On August 22, the Ningxia Hui Autonomous Region Health Commission announced that on August 21, the General Hospital of Ningxia Medical University confirmed a case of plague (bubonic plague) and was in critical condition. In this regard, the author has sorted out several questions about the plague, hoping to help you answer questions and reduce unnecessary anxiety.
1. What is plague
Plague is a highly contagious disease mainly transmitted by The bacterium Yersinia pestis through flea rats, and is a natural epidemic disease widely spread among wild rodents. Once infected with plague, the disease progresses abnormally rapidly, often dying within 1 to 3 days. If left untreated, the case fatality rate is as high as 30% to 60%. Plague is an international quarantine infectious disease and a statutory Class A infectious disease in China.
2. What are the sources of infection
The source of plague infection is mainly rats, but some wild animals, such as marmots, dogs, sheep, rabbits, squirrels, etc. can be used as a source of infection. Humans can also be a source of infection, but humans are the main source of infection, mainly spreading pneumonic plague. Pneumonic plague mainly infects the respiratory system, and can be transmitted to the surrounding people through coughing and hemoptysis, so people are also an important source of infection of pneumonic plague.
3. There are several types of plague
According to the main part of the lesion, plague can be divided into bubonic plague, pneumonic plague, sepsis type plague and some rare types, such as enteric plague, meningitis type plague, eye plague, skin plague and so on.
Bubonic plague is the most common, and in addition to the systemic manifestations of plague, the lymphadenopathy of the site of invasion is its main feature. The most common sites are inguinal lymph nodes, subarms, neck and submandibular lymph nodes, mostly unilateral. Lymphadenopathy occurs at the same time as fever and is manifested by rapid diffuse lymphadenopathy, typically marked tenderness and hardness of the lymph nodes, adhesions to the subcutaneous tissue, loss of mobility, significant edema of surrounding tissues, and may be hyperemia and bleeding. Due to the intense pain, patients are often in a passive position.
Pneumonic plague is divided into primary pneumonic plague and secondary pneumonic plague.
Primary pneumonic plague onset is abrupt, chills and high fever, severe chest pain, cough, and large amounts of frothy pink or bright red blood sputum can occur within 24 to 36 hours of onset; shortness of breath and difficulty breathing; only a small amount of scattered crackles or slight pleural friction sounds can be heard in the lungs, and fewer lung signs are often disproportionate to severe systemic symptoms. Thoracic x-rays show high-density shadows with patchy edges blurred by multi-lobed segments. If effective treatment is not given in a timely manner, patients die of toxic shock, respiratory failure, and heart failure more than 2 to 3 days after the onset of the disease.
Secondary pneumonic plague is a sudden exacerbation of the disease based on symptoms of bubonic plague or septic plague, with the appearance of a respiratory manifestation of primary pneumonic plague.
Septic plague Develops sepsis without local symptoms after infection with plague bacteria, which is primary septic plague.
4. How to prevent plague
Plague is preventable and curable. Timely use of antimicrobial treatment can reduce the case fatality rate of plague.
To prevent plague, remember the "three major disciplines":
1. Do not touch, do not peel, do not cook diseased (dead) marmots and other diseased (dead) animals.
2. Do not sit around the marmot cave and rest, do not camp in the grassland overnight, in case of flea bites.
3. Do not visit the home of a plague patient or suspected plague patient or mourn in the home of the deceased.
Text: Luo Xuehong, Professor of Emergency Department, Xiangya Hospital, Central South University
Source: Health Newspaper