Frequently Asked Questions
on Atypical Pneumonia

The illness

Q1: What is the Severe Respiratory Syndrome (atypical pneumonia)?

A1: The illness is an acute respiratory infection of unknown cause that has recently been reported in a number of regions including Hong Kong.

Q2: What are the symptoms and signs of atypical pneumonia?

A2: The main symptoms of atypical pneumonia include fever, malaise, chills, headache and myalgia. Chest X-ray shows radiological changes compatible with pneumonia. Other symptoms include cough, shortness of breath or breathing difficulty.

Q3: Would patients with atypical pneumonia have fever?

A3: Yes.

Q4: What is the difference between atypical pneumonia and influenza?

A4: The symptoms of influenza include fever, cough and headache which usually subsides in a few days without any serious complications or signs of pneumonia.

Q5: What is the difference between "classical" pneumonia and atypical pneumonia?

A5: "Classical" pneumonia is usually caused by bacteria such as Streptococcus. It is usually presented with earlier onset of severe symptoms including fever, chest discomfort and productive cough. On the other hand, atypical pneumonia is mainly caused by Influenza, Mycoplasma, Chlamydia, Adenovirus or other unknown agents.

Q6: What is the incubation period of atypical pneumonia?

A6: The incubation period is estimated to be between 2-7 days.

Q7: If one suspects having pneumonia, should one attend the Accident and Emergency Department immediately?

A7: It is advisable to seek early medical advice if you suspect signs and symptoms of pneumonia.

Q8: If atypical pneumonia is suspected, do you need a chest X-ray to confirm the diagnosis?

A8: You should seek early medical advice and radiological examination will help to confirm the diagnosis of atypical pneumonia.

Q9: Is there any treatment available?

A9: Experiences from local cases show that some patients show favourable response to ribavirin (a broad spectrum antiviral drug) and steroid treatment.

The transmission

Q10: What is the route of transmission of atypical pneumonia?

A10: Transmission of the virus is by droplets and direct contact with the patient's secretions.

Q11: Is there any evidence to suggest that atypical pneumonia is air-born transmission?

A11: Based on available information and the result of epidemiological analysis, transmission is most consistent with droplet spread of respiratory secretion. However, other routes of transmission cannot be ruled out.

Q12: Is it safe to use public swimming pool?

A12: No epidemiological evidence suggests atypical pneumonia could be transmitted through swimming. No infection through swimming has been reported so far. People who are not feeling well should refrain from using public swimming pools.

Q13: Could one contract atypical pneumonia from handling dollar notes?

A13: According to currently available scientific data, transmission is most consistent with droplet spread of respiratory secretion. There is no evidence that it could be transmitted via handling dollar notes. However, people should pay attention to their personal hygiene.

The prevention

Q14: Is there any vaccine available for atypical pneumonia?

A14: As the causative virus is not yet fully understood, vaccine is not yet available.

Q15: Can influenza vaccine prevent atypical pneumonia?

A15: No.

Q16: How could we prevent contracting atypical pneumonia?

Maintain good personal hygiene: cover nose and mouth when sneezing or coughing; wash hands when they are dirtied by respiratory secretions e.g. after sneezing; use liquid soap for hand washing and disposable towel for drying hands; do not share towels.

Develop healthy living lifestyle.

Maintain good ventilation.

People who has respiratory symptoms or care for patients with respiratory symptoms should wear mask.

Consult your doctor promptly if develop respiratory symptoms.

Q17: How can we avoid contracting atypical pneumonia in office setting?

A17: If not feeling well, one should seek early medical advice and refrain from work. All staff should maintain good personal hygiene and healthy lifestyle. The office should maintain good ventilation by keeping windows open. If air conditioner is in use, one should clean the filter regularly. Office furniture and equipment should be kept clean.

Q18: How can we prevent contracting atypical pneumonia in lifts?

A18: Members of the public are reminded to maintain good personal hygiene. Cover nose and mouth when sneezing or coughing. People with symptoms of respiratory tract infection should wear mask. Lift should be kept clean.

Q19: Could one contract atypical pneumonia by visiting a healthcare facility?

A19: The Department of Health has already issued advice to all doctors on the prevention of spread of atypical pneumonia in healthcare settings. People seeking medical consultation should maintain good personal hygiene. Putting on mask help prevent transmission of the infection.

Q20: What precautionary measures should be adopted if a family member or friend has contracted atypical pneumonia?

A20: Children should not visit people known to have atypical pneumonia. People visiting patients with atypical pneumonia should strictly follow the recommended precautious measures.

People who have close contact with cases of atypical pneumonia should note the following:

Wear a facemask for 7 days starting from last contact with the patient infected (the incubation period of atypical pneumonia is up to 7 days).

Cleanse used toys and furniture properly (cleansing with 1:49 diluted household bleaching solution).

Pay attention to your own health and seek early medical advice if unwell.

Family members who are school staff or students should stay at home for 7 days (the incubation period of atypical pneumonia is up to 7 days).

Q21: Will the Department of Health carry out home disinfection for confirmed cases of atypical pneumonia?

A21: The Department of Health will provide disinfection advice to family members.

Q22: Should we wash our clothes after visiting hospitals immediately?

A22: Yes.

Q23: What is the Department of Health advice in regards to share food at home or in restaurants?

A23: The public is advised to adopt the good practice of using serving spoons and chopsticks.

About facemask

Q24: Could atypical pneumonia be prevented by wearing facemask?

A24: Wearing facemask would help to prevent contracting the disease. It is advisable that the public should maintain good personal and environmental hygiene.

Q25: Who should wear facemask?

A25: The following people should wear facemask:

People with respiratory symptoms

People who care for patients with respiratory symptoms

People who have close contact with confirmed cases of atypical pneumonia should wear facemask for 7 days starting from last contact

Healthcare worker

Q26: What type of facemask should be used for prevention of the illness?

A26: Ordinary surgical facemasks are effective in preventing the spread of droplet infection.

Q27: Is N95 facemask the only effective model to prevent atypical pneumonia?

A27: Surgical facemask and N95 facemask are both effective in preventing the spread of droplet infection.

Q28: How often do we replace one's facemask?

A28: In general, a surgical facemask can be continuously used for several hours under ordinary condition. One should replace the facemask immediately when it is worn out or damaged.

About travelling

Q29: Is it safe to travel to Mainland China?

A29: The World Health Organization has not recommended restricting travels to any destinations in the world. Consult medical advice promptly if feeling unwell. Travellers who develop symptoms of atypical pneumonia are advised not to undertake further travel until fully recovered.

Q30: Is it safe for tourists to visit Hong Kong?

A30: Hong Kong has a high standard of medical care and effective surveillance on infectious diseases. Therefore, Hong Kong is still a safe place to visit.

Q31: Should tourists take any precautions when visiting Hong Kong?

A31: Tourist should observe good personal hygiene and avoid visiting overcrowded places.

26 March 2003
Department of Health