Be alert! A case of plague has been confirmed in a place in China, and the condition is critical!

Ningxia reported in the early morning: A case of plague was confirmed! A 55-year-old woman was in critical condition

According to the Ningxia Health Commission website on the 22nd, on August 21, 2021, a case of plague (bubonic plague) was confirmed at the Ningxia Medical University General Hospital.

Screenshot source: Ningxia Hui Autonomous Region Health Commission official website

The patient, Ma Moumou (female, 55 years old, registered in Zhenguan Village, Baofeng Town, Pingluo County, Shizuishan City, currently lives in Chabu Commune, Ulan Town, Otog Banner, Ordos City, Inner Mongolia Autonomous Region, and has been engaged in grazing all year round), developed symptoms of nausea and vomiting at around 13:00 on August 14, and went to a clinic in Ulan Town, Otog Banner for treatment; at around 20:00 on August 15, her son drove her back to Chengguan Town, Pingluo County, and went to Xinhetang Clinic on the shores of Jinshui Lake for treatment; at around 17:00 on August 16, she went to Xinhetang Clinic again for treatment, and went to Pingluo County People's Hospital for treatment at around 20:00; at around 0:30 on August 17, her son drove her to the General Hospital of Ningxia Medical University for treatment, and she was admitted to the hospital in the early morning; on August 20, she was diagnosed as a suspected case of plague; on August 21, she was confirmed as a case of plague, and her condition was critical.

In accordance with relevant national laws and regulations and the "National Plague Control Emergency Plan", the Ningxia Hui Autonomous Region Government decided to launch a level-four emergency response to plague epidemic prevention and control from 1:00 on August 22, 2021, to make every effort to treat patients, and fully implement comprehensive prevention and control measures to ensure that the epidemic does not spread.

According to the plague epidemic classification, the warning levels correspond to the following:
The warning levels are Level I for particularly severe pandemic epidemics (Level I) and severe pandemic epidemics (Level II);

A larger epidemic (Level III) is a Level II warning;
The general plague epidemic (level IV) is a level III warning.

It is understood that plague is a Class A infectious disease in our country. Once the news was reported, it became a hot topic.

What is plague? How is it spread? And how can we prevent it?

1

What is plague?

Plague is a highly contagious disease caused by infection with Yersinia pestis. It is a Class A infectious disease among legally prescribed infectious diseases in my country, ranking first among legally prescribed infectious diseases. Plague is mainly prevalent among rodents. Rats and marmots are the natural hosts of Yersinia pestis, and rat fleas are the transmission medium.

In August last year, there were two plague deaths in Inner Mongolia. On August 2, a death occurred in Sujixin Village, Wendunling Village Committee, Shibao Town, Damao Banner, Baotou City, Inner Mongolia. After nucleic acid testing, gene sequencing testing and epidemiological investigation by the two-level CDCs in Inner Mongolia and Baotou City, it was determined that the deceased died of intestinal plague; on August 6, in Biketi Village, Shadege Sumu, Urad Front Banner, Bayannur City, a patient died of multiple organ failure due to ineffective rescue. After consultation by an expert group, it was determined that the deceased died of bubonic plague.

2

When was plague discovered?

A review of the history of plague epidemics:

Plague is an ancient infectious disease that has occurred three times in human history.
The first plague pandemic, the Great Plague of Justinian, began in the mid-sixth century and disappeared in the eighth century, killing hundreds of millions of people in Europe and Asia.

The second plague pandemic began in the middle of the 14th century and lasted for 300 years. Continental Europe lost between one-third and one-half of its population.

The third plague pandemic started in Yunnan and Mumbai in the second half of the 19th century, and finally broke out in northern Manchuria (Manchukuo). Later, there was plague in Shanxi, the second plague in Northeast China, and plague in other parts of Europe, Asia and Africa. It did not disappear until the 1930s, and tens of millions of people died of plague around the world.

my country is one of the countries most affected by plague. After the founding of the People's Republic of China, plague was effectively controlled. However, due to the existence of different types of plague foci in many provinces and regions of my country, sporadic cases have occurred in recent years.

3

What are the characteristics of plague?

The disease has an acute onset, a short course, a high mortality rate, is highly contagious, and spreads quickly. Especially for septicemic plague and pneumonic plague, if left untreated, the mortality rate is 30% to 100%. The incubation period of plague is short, generally 1 to 6 days, and in some cases it can reach 8 to 9 days.

4

How is plague spread?

Rats and rodents, including Rattus norvegicus and Rattus flavipectus, are the main sources of infection. Wild foxes, wolves, cats, rabbits, camels and sheep may also be sources of infection. Patients are the source of infection for pneumonic plague. Transmission route:

Transmission is through rat and flea bites. Rat and flea bites are the main route of transmission, which can transmit the pathogen (Yersinia pestis) to humans, forming a "rodent → flea → human" transmission method.
Respiratory tract infection: The patient's respiratory secretions carry a large number of Yersinia pestis, which can be transmitted from person to person through droplets and can cause a human plague pandemic.
It is transmitted through the skin, and infection occurs when the broken skin and mucous membranes of a healthy person come into contact with the pus, blood, sputum of a patient, or the skin, flesh, and blood of a sick animal.

The cute groundhogs are a stable reservoir of plague bacteria and have a high rate of carriers.

Is plague transmitted by domestic mice? "Plague exists in wild animals for a long time, especially rodents." Chen Anguo, a researcher at the Institute of Subtropical Agriculture Ecology of the Chinese Academy of Sciences, said that there are 186 species of rodents in the world that can infect and spread plague, and more than 40 species in my country, such as the marmot on the Qinghai-Tibet Plateau, the yellow rat on the Songliao Plain, the giant gerbil in the Junggar Basin, the gerbil on the Inner Mongolia Plateau and the rat in Yunnan.

Marmots are groundhogs. Although they look cute, they are stable reservoirs of plague bacteria and have a high rate of carrying bacteria. Therefore, we must resolutely avoid hunting and eating marmots and various wild mice.

If house mice come into contact with wild mice, they are easily infected with plague, and the fleas that parasitize on house mice will bite people and cause human plague. Among them, the yellow-breasted rat, the brown rat and the black rat are all important sources of human plague.

Is feeding groundhogs a trend? Experts warn: Don’t do it

Recently, someone posted a short video online. In the video, a little girl was feeding a marmot with a drink in Ganzi Tibetan Autonomous Prefecture, Sichuan. The little girl did not look much taller than the marmot. As she was feeding the drink, the words "gurgle gurgle" were displayed in the video. Many netizens left comments, saying that the marmot was very cute and called for loving nature and protecting animals.

The reporter found that on some short video platforms, there are quite a few short videos of people posting videos of themselves and marmots, including intimate behaviors such as feeding and watering them directly with their hands, and feeding them food including cabbage, steamed buns, cucumbers, cakes, biscuits, etc.

Feeding marmots with bare hands has become a popular "standard action" on the plateau. Keywords such as "cute marmot" and "super cute marmot" are used in these short videos. Some netizens even believe that feeding marmots with bare hands is a manifestation of harmonious coexistence between humans and nature.

Some short videos show people feeding groundhogs with bare hands

In fact, these animals are not as cute as people imagine. The Sichuan Provincial Center for Disease Control and Prevention once pointed out in a document that "Himalayan marmots (commonly known as groundhogs) are one of the main hosts for the spread of plague. The strains carried by marmots are the most pathogenic and most likely to cause death among the strains found in our country."

The Sichuan Provincial Center for Disease Control and Prevention calls on everyone, for the sake of everyone's health, not to have close contact with marmots, and not to capture, raise, or skin and eat them, so as not to become the protagonist of the next epidemic.

5

What are the symptoms after being infected with plague?

Clinical manifestations of plague infection:

Based on the clinical manifestations and characteristics of the disease, plague can be divided into bubonic plague, pneumonic plague, septic plague and other types of plague.
Bubonic plague: high fever and chills, accompanied by nausea and vomiting, headache and pain in the limbs, facial flushing, conjunctival congestion, and bleeding spots on the skin and mucous membranes. It is often manifested by enlarged and rapidly developing lymph nodes in the groin, armpits, and neck. After a week, the lymph nodes quickly become purulent and rupture.
Pneumonic plague: Acute onset, with chills, high fever, headache, chest pain, rapid breathing, purple lips, cough and mucous or bloody foamy sputum, and death often due to heart failure or hemorrhagic shock.

Septicemic plague: high fever, chills, confusion, coma, and then septic shock, disseminated intravascular coagulation, and extensive skin hemorrhage and necrosis.

Population Susceptibility:

The general population is susceptible. Field workers, people who have close contact with marmots or who skin and eat marmots, and herders are high-risk groups. Plague infection can provide lasting immunity, and vaccination can provide a certain degree of immunity.

6

How to prevent plague?

Experts remind the general public: Strictly follow the requirements of "three no's and three reports" for plague prevention and control, take effective personal protection measures, and improve self-protection awareness and ability.

1. “Three Don’ts”: Don’t hunt epidemic-source animals privately, don’t skin and eat epidemic-source animals, and don’t carry epidemic-source animals and their products out of the epidemic area privately.

2. “Three reports”: report any sick (dead) marmots or other animals, report any suspected plague patients, and report any patients with unexplained high fever or sudden death.

3. Maintain good personal hygiene habits, try to avoid crowded places, and wear masks when going to medical institutions or when you have fever, cough and other related symptoms.

4. If you suspect that you have had contact with a case, you can report it to the local disease control department and obtain professional guidance. If you have symptoms such as fever, cough, lymph node pain, hemoptysis or bleeding, you should seek medical attention in time.

5. When traveling, try to minimize contact with wild animals. Do not play with marmots whose health status is unknown. Take precautions against flea bites by using repellents and reducing body exposure to avoid flea bites. Do not hunt or eat wild animals privately.

Source: Science Popularization China