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China - Foshan CDC Issues Warning on Scrub Typhus - 2 dead - Guangdong province

sharon sanders

Editor-in-Chief & President
Two died of the bite of death, Foshan CDC issued a warning tsutsugamushi

At 10:45 on September 16, 2010
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Yesterday afternoon, Foshan City, the hospital held a news conference, ICU Director, Department of Infectious Diseases Director Luo Hongtao Zhou Lixin, and to give in the situation where Ms., severe scrub typhus causes of death are described and explained.

City Nanhai District, a hospital and health sector data are not complete, Foshan, every year many cases of scrub typhus were treated, and deaths every year. If the First Hospital has treated more than 10 cases this year, but no sign of increase in cases.

A week ago, Nanhai Luo village within a 60-year-old man Tse Yin died of scrub typhus was suspected. For the patient, the South China Sea Red Cross Hospital, vice president Yin Walker told reporters, Tse Yin is unique within, soon after the onset of multiple organ failure, is encountered in the hospital the past few years the most serious cases. According to its introduction, the South China Sea Red Cross hospital admissions each year are tsutsugamushi bite cases.

Experts said, "The earlier the earlier the treatment of scrub typhus, the better."

Case 1: Sanshui an elderly woman died of severe scrub typhus

Suspected of being at a funeral on the 66-year-old insect bite Ms. Fan, a result of severe tsutsugamushi disease with multiple organ injury, yesterday 12:41 Sanshui just been sent back to the ambulance after the death.

Suspected to be insect bites in the funeral

Yesterday, 11:20, reporters came to the First Hospital ICU door, Miss Fan's husband, daughter, wife, aunt, neighbors and other relatives and friends are waiting for Ms. Fan out of ICU.

Ms. Fan's daughter, Miriam, said Min, Sept. 2, Ms. Fan Sanshui District People's Hospital from the city go to a hospital, his condition has not improved. Starting from about the middle of July, Ms. Fan fever, consciousness is not clear, loss of appetite, no effective treatment at a local hospital after the Aug. 28 referred to the Sanshui District People's Hospital. Ms. Fan has begun to deteriorate, pneumonia, thrombocytopenia, incontinence.

The reporter saw Min instrument provides the people, Sanshui District, issued by the hospital, "hospital to prove" clear wrote: Miss Fan at August 28 ~ September 2 treated for 5 days in the hospital, suffering from lung infection; scrub typhus, fast-type atrial fibrillation, cardiac function III; chronic renal failure; fatty liver; hypersplenism.

Min-yee said that in order to better treatment of the mother, her mother referred to the City, a hospital, just the first day of admission was taken to the emergency department before being admitted to ICU treatment.

"We are Poor Families, has more than 10 million loan was used to treat." Min-yee said that due to the heavy condition, considering the prognosis poor, for comprehensive consideration, the family decided to Ms. Fan home. Yesterday 12:30 or so, Ms. Fan was sent ICU. Reporter saw Miss Fan in a coma, breathing heavily.

12:42, Miss Fan quietly passed away.

"She should be in her mother's funeral to be insect bites!" Ms. Fan said a neighbor, on August 10 at Miss Fan Ho-law's funeral, Ms. Fan funeral back to Gao Gang, who sit above the grass, "may Comparison of wet grass, hidden tsutsugamushi inside. "

Min-yee told reporters, Miss Fan in early diagnosed coronary heart disease, high blood pressure, but usually in good health and rarely get sick.

Eventually diagnosed as scrub typhus

Zhou Lixin, director of a hospital ICU market, said Ms. Fan has just admitted to a hospital city, showed difficulty in breathing, unconsciousness day. Since Ms. Fan continuous days of fever, severe pneumonia symptoms, admitted to ICU after the treatment. However, symptomatic treatment of respiratory diseases is not obvious, the hospital immediately organized a Department of Respiratory Medicine, Infectious Diseases and other expert consultation.

Consultation process, the infection specialist found that Ms. Fan has a perineal eschar, combined with low number of platelets results of laboratory tests and the symptoms eventually diagnosed as scrub typhus, pulmonary, blood, liver, heart, kidney and many other dirty device failure.

"We generally believe that two organ failure, the cure rate is 70%, three organ failure, the cure rate is 50%, four organ failure, the cure rate is 30%, 5-organ failure less than 10% cure rate." Zhou Lixin said , Ms. Fan severe scrub typhus due to the merger more than five organ failure, Ms. Fan Group believes that the cure rate is very low.

Zhou Lixin told reporters that all admitted to the ICU each year the number of cases of severe scrub typhus cases, deaths every year, between spring and summer of this year have been deaths.

Case 2: South China Sea in an old people died of multiple organ failure

Recently, the network spread "Nanhai Luo village, an elderly tick bite is fatal incident" yesterday, said the health sector and the South China Sea area, the patient died of multiple organ failure, and hospitals tick rule is coccidiosis, in connection with the scrub typhus.

Week after onset

In-law Miss Feng Yin Tse described on September 2 and 7 am, Macabeo fever Services Zhuang Weisheng station to treatment, doctors diagnose fever 38.5 ℃, opened some medical back.

But over the past two days, fever and did not back down, but the swollen face up. September 5 at noon, took her to the Red Cross Hospital, Nanhai District, on the back to the village playing Diaozhen.

Yin Tse home in the evening, the situation is not improved, fever, occasional cough. 6 September morning, she once again came to the South China Sea Area Red Cross Hospital clinic, blood and urine tested, of which only 39 platelet levels (100 to 300 normal).

The morning of September 7, within the Yin Tse worse condition, fast heartbeat, panting, his face plainer. ECG in the hospital, "tachycardia, heart failure and so on," the doctor recommended hospitalization. At 4 o'clock on the September 8, Xie Yin was transferred within the ICU, the doctor on duty the day after careful inspection and found a wound on his neck, black block, like a big thumb. The doctor said, "is to be insect bite wound."

9, at 8 o'clock, the doctor declared no hope of rescue. 9:20, back to the village within the Yin Tse immediately declared dead.

The suspected scrub typhus

Red Cross Hospital, according to the South China Sea within the Yin Xie final diagnosis showed: "1, respiratory and cardiac arrest; 2, multiple organ failure; 3, metabolic acidosis; 4 thrombocytopenia; 5, scrub typhus?" this "final diagnosis" in the fifth item "scrub typhus", hit a question mark. Walker responded that the vice president, said Yin, an integrated clinical performance, determine patients died of multiple organ failure, the hospital suspected of scrub typhus, but you can rule out the possibility that ticks echinococcosis.

Yesterday afternoon, the South China Sea Area CDC involved in the incident, the South China Sea area to the Red Cross Hospital for the transfer of the deceased, the diagnosis and treatment information. Relevant person in charge responded, scrub typhus and tick-borne disease is not infectious disease reporting law. Nanhai District, sporadic cases reported every year, scrub typhus (no clustered cases reported), but severe cases rarely occurs.

Yin Walker told the South China Sea every year, the Red Cross hospital admissions were cases of tsutsugamushi bite, is very common. But Tse Yin is unique within, soon after the onset of multiple organ failure, is encountered in the hospital the past few years the most serious cases.

To the bamboo forest before the onset of firewood

Miss Feng family members said at first, they suspected to be tick insect bite, but the hospital, suspected chigger insect. According to family members to reflect, Xie Yin within a few days before the onset of illness had a small bamboo forest collecting firewood to a neighboring village, where they suspect is bitten.

Warning: the prevention and control of scrub typhus

Yesterday afternoon, the City Center for Disease Control issued through the newspaper, "tsutsugamushi disease prevention and control" of the early warning.

First, what is scrub typhus?

Scrub typhus, also known as scrub typhus, is caused by the Rickettsia tsutsugamushi natural foci of disease. Rickettsia sojourn in chigger mites, and by egg passage. Chigger mite larvae need to learn from people or animals from the lymph or blood to complete the development of insect larvae to the juvenile process.

Chigger mites live in the warm, moist, brush the edge of wilderness areas and lakes flat sides. People who might be infected chigger bites sick. The disease mostly distributed in the local pop occasionally.

Second, main symptom

Incubation period of 5 to 20 days, usually 10 to 14 days. The main clinical features of sudden onset, fever, bite with eschar or ulcer, swollen lymph nodes and rash. Each patient had severe delirium, listen to, altered mental status and neurological symptoms such as growth or slow heart rate, microcirculatory disorders and other symptoms of the cardiovascular system.

Third, how people infected with scrub typhus?

Of human infection with scrub typhus infection in rodents mainly through access to Rickettsia chigger bite of infected larvae. Rodents is the main source of infection of scrub typhus and storage of the host.

Fourth, the prevention of scrub typhus?

Since the breeding of rodents and tsutsugamushi, reproduction by climate and geographical factors, significant seasonal prevalence of scrub typhus and regional. 10,11 high season on the north, south, then a 6 ~ August for the popular peak in November decreased. At present, the disease is in epidemic seasons, to remind the public attention to prevention:

1, elimination of sources of infection, mainly rodent.

2, spraying, remove chigger mites breeding environment. Such as the eradication of weeds around the home, transforming the environment, eliminate chigger breeding ground is the most fundamental measures. Fieldwork in endemic areas, the first while spraying, weeding and then after the operation.

3, good personal protective measures. ① avoid lying or sitting on the grass in the stream to avoid weed shrub on dry clothes. ② outdoor activities in endemic areas, should be fastened cuffs, collar and trousers mouth, rubbed on exposed body parts of mosquito repellent.

Clear up doubts: diagnosis of scrub typhus needs 5 ~ 7 days

Miss Feng said, ICU doctors have pointed out that the wounds are Macabeo tsutsugamushi bite, and this situation is common in the rout. And let her understand is that since it is a universal phenomenon, why the patient in the hospital from the patients do not find out the cause?

Reporter also noted that the deceased Miss Fan Sanshui from July until after the onset in mid-September 2nd city into a hospital, although the Sanshui hospital treatment days, but has not confirmed the cause.

Yin Hua Ketan words, the more hidden parts of tsutsugamushi bite, eschar (or ulcers) is difficult to find patients with a history of complaining is not clear, it is easy to be misdiagnosed and treated as a normal fever treatment.

Zhou Lixin also known, the location of tsutsugamushi bites generally more subtle and difficult to find, and diagnosis of scrub typhus usually takes 5 to 7 days, as the first week's performance is not obvious. He said the symptoms of scrub typhus is mainly sustained days of fever, hepatosplenomegaly, heart rate increased, white blood cells, thrombocytopenia. Odoriferous parts, such as perineal, axillary positions, such as found in eschar.

"The earlier the earlier the treatment of scrub typhus, the better." Zhou Lixin, once people realize that the days of high fever and their continued, and had recently come into contact with wet grass, swamps, etc., or through insect bites, there uncomfortable, there are scars on the skin, it should be immediately to the hospital, and take the initiative to tell the doctor-related contact history.

Saying: mild scrub typhus mortality was zero

City Luo Hongtao, director of a hospital infection that scrub typhus in the humid, hot in the south is more common in the winter or occasional cases reported in northern regions.

Luo Hongtao, said the initial stage of scrub typhus epidemic in the liberation and a higher mortality rate. To the last century 80's, the scrub typhus epidemics and severe tsutsugamushi disease mortality was 70%. 80 on the last century began to analyze a large number of scrub typhus cases found that cases occurred with the liberation is different. As the two periods of pathogens carried by different tsutsugamushi, scrub typhus after a phase can be combined to show the characteristics of multiple organ failure, therefore, higher death rate.

Chigger mites live in the grasslands, swamps and other wet areas, carrying the bacteria bites chigger larvae of the human body, the bacteria spread to the human body, "it had a couple in love sitting grass, while infected with scrub typhus cases."

"The mild scrub typhus good prognosis, primary hospitals can cure the disease. However, scrub typhus and severe multiple organ failure, then death rates will be high." Luo Hongtao said she had studied 96 cases of severe scrub typhus and analysis, more than three organ failure in people with severe scrub typhus, the mortality rate 90%.

Luo Hongtao said that, overall mortality rate of scrub typhus is about 0 to 40%, mild scrub typhus mortality rate was 0, severe scrub typhus patients with multiple organ failure, mortality rate of 80%. The treatment of scrub typhus in the principal drug chloramphenicol, the effect is obvious with this drug.

Luo Hongtao, said the First Hospital of Infectious Disease, more cases of scrub typhus were treated each year, has treated more than 10 cases this year, but no sign of increase in cases.

Feelings Hotline: Prevention of scrub typhus

Recently, several cases of scrub typhus consecutive city. At noon yesterday, a family of scrub typhus who had just been received from the hospital to die. According to the First Hospital ICU, infection specialists, said scrub typhus in the hot, humid south quite common to many cases of admissions every year, and deaths each year.

In the end, tsutsugamushi what? Where it is in the end of life? Tsutsugamushi what people like to bite site, What are the symptoms after the bite? Why small tsutsugamushi after the bite of death? Scrub typhus in the end should be how to prevent? Many members of the public mind full of doubt.

Tomorrow, the newspaper "feelings hotline" network of co-Guang city, invited the city three experts, to answer readers call to answer all of the doubts of tsutsugamushi and scrub typhus.

Time: 9 月 17 日 (星期五) 9:30 ~ 11:30

Feelings Hotline: 83808380

Invited guests:

1, Municipal Center for Disease Control Disease Control Section, Jane Wu

2, City Luo Hongtao, director of a hospital infection

3, City Second Hospital, Zou Ming-chao, director of infection

(On the fly-yang Li Feng Bao-Zhi)

Source: "Foshan Daily"


http://gd.people.com.cn/GB/123937/123963/12743084.html
 
Re: China - Foshan CDC Issues Warning on Scrub Typhus - 2 dead - Guangdong province

Re: China - Foshan CDC Issues Warning on Scrub Typhus - 2 dead - Guangdong province

Seems like a rodent problem. Where are the natural predators of rodents - cats?

Also please see this thread:

China - Henan/Shangdong Province: Unknown disease kill 31 - 33, possibly a new Bunyavirus carried by ticks

http://www.flutrackers.com/forum/showthread.php?t=152202
 
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