Ye Zhenzhen covered her stuffy chest, feeling that she was really a little bit of altitude sickness.

Within a few hours, many people will experience altitude sickness from the low-altitude eastern cities to this highland pasture at an altitude of 4,000 meters.

In order not to affect the trip to M Village, Zhen Zhen endured the feeling of tightness in her chest, cheered up, and said with a smile: "I'm fine, I can ride a horse, I coughed just now, and I was also shocked, but I didn't expect that there was still a place where there was no car." ”

Seeing the smile on Zhen Zhen's face and her good spirit, Nan Zhiqiao's nervous mood slowly relaxed, and she talked about her previous experience in Tibet, "Tibet is a vast territory, and it is normal for many herders to move between summer pastures and winter pastures according to the seasons, and ride horses for three or four hours from one pasture to another. ”

Lao Zhao pointed to a wooden house not far away, "There is a transit station, from where you can ride a horse to M Village." ”

Lao Zhao looked at Zhen Zhen hesitantly, then looked at Nan Zhiqiao, and asked, "Can my brother and sister ride a horse?"

"Yes. When she was in school in Xinjiang, she learned to ride a horse, and later came to work in Beijing, and she would also go horseback riding with Nan Zhiqiao.

"Okay, it takes three hours to ride a horse from here to M Village, Director Nan used to ride horses through the plateau pastures here, and my younger siblings are here for the first time, can you stand it?" Lao Zhao saw that Zhen Zhen was a thin little girl, and she coughed and had chest tightness just now, and couldn't help but worry.

"It's okay, I'm the same as Mr. Nan. Although Lao Zhao said it out of concern, he felt that he was being said to be a burden, and Zhen Zhen immediately said that she didn't need to take special care of herself.

The stubborn tone made Lao Zhao stunned.

Lao Zhao smiled and changed his name, "Okay, Teacher Ye, Director Nan, let's go." ”

——

Riding a horse and galloping in the plateau pasture, the blue sky and white clouds overhead, the green grass under the feet, and the snow-capped mountains in the distance.

The three of them rode across a shallow river, crossed a high slope, and saw multicolored prayer flags in front of them.

Lao Zhao at the front lowered his speed, held the reins with one hand, and pointed to the colorful prayer flags in front of him with the other, "It's almost here, it's ahead." ”

Ahead, the multicolored prayer flags on the herdsmen's tents flutter in the wind, and tents of different colors and shapes are scattered among the blue grass.

Two of the white medical tents stand out.

The three dismounted and entered a medical tent.

These medical tents were improvised by medical teams who had come here to investigate the outbreak.

Because before coming here, Lao Zhao had already greeted the investigation team here, and the others were not surprised to see the three people who suddenly appeared, and after a brief introduction, the investigation team directly reported the latest investigation progress to Lao Zhao.

The investigation team consisted of three on-site investigators sent by the county CDC and two doctors from the local health center.

One of them, a man in his thirties, was the leader of the first batch of investigation teams and a staff member in charge of the on-site investigation of the L County Disease Control and Prevention.

Dorjee is black and strong, and speaks Mandarin with a serious local accent, "In the past two days, our investigation team has visited 37 households in Village M, with a total of 232 people. Since March 1, 15 probable cases have been found, all Tibetan herders, spread across five households. ”

Dorjee was about to continue to talk about the specific situation of the case, when Nan Zhiqiao suddenly interrupted and asked, "How is the related case defined this time?"

Duo Ji was stunned for a moment and looked at Lao Zhao.

Lao Zhao explained on behalf of Dorjee: "Since none of the seven deaths went to the hospital and there were no laboratory data, the definition of the case could only rely on clinical manifestations. After discussion between the autonomous region's CDC and the county CDC investigation team, the search case was defined as a patient with fever in and around M Village since March 1 this year. ”

Lao Zhao made another gesture to Dorjee and motioned for him to continue explaining.

Dorjee picked up a paper questionnaire from the table in the corner of the medical tent, put it in front of Nan Zhiqiao, and explained: "The cases found in this search are divided into three levels: first, suspicious cases, in and around M Village, since March 1 this year, patients who have reported having a fever;

The second is a probable case, in the village of M and its vicinity, since March 1 this year, patients with fever, headache, cough, sputum production, and blood in the sputum;

The third is to confirm the case, in the village of M and its vicinity, since March 1 this year, patients with acute fever, headache, cough, sputum, and blood in the sputum, plus specific laboratory testing basis. ”

Dorjee put a few more forms in front of Nan Zhiqiao and continued, "After two days of investigation, it was found that since March, there have been 15 possible cases related to this incident.

One of the suspected cases, a 30-year-old male, reported that he had fever, runny nose, runny nose, cough and other symptoms on March 5, and the symptoms disappeared after one week.

The information on the possible cases is in the form you have in hand. ”

Nan Zhiqiao looked down at the table, and Ye Zhenzhen also came to the front, and at the top of the form was written "List of possible cases of unknown diseases in M Village in a certain year".

The form is marked with the household number, the name of the head of the household, the name of the case, gender, age, interrelationship, time of onset, and time of death.

In addition to the descriptive language, there is also a map of the onset time distribution, everything is done professionally.

Zhen Zhen sighed in her heart, it seems that this Dorjee has also undergone professional training in abortion investigation, and the questionnaire is very beautiful.

While Nan Zhiqiao and Zhen Zhen were looking at the questionnaire, Dorjee continued: "None of the 15 patients had a history of eating common food, and there was a river between the summer pasture and the winter pasture in Village M, and all the people and animals in the village took water from this river, and no livestock deaths were found in the village.

The patient was not found to have been exposed to toxic chemicals before the onset of illness, there were no chemical factories in the local area, and the climatic and environmental conditions were consistent with those of previous years. ”

Nan Zhiqiao nodded slightly, motioning for Dorjee to continue.

Dorjee concluded: "The cases in this incident have common clinical manifestations: sudden onset of fever, headache, cough, sputum production, and blood in the sputum. There are special manifestations of infectious diseases: high fever, severe pain, systemic poisoning symptoms of body aches, respiratory symptoms of cough, cough and cough of bloody sputum.

Characteristics of the disease: rapid progression of the disease and high case fatality rate.

Clustering characteristics: Gathering of family relatives.

Characteristics of the location of the disease: in the steppe pastoral area.

Occupational characteristics: All the patients are Tibetan herders. ”

After Dorjee finished speaking, he quietly looked at Nan Zhiqiao and Zhen Zhen who came from the national disease control, and saw that the two of them did not react much, and turned their eyes to Lao Zhao again.

Lao Zhao answered: "According to the idea of the hypothesis of the etiology of unexplained diseases, what are you considering the etiology?"

Dorjee: "Our investigation team initially considered it to be an acute infectious disease: a suspected outbreak of pneumonic plague, a suspected outbreak of pulmonary anthrax, and possibly other uncommon acute infectious diseases. ”

Before getting the lab test results, what Dorjee said was just speculation.