On December 18, a number of cases of hemorrhagic fever patients in Xi'an attracted attention. It is reported that hemorrhagic fever is a common infectious disease in the north, mainly characterized by fever, bleeding and kidney damage, and severe ones can lead to death. Starting in October every year, the Guanzhong area of Shaanxi Province enters the high incidence of hemorrhagic fever.
Local netizens told Red Star News that rats had appeared in some strawberry greenhouses and schools in Xi'an, and soon there were multiple cases of hemorrhagic fever confirmed. On the 19th, Red Star News learned from the Xi'an Chang'an District Center for Disease Control and Prevention that there are indeed a number of patients with hemorrhagic fever in the city in recent days, but it has nothing to do with strawberries, "If there is fever and fever and other physical discomfort, please go to the designated hospital in time for medical treatment." In addition, vaccination is an effective way to prevent the disease, but it is necessary to consult the receiving doctor for matters related to vaccination. ”
So what is hemorrhagic fever? Will it be human-to-human? And why is it concentrated in Xi'an? By inquiring about relevant information and consulting disease control experts, Red Star News reporters learned that hemorrhagic fever is a natural epidemic disease, and its source of infection is rats, mainly through contact transmission after rodent secretions or excrement pollution, and will not be transmitted from person to person.
The population is generally susceptible to haemorrhagic fever, and there have been no human-to-human transmission cases
"Haemorrhagic fever is a seasonal infectious disease prevalent in the Northwest Territories, which is a high incidence period every autumn and winter, and this year is not much different from previous years." Wang Zhi, deputy chief physician of surgery at the Eighth Hospital of Xi'an, told reporters that the winter infectious diseases currently circulating in the northwest region are mainly influenza and hemorrhagic fever, and hemorrhagic fever is an infectious disease transmitted by rats and ticks.
"Mainly because we humans have used foods containing hantavirus that have been bitten by ticks or bitten by rodents. If we eat these things and are not fully cooked, these viruses will remain in the food and then be ingested by us to develop the disease. Wang Zhi said.
Public information shows that renal syndrome hemorrhagic fever, also known as epidemic hemorrhagic fever, is a natural source of disease caused by hantavirus, with rodents (haddock rats and brown rats) as the main source of infection. Mainly through rodent saliva, urine and other virus-containing excrement, secretions or direct bites of people, the virus is transmitted directly or indirectly, resulting in a kind of fever, bleeding and kidney damage. The disease is generally susceptible and has a high incidence among farmers who often work in the field, or among workers and students engaged in agricultural industries and food processing.
Wang Zhi said that the first symptom of hemorrhagic fever is fever, which is often mistaken for a heavy cold, thus delaying the condition, "The typical symptoms are 'three pains', that is, headache, low back pain, orbital pain, if these symptoms appear, then go to the hospital to check for positive hemorrhagic fever antibodies, basically can be diagnosed." Wang Zhi also stressed that hemorrhagic fever is a very intense infectious disease, especially in young adults, the incidence is relatively high, and it is possible to cause death, and it is necessary to pay attention to the disease.
According to the data released by the China Center for Disease Control and Prevention and the Huajing Industry Research Institute, the number of epidemic haemorrhagic fever in China from January to August 2020 was 4359 cases and the number of deaths was 21; in 2019, the number of epidemic haemorrhagic fever in China was 9596 cases, and the number of deaths was 44, with an average mortality rate of 0.4%.
2004-2017 National and Shaanxi Provincial Hemorrhagic Fever Data Statistics Data Source: National Public Health Science Data Center
"Haemorrhagic fever is not a respiratory infectious disease like SARS or influenza A, it is not transmitted from person to person, mainly through contact after contamination with rodent secretions or excrement, so there will be no large-scale leapfrog infection." Song Rui, chief physician of the Infectious Disease Diagnosis and Treatment Center of Beijing Ditan Hospital, said in an interview with the media that due to the acute onset of hemorrhagic fever, the rapid progression, and the mortality rate of severe patients, if it cannot be diagnosed and treated in time, the serious ones can be life-threatening.
In terms of contagiousness, Song Rui believes that this disease is generally sporadic, rarely clustered, and the risk of transmission in direct contact with the population is very small, "severe patients with hemorrhagic fever due to acute kidney failure, such patients need to do dialysis to save life, patients do not infect others through the respiratory tract and contact, so dialysis does not need to be isolated alone." ”
According to relevant reports, pregnant women may infect their babies through the placenta after being infected with the virus. However, there are no human-to-human cases of hantavirus in China.
The Guanzhong area is a high incidence of haemorrhagic fever, and the incidence of this year is higher than in the past
It is understood that there are currently two main types of hantavirus that cause hemorrhagic fever in Renal syndrome in China, namely, the Hantan virus type (type I. carried by wild rats) and the Seoul virus type (type II. carried by domestic mice). Xi'an Cdtec once said that since the first case of hemorrhagic fever was detected in Xi'an, it has been a peak city for the incidence of hemorrhagic fever, and the main source of infection is haddock rats.
The article "Expert Consensus on the Diagnosis and Treatment of Hemorrhagic Fever for Renal Syndrome" published in the Shaanxi Medical Journal shows that Shaanxi Province, especially the Guanzhong region, is a high incidence area of the disease. According to the statistics of the Shaanxi Provincial Center for Disease Control and Prevention, in 2015, 2016 and 2017, 1388 cases, 960 cases and 2001 cases of hemorrhagic fever were reported in Shaanxi Province, accounting for 13%, 10% and 17% of the total number of cases in the country that year.
The onset of hemorrhagic fever is not related to eating strawberries.
On December 18, a local netizen in Xi'an broke the news online, saying that many local hospitals in Xi'an were full of patients infected with hemorrhagic fever, and said that the disease may be related to the consumption of strawberries. On the 19th, Red Star News learned from the Xi'an Chang'an District Cd-operative Center for Disease Control and Prevention that there are indeed many patients with hemorrhagic fever in the city in recent days, but it has nothing to do with eating strawberries. It is reported that the agricultural department of Chang'an District of Xi'an has carried out special risk monitoring of strawberries, and no pesticide residues and other abnormal conditions have been found.
Through inquiring about the website of the Xi'an Municipal Center for Disease Control and Prevention, the Red Star News reporter noted that since the beginning of winter this year, major hospitals in Xi'an have successively received a number of cases of hemorrhagic fever patients. Since October 2021, the incidence of hemorrhagic fever in Xi'an renal syndrome has increased significantly compared with the previous period and the same period last year, and the number of severe cases and deaths has increased compared with the latest year, and the incidence level has remained at a high level.
For the sudden emergence of multiple cases of hemorrhagic fever in Xi'an, Ding Hong, a professor at the School of Pharmacy of Wuhan University, said that this may be related to the local environment, "which requires investigating the relevant local environment, such as nutrients, sources of infection, etc." ”
Zhao Yingren, director of the Department of Infectious Diseases at the First Affiliated Hospital of Xi'an Jiaotong University, said, "There is a certain relationship with this year's flood, when the flood occurs, rats are gathered in high places, and people live in places that are relatively high." ”
"In fact, the incidence of hemorrhagic fever in Guanzhong (including Xi'an, Xianyang, Weinan, Baoji and other places) is the highest, and northern Shaanxi and southern Shaanxi are not so serious, and we can clearly distinguish regional differences from indicators such as rat density and poisoning rate." Yu Pengbo, director of the Institute of Virology of the Shaanxi Provincial Center for Disease Control and Prevention, once said in an interview with the media that due to the fertile soil in the Guanzhong area, the longitudinal rivers, wheat, corn and other crops, the climatic environment is very suitable for the growth of rats; at the same time, due to the accelerated urbanization of rural areas around Xi'an City, the large-scale expansion of new industrial parks, and the continuous reduction of farmland and wasteland, resulting in serious fragmentation of the habitat of black line rats, the destruction of the living environment of rats, they are homeless, they begin to run everywhere, resulting in the spread of the virus.
It is understood that vaccination with hemorrhagic fever vaccine can effectively reduce the incidence of hemorrhagic fever and alleviate the severity of the disease, which is an important means for the prevention and control of hemorrhagic fever in the epidemic area. Hemorrhagic fever vaccine is suitable for people aged 16-60 years without contraindications to vaccination, and after full immunization, it can stimulate the body to produce neutralizing antibodies against hantavirus. In accordance with relevant national regulations, Shaanxi Province implements a classified vaccination policy for hemorrhagic fever vaccines. In key districts and counties with a high incidence of hemorrhagic fever in Guanzhong, free vaccinations were given to farmers and rural students aged 16-60. Districts and counties with a high incidence of non-hemorrhagic fever outbreaks have adopted a voluntary, self-funded vaccination policy.
Red Star News reporter Luo Mengjie