CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

[alert]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

OK. So it is both a dog and a marmot. This article is in English and has not been through a translator. I think the dog is an ordinary canine (that did have fleas), and the marmot is well, a marmot.

http://www.chinadaily.com.cn/china/2009-08/06/content_8530516.htm

Outbreak linked to dead dogBy Cui Xiaoghuo (China Daily)
Updated: 2009-08-06 07:49 Comments(0) PrintMailThe origin of the pneumonic plague might be the dog raised by the first victim, disease control specialists discovered yesterday.

The victim, a 32-year-old herdsman, owned a dog that died after contracting the plague from an ill wild marmot.


Related readings:
Pneumonic plague under control
Pneumonic plague kills 3rd man in Qinghai Pneumonic plague kills 3rd man in Qinghai
Pneumonic plague kills two, infects 10 in Qinghai
Plague a growing but overlooked threat: study



While the herdsman was burying the body of the dog, he was beaten by the fleas residing on the dead animal, causing him to contract the deadly plague, Wang Hu, a local disease control official, told Xinhua News Agency.

Three days later, the herdsman fell ill of the plague and eventually died, said the director of the Qinghai provincial center for disease prevention and control.

The pneumonic plague usually contaminates humans in one of three ways: through fleas that pass the bacteria from animals to humans, through the mouth-to-mouth contact or saliva exchanges among humans, and finally, through having wounds exposed to sick animals, he said.

The first victim fell ill through close contact with the animal. The disease spread as he talked to others in his village, health experts have predicted. "The first victim had no protection methods when burying the dead animal and was wearing no protection when keeping close contact with residents around him. These caused the spreading of the plague," Wang added.

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

If they go a little more time with no new cases I predict the quarentine will be lifted shortly.

[tropical]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

#58:
"记者在现场看到，防疫人员以该院为中心，划出了数层隔离圈。 Reporters on the scene saw quarantine personnel to the hospital as the center, draw a circle several layers of isolation. 最外围的一道警戒线距离医院大概有数百米。 Together with the external cordon around several hundred meters away from the hospital. 警戒线附近停着一辆警车，旁边还有一顶蓝色帐篷。 A cordon of police vehicles parked nearby, next to a blue tent. 在阳光的暴晒下，身穿白色连体隔离服、“全副武装”的防疫人员仍在沿着警戒线巡视。 Under the exposure in the sun, wearing a white Siamese隔离服, "heavily armed" officers are still in quarantine inspections along the cordon. 看到记者的车靠近，他连连摆手，示意此处不能停留。 That reporters were around the car, he repeatedly Baishou signal can not stay here.

据记者了解，在距离县城几十公里之外的疫源地，即发病牧民聚居的帐篷区，也采取了同样严格的隔 离措施。 This reporter has learned that several tens of kilometers away from the county outside the foci, that is, the incidence of the tent area inhabited by pastoralists, but also to take the same strict quarantine measures. 隔离半径以公里计，任何非专业人员均不得出入隔离区。 Km radius of isolation to any non-professionals are not allowed to access the area of separation. 即使是防控专家，也需要在接受严格的防护和消毒措施后才可进出。 Even the prevention and control expert, but also in strict protection and disinfection measures in order to access."


From the above it seems that they have diferently layered circles,
and that the stronger sealing is circling the hospital.

So maybe they think they put all the suspected contacts into the hospital, and don't blanketing by an antibiotic.

But, on the other side, having alarming eventual past contacts anywhere from few weeks ago, means that they are not sure if all infected are in the hospital.

The Russian border area alarming could point to animal vectors, as wroted to be cyclic/endemic there, but stil could point to human alert also.

Exists the possibility of IV antibiotic treatment neccessity, instead of tablets, as a reason to not blanketing, if the strain are more resistant.

Sems of low probability that after be made all that town layering sealings, they leave potential infected to escape the area because of terrain control problems (with all the body temperature sensors at hand to locate the night movings; if the problem are night fleds).

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

there is a video with this article:

http://news.cctv.com/china/20090806/100060.shtml

[alert]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

This is an official source from state-run Chinese media. Note the repeated use of the word virus. That is an error, as plague is bacterial. But that error could explain why we aren't reading about people being given antibiotics - the media doesn't mention antibiotics because they don't understand this is bacterial.

A cynic might suggest that as to say this isn't plague, but some unkown virus, but too much else of the story we heard so far is consistent with pneumonic plague (including the marmot) and people have reportedly tested positive for plague, so I believe the error is in this article. Plague is just something reporters have NO familiarity with, even in rural areas.

Also note the new information - the first fatality was a sheperd. There might be infected sheep involved in the spread as well.

http://www.cctv.com/program/cctvnews/20090806/101158.shtml

Qinghai pneumonic plague "under control"
2009-08-06 08:45 BJT
Mail　|　 Share 　| Print　|　Text: A A A



Watch Video

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Health officials in Qinghai province say, no new cases of pneumonic plague have been found except for the 12 patients in the town of Zi-ke-tan who were quarantined last Friday. Three have died and two are in critical condition.

The Ministry of Health says, prompt and effective action was taken to contain the disease. The source of the infection has been traced to a shepherd's dog which died after eating an marmot infected with the virus. The dog's owner caught the virus while burying the dog and died a few days later.

The local government sealed off a 3 thousand 5 hundred square kilometer radius around the township, and set up 23 quarantine stations. More than 200 people are still being held in quarantine.

[Giuseppe]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

Dog suspected source of China plague: state media - Yahoo! News

Dog suspected source of China plague: state media

BEIJING (AFP)


A dog is suspected to be the origin of an outbreak of pneumonic plague in northwest China that has killed three people and left 10,000 under strict quarantine, state media reported.

Ziketan, a remote town in a Tibetan area of Qinghai province, has been locked down since Saturday in an effort to contain the spread of the highly virulent disease.

One patient was in critical condition and seven others were infected, most of them relatives of the first fatality, a 32-year-old herdsman, or local doctors, Xinhua news agency said.

Initial tests had shown that the herdsman's dead dog was the likely origin of the outbreak, Xinhua reported late Wednesday, quoting professor Wang Hu, director of the Qinghai disease control bureau.

Wang said it was likely that the dog died after eating a plague-infected marmot and that the man became infected while burying the dead dog. He died three days later.

"The first victim buried the dead dog without any protection. After he became infected, his relatives and neighbours were in close contact with him without taking any protective measures, leading to their infection," Wang was quoted as saying.

The World Health Organization says the bacteria which causes the plague is endemic in some rodents in the region, such as marmots.

Chinese health ministry experts quoted by Xinhua said the strict quarantine measures were proving effective and the outbreak was unlikely to spread further.

"There is no need to worry about the infection if you travel to Qinghai, not to speak of panic," professor Liang Wannian, deputy director of the ministry's emergency office, was quoted as saying.

The remote and mountainous area is sparsely populated, which is also helping to contain the outbreak.

Residents of Ziketan contacted by AFP Wednesday said some people had tried to flee but it was unclear if any had managed to breach the quarantine zone, which covers an area of 3,500 square kilometres (1,400 square miles) centred on the town.

Pneumonic plague spreads through the air, making it easier to contract than bubonic plague, which requires that a person is bitten by an infected flea.

The WHO says pneumonic plague is the most virulent but least common form of plague. The mortality rate is high and patients can die 24 hours after infection.
-

<cite cite="http://news.yahoo.com/s/afp/20090806/hl_afp/healthchinaepidemic_20090806062234">Dog suspected source of China plague: state media - Yahoo! News</cite>

[alert]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

There seems to be some discrepancy of whether the dog simply had contact with the marmot, or actually ate it. If the dog ate the ill marmot, then the dog itself would have gotten septicemic or pneumonic plague (no flea), and the man would have become ill from the dog's coughing (no flea again).

At this point, I am again reminded of the warning that people in that area often consider marmots dirty animals, so it is tempting to blame anything on a marmot. The dog could just have easily been bitten by an infected flea (that came from say, a rat).

http://news.xinhuanet.com/english/2009-08/06/content_11837403.htm

Local officials: Foreign reports about escape from NW China plague-hit area groundless


www.chinaview.cn 2009-08-06 18:18:23 Print

HAINAN PREFECTURE, Qinghai, Aug. 6 (Xinhua) -- Local officials coping with pneumonic plague control in northwest China's Qinghai Province Thursday denied recent foreign media reports about people escaping from the plauge-hit area on foot.

The officials told Xinhua that the reports about escape were groundless and there were no facts supporting them.

AFP Wednesday quoted a businessman who works in Ziketan township as saying, "Some of my hometown folks left, they are afraid of pneumonic plague."

On the same day, AP reported that two residents said a lot of people (from the town) "ran off last night.

After 12 patients in Ziketan township of Xinghai country in Qinghai's Hainan Tibetan Autonomous Prefecture were quarantined on July 31, the local government has sealed off 3,500 square km centered around Ziketan Township, with a population of 10,000, and established 23 quarantine stations working around the clock.

No other infections were found except for the 12, three of whom died and one was in critical condition as of Wednesday, according to Dong Fukui, deputy government chief of Hainan prefecture that administers Ziketan.

More than 140 epidemic-prevention professionals from the Ministry of Health and the provincial-level institutions are working in the area to control the deadly disease.

Dong Fukui told Xinhua Thursday that he was just back from the Ziketan grassland after having talked with more than 20 local herdsmen. He explained to them some knowledge about the pneumonic plague and local government's actions against it.

Efforts have been intensified to improve awareness of the plague among locals, according to Dong.

Authorities publish the status of the plague everyday, which helped contain the disease. More than 40,000 brochures and leaflets on pneumonic plague along with 400 CDs have been distributed in the area.

Dong said he was so pleased that many locals in the quarantined area voluntarily joined the disease-control efforts. Some patrolled around the area by their own motorcycles. The prefecture government had decided to subsidize the local volunteers, Dong added.

Actions against the plague are effective and the disease is unlikely to spread from the epidemic center, according to specialists taking part in the plague control.

"Supplies in the area are guaranteed. It is not necessary for the locals to escape," Dong said.

Staff at the Jiudaoban quarantine station told Xinhua that they did not see any resident flee from the epidemic center. Motor vehicles queued up at the station for quarantine and disinfection. They were in good order, though the process was slow. Dong said people involved did not complain and remained calm.

According to Qin Jianxin, deputy head of the public security bureau of Xinghai County who is in charge of the quarantine station which is nearest to Xinghai county, there are 18 people working with the station. Quarantine vehicles patrol the area round the clock. All of the vehicles are employed for the plague control.

"This is the last pass and the only way toward the epidemic center. We've seen no local residents come out of the center," Qin noted.

Specialists taking part in the plague control estimate that the lockdown was expected to be lifted in the near future when conditions were ready.

They discovered the origin of the pneumonic plague was possibly the dog raised by the first victim, who was a 32-year-old herdsman. He owned a dog that died after contracting the plague from an ill wild marmot.

Wang Hu, head of the Qinghai provincial center for disease prevention and control, told Xinhua earlier that while the herdsman was burying the body of the dog, he was beaten by the fleas on the dead animal, causing him to contract the plague.

[alert]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

And Promed posting #4. Yes, dogs can contract plague, and apparently, according ot the moderator here, the signs are not as obvious as in some other animals (bold text).

http://www.promedmail.org/pls/otn/f?p=2400:1001:4166231683605642::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,78666

Archive Number 20090806.2778
Published Date 06-AUG-2009
Subject PRO/AH/EDR> Plague, pneumonic - China (04): (QH)


PLAGUE, PNEUMONIC - CHINA (04): (QINGHAI)
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 6 Aug 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5hS5A-DJTVP-woDOUuOi7NJIyYfcQ>


A dog is suspected to be the origin of an outbreak of pneumonic
plague in northwest China that has killed 3 people and left 10 000
under strict quarantine, state media reported. Ziketan, a remote town
in a Tibetan area of Qinghai province, has been locked down since
Saturday [1 Aug 2009] in an effort to contain the spread of the
highly virulent disease.

One patient was in critical condition and 8 others were infected,
most of them relatives of the 1st fatality, a 32-year-old herdsman,
or local doctors, Xinhua news agency said.

Initial tests had shown that the herdsman's dead dog was the likely
origin of the outbreak, Xinhua reported late Wednesday [5 Aug 2009],
quoting professor Wang Hu, director of the Qinghai disease control
bureau. Wang said it was likely that the dog died after eating a
plague-infected marmot and that the man became infected when he was
bitten by fleas while burying the dead dog. He died 3 days later.

"The 1st victim buried the dead dog without any protection. After he
became infected, his relatives and neighbours were in close contact
with him without taking any protective measures, leading to their
infection," Wang was quoted as saying.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Regarding dogs and plague, an American Veterinary Medical
Association reference
(<http://www.avma.org/reference/zoonosis/znbuboni.asp>), with the
citation numbers changed to begin at 1, states:

"Generally, the canine family is believed to be more resistant to
plague than the feline family and if they develop the disease at all,
the disease usually is subclinical, that is, not easily recognizable.
Wild carnivores in the dog family, such as coyotes and foxes, can
develop blood titers against _Yersinia pestis_ (1,2) Experimentally,
dogs inoculated with _Y. pestis_ develop bacteremia and have had _Y.
pestis_ isolated for 10 days from the oropharynx (1). Subclinically
and clinically affected dogs can develop antibodies against _Y.
pestis_ (1), and people have contracted plague after skinning
infected coyotes and foxes (1,3).
References
----------
1. Poland J, Barnes A. Plague. In: Steele JH, ed CRC handbook series
in zoonoses Boca Raton, Fla: CRC Press, 1979.
2. Rust JH jr, Cavanaugh DC, O'Shita R, et al: The role of domestic
animals in the epidemiology of plague. I. Experimental infection of
dogs and cats. J Infect Dis 1971; 124: 522-6 [although a different
reference in the same journal actually discusses the serologies: The
role of domestic animals in the epidemiology of plague. II. Antibody
to _Yersinia pestis_ in sera of dogs and cats. Rust JH jr, Miller BE,
Bahmanyar M, et al. J Infect Dis 1971; 124(5): 527-31. - Mod.LL]
3. Barnes AM: Surveillance and control of bubonic plague in the
United States. Symp Zool Soc London 1982.

Marmots are large rodents related to the American woodchuck (_Marmota
monax_), are thought to be significant zoonotic reservoirs for _Y.
pestis_ in Eastern Asia. The name marmot
(<http://en.wikipedia.org/wiki/Marmot>) comes from French marmotte,
from Latin mures monti, "mountain mouse." - Mod.LL]

[see also:
Plague, pneumonic - China (03): (QH) 20090805.2764
Plague, pneumonic - China (02): (QH) 20090803.2724
Plague, pneumonic - China: (QH), RFI 20090801.2702
Plague, human - Mongolia: (BO), RFI 20090612.2177
2007
----
Plague, bubonic - Mongolia (Gobisumber) 20070924.3163
Plague, human, fatal - Mongolia (Hovsgol) (03) 20070810.2602
Plague, human, fatal - Mongolia (Hovsgol) 20070807.2567
Plague, rodents - Russia (Volgograd, Astrakhan): susp. 20070128.0368
2005
----
Plague - China (Tibet) 20050626.1798
Plague, camels - Uzbekistan, Kazakhstan, Turkmenistan: susp. 20050212.0479
2004
----
Plague - Turkmenistan (Dashoguz): susp (02) 20040707.1820
Plague - Turkmenistan (Dashoguz): susp 20040706.1811
Plague warning - Russia: RFI 20040427.1178
2003
----
Plague - Mongolia 20030908.2255
Plague, bubonic - Kazakhstan (Kzyl-Orda) 20030822.2119
Plague - Kazakhstan (Mangistausk): suspected 20030801.1881
2002
----
Plague - Mongolia 20020919.5361
2001
----
Plague, bubonic - Mongolia (Central): correction 20010904.2115
Plague, bubonic - Mongolia (Central) 20010808.1871
2000
----
Plague, bubonic - Mongolia & China: background (03) 20000924.1645
Plague, bubonic - Mongolia & China: background (02) 20000920.1620
Plague, bubonic - Mongolia & China: Background 20000802.1290
Plague, bubonic, marmots - Mongolia: RFI 20000801.1274
1999
----
Plague, bubonic - Kazakhstan (05) 19990817.1418
Plague, bubonic - Kazakhstan 19990802.1322
1998
----
Plague, marmots - Kyrgyzstan (Dzhetyoguz) 19980811.1572]
...................................ll/mj/dk

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

I don't get why xinhua is lieing about the people leaving the town. I beleive the Associated Press more than I do any state media. They even quoted towns people.

[alert]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

Who knows. Possibly to reduce fear in neighboring towns. The good news is with the most common incubation period being 1-3 days, and it being now six days from the announcement of the isolation of the 12 cases, the chance of further cases is low. It isn't quite zero, as the incubation period of pneumonic plague can be as long as 14 days in rare cases, but it is sharply declining.

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

They said that they will life the quarentine in 3 more days in one article I seen. A total of nine days quarentine.

[alert]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

They said that they will life the quarentine in 3 more days in one article I seen. A total of nine days quarentine.

Can you post that article? That would be a bad sign. According to ProMed (the posting is about an outbreak that turned out NOT to be plague)

http://www.promedmail.org/pls/otn/f?p=2400:1202:1309425294447991::NO::F2400_P1202_CHECK_DISPLAY,F2400_P1202_PUB_MAIL_ID:X,74242

Of note is that the incubation period for plague is 1 to 14 days.

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

there is a video with this article:

http://news.cctv.com/china/20090806/100060.shtml

Right here

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

Acording to some researching I just did the longest incubation period is 6 days. NO LONGER. This is not a disease that waits two weeks in your system.

[Rwilmer]

Re: CHINA: QINGHAI, PNEUMONIC PLAGUE (from ProMedMail.org, edited): 12 cases (with three deaths, one in critical condition, 218 in hospital)

there is a video with this article:

http://news.cctv.com/china/20090806/100060.shtml

CCTV Network News (midnight news): continue to pay attention to the state, Hainan, Qinghai Province Xinghai County of pneumonic plague epidemic, as at 17 o'clock on the 5th, 12 patients had died among the three cases, two cases of critically ill, there is no new confirmed cases and suspected cases. At present, the pneumonic plague foci has been found.

Xiaoqin Long press: Hainan People's Hospital is the state of the pneumonic plague epidemic of the fixed-point hospital. The hospital is the largest state hospital in Hainan, but only one in the treatment of patients in the hospital for observation to isolate the masses, but now they have lifted the quarantine.

Another eight patients with pneumonic plague still in possession of Xinghai County hospital for treatment, the epidemic took place there more than 200 close contacts to continue to observe isolation.

Hainan, the state Ministry of Health to the members of the Group of plague prevention and control of the Ministry of Health Deputy Director of the Office of Health Emergency Liang years: those in close contact also did not find anything unusual plague of infectious diseases in accordance with the provisions of the close contacts of all we have to isolate the longest incubation period 9 days so we have a few days if the situation did not appear at that time we can say that we have achieved complete victory in the prevention and control to say the least, now in control of our initial results we have achieved

Experts said the July 27, Hainan state Xinghai County Town sub-section of a herdsman's home because the dog ate the virus with pneumonic plague death Marmota, pastoralists in the landfill when the dog was infected and died three days later .

Endemic Qinghai Wang, director of prevention and control: the mouse疫毒edge of Qinghai-Tibet Plateau are highly infected, the disease is very short.

According to epidemiological investigation and laboratory test results, in close contact with the deceased's relatives and village doctors were also infected with pneumonic plague cases were diagnosed in 12 cases.