Re: Tibet: outbreak of pneumonic plague
http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85020
Archive Number 20100926.3490
Published Date 26-SEP-2010
Subject PRO/AH/EDR> Plague, pneumonic - China: (Tibet Autonomous Region)
PLAGUE, PNEUMONIC - CHINA (TIBETAN AUTONOMOUS REGION), REQUEST FOR INFORMATION
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[1]
Date: 26 Sep 2010
Source: Sydney Morning Herald / AFP
<http://news.smh.com.au/breaking-news-world/plague-breaks-out-in-chinas-tibet-20100926-15s6z.html>
Plague breaks out in China's Tibet
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China issued a health alert in its southwestern region of Tibet after
5 people were diagnosed with the plague, an often fatal infectious disease.
One of the 5 has already died from a severe lung infection attributed
to the pneumonic plague, while one other patient was in a critical
condition, the Tibet health department said in a statement on its
website on Sunday [23 Sep 2010].
The outbreak was 1st detected on Thursday [23 Sep 2010] last week in
Latok village in Tibet's Nyingchi Prefecture, the department said.
The four patients, all of whom had contact with the deceased, have
been quarantined, it said.
Disease control experts have been dispatched to the area in an effort
to control the further spread of the disease, it said.
The department also issued a warning to anyone who has visited the
region near the outbreak to seek immediate medical attention should
they develop fever, cough or other flu-like symptoms common to the plague.
Pneumonic plague is spread by rodents like marmots, which are
numerous in Tibet.
An outbreak of the disease last year killed 3 people in Ziketan, a
town in a Tibetan area in neighbouring Qinghai province.
The World Health Organisation says pneumonic plague is the most
virulent but least common form of plague. The mortality rate can be
high, but prompt antibiotic treatment is effective.
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Communicated by:
ProMED-mail Rapporteur Dan Silver
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[2]
Date: 26 Sep 2010
Source: Google News
<http://www.google.com/hostednews/ap/article/ALeqM5gNB9Xgm6lYfNj0MNcHGtToMb2xPAD9IFE5000>
5 infected with deadly pneumonic plague in Tibet
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Chinese authorities say 5 people have been sickened with pneumonic
plague in Tibet and that the deadly disease has killed one of them.
The Tibetan regional health department says the cases were reported
in Laduo, a village in Lang county in the remote region.
The department said in a statement Sunday [26 Sep 2010] that the 1st
case was found [23 Sep 2010] and that the patient died of a severe
lung infection. The remaining 4 people have been quarantined.
The disease can kill in as few as 24 hours if left untreated.
Last year, an outbreak of the disease in a farming town in Qinghai
province killed three people and sickened nine, prompting authorities
to seal off the community of 10,000 people for more than a week.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[Borrowing from Mod.LL's comment associated with the prior outbreak
of plague in Qinghai China in 2009 (see Plague, pneumonic - China:
(QH), RFI 20090801.2702), "Primary pneumonic plague (one percent of
natural plague presentations) arises as a result of inhalation of
plague bacilli in infectious aerosols, such as would be produced when
there are secondary pneumonic complications in bubonic/septicemic plague.
Primary plague pneumonia has a short incubation period of 1-3 days,
after which there is sudden onset of flu-like symptoms including
fever, chills, headache, generalized body pains, weakness, and chest
discomfort. A cough develops with sputum production, which may be
bloody, and increasing chest pain and difficulty in breathing. As the
disease progresses, hypoxia (low oxygen concentration in the blood)
and hemoptysis (coughing up blood) are prominent. The disease is
invariably fatal unless antimicrobial therapy commences within 24
hours of exposure.
Patients with primary pneumonic plague generate large quantities of
infectious aerosols that pose a significant risk to close contacts.
CDC (US Centers for Disease Control and Prevention) guidelines
identify contacts within 2 meters (6.5 ft) as being at greatest risk
and do not consider the organism likely to be carried through air
ducts or vents. Persons who have been in contact with pneumonic
plague patients or handling potentially infectious body fluids or
tissues without appropriate protection should receive preventive
antimicrobial therapy. The preferred antimicrobial agents for
prophylaxis are tetracyclines, quinolones, or chloramphenicol.
Of note, in June 2005 there was an outbreak of plague in the Tibetan
Autonomous Region involving 5 individuals. An association with
handling marmots for consumption was attributed as the vehicle for
transmission. At that time the reports did not specify the form of
plague (bubonic vs pneumonic) but with the implementation of
quarantine measures, it was hypothesized that there were pneumonic
manifestations. (see Plague - China (Tibet) 20050626.1798).
More information on this outbreak from knowledgeable sources in the
region would be greatly appreciated.