The Centre for Health Protection (CHP) in Hong Kong is investigating four influenza A outbreaks at kindergartens in Sham Shui Po, Kowloon Tong, Hung Hom and Wan Chai, as well as an outbreak of an influenza-like illness at a kindergarten in Tsing Yi, according to a government release.

The kindergartens affected are Tsung Tsin Primary School and Kindergarten, two campuses of St. Catherine’s International Kindergarten in Kowloon Tong and Hung Hom, Hong Kong Ling Liang Church Kindergarten in Wan Chai and ESF Tsing Yi International Kindergarten.

Since the city entered the winter influenza season at the end of December, the health center had recorded at least 157 cases of flu outbreaks in kindergartens or child care centers, Apple Daily reported.

A CHP spokesperson said it is of prime importance that children with fever, regardless of the presence of respiratory symptoms, should not be allowed to attend school.

Parents of sick children should seek medical advice and keep the children away from school until 48 hours after the fever has subsided.

Meanwhile, the center is investigating two cases of severe paediatric influenza A infection, both affecting 11-month old babies. Neither child had received an influenza vaccination for the current season.

An 11-month-old girl who suffered fever, coughing and shortness of breath from January 14 was admitted to the Prince of Wales Hospital, where her condition is now critical. The clinical diagnosis was influenza A infection complicated with severe pneumonia

Another patient, an 11-month-old boy who had symptoms including a fever, coughing and a runny nose from January 9 was admitted to the Queen may Hospital when his condition worsened and he developed twitching of his head and limbs.

From December 30 last year to January 15, a total of 113 severe cases of influenza have been recorded, causing 44 deaths.