HKU015

01/01/98

Crisis Communication: The Asian Bird Flu

The bird flu virus (H5N1) was first detected in the New Territories of Hong Kong in early 1997.
This strain of virus had been previously known to infect only birds, but had now crossed the
species barrier and infected humans. By the end of 1997, the confirmed number of cases had
reached 18, and resulted in six deaths. The implications for Hong Kong were enormous as the
Asian bird flu not only threatened the health and welfare of the people of Hong Kong, it also
impacted on Hong Kongs economy and reputation in terms of international tourism and trade. In
managing the Asian bird flu crisis, the Hong Kong Government was faced with several
challenges: it needed to communicate the facts of the situation effectively, explain what actions it
had taken to alleviate the situation, and also communicate to an increasingly hysterical public
both locally and internationally.
Bird Flu Viruses
The influenza virus is a masterful quick-change artist.
-Robin Henig1

There were 15 varieties of bird flu.2 Each variety sustained itself in the wild aquatic bird
populations of the world. These strains of bird flu in ducks and shorebirds showed little genetic
change over time and were quite harmless to these natural hosts. When bird flu transferred to
other species, such as chickens, however, they had the opportunity to multiply in huge numbers
and to accumulate mutations, the variants of which could cause disease.

Henig, R. M., Why Hong Kongs Bird Flu Signals a Serious Threat, URL: http://www.junkscience.com/news/fluprimr.htm,
October 1998.
2
Bird Flu What can I expect as a Hong Kong resident now and in the future?, Interflow: The University of Hong Kong Magazine,
Issue 79, pp. 23-25.

Vanessa N. Clark prepared this case under the supervision of Dr. Gilbert Wong, The University of Hong Kong, and
Nina Hansen, Associate of Poon Kam Kai Institute of Management, Hong Kong, for class discussion. This case is not
intended to show effective or ineffective handling of decision or business processes.
This case is part of a project funded by a teaching development grant from the University Grants Committee (UGC) of
Hong Kong.
Copyright 1998 The University of Hong Kong. No part of this publication may be reproduced or transmitted in any
form or by any means - electronic, mechanical, photocopying, recording, or otherwise (including the Internet) - without
the permission of The University of Hong Kong.
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Crisis Communication: The Asian Bird Flu

Influenza viruses were comprised of a group of Ribonucleic Acids (RNA) embraced by two outer
protein membranes, haemagglutinin (H) and neuraminidase (N), also known as antigens.3
Influenza viruses lacked a type of genetic proof-reading ability which was usually only found
in more stable viruses, therefore antigens sometimes underwent periodic changes, called antigenic
shifts. Such shifts led to substantial changes in the outer protein membranes H and N. Although
changes might be slight, they were very significant, and could be likened to a virus undergoing
plastic surgery where the immunity systems of humans no longer recognised the virus and were
susceptible to it.
Antigenic shifts, where bird flu has transferred to humans, occurred three times in the 20th
century. Virus H1N1 caused the Spanish flu of 1918-1919 that killed up to 40 million people. A
change in H1N1 to H2N2 saw the Asian flu in 1957, and a change from H2N2 to H3N2 resulted
in the Hong Kong flu of 1968.4 The Hong Kong flu of 1968 began with a single case. However,
within five months, it transcended geographical boundaries and spread to the rest of the world and
killed more than 700,000 people.
Among the 15 varieties of bird flu, H5 and H7 subtypes were recognised as potentially bad strains
that could have lethal consequences for chickens.5
Avian Virus H5N1

The avian virus H5N1 was first found to have killed thousands of sea birds in South Africa in
1961. This strain of influenza was previously known to infect only birds. However, in May 1997,
Hong Kong authorities recorded the first case of a human contracting H5N1. The victim, a threeyear old toddler, later died from respiratory complications. Initially the virus was identified as
Influenza A, although the subtype was not determined. In August 1997, the Centres for Disease
Control and Prevention (CDC), based in Atlanta, USA, confirmed that the virus was Influenza A.
The CDC reported that unlike common flu, the human reaction to H5N1 had been unusually
severe. It had an incubation period of one to three days, after which cold-like symptoms would
develop. These symptoms might persist for as long as three weeks and in serious cases develop
into severe pneumonia, cause other respiratory problems, or lead to death.
A Crisis Unfolds: Bird Flu in Hong Kong
The child fell ill on May 11. He was admitted to Baptist Hospital on May 15,
transferred to Queen Elizabeth on May 16 and died on May 21.
6

-Dr. Paul Saw Thian-aun, Deputy Director of Health

March-May 1997

Bird flu H5N1 was first detected between March and May of 1997 in chickens on three farms in
the New Territories, a predominantly rural and agricultural-based area in Hong Kong. Some
6,800 chickens were reported to have succumbed to the virus during this time. The Agriculture
and Fisheries Department was extremely concerned with the situation and consulted Professor
Kennedy Shortridge, a microbiologist at The University of Hong Kong. He contacted fellow flu
specialist Dr. Robert Webster, Chairman of the Virology Department at St. Jude Childrens
Research Hospital in Memphis, USA. Professor Shortridge had more than 20 years experience
3

About Influenza, URL: http://oms.b3e.jussieu.fr/FluNet/, October 1998.

The Flu Fighter, Interflow: The University of Hong Kong Magazine, Issue 79, pp. 21-23.
5
Bird Flu What can I expect as a Hong Kong resident now and in the future?, Interflow: The University of Hong Kong Magazine,
Issue 79, pp. 23-25.
6
Moir, J., and Mathewson, R., Health Chiefs in Bird Flu alert after Boy, 3, Dies, South China Morning Post, 21 August, 1997.
4

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in researching animal and avian viruses and, Dr. Webster was a member of the international team
on H5N1 influenza virus.
May 1997

In Case #1, a three-year-old toddler developed cold-like symptoms (fever, abdominal pain, a sore
throat and a cough) and was admitted to Queen Elizabeth Hospital on 16 May, 1997.7 He was
transferred to the intensive care unit after his condition deteriorated, and he later died of multiple
medical complications on 21 May, 1997. The boy was a student at a school where chickens and
ducklings were kept [see Exhibit 1].
On 20 May, 1997, Dr. Wilina Lim, Chief Virologist at the Department of Health received a
specimen from the three-year-old victim. Her laboratory determined that the infectious agent was
some type of Influenza A. The test kits provided by the World Health Organisation (WHO) gave
no indication of the specific strain or subtype of Influenza A, however. In any event, it was not
uncommon for flu viruses to resist identification. Repeated testing of the specimen yielded no
clear identification of the virus.
June 1997

In June, Dr. Lim sent samples of the specimen to the CDC in Atlanta, USA, and to Mill Hill in
England. These laboratories played important roles in a global surveillance network for tracking
down changes in flu viruses. Dr. Lim also forwarded a sample to Dr. Jan De Jong, a virologist at
the Dutch National Institute of Health and the Environment.
August 1997

In August 1997, Dr. De Jong visited Hong Kong to confirm that the H5 component of the sample
had indeed come from a human patient and was not attributable to laboratory contamination.
On 20 August, 1997, the Department of Health announced that a strain of Influenza A virus
(H5N1) was isolated in a human in Hong Kong.8 Director of Health, Dr. Margaret Chan, advised
members of the public not to panic as there was no conclusive evidence that indicated the virus
posed any significant threat to humans.
November 1997

Four cases of bird flu were confirmed in November. In Case #2, a two-year-old boy developed
cold-like symptoms and was admitted to Princess Margaret Hospital on 7 May 1997. He made a
complete recovery and was discharged on 9 November, 1997. In Case #6, a 37-year-old male
was admitted to Queen Elizabeth Hospital on 24 November, 1997 and was later discharged.
There were two poultry stalls on the ground floor of the building where he lived. In Case #3, a
13-year-old girl developed cold-like symptoms and was admitted to Prince of Wales Hospital for
treatment of pneumonia on 26 November, 1997. Her condition deteriorated and she died on 21
December, 1997. In Case #4, a 54-year-old male was admitted to Queen Elizabeth Hospital on
29 November, 1997. His condition deteriorated and he died on 5 December, 1997.
December 1997

In Case #7, a 24 year-old female developed cold-like symptoms and was admitted to Yan Chai
Hospital on 7 December, 1997. She recovered and was discharged.
7

Update on Influenza A H5N1, URL: http://www.info.gov.hk/dh/new/23-01-98-1.htm, October 1998, (See also Exhibit 1).
Discovery of the First Case of Influenza A Virus (H5N1) in man in HK, URL: http://www.info.gov.hk/dh/new/20-8-97.htm, October
1998.
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Also, on 7 December, 1997, a Special Working Group on H5N1 announced that the human-tohuman transmission of the H5N1 Influenza A virus had not been proven and that further
investigations were necessary.9 Hong Kong authorities worked closely with the WHO, CDC and
other agencies. Chairman, Dr. Paul Saw Thian-aun commented that influenza surveillance was
stepped-up also.
In Case #5, a five-year-old girl was admitted to Princess Margaret Hospital on 10 December,
1997. She was discharged on 29 December, 1997. Chicken stalls were in close vicinity of her
home and playing area. In Case #17, a six-year-old girl was admitted to Kwong Wah Hospital on
11 December, 1997. She was discharged on 22 December, 1997.
The Department of Health and the Agriculture and Fisheries Department issued guidelines for
officers coming into contact with birds during the course of their work, in a joint announcement
on 12 December, 1997.10 In Case #8, a two-year-old boy, a cousin to case #5, was admitted to
Princess Margaret Hospital on 13 December, 1997. Recovery was complete and he was
discharged on 29 December, 1997. In Case #9, a 4 year-old boy was admitted to Yan Chai
Hospital on 13 December, 1997 also. He made a full recovery and was discharged on 31
December, 1997.
On 15 December, 1997, the Government set up an Inter-Departmental Co-ordinating Committee
(ICC). 11 ICC co-ordinated the efforts of various government departments to control and contain
the spread of H5N1, provided publicity and education on the bird flu, and assisted departments in
the implementation of contingency measures.
In Case #12, a 60-year-old female was admitted to United Christian Hospital on 17 December,
1997. Her condition deteriorated and she died on 23 December, 1997. In Case #16, a 19-yearold girl was admitted to Yan Chai Hospital, also on 17 December, 1997. She recovered and was
discharged from hospital.
The Department of Health announced on 17 December, 1997, that it wouldnt rule out the
possibility of a mass slaughter of all chickens in Hong Kong. A joint announcement from the
Department of Health and the Agriculture and Fisheries Department also proclaimed that the
Government would undertake a mass slaughter of chickens in Hong Kong once it was proven that
chickens carried the H5N1 virus.
On 17 December, 1997, the South China Morning Post newspaper published a summary of
actions taken by the Government in response to the crisis, and also provided hotline contacts. 12
In Case #10, a one-year-old boy was admitted to Tuen Mun Hospital on 18 December, 1997. He
recovered and was discharged on 20 December, 1997. In Case #11, a three-year-old girl was
admitted to Tuen Mun Hospital on 21 December, 1997 and discharged on 22 December, 1997.
She was re-admitted on 26 December, 1997 and discharged later the same day. In Case #13, a
25-year-old female was also admitted to Tuen Mun Hospital on 21 December, 1997 for treatment

Updates on H5N1 Influenza A Situation, URL: http://www.info.gov.hk/dh/new/07-12-97.htm, October 1998.

Guidelines for Officers coming in contact with Birds during the Course of their Work, URL: http://www.info.gov.hk/dh/new/12-1297.htm, October 1998.
11
Use Amantadine in the Management of H5N1 Infections, URL: http://www.info.gov.hk/dh/new/16-12-97.htm, October 1998.
12
Action and Hotlines URL: http://www.scmp.com/news/special/ble_Id=19971217013456055&folio=Main, October 1998.
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of pneumonia. She suffered respiratory failure and died on 14 January, 1998.

December, 1997, she had been buying chicken from Tin Yiu Market every day.

From 10

On 24 December, 1997, the Government announced a ban on the importation of chicken from
China13 In banning imports from China, the Government made an agreement with mainland
Chinese officials that chickens would be quarantined for five days before being exported to Hong
Kong in the future.
In Case #14, a 14 year-old girl was admitted to Princess Margaret Hospital on 26 December. She
made a full recovery and was discharged on 13 January, 1998. After school and on weekends,
she had worked at a vegetable stall run by her family at Shek Kip Mei market where there were
chicken stalls. In Case #18, a 34 year-old female was admitted to Queen Elizabeth Hospital. Her
condition deteriorated and she died on 11 January, 1998.
On 28 December, 1997, a chicken farm in Yuen Long and a wholesale poultry market in Cheung
Sha Wan were found to be infected with H5N1. Access to these areas was immediately
restricted. On the same day, Government Information Services (GIS) announced the wide-scale
slaughter of all chickens on local farms, mixed poultry farms and poultry retail outlets. Secretary
for Economic Services, Stephen Ip Shu-kwan, announced that the slaughter would take 24 hours
to complete beginning on 29 December, 1997.
At the end of the month, Agriculture and Fisheries Department Director, Lessie Wei Chui Kityee, advised that the Department had failed in its attempt to complete the mass slaughter of
chickens in 24 hours.
January 1998

In Case #15, a three-year-old boy was admitted to Princess Margaret Hospital on 2 January, 1998.
He made a full recovery and was discharged on 11 January, 1998.
On 20 January, 1998, the Department of Health released information for tourists coming to Hong
Kong. 14
A comprehensive plan to combat avian flu was announced by the Government on 23 January,
1998.15 Immediate and long-term measures to minimise the risk of humans contracting the virus
through contact with infected poultry included a new import control system covering mainland
China farms, border entry points, chicken farms, and wholesale and retail sales outlets.
Parallel Developments in Hong Kong and around the World
While these events unfolded, the people of Hong Kong and the rest of the world watched with
growing apprehension. Some parallel developments took place around the world, particularly
within the scientific and medical fields.
Scientific Challenges

You learn very fast not to drink a lot of coffee before you go into the lab
Getting in and out of the lab becomes a time-consuming process.
13

Preventative Measures for Avian Flu Implemented, URL: http://www.info.gov.hk/dh/new/23-12-97.htm, October 1998.
Information on Influenza A H5N1 (bird flu or avian flu) for Tourists coming to Hong Kong, URL:
http://www.info.gov.hk/dh/new/20-01-98.htm, October 1998.
15
Comprehensive Plan to Combat Avian Flu, URL: http://www.info.gov.hk/dh/new/23-01-98-3.htm, October 1998.
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-Henry Matthews, Safety Co-ordinator, CDCs National Centre for Infectious Diseases16

At CDC, a wing of rooms used to study dangerous Rickettsia bacteria was converted into a
laboratory for bird flu H5N1. Here, a team of six scientists worked tirelessly, although
unearthing the mysteries of H5N1 continued to evade them. Apart from sorting through blood
samples and virus specimens, two significant questions were: Why did the virus jump from
poultry to people? And, how did the virus pass from person to person?
Epidemiologists from WHO and CDC monitored the situation to see whether bird flu H5N1 was
able to be transmitted from human to human. This would be the key to understanding whether
H5N1 would spread beyond the region. The likelihood that bird flu could be passed between
humans increased after the release of the results of 502 preliminary blood tests.17
Vaccine Development

This is a novel virus, it hasnt been seen in humans before.

-Dr. Alan Hay, Director, WHO World Influenza Centre, London18

In December 1997, the Hong Kong Government looked into the matter of producing a vaccine for
H5N1. WHO scientists advised, however, that a vaccine would take at least six months to
complete. This would be too late for Hong Kongs traditional peak flu months of March and
July, given that the majority of people had no resistance if bird flu spread. Dr. Hay indicated that
mass manufacturing of a vaccine for H5N1 required strict safety conditions. Furthermore, as flu
vaccines were produced by incubating viruses in chicken eggs, these methods would not work
with H5N1 because H5N1 would kill the eggs.
Hong Kong health chiefs announced that they would authorise the development of a vaccine if
the number of cases escalated and transmission from human-to-human was confirmed. Deputy
Director of Health, Dr. Paul Saw Thian-aun, indicated that given the worst-case scenario of a
pandemic where no vaccines were available, amantadine would be used in the treatment of bird
flu, although amantadine had known side-effects.
The Government Acts: Crisis Communication and Crisis Management
The Government was faced with increasing pressure to contain the bird flu virus and to control
the spread of H5N1. It was also faced with several challenges: how to communicate effectively
the facts of the situation and what actions it had taken to alleviate the situation, and how to
communicate to an increasingly hysterical public both locally and internationally.
Crisis Communication

The Government set up an Inter-Departmental Co-ordinating Committee (ICC). The purpose of

ICC was to co-ordinate the efforts of the various government departments. In the later phase of
the bird flu crisis, the Department of Health set up a Special Information Unit (SIU) that was
responsible for inter-departmental communication also.

16

Meyer, T., Scientists Seek H. Kong Flu Answers, URL: http://www.washingtonpost.com/wp-srv/inatl/longterm/birdflu/birdflu.htm,

4 February, 1998.
17
First Avian flu case CDC Serology Test Preliminary Results, URL: http://www.info.gov.hk/dh/new/27-12-97.htm, October 1998.
18
Moir, J., Tests Under way on two more Suspected Victims of Bird Flu, South China Morning Post, 19 December, 1997.

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In communicating to increasingly apprehensive local and international audiences, the

Government held press conferences, maintained a Government web page, and held briefing
sessions with Consuls General in Hong Kong.
Inter-departmental Co-ordinating Committee

Since the first few cases were discovered, surveillance has been set up to detect
wider spectrum of presentation of the cases to provide more information on the
new strain and its mode of transmission.
-Dr. Paul Saw Thian-aun, Chairman, Inter-departmental Co-ordinating Committee.19

On 15 December, 1997, the Government set up an Inter-Departmental Co-ordinating Committee

(ICC). The purpose of ICC was to co-ordinate the efforts of various government departments in
order to control and contain the spread of H5N1, provide publicity and education on the bird flu,
and assist departments in the implementation of contingency measures necessary for the control
of bird flu. ICC comprised representatives from the Department of Health, Agriculture and
Fisheries Department, Urban Services Department, Regional Services Department, Education
Department, Social Welfare Department, Hospital Authority, Environmental Protection
Department, Home Affairs Department and the Health and Welfare Bureau.
A list of preventive measures was formulated based on a review of the initial assessments of the
first six confirmed cases and three suspected cases of bird flu. General out-patient clinics and
private medical practices were used for surveillance of the virus. The Agriculture and Fisheries
Department, Urban Services Department and Regional Services Department were involved with
surveillance and monitored poultry movements between China and Hong Kong. The Education
Department and Social Welfare Department provided schools and childcare centres with up-todate information on preventive measures, and the Hospital Authority informed the Department of
Health immediately of any suspected cases to allow for early investigation.
Special Information Unit

The Department of Health set up the Special Information Unit (SIU) in the latter stages of the
crisis. The SIU worked closely with the Hospital Authority to identify suspected cases and to
confirm cases of bird flu. This enabled both agencies to arrive at a consensus in responding to
media queries. Whenever the media raised issues, the SIU informed the departments and officers
concerned before responding. This ensured that information released was standardised and
communicated in a more convincing way, or expressed in a more readily understood manner. If
more than one Department had responsibility for an area under enquiry, the SIU would seek
information from all Departments concerned before responses were made.
Press Conferences

Government officials drew dramatic and often critical responses from both the media and
politicians. For example, Dr. Margaret Chan Fu-chun, Director of the Department of Health,
openly admitted that she had been eating chicken every day throughout the period when fear of
chickens spreading bird flu peaked. This statement drew criticism from provisional legislator, Dr.
Leong Che-hung, who commented that Dr. Chans own confidence in eating chicken was
insufficient to calm the growing unease of the public. Journalist Mariana Wan also criticised Dr.
Chan for giving confusing health advice to the public. Dr. Chans statement also conflicted with
that of the Hong Kong Medical Association, which suggested that frozen chicken and eggs were
not safe to eat. A spokesperson from the Department of Health maintained, however, that there
19

Committee Draws up Action plan for Avian Flu, URL: http://www.info.gov.hk/isd/news/dec97/1216act.htm, October 1998.

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was a limit to briefing Government officials and that it was not possible to anticipate what would
be said and by whom.
Government Information Services

From November 1997, the Government Information Service (GIS) maintained the Government
Information Centre web page. It contained major government and quasi-government decisions
and announcements, suggested preventive measures, provided government officials speeches,
and outlined press conferences. In addition, updated information on confirmed and suspected
cases of bird flu was regularly published. The Government considered it an invaluable single
access point for information published by official and quasi-official organisations in Hong Kong.
Briefing Consuls General on H5N1

The chance for a tourist catching bird flu therefore is minimal.

-Katherine Fok, Secretary, Health and Welfare Bureau20

The first briefing to representatives of Consuls General in Hong Kong regarding bird flu was
conducted by Katherine Fok, the Secretary for the Health and Welfare Bureau, on 6 January,
1998. Consuls General of Australia, Britain, Canada, Indonesia, Japan, Korea, Malaysia, New
Zealand, Norway, the Philippines, Singapore, Thailand and the USA attended the briefing.
Government representatives included Dr. Margaret Chan Fu-chun, Director of the Department of
Health, Gregory Leung, Deputy Secretary for the Health and Welfare Bureau, and Dr. Leslie
Sims, Senior Veterinary Officer, Agriculture and Fisheries Department.
The prime objective for the briefing was to reassure foreign representatives that it was safe for
overseas visitors to come to Hong Kong. The briefing also covered the measures that had been
taken by the Government to prevent the further spread of the virus. WHO findings were
presented and Mrs. Fok stressed that no countries had imposed travel restrictions or quarantine
measures on Hong Kong. She reassured representatives that efforts were being made to devise a
surveillance system to ensure future chicken and poultry imports to Hong Kong were H5N1
virus-free.
Mass Media Responds

On 8 December,1997, Dr. Huang Chen-ya, Health spokesman of the Democratic Party, noted the
potential adverse effects of the bird flu crisis on Hong Kongs vibrant tourism industry. He said
that overseas reporters had questioned him about the bird flu, as foreign countries had expressed
concern of the possibility that their citizens might contract the bird flu virus while visiting Hong
Kong. Health officials in Taiwan and Japan warned their people that Hong Kong was temporarily
unsafe to visit. The Research Centre of Bird Flu in Australia warned Australians that it was not
safe to visit markets that sold birds in Hong Kong. An article that appeared in the Australian
newspaper, The Australian, mentioned that the bird flu might mutate and subsequently give rise
to a pandemic, similar to the one of 1968.
The Hong Kong Tourist Association (HKTA) said that its overseas offices in South East Asia had
received many enquires concerning the bird flu situation. The Department of Health insisted,
however, that WHO had not categorised Hong Kong as a city of high risk. Hence, nothing was
done to educate the international audience on bird flu. Under increasing pressure from overseas
countries, the Department of Health later prepared a fact sheet that explained the avian flu to

20

Health Chiefs brief Consuls General on H5N1, URL: http://www.info.gov.hk/isd/news/jan98/0106shw.htm, October 1998.

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tourists and/or tourist groups planning to visit Hong Kong.21 Some local newspapers commented
that the fact sheet did not present all of the facts, however, as H5N1 had already claimed two
lives, and no mention was made of this.
Crisis Management

In managing the Asian bird flu crisis, the Government made several major decisions. It banned
imports of chickens and restricted entry to infected areas. It also took a bold step to depopulate
all of the Hong Kong markets and chicken farms when it ordered the mass slaughter of all
chickens in Hong Kong. The Government also took measures to ensure the import of virus-free
chickens from China.
Imports Banned and Restricted Entry to Infected Areas

The Government banned the importation of chickens from China on 24 December, 1997, soon
after it was confirmed that H5N1 had infected imported chickens at two market stalls. That two
of the bird flu sufferers lived near these two markets was taken into account when arriving at the
decision to ban imports. Furthermore, there was a possibility that victims had contracted bird flu
when they visited these markets.
A chicken farm in Yuen Long and the poultry wholesale market in Cheung Sha Wan were also
found to be infected with H5N1, the Agriculture and Fisheries Department discovered on 28
December, 1997. These infected areas were immediately declared no-go zones and police
officers, wearing masks, were posted at entrances of these areas to monitor the movements of
people and animals to and from the areas.
Mass Slaughter of Chickens and Poultry Ordered

On 28 December, 1997, the Government ordered the slaughter of all chickens on local chicken
farms, and all poultry at wholesale markets and retail outlets. The GIS claimed that the move was
a proactive step to safeguard public health. The Secretary for Economic Services, Stephen Ip
Shu-kwan, announced that the mass slaughter of all chicken and poultry would take 24 hours to
complete, beginning the following day. Government statistics indicated that there were
approximately 160 chicken farms, 39 mixed poultry farms and 990 market stalls to be covered by
the operation. It was estimated that a HK$40 million compensation package would be required in
order to compensate farmers, wholesalers and retailers.
The operation of mass slaughter was twofold: first, the owners of retail stalls at markets were
asked to kill their own chickens; and second, some 1,200 Agriculture and Fisheries Department
staff slaughtered chickens on chicken and mixed poultry farms. Carcasses were collected and
dumped in landfills by some 200 Urban Services Department and Regional Services Department
staff.
Although the mass slaughter was to be completed within 24 hours, regardless of the remoteness
of farms, Agriculture and Fisheries Director, Lessie Wei Chui Kit-yee, announced that the
Department had failed to meet this target. She cited various reasons:

Staff were not familiar with catching chickens.

A lack of carbon dioxide in Hong Kong to gas the chickens and poultry required
manual slaughter by cutting the throats of chickens. It was estimated that 1,200

21

Information on Influenza A H5N1 (bird flu or avian flu) for Tourists coming to Hong Kong, URL:
http://www.info.gov.hk/dh/new/20-01-98.htm, October 1998.

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cylinders of carbon dioxide would be needed for the operation. There were only 400
cylinders available in Hong Kong, however. An additional 200 cylinders were
obtained from other provinces of China, making a total of 600 cylinders of carbon
dioxide available for the operation.
Staff were not familiar with the exact location of chicken and mixed poultry farms.
Of the 1200 staff involved, only 20 officers had good knowledge of the exact
location of the farms.
The logistics of providing minimum training and protective clothing to the 1,200
Agriculture and Fisheries staff involved in the slaughter were prohibitive.
The logistics of organising and co-ordinating the 200 Urban Services Department
and Regional Services Department staff involved with the disposal of the carcasses
were prohibitive.

Measures to Ensure Virus-free Chickens from Mainland China

We must ensure that chicken farms both in Hong Kong and those in Guangdong
supplying Hong Kong, are free from virus infection a control system will have
to be put in place to verify the health status of all chickens.
-Mrs. Lessie Wei Chui Kit-yee, Director, Agriculture and Fisheries Department22

After the mass slaughter, Chief Secretary of Hong Kong, Anson Chan Fang On-sang, announced
that chickens originating from mainland China would only be allowed to be imported once a
mechanism to check the hygiene of such poultry had been developed and implemented. Dr.
Leslie Sims, Senior Veterinary Officer of the Agriculture and Fisheries Department announced
that each shipment of imported poultry would be screened by a rapid blood test. Blood samples
from poultry in every truck would be taken and examined by staff of Agriculture and Fisheries
Department upon arrival at Man Kam To border entry point. After blood samples were taken, the
doors of the rear compartments of trucks, which contained caged chickens, would be sealed with
official stamps in an attempt to prevent unauthorised chickens making it to Hong Kong markets.
To ensure imported poultry was free from H5N1 before being sold at markets, Agriculture and
Fisheries Department laboratories worked shifts to obtain prompt test results.
Mainland China health authorities also pledged to step up monitoring of chicken farms. In a cooperative measure, Yu Dahai, Chief of the National Animal and Plant Quarantine Bureau of
China, announced a scheme that required the registration of all farms supplying poultry to Hong
Kong. Only registered farms were able to export chickens to Hong Kong, and all birds had to
carry health certificates. Random spot-checks would be conducted and at least 400 blood
samples would be taken and tested each day. Copies of test records and certificates would be sent
to the Agriculture and Fisheries Department.
Stakeholders Interests
At the height of the Asian bird flu crisis, the Government was repeatedly criticised for not
communicating effectively or openly with the people of Hong Kong, the international community
and stakeholders who represented diverse interests. Instead, many watched with apprehension as
the bird flu crisis unfolded.

22

Concerted Effort to Ensure Virus-free Poultry in Hong Kong, URL: http://www.info.gov.hk/isd/news/dec97/pre-h5n1.htm, October
1998.

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General Public

I dont think thats enough The Department of Health should inform the
public what direction their investigation is taking even if they have not yet
come to specific conclusions.
-Dr. Leong Che-hung, Provisional legislator23

Many people felt that the Government was not in control of the Asian bird flu crisis, even though
the Government had taken drastic action. More than 8,300 people rushed to public hospitals and
sought flu tests on 26 December, 1997 alone. Many people refused to eat chickens and there was
uncertainty in terms of whether it was safe to eat chicken eggs.
Overseas Visitors

The bird flu cases had become an international incident and would hit the
tourism industry if it was not handled properly.
-Dr. Huang Chen-ya, Health spokesman of the Democratic Party24

The Asian bird flu crisis focused international attention on Hong Kong. Around the world,
Governments warned their citizens not to visit Hong Kong, or if visits were inevitable, then
visitors should avoid all contact with birds. Japan was the first to announce the development of a
vaccine as a result of fears that bird flu H5N1 had reached its shores. On 20 January, 1998, a
Hong Kong daily newspaper, the South China Morning Post, reported that nothing grabbed
peoples attention as quickly as a new strain of bird flu. The bird flu crisis attracted more world
media attention than anything else since the change in sovereignty on 1 July, 1997. Much more
information was published on the Internet and the World Wide Web also.
Health-care workers

The Fire Services Department should advise us how to handle patients with the
disease and the procedures for transferring the patients between hospitals. There
are no prevention methods and no vaccination is available;
-Cheung Kim-fan Chairman, Ambulance-Mens Union25

In response to the above, a Department of Health spokesman advised the media that guidelines
had been given to the ambulance services. Furthermore, existing guidelines for handling
infectious diseases were adequate, as not only ambulance-men were at risk of contracting H5N1.
Health-care workers, including doctors and nurses, were at risk too.
A spokesperson from the Hospital Authority claimed that a briefing session was aimed at
disseminating information about the virus and establishing additional preventive measures in
order to alleviate front-line workers concerns. Nursing staff accused the Authority of
underestimating the seriousness of the disease, however. Representatives of nursing staff also
claimed that the updated guidelines contained basic information on infectious diseases only.
Cecilia So Chui-keun, President of the Hong Kong Nurses General Union, expressed the concerns
of front-line workers that the Hospital Authority was too optimistic. According to Ms. So, the
Authority recommended that it was safe to be within a metre of an infected person, and there was
no need for special ventilation nor airtight doors. She went on to state that we shouldnt be
23

Buerk, S., and Wong, B. W-Y., The Bird Flu Hotlines: Border alert on Poultry Anson Chan Announces Taskforce to keep Public
Informed about Virus, South China Morning Post, 14 December, 1997.
24
Lee, S., Doctors to get Bird Flu Guidelines, South China Morning Post, 8 December, 1997.
25
Lam, R. W., Tests Fails to Clear Mystery over Bird Flu, South China Morning Post, 10 December, 1997.

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relieved because the disease could be transmitted to our families and other patients. And the
infected patients are now staying in all kinds of wards.26 A spokesperson from the Association of
Hong Kong Nursing Staff commented that more guidelines on preventive measures should have
been given to staff in accident and emergency wards, and intensive care units, as special
guidelines for these staff did not exist.
Poultry Industry

The poultry industry came under enormous financial pressure at the time when Hong Kong
people were advised not to eat chicken during the height of the Asian bird flu crisis. Wholesalers
tried to rebuild consumers confidence by sterilising Cheung Sha Wan Market, Hong Kongs
largest poultry wholesale market. Wholesale chicken prices continued to fall from HK$13.90 to
HK$9.90 per kilogram, and chicken sales dropped by half.
On 21 December, 1997, chicken farmers in Yuen Long requested that the Government buy all
their chickens at a cost of HK$30 million. They urged the Government to kill all their chickens
so that they could raise virus-free chickens. Chicken farmers also claimed that by not killing their
chickens, they would sustain greater financial losses because they would have to feed them. They
also asked the Government to provide health certificates for newly raised chickens and to prohibit
the importation of chickens. These actions, they claimed, would restore public confidence, and
thus return chicken to the Hong Kong diet.
Compensation to Poultry Industry

Of course, there should not be any profiteers, and the fund calculations should
be well-founded.
-Selina Chow Liang Shuk-yee, Liberal Party

The bird flu situation was an accident that society needed to share.
-Tsang Yok-sing, Chairman, Democratic Alliance for the Betterment of Hong Kong

Key political parties in the Provisional Legislature supported the move to slaughter all local
poultry. They agreed that chicken sellers had suffered heavy losses, and that it was acceptable to
use public money for compensation.
On 7 January, 1998, the Government finalised its compensation package for people directly
affected by the mass slaughter of chickens. It would compensate owners of the slaughtered
chickens and provide financial assistance to those whose livelihood was directly affected. The
total amount paid out under the package was HK$104 million. A further HK$650 million would
be available for two per cent low-interest-rate loans. The Secretary for Economic Services, Mr.
Stephen Ip Shu-kwan, said that the finalised package was drawn up having taken into account
views expressed by the affected parties and legislators [see Exhibit 2].
Politicians

Its obvious its not just one of those isolated cases. I think its about time we
looked into producing a vaccine, now its obvious it will affect more people.
-Dr. Leong Che-hung, Provisional Legislator27

26

Lam, R. W., Bid to cut Fears of Frontline Workers, South China Morning Post, 30 December, 1997.
Woman fights for life as Doctors Urge Officials to come clean on Killer Virus: Three more ill as Bird Flu spreads, South China
Morning Post, 13 December, 1997.
27

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Hong Kong politicians were very concerned with the way that the Government handled the bird
flu crisis. They interrogated the Government at every opportunity through the mass media and
during meetings of the Provisional Legislative Council. Many commented that the Government
was unable to handle the crisis. Martin Lee Chu-ming of the Democratic Party accused the
Government of failing to provide the public with a high degree of transparency regarding
information surrounding the bird flu. Executive Councillor Tam Yiu-chung claimed that the
Government had underestimated the deadly bird flu virus, made decisions in a hurry, was illprepared and lacked sufficient evaluation processes, and failed to make a comprehensive plan, or
if there was one, failed to make it known and available to the public.
Mass Media

The mass media in Hong Kong is working in an exceptionally fast manner.

Spokesperson, Department of Health28

Many Hong Kong-based newspapers and periodicals covered the Asian bird flu crisis across more
than 39 radio and television broadcasting channels. Mass media presence and coverage, both
locally and internationally, was substantial [see Exhibits 3 and 4].
Lessons in Crisis Communication and Crisis Management
Six months had passed since the bird flu virus H5N1 had claimed its first victim. A taskforce
comprised of senior Government officials from the ICC and the SIU was assembled and was
issued a brief to formulate a Crisis Communication Strategy for the Government to implement
across all Government departments and quasi-Government agencies. In formulating such a
strategy, the taskforce decided to conduct and facilitate several debriefing sessions with the
different Government Departments, officials and staff involved in the Asian bird flu crisis. They
would approach the debriefings along the following lines:
How did the Government communicate the facts of the situation?
What actions did the Government take to alleviate the situation?
How did the Government communicate these undertakings to an increasingly
hysterical public both locally and internationally?

28

Interview with Mrs. Lam from the Health Department of Hong Kong

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EXHIBIT 1
CASE NOTES OF THE 18 CONFIRMED CASES OF H5N1

Case #1
A three-year-old boy became ill on 11 May, 1997 with fever, sore throat and abdominal pain and
was admitted to Queen Elizabeth Hospital on 16 May, 1997. He died of multiple medical
complications including pneumonia, ARDS, Reyes Syndrome and liver and renal failure on 21
May, 1997. His school kept chickens and ducklings but there was no history of the patient
coming into direct contact with these birds. Virus was isolated from tracheal aspirate taken on 19
May, 1997.
Case #2
A two-year-old boy developed high fever, cough, sore throat and running nose on 6 November,
1997 and was admitted to Queen Margaret Hospital on 7 May, 1997. Recovery was complete.
He was discharged on 9 November, 1997. Virus was isolated from nasopharyngeal aspirate taken
on 7 November, 1997.
Case #3
A 13-year-old girl developed fever, sore throat, running nose, headache and cough on 20
November, 1997. She was admitted to Prince of Wales Hospital for treatment of pneumonia on
26 November, 1997. Her condition deteriorated rapidly and she was put on mechanical
ventilation in the Intensive Care Unit. She died on 21 December, 1997 because of pneumonia
and multi-organ failure. Test for influenza A was positive. Virus was isolated from tracheal
aspirate taken on 26 November, 1997.
Case #4
A 54-year-old retired man developed fever, chills, rigor cough and shortness of breath on 24
November, 1997, and was admitted to Queen Elizabeth Hospital on 29 November, 1997. His
condition deteriorated and he died on 5 December, 1997 of complications arising from
pneumonia. He had been to Korea with a friend from 26 to 29 November, 1997. Virus was
isolated from bronchoalveolar lavage taken on 1 December, 1997.
Case #5
A five-year-old girl developed fever, cough and vomiting on 7 December, 1997. Her symptoms
persisted despite treatment. She was admitted to Queen Margaret Hospital on 10 December,
1997. Provisional diagnosis was tonsillitis. Recovery was complete. She was discharged on 29
December, 1997. There were chicken stalls in the close vicinity of her living place and playing
area. Virus was isolated from nasopharyngeal aspirate taken on 11 and 13 December, 1997.
Case #6
A 37-year-old Office Assistant developed chills, rigor, malaise and myalgia on 17 November,
1997. A few days later, he developed productive cough with blood-stained sputum. His
symptoms persisted despite treatment and he was admitted to Queen Elizabeth Hospital on 24
November, 1997. Chest X-ray showed bilateral pleural effusion and patchy consolidation of both
lower zones. Fulminant atypical pneumonia was diagnosed on 9 December, 1997. There were
two poultry stalls on the ground floorof the building where he lived. He gave a history of buying
poultry from the market two days before the onset of illness. The case was diagnosed by a rise in
antibody titre by micro-neutralisation test on blood taken on 24 and 28 November, 1997, and 5
December, 1997.

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Case #7
A 24-year-old Filipino domestic helper developed fever, sore throat, headache, cough, dizziness,
mild shortness of breath and loss of appetite on 4 December, 1997. She was admitted to Yan
Chai Hospital on 7 December, 1997. Her condition deteriorated in the following days and she
required ventilatory and inotropic support in the intensive care unit. Chest X-ray showed left
lower zone consolidation. At present, her condition remained critical. Test for H5 was positive.
Virus was isolated from tracheal aspirate taken on 8 and 12 December, 1997.
Case #8
A two-year-old boy, a cousin of the fifth case. He developed fever, cough and running nose on
12 December, 1997 and was admitted to Queen Margaret Hospital on 13 December, 1997.
Recovery was complete. He was discharged on 29 December, 1997. There were chicken stalls in
the close vicinity of his living place and playing area. Test showed influenza A positive. Virus
was isolated from throat swab taken on 12 December, 1997 and from nasopharyngeal aspirate
taken on 13, 14 and 15 December, 1997.
Case #9
A four-year-old boy developed fever, cough and running nose on 10 December, 1997. As his
symptoms persisted, he was admitted to Yan Chai Hospital on 13 December, 1997. He made a
full recovery and was discharged on 31 December, 1997. Directigen for flu A was positive and
virus was isolated from nasopharyngeal aspirate taken on 15 December, 1997.
Case #10
A one-year-old boy developed fever, cough and running nose on 16 December, 1997. He was
admitted to Tuen Mun Hospital on 18 December, 1997. Recovery was complete. He was
discharged on 20 December, 1997. Virus was isolated from nasopharyngeal aspirate taken on 18
December, 1997.
Case #11
A three-year-old girl developed fever, cough and running nose on 16 December, 97. She was
admitted to Tuen Mun Hospital first on 21 December, 97 and discharged on 22 December, 97,
and then admitted again on 26 December, 97 and discharged on the same day. Virus was isolated
from throat swab taken on 22 December, 97.
Case #12
A 60-year-old female was admitted to United Church Hospital on 17 December, 1997 for fever,
chills and rigor since 16 December, 1997. She had history of malignant thymoma treated with
radiotherapy. A heart murmur was detected. Provisional diagnosis was endocarditis and she was
treated with antibiotics. Her condition deteriorated over the following few days. She was
transferred to the intensive care unit on 21 December, 1997. Chest X-ray showed bilateral
haziness. She died on 23 December, 1997. Directigen for flu A and monoclonal antibody for H5
were positive and virus was isolated from tracheal aspirate taken on 22 December, 1997.
Case #13
A 25-year-old female developed fever, cough, headache, dizziness and arthralgia on 17
December, 1997 and was admitted to Tuen Mun Hospital on 21 December, 1997 for treatment of
pneumonia. She was in respiratory failure and died on 14 January, 1998 of viral pneumonitis and
ARDS. From 10 December, 1997, she had been buying chicken from Tin Yiu Market every day.
Directigen for flu A was positive and virus was isolated from nasopharyngeal aspirate and sputum
taken on 24 December, 1997 and from tracheal aspirate taken on 25 December, 1997.

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Case #14
A 14-year-old girl developed cough, fever and running nose on 23 December, 1997 and was
admitted to Princess Margaret Hospital on 26 December, 1997. She had a history of histiocytosis
X and diabetes insipidus. CXR showed haziness, particularly on the left side. Her symptoms
worsened after admission and she was transferred to the intensive care unit on 29 December,
1997. Nevertheless, she made a full recovery and was discharged on 13 January, 1998. She
worked every day after school and on weekends at the vegetable stall run by her family at the
Shek Kip Mei market, where there were chicken stalls, however, a history of petting chicken
could not be recalled. Virus was isolated from nasopharyngeal aspirate taken on 28 and 29
December, 1997.
Case #15
A three-year-old developed fever, running nose and cough on 28 December, 1997 and was
admitted to PMH on 2 January, 1998. His condition was satisfactory. He made a full recovery
and was discharged on 11 January, 1998. Virus was isolated from throat swab taken on 29
December, 1997.
Case #16
A 19-year-old girl developed fever and cough with whitish sputum on 14 December, 1997 and
was admitted to Yan Chai Hospital on 17 December, 1997. Her condition deteriorated and she
required treatment in the intensive care unit. She was transferred to a general ward on 15
January, 1998 and her condition was fair. Virus was isolated from nasopharyngeal aspirate taken
on 21 December, 1997. Micro-neutralisation test on blood taken on 19 and 27 December, 1997
was positive.
Case #17
A six-year-old girl developed fever, cough, running nose and sore throat on 7 December, 1997.
She was admitted to KWH on 11 December, 1997. CXR on treatment and was discharged on 22
December, 1997. She had a history of contact with chicken at a market in Tuen Mun on 23
November, 1997. Micro-neutralisation test on blood taken on 12 and 23 December, 1997 was
positive.
Case #18
A 34-year-old female developed fever, bed sore over left thigh, paraplegia and pleural effusion
before 28 December, 1997, when she was admitted to Queen Elizabeth Hospital. She had history
of SLE with nephritis. CXR showed right lower zone haziness. On 7 January, 1998, her
condition deteriorated with high swinging fever, and she was transferred to the intensive care unit
because of respiratory failure. CXR showed bilateral haziness. Blood culture showed MRSA
septicaemia. She developed septicaemic shock and convulsion on 11 January, 1998 and died on
the same date. Virus was isolated from tracheal aspirate taken on 9 January, 1998.
Source: Update on Influenza A H5N1, URL: http://www.info.gov.hk/dh/new/23-01-98-1.htm, October
1998.

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EXHIBIT 2
COMPENSATION PACKAGE

Chicken Farmers

Compensation amount = number of poultry x respective compensation rate (see Schedule)

Injection of HK$80 million into the Kadoorie Agricultural Aid Loan Fund
Low interest (recommended 2%) loans through KAALF (HK$500,000 maximum)
Poultry Wholesalers in Cheung Sha Wan: Temporary Wholesale Poultry Market and Western
Wholesale Food Market.

Compensation amount = number of poultry x respective compensation rate (see Schedule)

Lump sum ex-gratia payment of HK$40,000 for each wholesaler
A new loan fund of HK$570 million to provide low-interest (2%) loans (HK$5 million
maximum)
A waiver of rentals for three months
Poultry Retailers

Compensation amount = number of poultry x respective compensation rates (see Schedule)

Lump sum ex-gratia payment of HK$30,000 for each poultry stall in Provisional Urban Council
(PUC)/Provisional Regional Council (PRC)/Housing Authority (HA) markets
Lump sum ex-gratia payment of HK$60,000 for each licensed fresh provision shop (poultry)
outside PUC/PRC/HA markets
Low interest (2%) loans from the new loan fund (HK$300,000 maximum)
Poultry Transport Operators based in Cheung Sha Wan: Temporary Wholesale Poultry
Market and Western Wholesale Food Market

Lump sum ex-gratia payment of HK$24,000 per lorry transporting live poultry and having record
with the Agriculture and Fisheries Department
Lorry owners expected to share payment with drivers and helpers
A waiver of rentals for car parking spaces in the wholesale markets for three months

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Schedule of Rates of Compensation for Slaughtered Birds

The rates per bird are inclusive of statutory compensation and ex-gratia elements where the full
value of the bird exceeds $30.
Locally-reared birds fetched a higher price than imported birds.
The wholesale and retail rates take into account that 80% of chickens consumed in Hong Kong
are imported.
Type of Bird
Chicken

Goose
Duck
Pigeon
Quail
Others

Farm Rate ($)29

Adult
38
Medium
28
Small
18
Hatching eggs 6
120
37
27
7
45

Wholesale Rate ($)

30
n/a
n/a
n/a
120
37
27
7
45

Source: Compensation for the Slaughter of Poultry, URL:

http://www.info.gov.hk/isd/news/dib/0107.htm, October 1998.

29

Rates for chickens includes an ex-gratia element for operating expenses.

18

Retail Rate ($)

34
n/a
n/a
n/a
120
40
30
8
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EXHIBIT 3
MASS MEDIA INDUSTRY IN HONG KONG 1987-1996

Newspapers
English
Chinese
Bilingual
Japanese
Other Language

1987
14
52
1
1
0

1990
17
53
1
1
0

1992
12
50
2
1
1

1993
16
58
1
1
1

1994
14
59
1
1
1

1995
11
41
2
3
2

1996
12
39
1
3
1

140
343
81
5
7
1

148
332
104
8
5
3

163
313
102
13
4
3

166
319
117
9
5
3

157
354
137
8
4
3

156
378
125
7
6
3

158
359
112
7
5
4

Operator

Commercial Television30
Operator
Channel

1
8

1
16

1
20

1
20

Periodicals

English
Chinese
Bilingual
Japanese
Trilingual
Other Language
Sound Broadcasting

Source: Hong Kong Annual Digest of Statistics 1997 Edition, p. 319.

30

Satellite TV is excluded.

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EXHIBIT 4
MASS MEDIA INDUSTRY IN HONG KONG AS AT 28 FEBRUARY 1998

Sound Broadcasting
Operator
Channel

Total
3
13

Commercial TV31
Operator
Channel

2
4

Subscription TV
Operator
Channel

1
20

Newspaper Frequency
Morning Daily
Afternoon Daily
Five times a week
Six times a week
Total

Chinese
23
3
0
3
29

English
2
0
2
4
8

B. News Agency Bulletins

Periodical Frequency
Twice weekly
Weekly
Every 10 days
Bi-weekly
Every 20 days
Monthly
Bi-monthly
Quarterly
Half-yearly
Irregularly
Total

Chinese
1
55
7
33
2
168
45
29
21
42
403

0
0
0
1
1

Language
5
0
0
0
5

30
3
2
8
43

English
1
17
0
11
0
79
17
20
12
6
163

Bilingual
0
11
0
7
1
43
14
24
6
10
116

Language
0
1
0
1
0
6
2
2
0
5
17

Total
2
84
7
52
3
296
78
75
39
63
699

Source: Office of the Telecommunications Authority

31

Satellite TV is excluded.

20

Bilingual

Total