Plague Doctor

Shanhai City is a small city, and Jiangxing Town in Shanhai City is an even smaller place. Although it is on the seaside, there is no tourism industry.

In this small town hospital, more than 20 similar cases were admitted from morning to night on August 2: fever, fatigue, and cough.

Those with mild illness are suspected of having a cold, and those with severe illness are suspected of pneumonia.

When the attending physician Huang Lin, who worked the night shift in the emergency medicine department, was treating an 18-year-old patient named Shen Haoxuan, she immediately realized something was wrong when she heard the patient clearly stated that he was infected by a middle-aged uncle's cough on the bus.

It's like an infectious disease outbreak.

So Huang Lin became alert and looked through the medical record system for similar cases that the hospital had treated throughout the day.

The middle-aged uncle Shen Haoxuan mentioned is indeed a person. He is a 43-year-old patient, Wang Guoxin, who was admitted to the Department of Internal Medicine from the emergency room at around 8 o'clock this morning.

The more Huang Lin looked at Wang Guoxin's hospitalization medical records, the more uneasy she became.

Zhang Bo, the doctor on duty, initially diagnosed Wang Guoxin as "right lower lung pneumonia."

Wang Guoxin's condition is quite serious, with a body temperature of 39.5c to 41c, coughing, dark brown thick sputum, occasional hemoptysis, and suspected erosion and rotten flesh, which is considered to be inflammatory and rotten tissue in the lungs. With fatigue and body aches, obvious crackles could be heard on the back of the right lung. The chest X-ray showed a 6cmx8cm patchy heterogeneous blurred shadow in the lower field of the right lung. The inflammation was severe but not specific.

He said that he had been coughing for several days, and this morning he started to feel particularly uncomfortable. He was coughing up more sputum and had hemoptysis, so he felt scared and came to the hospital for a check-up.

At that time, Dr. Zhang asked the patient to complete three major routine tests, including liver and kidney function tests. The blood routine showed that white blood cells were significantly elevated. Based on the results of emergency chest Treatments include hemostasis, sugar and saline rehydration support, and oral acetaminophen for fever reduction.

The patient's temperature chart made Huang Lin's heart twitch. Although she took antipyretic drugs orally, the patient's temperature did not drop and remained above 39 degrees Celsius.

"I hope I'm just sensitive." Huang Lin immediately called the inpatient department to learn about Wang Guoxin's current condition. As a result, her heart sank to the bottom of the ice cellar.

The nurse on duty gave her feedback that the patient's symptoms such as coughing, sputum production, and hemoptysis had significantly worsened, and his energy level had become even more depressed...

Huang Lin felt that this was not like ordinary pneumonia.

Dr. Zhang may have misdiagnosed...

Huang Lin’s internship experience in college told her that if it were a top-tier hospital, it would be normal to treat forty or fifty pneumonia patients a day; but for Jiangxing Town Hospital, twenty pneumonia patients a day would be too many. Yes, she knows this very well after working here for several years after graduating from her undergraduate degree.

Wang Guoxin was the first pneumonia patient admitted today. The second case appeared at around 3 p.m., and the outbreak continued after 7 p.m.

Eighteen cases of pneumonia have been treated by her! Coupled with what Shen Haoxuan said...

"This could be an infectious form of SARS."

Huang Lin told another doctor on duty in the emergency room, Zhao Yutao, who was in charge of surgery, about the situation she discovered, and considered reporting the epidemic.

The town hospital is small, with only two doctors in the emergency room, one inside and one outside.

"Epidemic!?" Zhao Yutao, who is middle-aged, frowned when he heard this. "The weather has been sultry these days. It is normal for there to be a few more pneumonia patients than usual."

Once an epidemic is reported, no matter whether it is true or false, there are many things to do. Especially now that it is late at night, Zhao Yutao is a little reluctant.

Zhao Yutao has never liked Huang Lin very much. She is a famous college student who graduated from Dongzhou University School of Medicine. She is young and energetic and always likes to cause trouble. "The first case you mentioned should be transferred to the city hospital for treatment. Our conditions are limited." He also wanted to persuade.

"Brother Zhao, this time is really unusual." Huang Lin insisted on her judgment, "We need to ask someone from the city's disease control department to come."

She immediately called the hospital infection management office and the Ministry of Medical Education to report it as "infectious atypical pneumonia" among the Class B infectious diseases. Moreover, it was not a single case but an outbreak.

"The incubation period of the first patient should be more than five days, and there were prodromal symptoms, but after the fever appeared this morning, the condition developed very quickly. The same was true for another patient who was suspected of being infected by the first patient. He had hemoptysis within 6 to 7 hours. !”

Huang Lin spoke very seriously, made the seriousness clear, and asked the other side to report it immediately.

There is a reporting time limit for infectious diseases: 2 hours for Category A infectious diseases and 24 hours for Category B and C infectious diseases.

When an outbreak occurs in Category B, it will be reported according to the time limit and method of Category A.

But that could also be within two hours. Huang Lin was really worried that the Ministry of Medical Education would delay the report and report it after an hour.

Every minute is extremely precious now. Every minute early we take epidemic control measures, we may save one more life.

The response from the Ministry of Medical Education was quite fast. The call was made to the Municipal Center for Disease Control and Prevention at 20:32 on the evening of August 2.

After Huang Lin finished her report and returned to work, she also admitted the 21st case of pneumonia, then the 22nd case, the 23rd case...

When the number of cases quickly exceeded thirty, Zhao Yutao panicked. The hospital's infectious diseases department also panicked. All the nurses knew something was wrong.

At the same time, the Municipal Center for Disease Control and Prevention immediately made arrangements for this public health emergency and asked Jiangxing Town Hospital to

We have done a good job in isolating patients and protecting the safety of medical staff. On the other hand, we have sent chief expert He Feng to lead a team to conduct epidemiological investigations and be responsible for on-site processing.

"Oh, okay, okay." When He Feng received the call from the center, his family was having dinner at home, "I'll leave now."

My wife is also a disease control officer and understands this, but my seven-year-old daughter Niuniu is not very happy: "Dad, please finish your meal before leaving."

"Dad has to do something. You listen to mom." He Feng stroked his daughter's head and left.

Doing disease control is a race against time. He runs wherever there is a suspected epidemic. This has long been the norm in his life.

Under the dark night, He Feng got on the epidemic prevention and control vehicle that came to pick him up. His deputy Li Wen immediately handed him a stack of documents, including the "Infectious Disease Report Card" filled out by the reporting doctor Huang Lin, relevant patient medical records and personal information. Report. He Feng looked at each page carefully, and the more he looked at it, the heavier his heart became...

The town hospital was unable to complete most of the pathogenic antibody tests, and it did not even have CT equipment. Moreover, half a day was too short, and it was still unclear what type of pneumonia Wang Guoxin had.

But He Feng agreed with Dr. Huang Lin's clinical judgment that this was not like ordinary pneumonia.

At this time, deputy Li Wen answered the phone and said in a cold voice: "Team leader He, there are thirty cases at Jiangxing Town Hospital."

"Isolate the entire hospital immediately." He Feng's nasolabial folds wrinkled slightly and he said resolutely: "The patient's cough and vomitus cannot leave Jiangxing Town, let the center send the equipment in, and everyone must take level three protection. This If things go wrong this time, we may have to apply for a blockade...Jiangxing Town."

He paused for a while, but in the end he did not say the ominous "blockade of Shanhai City".

Hopefully it's just a false alarm, and hopefully the spread is through close contact with the patient and inhaling the droplets they cough up.

I hope...the epidemic area will not be very big...

The uneven road made the car bumpy. He Feng looked out the window at the streets retreating in the dark, and the faces of his wife and daughter flashed in his mind.

Niuniu, it may take a few days for dad to come home this time.

Love the Plague Doctor.