Early summer.

Lianhai City, located by the sea, is gradually rising in temperature.

Dawan Village, 200 kilometers west of Lianhai City, is located in the basin in the center of the Yuntai Mountains, and the temperature is exceptionally high.

Located in the middle of a small basin, Dawan Village is very low, and there is a winding mountain river in front of the village, from which the name Dawan Village is derived.

Dawan Village is located in the middle of nowhere, more than 30 kilometers from the nearest town, and a road that opened a few years ago connects Dawan Village to the outside world.

The highway is located in a steep mountainous area, known as the "Eighteen Pan", usually the villagers buy daily necessities in the small shop in the village, some important daily necessities, but also have to travel 30 kilometers to the town to buy.

Uncle Li's family, who lives in the east of the village, just had a little grandson last year, and the little grandson turned one year old in the early summer of this year.

Seeing that it was summer, Uncle Li felt sorry for his little grandson, so he went to the town to buy some baby products, such as diapers, milk powder, talcum powder, shower gel, baby food and the like.

The weather is gradually getting hotter, and the little grandson is weaned, and the milk powder and baby food that Uncle Li bought come in handy.

5 meals of milk powder a day, two meals of supplementary food, and the little grandson was fed for nothing.

As the weather gets hotter and hotter, the little grandson has problems that other little babies often have in summer, and there are a lot of red spots on the little buttocks.

At first, the whole family thought it was because of diapers, the weather was too hot, and the baby was fat.

Aunt Li asked her daughter-in-law to bathe the baby and rub talcum powder all over her body, and increase the frequency of changing diapers.

After a day, the red spots on the little grandson's buttocks not only did not lessen, but became heavier and heavier, and some places had begun to blister and break the skin.

That night, the little grandson began to have a fever and vomit and could not eat anything.

The baby cries incessantly, and the mother holds the baby in her arms all night.

At around 2 a.m., the baby's crying gradually became quieter.

Just when the whole family thought that the baby's condition was starting to improve, they found that he had a fever of 39 degrees and could not wake up.

The child fell into a coma.

The family rode a tricycle overnight to take the baby to the town's health center.

Doctors at the health clinic examined the child and found that he had a fever and coma, and his first reaction was meningitis caused by certain bacteria.

Blood was drawn first, and antibiotics were given immediately according to experience before the results came out.

The results of the blood test came back quickly and there was no bacterial infection.

Antibiotics have no effect.

The condition of the little baby was getting worse, and the doctors at the health center were helpless and recommended a transfer.

——

Lianhai First People's Hospital, Department of Neurology.

Uncle Li's youngest grandson, Li Lele, was transferred from the local health center and placed in the neurology ward.

Zhang Jianzhong, director of the Department of Neurology, as the attending doctor, arranged a series of examinations for Li Lele.

Blood test, urine test, cerebrospinal fluid test, brain CT, whole body MRI, infectious bacterial, virus, and parasite tests for various diseases......

No other cause was found than brain edema, and the cause of brain edema is unknown.

In the end, only a temporary diagnosis of "encephalopathy of unknown cause" could be made.

The cause could not be found, and the director of the neurology department decided to apply for a hospital-wide expert consultation.

——

The First People's Hospital of Lianhai City, large conference room.

Specialist consultation.

The doctors who participated in the consultation were all big bulls in various departments of the hospital, and Gu Jiashu sat in it.

The doctors sat around the round table of the conference, each holding a copy of Li Lele's medical records.

Zhang Jianzhong, director of the Department of Neurology, introduced Li Lele's condition, "The child was transferred to the Department of Neurology of our hospital from the local health center, and the physical examination on admission found that there were erythema on the buttocks, blisters and broken skin, and a fever of 38.6.

Neurological symptoms include stress disorder, drowsiness, and now in a coma.

The various examinations in the laboratory are in the medical record, and you can refer to them. ”

A doctor expressed his opinion, "The CT result of the patient's brain shows that the brain has edema, could it be Creutzfeldt-Jakob disease?" ”

Creutzfeldt-Jakob disease is a contagious disease, and everyone looks like Gu Jiashu, the head of the infectious disease department.

Gu Jiashu has been in charge of treating Creutzfeldt-Jakob patients and is familiar with this disease.

Gu Jiashu: "The CT of the patient's brain can't be seen, and the diagnosis can't be made, Creutzfeldt-Jakob disease needs a certain transmission route, the patient belongs to an infant, has not had surgery, and the surgical transmission can be ruled out, and then we have to see if he has been exposed to food with prions, of course, the final diagnosis requires laboratory tests, I will contact the CDC to do a pathogenic protein test." ”

"Could it be some rare viral or bacterial infection?"

"It's possible, but blood tests show a small chance of bacterial infection, and broad-spectrum antibiotic therapy is not effective."

"Could it be poisoning?"

"It's also possible, but to know what kind of poison is caused by it, this amount of investigation is very large, and the laboratory is investigating some related common poisons, and it will take a while to get results."

At the end of the whole expert consultation, no possible cause was found, so we could only continue symptomatic treatment.

——

Lianhai Center for Disease Control and Prevention, Emergency Office.

It's almost noon time to get off work, and the people in the office are discussing the issue of lunch again.

Gu Yanan remembered that her brother had asked her to have dinner before, but she pushed her away because of something, but now she has time, so she called.

"Brother, do you have time at noon? How about you go to the boiled fish shop on the street next to your hospital for dinner? ”

"Okay, but there's something I want you to help with before we eat."

"Huh? No, your parents will force you to go on a blind date again, you let me make an idea, right? ”

"Of course not, it's business, I just participated in a consultation, a small patient was admitted to the neurology department of our hospital, and the cause was not found in various examinations, and the preliminary diagnosis was unexplained encephalopathy, and some doctors suspected that it might be Creutzfeldt-Jakob disease, and wanted your disease control to help do pathogen prion testing."

"No problem, I'll say hello to my colleagues in the laboratory of the laboratory department, you send someone to send the patient's cerebrospinal fluid specimen, as for filling in the information on the online reporting system, fill in the suspected Creutzfeldt-Jakob disease patient first, and we will accept it here."

"Okay, I'll send someone to send the specimen over now, and I'll wait for you directly at that boiled fish shop in 20 minutes."

——

Boiled fish shop.

When Gu Yanan arrived, he found that his brother Gu Jiashu was already sitting by the window, ordering the dishes, the boiled fish had been served, and there were two cups of freshly squeezed pomegranate juice.

"Brother, you're so fast, the dishes are on the table, and my favorite pomegranate juice."

"It's not that the old brother is fast, it's the boss who is fast, I have booked a table with the boss and ordered good dishes before I came, because it is the early summer season, and there are no fresh pomegranates in the store, or the cold storage stock pomegranates I bought from the fruit supermarket next door, and brought them to the store for the boss to squeeze the juice."

"It's still my brother who is good to me."

"I know that my brother is good to you, but I don't often go to dinner with my brother? Now it's hard for me to even see you, you're either busy with work or dating, and you don't have enough time to meet your brother. ”

"Brother, where do I have time to be busy with dating now, I don't have enough working time?"