PLAGUE, PNEUMONIC - CHINA (06): (QINGHAI), WHO

Date: Tue 11 Aug 2009
Source: WHO Outbreak Reports [edited]
<http://www.who.int/csr/don/2006_08_11/en/index.html>


On 1 Aug 2009, the Ministry of Health (MoH), China reported a cluster
outbreak of pulmonary plague cases in the remote town of Ziketan, Qinghai
province. The 1st case was a 32 year old male herdsman, who developed fever
and hemoptysis on 26 Jul 2009. He was referred to a hospital but died en
route, and was buried the following day. On 30 Jul 2009, 11 people who had
close contact with the case (mainly relatives who attended the funeral)
developed fever and cough, and were all hospitalized. On 1 Aug 2009,
specimens taken from all these 12 people, including the 1st case, tested
positive for plague.

On 2 Aug 2009 both the 64 year old father-in-law of the index case and a 37
year old male neighbor of the 1st case (who helped to bury the corpse) also
died. Of the remaining 9 cases, one is in critical condition, one had acute
symptoms of fever and cough, and 7 are in stable condition.

As of 6 Aug 2009, the local health authority has isolated 332 close
contacts for further medical observation, and implemented traffic control
around the affected area. Experts on both disease prevention and control
and clinical management have been dispatched to Qinghai province.
Protective clothes, X-ray machines and other medical equipment have been
sent to the affected area. Prevention guidance pamphlets have also been
disseminated.

According to the epidemiological investigation, the source of this outbreak
was a wild marmot, which had contact with the dog of the index case.
Ziketan is in an area of natural plague bacteria circulation amongst
animals and at the present time it is the active season for plague
transmission amongst animals. No drug resistance of the bacterium has been
found so far and the 3 death cases have been attributed largely to delayed
treatment.

China has established a national surveillance network for plague, and has
prepared necessary supplies in high-risk areas. After this outbreak,
special funds, supplies and experts were quickly dispatched to the affected
area.