Reassurance urgently needed over cause of doctor's death

It is a serious incident whenever an outbreak of disease occurs in a hospital - even more so when a group of doctors are infected.

At Princess Margaret Hospital in Kwai Chung, three doctors in the oncology department fell ill to a disease preliminarily thought to be the Shiga toxin-producing E. coli, also known as STEC.

A doctor reported to be healthy and in his 30s died last Friday, three days after the onset of symptoms including fever and diarrhoea.

The two others also had the same symptoms but, fortunately, of a less severe degree.

The group infection is cause for grave concern. Although STEC is suspected as the culprit at this stage, only the stool sample of one of the two other doctors tested positive for STEC. The bacteria has not been found in the others, including the deceased.

The University of Hong Kong's infectious disease expert Yuen Kwok-yung - who helped fight the SARS epidemic in 2003 and Covid-19 during the pandemic - has again been invited by the health authority to tackle the infection case.

According to Yuen, it was very rare that a healthy adult would die suddenly after such an infection. He said that even if the deceased had been infected with STEC, the severity of his conditions was also highly "atypical."

The remark was far from reassuring.

So far, the authority has been unable to ascertain the cause of death even though STEC had been mentioned as a possibility.

In the event that STEC is eventually determined to be the cause for the group infection at PMH, it is believed that more medical staff may have also been exposed to it and more people may have fallen sick as a result.

The authority may well consider expanding the probe to other medics who had accessed the toilet and facilities that the three doctors had reportedly shared.

A questionnaire to all medical staff at the hospital enquiring about their recent health conditions could also be useful.

They should also contact the patients that the infected doctors had seen - could one of those have been the cause?

Yuen said no one should rule out other possibilities, including chemical exposure or autoimmune conditions. Whether it turns out to be STEC, as currently suspected, or something unknown yet, it is important that the cause is determined and announced in a timely manner.

The case file must not be closed with a simple reference to STEC as the probable cause.

Speculation over the group infection is becoming viral on the internet and it is essential for the authority to keep the public fully informed as the probe led by Yuen and other experts continues.

People are still recovering from the pandemic nightmare and it would be good to be reassured that STEC is not readily transmissible because E. coli primarily passes through the fecal-oral route or direct contact with the infected.

According to the Centre for Health Protection, Shiga toxin-producing E. coli is also blamed for serious food-borne disease and outbreaks.

Nonetheless, no matter what it may be, everyone should maintain good personal hygiene, which offers the first line of defense against disease.