Death of Xu Lizhi, a bird flu patient in Anhui Province

Introduction: "raise birds to be immune, dead birds can not eat, sick chickens to report, harmless treatment." ——Nowadays, 270000 people in Xiuning County recite these four easy to understand words After Xu Lizhi died in Xiuning County, Anhui Province, almost everyone had a bird flu prevention and control knowledge card On the evening of November 23, the Ministry of Health informed Xu Lizhi that after she was infected with highly pathogenic avian influenza, the above four sentences were pasted at the entrance to every village in Xiuning County Xu Lizhi is the third case of human avian influenza confirmed by the Ministry of health in China and the second in Anhui Province Xu Lizhi, female, 34 years old, is a member of jingoushu village, Shandou village, Shandou Township, Xiuning County, Anhui Province According to the data provided by Xiuning County headquarters for the prevention and control of major animal epidemics (county fingers), Xu Lizhi once worked in Hangzhou with her husband during the Spring Festival of 2005 On July 20, when he was ill on business, he returned home to Jingushu, Shandou township The reporter learned on the spot that Xu's husband, named Chen Facai, had been married to Xu Lizhi for a long time Although the road leading to this remote mountain village has been "blocked" by the local government, the reporter still interviewed a person who had contact with Chen Facai after Xu Lizhi's death, and gradually clarified the causes and consequences of Xu Lizhi's death On October 17, Xu Lizhi bought two chickens (another said three chickens) from a chicken dealer from other places After a few days of raising, the chickens fell ill and died Xu "slaughtered and ate them by himself" The Ministry of health's notice that "patients have contact history with dead birds before the onset of the disease" also gives evidence to this statement On November 11, Xu suddenly felt sick and sore The next day, Xu started a high fever and went to the village health center to find a village doctor for treatment "My family didn't care too much at first, so I went to take a few drops when I had a fever, and then I went back home after the fever subsided." In this way, Xu Lizhi stayed at home for three days On November 14, Xu Lizhi had a fever again and went to the village doctor for treatment, but the fever persisted The temperature reached 40.3 ℃ at the highest, and she suffered from chills and coughs Chen Facai saw that the situation was not good, so he hurriedly took her to the health center of five towns with a motorcycle and was diagnosed with pneumonia of unknown cause At the five town health center, a dean surnamed Xiang refused the reporter's request for an interview, while the medical staff related to Xu Lizhi has been isolated for medical observation, and the reporter cannot contact At 4 p.m on November 16, after receiving the report, the administrative department of health of Xiuning County immediately organized experts in the county for consultation During this period, the expert group established by Huangshan people's hospital was fully responsible for the treatment of patients, and the health department of Anhui Province sent two groups of experts to attend the treatment After full treatment, the patient died at 1:48 p.m on November 22 "To save a patient is to ignore the cost." On the evening of November 24, Cheng Yongning, deputy mayor in charge of health in Huangshan City, paid more than 200000 yuan for direct expenses in an exclusive interview with our reporter Cheng Yongning further revealed that on the afternoon of November 22, a team of five experts sent by the Ministry of health arrived in Xiuning "The expert group was eager to see the patient, but failed to do so, one hour short." Therefore, the members of the expert group took samples of the dead's serum and throat secretions from the hospitals in five towns and returned to Beijing In the afternoon of November 22, Xiuning County cremated Xu Lizhi's body according to relevant regulations At 22:00 p.m on November 23, the Ministry of Health announced that China Center for Disease Control and prevention reviewed the test results of Anhui Provincial Center for Disease Control and prevention, and confirmed that the tracheal secretion of the patient was positive for H5N1 avian influenza virus nucleic acid According to the clinical manifestations, epidemiological investigation and laboratory test results, the expert group of the Ministry of health determined that the patient was a confirmed case of human infection with highly pathogenic avian influenza Jingushu villager group is located in a mountain depression of Shandou Township, Wucheng Town, Xiuning County, surrounded by hills and trees This villager group is relatively independent and does not border with the surrounding villages There are 124 people from 32 households in the group, with a permanent population of more than 70, and an annual per capita income of 2000 yuan Because there are more mountains and less fields, and the transportation is inconvenient, the main income source of villagers depends on going out to work At 8:00 p.m on November 24, when arriving at the entrance of Jingushu village, the reporter found that there was a wooden house less than 10 square meters at the entrance of the only lane embedded between the two mountains The staff of the animal epidemic prevention and control headquarters of Xiuning County set up cards here A staff member said that because some villagers were isolated for medical observation, no outsiders were allowed to enter Reporters found that on the walls of the wooden house, there were several pieces of bird flu propaganda materials One of them is a letter from Shandou township to farmers' friends, which is mainly about the general knowledge of avian influenza prevention and control The date of signing is November 12 The other one is the circular, which requires that water and dry poultry should not be mixed and kept separately; they should not be released and kept in captivity, and the date of settlement is November 22 According to the people who have contacted Chen Facai, every year in Jingushu village, chickens die of illness, and people in the village never take it seriously At the beginning of October this year, dozens of chickens from eight families died of illness Most of them were eaten by villagers, and nothing happened Wu Jiang, deputy head of Xiuning County, said 13 chickens had died in the village since October Among them, 3 were slaughtered by the villagers themselves, and the rest died of other diseases, "no avian influenza virus has been confirmed" [NextPage] it is said that Xu Lizhi, the deceased, was in good health all the time She was not seen to go to the hospital at ordinary times Besides herself, her husband, mother-in-law and 11 year old daughter ate chicken this time, but she was the only one who got sick A villager in five towns told reporters that he had never heard of bird flu before, but only knew about "chicken plague" After Xu Lizhi got sick this time, people came from the county and the countryside to kill and bury all the chickens and ducks in the village Each family also sent out two publicity materials to organize everyone to clean up And to every household has been issued a disinfectant solution, required every two days in front of the house after the disinfection According to reports, Hu nianyou, a doctor of the township hospital, went to the village every day to take the temperature for the villagers after Xu Lizhi was hospitalized From November 17 to now, the temperature of more than 60 people in the village group of Jingushu is very normal, and there is no abnormal situation such as fever According to a report from Anhui Provincial Department of health, 41 close contacts, including Xu Lizhi's relatives and medical staff who receive and treat patients, are undergoing a 7-day medical observation At present, no abnormal clinical manifestations such as fever have been found in these people As of November 24, 13 people had been released from quarantine, a local official told reporters After the outbreak of Xu Lizhi's disease, 219 chickens in Jingushu village were slaughtered, "according to the requirements of the state, each chicken was subsidized 10 yuan." According to the data provided by Xiuning County Fangzhi, poultry within 5km around Jingushu village have been forcibly immunized, involving 18 administrative villages, 127 village groups, 5656 households and 43454 poultry Now, the county's poultry market has been "temporarily closed," added Yao Anna, deputy county head of Xiuning County In addition, the relevant departments at higher levels have collected blood samples of 33 pigs, ducks and chickens from Jingushu village and surrounding villages Cheng Yongning, deputy mayor of Huangshan City, said with certainty that, according to the opinion of the expert group, Xiuning County, including five towns and Shandou Township, is not an epidemic area or focal point For this conclusion, "the panel has signed." Anhui Provincial Department of health in the evening of 23 also released a notice on its website: according to the information provided by the Department of agriculture, there was no bird flu epidemic in Xiuning county However, where does the H5N1 virus that killed Xu Lizhi come from? How did the two deadly chickens she bought from a chicken dealer catch the bird flu virus? Wu Jiang, deputy head of Xiuning County, stressed that according to the investigation by the public security department, the two chickens were not local to Xiuning County, but all of them were imported from other parts of Huangshan City Because the chicken and duck Market in Xiuning County is not very standardized, and it is very difficult for the public security department to obtain transaction invoices and evidence, etc., it is "still under investigation" At present, the research results of avian influenza show that the incubation period of human infected with avian influenza virus is generally 7 days, and a few experts think that the maximum can be 21 days Wu Tongsheng, the chief physician who once treated Zhou maoya, a bird flu patient in Zongyang, Anhui Province, believes that from the time Xu Lizhi contacted poultry to the time of disease onset, it cannot be ruled out that H5N1 virus came from dead poultry Zhang Xinyu, director of animal husbandry in Xiuning County, confirmed to reporters that Xu Lizhi had indeed eaten dead chickens, while experts from Anhui Provincial Department of health did not take samples of dead chickens, but only live birds from Jingushu village and surrounding villages In addition, the infection chain of "migratory bird poultry human" is also the focus of experts According to an internal data obtained by our reporter from the local area, "Huangshan City is the unique habitat for birds", which is not only the wintering place for migratory birds, the place where they move and rest, but also an important channel for migratory birds to migrate Migratory birds from Siberia fly to Poyang Lake, Southeast Asia and Australia along the line through Taiping Lake and Xin'an River in Huangshan City.