Shanhai City is a small city, and Jiangxing Town in Shanhai City is even more small. Although it is by the seaside, there is no tourism.
In the town hospital in this small place, more than 20 similar cases have been treated from morning to night on August 2: fever, fatigue, and cough.
Mild cases are suspected of a cold, and severe cases are suspected of pneumonia.
When Huang Lin, an attending physician on the night shift in the emergency department of internal medicine, was treating an 18-year-old patient named Shen Haoxuan, she heard that the patient clearly stated that she was infected by a middle-aged uncle's cough on the bus, and she immediately noticed something was wrong.
It's like a contagion outbreak.
So Huang Lin became vigilant, and looked through the medical record system for similar cases admitted to the hospital throughout the day.
The middle-aged uncle Shen Haoxuan was talking about was indeed a real person. It was Wang Guoxin, a 43-year-old patient who was admitted to the Department of Internal Medicine from the emergency department at 8 o'clock this morning.
The more Huang Lin looked at Wang Guoxin's hospital records, the more uneasy she felt.
On-duty doctor Zhang Bo initially diagnosed Wang Guoxin as "pneumonia in the lower right lung".
Wang Guoxin's condition is quite serious, with a body temperature of 39.5c~41c, cough, dark brown sticky sputum, occasional hemoptysis, and suspected rotten flesh, which is considered to be rotten tissue of lung inflammation. Accompanied by fatigue, body aches, obvious moist rales can be heard on the back of the right lung, X-ray chest X-ray shows 6cmx8cm patchy heterogeneous fuzzy shadows in the lower field of the right lung, the inflammation is severe, but not specific.
He said that he had been coughing for a few days, and this morning he began to feel very uncomfortable, with increased sputum and hemoptysis, so he felt scared and came to the hospital for a look.
At that time, Dr. Zhang perfected the three major routines for the patient, such as liver and kidney function tests, and the blood routine showed a significant increase in white blood cells. Based on the results of the emergency chest x-ray examination, Dr. Zhang considered it a bacterial infection of the lungs. After giving the sputum and blood for bacterial culture, he immediately administered empirical medication, including intravenous injection of cefuroxime sodium for anti-infection and fensulfame. Hemostasis, sugar and saline rehydration support and other treatments, as well as oral acetaminophen for antipyretic.
The patient's temperature sheet made Huang Lin's heart churn. Although he took antipyretic drugs orally, the patient's temperature did not drop, and it remained above 39c.
"I hope it's just me being sensitive." Huang Lin immediately called the inpatient department to learn about Wang Guoxin's current condition, but her heart sank to the bottom of the ice cellar.
The nurse on duty gave her feedback that the patient's cough, sputum, hemoptysis and other symptoms were obviously aggravated, and his spirit was even more listless...
Huang Lin felt that this was not like ordinary pneumonia.
Doctor Zhang may have misdiagnosed...
The internship experience in college told Huang Lin that if it is a top-tier hospital, it is very common to treat forty or fifty pneumonia patients a day; but for Jiangxing Town Hospital, twenty pneumonia patients a day is too many Yes, she is also very clear about this after working here for several years after graduating from undergraduate.
Wang Guoxin was the first patient with pneumonia admitted today. The second case appeared at 3:00 pm, and the outbreak became violent after 7:00 pm.
Eighteen patients with pneumonia have been treated by her hands! Plus what Shen Haoxuan said...
"It could be a contagious atypical pneumonia."
Huang Lin told another doctor on duty in the emergency room, Zhao Yutao, who was in charge of surgery, about what she had discovered, and considered reporting the epidemic.
The town hospital is small in scale, and there are only two doctors in the emergency room, one inside and one outside.
"Pandemic!?" Middle-aged Zhao Yutao frowned upon hearing this. "The weather is sweltering these days. It's normal to have a few more pneumonia patients than usual."
Once the epidemic is reported, no matter whether it is true or false in the end, there will be many things. Especially now that it's 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 vigorous, and always likes to make trouble. "The first case you mentioned should be transferred to the city hospital for treatment. Our conditions are limited." He still wanted to persuade.
"Brother Zhao, this time is really unusual." Huang Lin insisted on her judgment, "We need to invite people from the city's CDC."
She immediately called the Hospital Infection Management Office and the Ministry of Medical Education, and reported it as "infectious atypical pneumonia" in the B category of infectious diseases, and there was not a single case, but an outbreak.
"The incubation period of the first patient should be more than five days, with prodromal symptoms, but after the fever appeared this morning, the disease developed very quickly. The same is true for another patient suspected of being infected by the first patient. Hemoptysis occurred within 6 to 7 hours. !"
Huang Lin spoke very seriously, and made it clear the seriousness, and asked the other side to report it immediately.
There is a time limit for reporting infectious diseases, 2 hours for Class A infectious diseases, and 24 hours for Class B and C infectious diseases.
When an outbreak occurs in Category B, it shall 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.
Now every minute is extremely precious, and every minute of epidemic control measures taken in the morning may save one more life.
The response from the Ministry of Medical Education was fairly quick, and it was 20:32 on the evening of August 2 when they called the Municipal Center for Disease Control and Prevention.
Huang Lin finished her report and returned to her post. She also admitted the 21st case of pneumonia, then the 22nd, and the 23rd...
When the number quickly exceeded 30 cases, Zhao Yutao panicked, and so did the hospital's Infectious Diseases Department, and all the nurses knew that something was wrong.
At the same time, the Municipal Center for Disease Control and Prevention immediately made deployments in response to this public health emergency, requiring Jiangxing Town Hospital to do a good job of isolating patients and protecting medical staff. On the other hand, it sent chief expert He Feng to lead a team to Conduct epidemiological investigations and be responsible for on-site handling.
"Oh, good, good." When He Feng received the call from the center, his family was having dinner at home, "I'm leaving now."
His wife is also in disease control, so she understands this, but her seven-year-old daughter, Niuniu, is not too happy: "Daddy, why don't you leave after eating."
"Father is going to do something, you listen to what mother tells you." He Feng stroked his daughter's head and set off to leave.
Doing disease control is a race against time, wherever there is a suspected epidemic, this has long been the norm in his life.
Under the dark night, He Feng got into the epidemic prevention and control vehicle that came to pick him up. Li Wen, his deputy, immediately handed him a stack of documents, which were the "Infectious Disease Report Card" filled out by the reporting doctor Huang Lin, relevant patient medical records and personal records. Report. He Feng looked carefully at each page, the more he looked at it, the more his heart sank...
The town hospital was unable to complete most of the pathogenic antibody tests, and it didn't even have CT equipment, and half a day was too short, so it was hard to say what kind of pneumonia Wang Guoxin was.
But He Feng agreed with Dr. Huang Lin's clinical judgment that this is not like ordinary pneumonia.
At this time, Li Wen, the deputy, answered the phone and said in a cold voice, "Group Leader He, there are thirty cases in the Jiangxing Town Hospital."
"Isolate the entire hospital immediately." He Feng's decree wrinkles were slightly wrinkled, and he said decisively: "The patient's cough and vomit cannot leave Jiangxing Town, let the center send the equipment in, and everyone must do three-level protection. This If we fail this time, we may have to apply for a blockade...Jiangxing Town."
He paused for a while, but he didn't say the ominous "blockade of Shanhai City" after all.
I hope it was just a false alarm, and I hope that the transmission can only be caused by close contact with the patient and inhalation of the droplets coughed up by him.
I hope... the epidemic area will not be very large...
The uneven road made the car a little bumpy, and He Feng looked out the car window at the retrograde street under the night, and the faces of his wife and daughter flashed in his mind.
Niuniu, it may take several days for Dad to come home this time.