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A ProMED-mail post
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International Society for Infectious Diseases
[1]
Date: Wed 5 Aug 2009
Source: Xinhua News Agency [edited]
As of late Tuesday [4 Aug 2009], 12 cases of pneumonic plague have
been confirmed in Xinghai County in the Hainan Tibetan Autonomous
Prefecture of northwest China's Qinghai Province. The cases include 3
deaths, 1 near death, and 1 in serious condition. The others are stable.
Local government has sealed off and quarantined the town of Ziketan,
the source of the outbreak and provincial health authorities have
deployed a team of experts to the area. There has been no report of
new infections.
At present, 218 people are quarantined in hospital, and 115 of them
had been in close contact with those infected. Local authorities have
handed out more than 40 000 leaflets and disks on plague prevention.
--
Communicated by:
ProMED-mail
******
[2]
Date: Tue 4 Aug 2009
Source: The Associated Press (AP) [edited]
Residents of a remote farming town in western China said Tuesday [4
Aug 2009] people were seeking to flee in defiance a lockdown by
authorities to prevent the spread of highly infectious pneumonic
plague, which has claimed 3 lives in the area.
Police have set up checkpoints around Ziketan in Qinghai province, a
town of 10 000 people, which has been put under quarantine after at
least a dozen people caught the lung infection, which can kill within
24 hours if untreated.
Some people tried to leave the quarantined area Monday evening [3 Aug
2009], mostly by foot, after the 3rd death was reported, 2 residents
reached by The Associated Press said. Most of the town's residents
are Tibetan herders of yaks, sheep, and pigs.
"A lot of people ran off last night when they heard that another
person died of this plague. They are mostly from other provinces,"
said a food seller who runs a stall at the Crystal Alley Market.
"They headed back home with food, water, and their donkeys."
Medical workers in Ziketan were disinfecting and killing rodents and
fleas that can be carriers for the bacteria that cause the plague,
according to a notice on the provincial health department website.
A Tibetan woman, a migrant construction worker from another village
in Qinghai, said there were very few people on the streets. "I've
heard the migrant workers who build projects went home last night [3
Aug 2009]," she said by telephone. "My boss told me that more than 50
of the 100 construction workers on our project left homes already."
It was unclear if the people who headed out of the town made it past
the police checkpoints, which residents say have been set up in
17-mile (28-kilometer) radius around Ziketan, which lies more than
300 miles (480 kilometers) west of Beijing.
The outbreak in Ziketan was first detected Thursday [30 Jul 2009],
although it isn't clear when the 1st victim died. The official Xinhua
News Agency said the latest victim was a 64-year-old man, a neighbor
of the first 2 fatalities, described in reports as a 32-year-old
herdsman and a 37-year-old man. The herdsman fell sick after burying
his dog, which had died suddenly, according to a report by the
official China National Radio, citing a hospital official. He died 4
days after the dog's burial and the relatives who handled his funeral
were showing symptoms within days, the report said.
Those relatives were among a further 9 people who are infected and in
a hospital, according to the local health bureau. One is in extremely
serious condition and another has developed symptoms of coughing and
chest pain, but the rest are in stable condition, Xinhua and the
health department said.
China has had cases of plague before. WHO said in a 2006 report that
most cases in China's northwest occur when hunters are contaminated
while skinning infected animals. In 2004, 8 villagers in Qinghai
province died of plague, most infected after killing or eating wild
marmots, creatures related to gophers and prairie dogs.
[Byline: Henry Sanderson]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[It is now clearly stated that pneumonic plague has occurred in all
12 individuals, 11 of whom were exposed to the index case. It is not
stated how soon antimicrobial therapy was begun in the affected
persons. It is generally said (1) that treatment of primary plague
pneumonia (primary here means acquired via the respiratory route)
should be begun once of the diagnosis is suspected since a delay of
more than 18 hours produces a very high mortality rate. It is also
not stated whether antimicrobial prophylaxis is being used in the 115
individuals who had been in close contact with the cases.
Reference
---------
1. Oyston PCF, Titball RW: Plague. In, Beyond Anthrax. The
Weaponization of Infectious Diseases. (Lutwick LI, Lutwick SM, eds),
Humana Press, New York, 2009, 55-76. - Mod.LL]
[Ziketan town can be located on the HealthMap/ProMED-mail interactive map at
[see also:
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
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