Transmission potential of primary pneumonic plague: time inhomogeneous evaluation based on historical documents of the transmission network

BACKGROUND: The transmission potential of primary pneumonic plague, caused by Yersinia pestis, is one of the key epidemiological determinants of a potential biological weapon, and requires clarification and time dependent interpretation. Method: This study estimated the reproduction number and its time dependent change through investigations of outbreaks in Mukden, China (1946), and Madagascar (1957). Reconstruction of an epidemic tree, which shows who infected whom, from the observed dates of onset was performed using the serial interval. Furthermore, a likelihood based approach was used for the time inhomogeneous evaluation of the outbreaks for which there was scarcity of cases. RESULTS: According to the estimates, the basic reproduction number, R(0), was on the order of 2.8 to 3.5, which is higher than previous estimates. The lower 95% confidence intervals of R(0) exceeded unity. The effective reproduction number declined below unity after control measures were introduced in Mukden, and before the official implementation in Madagascar. CONCLUSION: While the time course of the latter outbreak could be explained by intrinsic factors and stochasticity in this remote and scarcely populated area, the former in Mukden suggests the possible continued chains of transmission in highly populated areas. Using the proposed methods, the who infected whom information permitted the evaluation of the time inhomogeneous transmission potential in relation to public health measures. The study also tackles the problem of statistical estimation of R(0) based on similar information, which was previously performed simply by counting the number of secondary transmissions regardless of time.     

Amalgam restorations, plaque removal and periodontal health

Abstract. A total of 156 approximal subgingival amalgam overhanging margins were assessed in the buccal segments of 13 patients for plaque accumulation, gingival inflammation, pocket depth and gingival shrinkage. Recordings were made immediately before and 2, 4 and 8 weeks fallowing scaling, removal of overhangs, and oral hygiene instruction. Surfaces with overhangs were compared with control surfaces, which were either intact or contained supragingival amalgams. Initially it was found that gingival inflammation and pocket depth were more extensive adjacent to subgingival amalgam overhangs than to sound teeth or those with supragingivally located amalgams. This appeared to be due to preferential plaque accumulation in relation to subgingival overhangs. For all parameters compared, differences apparent at the baseline had disappeared by the end of the 8-week study period. Contouring of defective subgingival restorations, followed by effective scaling and oral hygiene instruction produced approximately 1 mm of gingival shrinkage, sufficient in most cases to produce clinical gingival health. Of the 156 subgingival fillings 83 (53 % ) became supragingival and 43 (28 %) reached the gingival crest by the end of the 8-week study period.     

Prostagiandin E1 and F2 α levels during development of shock induced by plague toxin

Laboratory of the Molecular Basis of Pathogenesis of Infectious Diseases, Central Research Institute of Epidemiology, Ministry of Health of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR V. I. Pokrovskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 105, No. 3, pp. 313–315, March, 1988.     

自四川省石渠县分离的1株疑似鼠疫菌的复活报告

目的利用动物试验和抗鼠疫噬菌体血清对1株已半干枯、污染严重且携带鼠疫噬菌体的疑似鼠疫菌株进行复活和分离。方法首先对该疑似鼠疫菌株进行动物传代,再经抗鼠疫噬菌体血清处理的赫氏琼脂培养基生长,结果使将要死去的菌株得到重新复活。结果对已半干枯、污染严重且携带鼠疫噬菌体的疑似鼠疫菌株进行了复活,分离出正常的鼠疫菌,并被鼠疫噬菌体所裂解。结论通过动物试验和抗鼠疫噬菌体血清使将要死去的菌株得到重新复活,类似菌株在自然界一定条件下一旦返祖成典型鼠疫菌,可能对再次发生动物鼠疫流行具有重要的意义。     

中国鼠疫自然疫源地分型研究Ⅰ.生态地理景观特征

目的 研究中国鼠疫自然疫源地鼠疫生态地理景观特征.方法 根据中国鼠疫疫情资料和对中国鼠疫自然疫源地生态地理景观的考察,制定鼠疫生态地理景观区划标准,建立反映鼠疫生态地理景观特征的方法.结果 中国鼠疫自然疫源地鼠疫生态地理景观有12型、19亚型.结论 为中国鼠疫自然疫源地分型研究提供了科学依据.     

Lessons learned about pneumonic plague diagnosis from two outbreaks, Democratic Republic of the Congo

Pneumonic plague is a highly transmissible infectious disease for which fatality rates can be high if untreated; it is considered extremely lethal. Without prompt diagnosis and treatment, disease management can be problematic. In the Democratic Republic of the Congo, 2 outbreaks of pneumonic plague occurred during 2005 and 2006. In 2005, because of limitations in laboratory capabilities, etiology was confirmed only through retrospective serologic studies. This prompted modifications in diagnostic strategies, resulting in isolation of Yersinia pestis during the second outbreak. Results from these outbreaks demonstrate the utility of a rapid diagnostic test detecting F1 antigen for initial diagnosis and public health management, as well as the need for specialized sampling kits and trained personnel for quality specimen collection and appropriate specimen handling and preservation for plague confirmation and Y. pestis isolation. Efficient frontline management and a streamlined diagnostic strategy are essential for confirming plague, especially in remote areas.     

云南省丽江鼠疫自然疫源地研究现状及展望

鼠疫是一种发病急、传播快、病死率高、传染性强的自然疫源性人兽共患病。鼠疫在自然界的存在是以鼠疫菌、宿主动物和媒介之间相互作用为基础,并在一定生物地理环境条件下自然进化形成的鼠疫生物地理群落,即鼠疫自然疫源地。丽江鼠疫自然疫源地的发现和证实,是云南鼠疫防治研究工作中的又一重要突破,目前,该疫源地范围不断扩大,鼠间鼠疫流行处于持续活跃状态,防控形势非常严峻。本文根据2005—2019年对丽江玉龙鼠疫自然疫源地历次现场调查、监测资料和相关研究文献,对该疫源地的范围、流行特点、宿主媒介生态学以及病原体特征研究进行概述,分析防治和研究中存在的问题,为该疫源地的监测防控及后续研究提供一些思考和方向。     

新冠肺炎,基于经方康复条辨

新型冠状病毒肺炎是人体感染冠状病毒引起以发热、乏力、干咳为主要临床表现。新冠肺炎在恢复期可能面临呼吸道功能、心理、体能等方面的康复问题。张炜教授就新冠肺炎康复问题,应用经方论治,充分发挥中医药独特优势,加快新冠肺炎恢复期康复。分别从少阳不和、少阴虚弱、厥阴虚弱3个方面论治睡眠障碍。从太阴脾虚、少阳积热论治食欲不振,从太阴脾虚、少阴虚弱论治喘息、乏力。     

王兴臣教授对新型冠状病毒肺炎中医病因病机的认识

王兴臣教授为全国第二批优秀中医临床人才,山东省名中医药专家,山东中医药大学中西医结合临床专业博士研究生导师,全国名老中医药专家学术经验继承工作指导老师,山东中医药大学第二附属医院新冠肺炎防控专家组专家。自疫情发生以来,始终战斗在抗疫第一线,对新冠肺炎进行了深入的思考,对本病中医病因病机潜心做出文献梳理,结合现代医学的认识,认为新冠肺炎为新冠病毒在伏气、时气的共同作用下致病,伏气是最重要的疫病致病因素,伏气、时气均与中医气化理论密切相关,而体质强弱决定本病的预后转归。故本文主要从伏气、时气、正气三个方面分析新冠肺炎中医病因病机,以期为中医瘟疫病的预测与防治、减少危重症的发生提供参考。