11 cases have been confirmed nationwide in the past four years. Is plague scary?

On July 19, the Ningxia Hui Autonomous Region Plague Epidemic Response Command issued an announcement that a case of primary plague (bubonic plague) imported from outside the region was confirmed in the Ningxia Hui Autonomous Region.

On that day, Ningxia launched a Level 4 emergency response to plague prevention and control. What are the hazards of plague? How is it transmitted? Do we need to be vigilant?

Screenshot of Ningxia Health Commission website

11 confirmed cases of plague in the past four years

Mainly occurs in Inner Mongolia and Ningxia

According to the Ningxia Hui Autonomous Region Health Commission, on July 19, a case of plague (bubonic plague) was confirmed at the Ningxia Medical University General Hospital.

The patient is a 45-year-old male herder. At around 9 a.m. on July 12, he developed fever, fatigue, confusion, and watery diarrhea, and returned to Yinchuan from Inner Mongolia. He was confirmed as a plague case on July 19.

As soon as the news came out, it sparked heated discussions online. Some netizens said that it was both an epidemic and plague, which made people worry.

In fact, the plague has not disappeared from the public eye. The Chinese Center for Disease Control and Prevention once published a special article explaining that in history, there have been three global pandemics of plague, which was once called the "Black Death" and caused serious losses to human life and health.

After the founding of New China, the Chinese government attached great importance to plague prevention and control, and the number of cases dropped significantly. By the 1980s, an average of about 20 cases were reported each year. In the 1990s, there was a brief increase in plague epidemics in southern my country. Since 2010, only sporadic cases have been reported each year, mainly concentrated in some northwestern provinces of my country.

In the past four years, sporadic cases of plague have occurred in my country every year, mainly in Inner Mongolia and Ningxia.

In 2019, five cases of plague were reported nationwide, with one death. Among them, four confirmed cases of plague were publicly reported in Inner Mongolia.

In 2020, 4 cases of plague were reported nationwide, with 3 deaths (1 case was reported in 2019). Among them, 2 deaths from plague occurred in Inner Mongolia.

In 2021, one case of plague was reported nationwide. The patient was admitted to the General Hospital of Ningxia Medical University and lived in Chabu Commune, Wulan Town, Otog Banner, Ordos City, Inner Mongolia Autonomous Region, and was engaged in grazing all year round.

Including this year's case, there have been 11 reported cases of plague in the past four years.

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How did past cases contract plague?

Be wary of three transmission methods

It can be noticed that in recent years, the Northwest region, especially Inner Mongolia, has been a frequent plague outbreak area. What is the reason? This has to do with the characteristics of the plague.

The main sources of plague infection are infected animals and patients with pneumonic plague. Common host animals include rodents and wild carnivores, such as Mongolian marmots, Himalayan marmots, Daurian ground squirrels, long-clawed gerbils, and Brandt's voles.

The Inner Mongolia Autonomous Region is a historical natural plague source, with four types of plague foci: Mongolian marmot, Daurian ground squirrel, long-clawed gerbil, and Brandt's vole, distributed in 57 banners and counties, with a total area of ​​337,000 square kilometers.

In 2019, two cases of plague imported from Inner Mongolia were discovered in Beijing, which attracted widespread attention. At that time, the Inner Mongolia Health Commission reported that the most recent case of human plague was in 2004, 15 years ago.

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So, how did the plague occur? The Chinese Center for Disease Control and Prevention conducted a traceability analysis of plague cases in Inner Mongolia and Ningxia in 2019 and 2021, and found that the husband of two patients with primary pneumonic plague who came to Beijing for treatment from Inner Mongolia was likely infected by inhaling aerosols containing plague bacteria while digging on his farm, and the wife was likely infected by contact with her husband. Another bubonic plague patient was infected after skinning a dead rabbit.

As for the plague cases in Ningxia in 2021, investigators found that there was a serious epidemic of plague with fleas in the patients' living area, and the patients may have been infected by flea bites.

Last year, the National Health Commission and the Inner Mongolia Health Commission pointed out that there are three ways for plague to spread. The first is through flea bites. Fleas bite plague patients or animals infected with plague, and then bite humans, causing human infection.

The second is transmission through direct contact. When people hunt, slaughter, or handle animals infected with plague, the plague bacteria can enter the human body through wounds on the skin (including very small wounds) and cause infection.

The third is through droplet transmission. Pneumonic plague patients or animals expel plague bacteria into the surrounding air through breathing and coughing, leading to the spread of pneumonic plague.

In terms of susceptible populations, humans are generally susceptible to plague. People working outdoors in epidemic areas or hunters and herders who hunt and skin marmots are more likely to come into contact with infected animals and have a higher chance of infection than the general population. It can also be seen from previous cases that many cases were engaged in herding.

How to prevent plague? Is treatment effective?

How can residents in the epidemic source area prevent plague? Officials remind people to do "three don'ts, three musts, and three protections" to improve their self-protection awareness and ability.

"Three Don'ts": Do not touch, skin, eat, or carry rats, hares, foxes, wolves, stray dogs, stray cats, gazelles, marmots and other animals; Do not rest in the wild, especially around the burrows of rats (including marmots), hares and other animals, and do not dig animal burrows; Do not contact patients who have died suddenly, patients suspected of plague, or patients confirmed of plague.

"Three musts": timely report dead rats, suspected plague patients, patients with unexplained high fever and patients who died suddenly; keep the residence and surrounding environment clean and tidy, keep cats in cages, dogs on tethers, and perform flea control regularly; and provide on-site treatment for patients to ensure that they can receive prompt and timely medical treatment.

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"Three protections": effective protection must be carried out. When people are outdoors or working, they must wear long pants and long-sleeved tops, and wear high boots or flea-proof socks when necessary. In the process of handling epidemic areas and epidemic sites, strengthen the personal protection of epidemic handling staff; health monitoring must be carried out. People engaged in high-risk occupations such as herders, rodent control personnel, field workers and residents in the epidemic source area must be monitored daily for health, and any abnormal situation must be reported in a timely manner; care must be carried out. People entering and leaving the epidemic site must be given necessary care to prevent people from entering the epidemic site without effective protection.

The Chinese Center for Disease Control and Prevention once published a document stating that plague is an ancient bacterial infectious disease that can be treated clinically with a variety of effective antibiotics. If patients can seek medical treatment early and receive standardized and effective treatment, the cure rate is very high. Suspected contacts can also avoid the disease by taking preventive medication.

Feng Zijian, deputy director of the Chinese Center for Disease Control and Prevention, also said that although the plague has left a painful memory for mankind in history, with the development of disease prevention and control systems and modern medicine, the plague is no longer an incurable disease. Most cases are sporadic, and large-scale infection of the population is almost impossible. Therefore, the public no longer needs to be terrified by the plague.

Source: China News Network

Reporter Yuan Xiuyue