Qingcheng County People's Hospital.

In the ward of a patient suspected of being infected with anthrax.

The four hospitalized patients were placed in two wards, and in one of them, Gu Yanan and Section Chief Li of the county disease control were checking the patient's symptoms.

Four patients, two of whom had swollen ulcers on both hands and had developed black eschars.

This is a typical symptom of cutaneous anthrax.

The doctor who received the patient also showed the results of the initial examination of the hospital to the CDC.

The hospital stained the blood sputum coughed up by the patient, and many purple-red stubby bacilli could be seen under the microscope, arranged in a bamboo shape, which is also the typical microscopic form of Bacillus anthracis.

Judging from the clinical symptoms and laboratory morphological test results, the infection of Bacillus anthracis can be preliminarily determined.

Because the patient was diagnosed with anthrax symptomatically, the attending physician had already started antibiotic therapy for four patients.

The patient was in good spirits and able to answer, and Gu Yanan began to ask some epidemiological questions.

"When did you start feeling uncomfortable?"

"I had a little cough last night, blistered on my hands, and this morning I got up with a severe headache and a high fever, so I called 120, and it was the ambulance that brought us over."

"You live together?"

"Well, we all live in the site dormitories."

There is a collective outbreak in the dormitory of the construction site, and it appears that there is a common source of infection.

"How many of your roommates are there?"

"There are three more, but they didn't stay in the dormitory last night, they went back to their home in Qingchuan County, and we also have a captain, who usually stays in the dormitory occasionally, and most of the time is home, and he didn't have a dormitory last night."

"Do you know their addresses?"

"Yes."

"Write us the address in a moment."

"Did you have any exposure to wild animals before you became ill? For example, rabbits, wild foxes, mice, etc., or have you never touched the cattle and sheep raised by the surrounding farms? ”

"Before we went in to work, the weeds and trees on the road had been cleared, there was no wildlife, and there were no farms around."

Another worker in the same ward suddenly added, "There are wild rats around our dormitory, I have seen them, but I have not touched them, and the wild rats have run away when they see people." ”

Unable to ask for more clues, Gu Yanan decided to go to the construction site where the patients used to work.

After getting the address of the construction site and the address of the roommate, the city disease control team and the county disease control team are preparing to act separately.

Suddenly, the sound of an ambulance's horn pierced the silence of the hospital, and another emergency patient arrived.

At the door of the emergency room, Gu Yanan saw a young man covered in bruises and bleeding from his mouth and nose being carried off the ambulance.

With such obvious bruising and bleeding symptoms, isn't it another case of pulmonary anthrax?

Gu Yanan followed the patient into the emergency room, and the ambulance was accompanied by the patient's family member, a young woman in her 20s.

Gu Yanan wanted to follow up on the patient's situation, but there were also people at the construction site and other workers' homes to investigate, so Gu Yanan reassigned tasks to everyone.

Zhou Lao and Gao Fei went to the construction site to have a look, focusing on inspecting the workers' dormitories and the surrounding environment, collecting specimens, especially soil samples nearby, and trying to catch a few wild animals if there were any.

Lu Li, Wang Xiaoxiao and Section Chief Li of the county disease control went to the homes of workers living in the county seat to investigate and see if the workers and their families of the construction team had similar symptoms.

Xiao Chu stayed with me in the county hospital to follow up on the previous 4 patients and the new patients just now. ”

Everyone immediately began to split up.

——

Qingcheng County People's Hospital, emergency room.

The emergency doctor looked at the condition of the newly arrived patient, his whole body was bruised, his mouth and nose were bleeding, and there were blisters on his hands, some of which had begun to break and scab.

The symptoms are exactly the same as the four patients sent before.

With previous diagnostic experience, doctors know what to expect.

Things are going in a bad direction, and new anthrax patients are being brought in.

The emergency doctor hurriedly instructed the other doctors and nurses around him, "Everyone wear gloves and masks, do not touch the patient's vomit and body fluids, and send the patient to the isolation ward." ”

Seeing the patient being pushed into the temporarily vacated isolation ward, the patient's family was anxious.

"Why not rescue in the emergency room? Why go to an isolation room? What exactly is my husband's illness? Is it contagious? ”

The doctors were busy doing various examinations for the new patient and disinfecting the place where he had stayed, and they didn't have time to explain to the family, and in a blink of an eye they saw Gu Yanan hanging a disease control work card, so they pushed the patient's family to Gu Yanan's side and said, "It just so happens that the disease control person is investigating this infectious disease, and she will ask you questions." ”

Gu Yanan did want to ask the patient's wife some questions.

The patient's wife looked at Gu Yanan with a questioning expression, and finally fixed her eyes on the work card on Gu Yanan's chest, which had the logo of the CDC and Gu Yanan's name.

"Doctor Gu, what is my husband's disease?" Patient's wife questioned.

"Doctors are doing tests, but based on the symptoms, anthrax infection is highly suspected."

"Anthrax?" Judging from the expression of the patient's wife, she did not know what kind of disease anthrax was, "Is anthrax serious?" ”

"Anthrax is a Class B infectious disease in China, but the pulmonary anthrax is managed according to Class A infectious diseases, and plague is a Class A infectious disease."

Everyone knows about the plague, and it is a disease on the same level as the plague!

It was so serious that the patient's wife was so frightened that she almost collapsed to the ground.

Gu Yanan held her and comforted her: "Anthrax can be cured as long as it is treated in time, but this disease is very contagious, so it must be isolated and treated, you have been in contact with your husband, and there is also a possibility of infection, so you must also take samples for examination, and I still have some questions to ask you." ”

Her husband was already ill and couldn't do anything else with her, so she nodded strongly, "What do you want to know?" ”

"When did your husband start feeling sick?"

"Last night he came back from the construction site and said that he was a little uncomfortable, I took his temperature, 37 degrees 3, low-grade fever, I thought it was a cold on the construction site, so I brought him some fever medicine at home to eat. Unexpectedly, I got up in the morning and had a fever of 39 degrees Celsius4, and I started talking nonsense, blisters on my hands, and coughing up blood. I was so frightened that I called 120 for an ambulance......" the patient's wife said and began to choke again, "how did you get this anthrax?" My husband has always been in good health. ”

Gu Yanan continued to ask, "What does your husband usually do?" ”

"He is a construction worker, he eats by technology, he usually works everywhere with the construction team, and he seems to be building roads recently."

Road builders again?

Is there a connection with the previous 4 patients?

It can't be a construction team, right?

"What construction site was he working on yesterday? Do you know the specific address? ”

"I know the general address, just at the foot of Qingcheng Mountain, I heard my husband say before that the thousand-year-old tomb in Qingcheng Mountain is going to be developed recently, and their construction team has contracted a section of the road under the mountain, and has been working there for three days."