to be reported to the local CDC.

Students who have been infected cannot return to school until they have recovered for 48 hours, Wang added.

The deaths of children in HK were more likely caused by a viral infection, which is yet to be determined, said medical expert Zhong Nanshan.

"But there is no reason so far for the public to panic," he noted, citing no evidence of a widespread epidemic.

(China Daily March 13, 2008)