The Centre for Health Protection believed that a 3-year-old girl who died last Saturday shortly after showing flu symptoms did not die of avian flu.

The cause of death, however, won't be established until after an autopsy whose results would be known today, the center's controller Thomas Tsang Ho-fai said at a press conference yesterday.

The girl, Ho Bo-yee, had a fever of 40.3 C and went to the emergency ward of Tuen Mun Hospital last Saturday. Her chest X-ray was normal and she was diagnosed with upper respiratory tract infection. She was given some medication before being discharged.

Her condition deteriorated rapidly on the same day. She was readmitted to the hospital in the afternoon while she was in cardiac arrest. She was certified dead in an hour at 5:27pm. Respiratory samples taken from her tested positive for influenza A/H3, but negative for H5 bird flu virus.

Tsang said the death of the girl was a rare case.

"It is rare that the conditions of a flu patient would deteriorate so rapidly. Most flu patients are able to recover naturally," he said.

An autopsy is being carried out to ascertain her cause of death, whose findings will be reported to the Coroner's Court today.

The girl's 6-year-old sister Ho Yuen-yee has been staying in the hospital's paediatric isolation ward since Sunday. Her chest X-ray revealed a shadow in her left lung. She was also tested positive to influenza A/H3, but negative to bird flu. She has been prescribed Tamiflu and is in stable condition.

The two girls had no history of leaving Hong Kong or contact with poultry, Tsang said.

The girls' grandfather, Ho Kwai-ming, accused the hospital of negligence. He said the hospital should not have discharged his little granddaughter, whose conditions deteriorated after taking the medicine prescribed by the emergency ward and when eating in a restaurant.

But Tuen Mun Hospital Service Director (Service Quality and Risk Management) Chung Kin-lai said whether there were human errors was not their foremost concern.

"The most important concern at this moment is to follow up on the other sister, provide support to the girls' family and remind our medical staff to uphold professionalism," he said.

There has been no outbreak of influenza in the school and kindergarten the girls were studying in.

Chinese University pediatrics associate professor Ellis Hon said his studies over the past few years have shown that only one out of 50 children admitted to hospital's intensive care unit has died of influenza, and three died of other respiratory viruses. "I think it is likely that the girl's death is caused by problems with the heart," he said.

He also said medicine and food allergy may also be the reasons for the girl's death.

Another pediatrician Tse Hung-hing said influenza may worsen the condition of hidden illnesses, such as congenital heart disease, within a short period of time.

Pediatrician Alvin Chan said conditions could rapidly worsen if the virus got into the children's blood.

Chan added that doctors at the emergency ward might not have been able to detect whether the girl had complications or hidden illnesses.

"Patients need to inform doctors of any new symptoms, such as coughing, after taking the medicine," he said.

(HK Edition 03/05/2008 page1)