Infected 300,000 people in 3 months, an infectious disease caused by fecal-oral transmission that year
Tianjin TEDA Hospital Li Qing
Just now, the People's Hospital of Wuhan University, the Wuhan Institute of Virology of the Chinese Academy of Sciences and other authoritative institutions released news that the transmission route of the new coronavirus pneumonia, in addition to the droplet transmission and contact transmission mentioned in the previous period, there is also a certain fecal-oral transmission.
Speaking of fecal-oral transmission, I am reminded of another big event, an infectious disease that has plunged Shanghai into panic - hepatitis A.
It was 1988, around the Spring Festival, when the weather in Shanghai was not very cold, people were preparing for the New Year, and the whole city was full of festive atmosphere.
But the good times did not last long, and in mid-January, many Shanghainese began to have symptoms such as fever, vomiting, and general weakness. At first, people didn't think it was a common cold, but the development of the disease was getting more and more wrong, the white eyeballs were yellowing, and the face and body were getting yellower.
People rushed to the hospital, but found that there were too many people with the same symptoms and at the same time. Since then, the number of patients has begun to grow wildly, and in just one day, the number of infected people has reached 19,000, most of them young people.
From the craziest period of January 30 to February 14, the number of cases per day exceeded 10,000. At that time, the hospital was crowded, all the medical staff in the city were in action, and the beds were even placed outside in schools, warehouses and hotels, and the panic swept through Shanghai, making people panic.
The epidemic at that time was characterized by:
1. The onset of illness is sudden and fierce;
2. The symptoms are obvious, more than 90% of patients have jaundice, and most patients have transaminases of more than 1000u;
3. The incidence of the disease is mainly concentrated in urban areas, mainly young and middle-aged;
4. More than 80% of patients have a history of eating hair cockles.
After examination, the vast majority of patients are diagnosed with hepatitis, and further examination confirms hepatitis A, an infectious disease of the digestive system caused by a virus.
The plague, from the beginning of the disease to the final control, in just 3 months, infected 300,000 people, 31 people died directly from the disease, and the direct economic loss reached nearly 500 million yuan (500 million in 1988), setting a new record for the world hepatitis A epidemic.
Viral hepatitis is divided into 5 types: A, B, C, D and E, although they are all hepatitis, but the routes of transmission are different. Hepatitis A is a fecal-oral transmission of digestive tract infectious diseases, generally more common in children, this time how can there be a major outbreak of young adults?
Under the follow-up and quarantine of the health and epidemic prevention department, the specific transmission route of this plague was determined.
At that time, Shanghainese loved a delicacy: hair cockles, this shellfish is oval in shape, the meat inside is fat and delicious, and Shanghainese favorite is to eat fresh hair cockles, mixed with spices and raw, or soaked in boiling water for a short time (5 to 10 seconds) to eat. The hepatitis A virus is "hidden" in the hair cockle.
The cause of hepatitis A in Shanghai in 1988
The habit of eating hair cockles in Shanghai did not start in 1988, so why did it go wrong in 1988?
At that time, the breeding environment of the hair cockle had begun to be polluted by human and animal manure. One of the main breeding areas, Qidong County, Jiangsu Province, has a large amount of domestic sewage discharged into the Yangtze River along the river, including hepatitis A virus excreted by hepatitis A patients, and the virus multiplies in large quantities with the reproduction of hair cockles.
Most of the carriers are farm boats, which do not carry hygienic treatment at all before transporting them. After investigation, it was found that another pollution factor is that in order to maintain the freshness of the grasshoppers, transport farmers use fresh stool to mix it into manure water every day to splash the hair cockles, which is also an important way of pollution.
In addition, the relevant departments at that time could not keep up with the hygiene management, supervision and testing of food such as hair cockles.
The excrement of hepatitis A virus patients is untreated, the excrement contaminates the water, the water pollutes the hair cockles, the inspection and quarantine of the hair cockles is lacking, people eat raw without processing, and one pass after another is lost, and finally causes a catastrophe.
From the hepatitis A outbreak in Shanghai, perhaps you have a certain understanding of "fecal-oral transmission".
Fecal-oral transmission is a common mode of transmission of infectious diseases, also known as transmission through the digestive tract.
Pathogens of some infectious diseases (bacteria, viruses, parasites, etc.) can survive in the stool, and after excreting with feces, contaminate hands, food or water sources, and enter the human body from the mouth, transmitting the disease to others.
Common infectious diseases transmitted through the fecal-oral route are hepatitis A, hepatitis E, typhoid fever, cholera, hand-foot-and-mouth disease, and some parasitic diseases, such as tapeworm disease, pinworm disease, and ascariasis.
Common routes of oral transmission are: eating contaminated food or drinking contaminated beverages, or touching contaminated objects or surfaces with hands to mouth, or direct contact with an infected person, such as Gu Sick, eating with the sick person or using the same utensils.
In other cases, farmers use contaminated manure to fertilize vegetables, and if these foods are not fully washed and cooked, people who eat these foods may be infected; for example, patients do not wash their hands after defecation, and directly touch other people's food or tableware with their hands, and the small partners who eat together will be infected.
In general, if the virus contaminates general household items, most sporadic diseases are transmitted through the fecal mouth caused by daily life exposure.
However, if a patient's excrement contaminates a water source, it can lead to a widespread epidemic.
Therefore, it is a top priority to avoid polluting water sources for infectious diseases transmitted by fecal-oral transmission routes, hygienic treatment of vomit, stool and other excrement of patients.
For each of us, the following personal protective measures are taken to prevent it:
1. Good personal hygiene habits are the most effective preventive measures: wash your hands regularly before meals and after going to the toilet, and wash your hands before processing food.
2. Fruits and vegetables should be carefully cleaned before eating.
3, all food, especially seafood, aquatic products, etc. should be deeply processed and eaten.
4. Advocate drinking boiled water, do not mix hot and cold water to drink, and avoid the onset of disease caused by bottled water pollution.
5. Infected or suspicious people should stay away from the kitchen or food processing places, and cannot process food.
6. Timely use chlorine-containing bleach or other effective disinfectants to clean and disinfect the surface contaminated by the patient's vomit or feces, immediately take off and wash the contaminated clothes or sheets, etc., wear rubber or disposable gloves when cleaning, and wash your hands carefully after cleaning.
In response to the new coronavirus pneumonia, because of the emergence of new transmission routes, the preventive measures must be adjusted accordingly and the content added.
When patients with mild diseases are isolated at home, special attention should be paid to the hand hygiene of individuals and family members, and as far as possible, avoid sharing bathrooms with family members. If there is no separate toilet, after each use, it can be disinfected at home by using a disinfectant that can effectively inactivate the new crown virus through lipid solvents such as ether, 75% ethanol, chlorine-containing disinfectants, peracetic acid and chloroform.
Severely ill patients are disinfected by professionals.
All in all, hand washing is the easiest and most effective way to deal with fecal-oral infectious diseases! Promote the seven-step method of washing hands frequently:
1. Wash your hands before eating: When eating, it is inevitable that your hands will touch food, and it is easy to eat the virus.
2. Wash your hands after going to the toilet: After going to the toilet, your hands may be contaminated with urine or feces, or you may also be contaminated with germs when you touch the toilet lid, open and close the door, and flush the water.
3. Wash your hands after blowing your nose: Your hands may be contaminated with a large number of germs after blowing your nose.
4. Wash your hands before and after wearing a mask: your hands may come into contact with germs, and you will wear a mask without washing your hands, and germs are easy to touch your mouth and nose.
5. Wash your hands before and after seeking medical treatment: The hospital environment is prone to germs.
6. Wash your hands before and after handling ingredients.
7. Wash your hands after touching your pet.
It is worth mentioning that at that time, there was also a rush to buy Banlan root, which may have been the first rush to buy Chinese medicine after the founding of the People's Republic of China.
Perhaps in order to comfort the masses and maintain social stability, experts advertise that banlan root can treat hepatitis A, and take banlan root treatment for ordinary hepatitis A patients in hospitals. As soon as the news came out, Banlangen was snapped up by Shanghai residents and residents of neighboring provinces, and the state also organized Banlangen from all over the country to be transferred to Shanghai.
At that time, when Shanghainese received guests at home, they could brew a cup of plate orchid board for guests, which also became a fashion and courtesy at that time.
Some people in Anguo County, Hebei Province (the main distribution and processing place of Chinese medicinal materials in the north), later recalled that before the Hepatitis A incident in Shanghai, The banlan root could not be sold, and many families burned it as firewood. After the outbreak of the incident, people took the banlan root out of the firewood pile and sold it for a large price, because the event also spawned many rich people.
From the current point of view, hepatitis A is a self-healing disease, the vast majority of patients do not need special treatment, BanLan root may play a placebo or stabilizing the role of people's minds.
Revisiting this history today is not to take this opportunity to comment on who was right and who was wrong in the past, but to remind everyone that what links we still need to improve to control the current infectious diseases.
Some of the pictures in this article come from the network, invaded and deleted