The latest investigation of the Lanzhou brucellosis incident: multiple infected persons were diagnosed by the hospital but received a "health certificate" from the National Health Commission
CCTV News, Beijing, November 3 (Ren Mengyan, reporter of CCTV) Last year, the case of the antibody-positive Brucella in Lanzhou caused many concerns.
According to the investigation results of the Gansu Provincial Health Commission, in the summer of 2019, the Lanzhou Biopharmaceutical Factory used expired disinfectants in the production process of veterinary Brucella vaccines, which caused incomplete sterilization of exhaust gas and carried bacteria-containing fermentation broth. The exhaust gas was blown to the Lanzhou Veterinary Research Institute and nearby communities in the downwind direction of the pharmaceutical factory, causing some local residents and students to develop antibody positive after contact.
Subsequently, the approval number of several veterinary drug products of Lanzhou Biopharmaceutical Factory was revoked, and 8 relevant persons in charge were dealt with.
According to the website of the Lanzhou Municipal Health Commission, as of September 14, 2020, a total of 21,847 people had been tested, 4646 were initially screened positive, and 3,245 were confirmed positive by the Provincial Center for Disease Control and Prevention.
The Lanzhou Municipal Health Commission emphasized that this incident was a "positive event of brucella antibodies" and was different from "infection with brucellosis."
Antibody positive is due to the serum antibodies produced by Brucella entering the body to stimulate humoral immune response, which generally reaches a peak in 3-6 months, and the antibody begins to decay after 6 months, and it is not easy to detect after 1 year.
There are no clinical symptoms, and experts recommend no treatment.
Brucellosis, also known as "lazy man's disease" in the folks, is a category B infectious disease. It is a zoonotic disease caused by bacteria of the genus Brucella invading the body, often accompanied by chronic sepsis and neurocirculation. , Especially the damage of the bone and joint system, the main clinical manifestations are fever, fatigue, sweating, joint muscle pain, and standard clinical treatment is required.
According to the Lanzhou Health and Health Commission, in the brucellosis incident last year, more than 4,000 people were initially screened to be positive. The Gansu Provincial Center for Disease Control and Prevention confirmed 3,245 positive cases. There was no case of brucellosis.
However, a number of netizens in Lanzhou recently reported to Voice of China that they were the infected people at the time, and they had symptoms such as fever, fatigue, and joint muscle pain, and were diagnosed with brucellosis by many hospitals. But when they reported to the Lanzhou Municipal Health Commission, the Health Commission denied that they were ill, still determined that they were "antibody positive and no health damage," and even provided a "health certificate."
The Lanzhou Municipal Health Commission insisted that the "bruillosis incident" had no effect on the health of the people. However, the reporter interviewed many medical experts on this matter. They all emphasized that the initial stage is the best treatment window for brucellosis. If not treated in time, some patients Long-term fever, sweating, severe joint pain, and even infertility, systemic multiple organ damage, and irreparable damage to the body.
“The high fever started on September 2 last year, and the fever was 18 days. I didn’t know it was because of this disease. When I was treated for a cold, I received injections, and took medicine, I didn’t get better. By September 28, my two legs were swollen and my joints were swollen. I can’t get out. I can’t get up on October. I can’t turn over and can’t walk from the bedroom to the bathroom.” In December 2019, Ms. Wang saw media reports that a large number of blue eyes appeared near the Lanzhou Animal Research Institute. After the bacteria was positive, she realized that she had brucellosis if she lived nearby.
Ms. Wang was diagnosed as "brucellosis, chronic brucellosis arthritis, and low white blood cell" by the Anning Branch of the 940 Hospital of the People's Liberation Army (Photo by Ren Mengyan, CCTV reporter)
On March 2, 2020, Ms. Wang was diagnosed as "brucellosis, chronic brucellosis arthritis, and low white blood cell" by the Anning Branch of the People's Liberation Army 940 Hospital.
On the prescription given to Ms. Wang in the hospital, the reporter saw, “Diagnosis: Brucellosis, brucellosis arthritis, low white blood cell. The prescription is: doxycycline hydrochloride dispersible tablets, rifampicin capsules and caffeic acid tablets B. Prescription doctor: Wei Jia".
Ms. Wang was once again diagnosed as "chronic brucellosis" by the Second People's Hospital of Gansu Province (Photographed by Ren Mengyan, reporter from China Central Radio and Television)
On March 13 this year, Ms. Wang was again diagnosed as "chronic brucellosis" by the Second People's Hospital of Gansu Province.
On the hospital certificate given to Ms. Wang by the hospital, the reporter saw: "Chronic brucellosis, admitted to the liver disease department, signed by the doctor: Li Wenbin".
However, due to the new crown pneumonia epidemic at that time, Ms. Wang did not live in the hospital and had to go home to take the medicine by herself.
"They started taking medicine for treating brucellosis in March. They said that after taking it, the white blood cells may be reduced. I said it was treated like this, so I increased the white blood cells while curing brucellosis." Ms. Wang told reporters.
The "Health Certificate" issued by the Lanzhou expert group received by Ms. Wang (photographed by Ren Mengyan, a reporter from China Central Radio and Television Station)
However, Ms. Wang’s illness was not approved by the Lanzhou Health Commission. She unexpectedly received the "Health Certificate". The reporter saw the statement: "After reviewing the Brucella antibody on July 19, your antibody is still It is positive, with a titer of 1:200++++, and it is assessed by the expert group that there is no harm to health. It is hereby certified."
The signature is: The Brucella Antibody Positive Event Expert Group of Lanzhou Veterinary Research Institute, and the stamp is the special diagnostic stamp of Lanzhou Pulmonary Hospital.
This "health certificate" made it unacceptable for Ms. Wang, who had already been diagnosed as a brucellosis patient by two hospitals.
She said: "'No harm to health', I was very angry at the time, and I said,'What I need is treatment, don't you pay attention to it?' They said to wait. There is no harm to health, no effect, 3 The monthly diagnosis report showed that it had become chronic brucellosis. What's more, the left arm can't be lifted, and the leg is severely swollen. They only said that it was compensation for 7,000 yuan and asked me to sign it. I didn't sign it."
In addition to Ms. Wang, who was identified as positive by the Lanzhou expert team, there are actually many Lanzhou residents who have been diagnosed with brucellosis by the hospital.
Mr. Zhang told reporters that he had a fever and joint pain since September last year. He was diagnosed with brucellosis by the First Hospital of Lanzhou University on January 9 this year.
The reporter saw that the prescription given to him in the hospital read: "Department of treatment: Department of Infectious Diseases. Clinical diagnosis: Brucellosis. Prescriptions: Doxycycline hydrochloride tablets and rifampicin capsules. Physician: Zhao Rongrong."
The health certificate issued by the Lanzhou expert team and the diagnosis certificate from the First Hospital of Lanzhou University received by Mr. Zhang (photographed by Ren Mengyan, reporter from China Central Radio and Television Station)
Mr. Zhang, who was diagnosed as a brucellosis patient by the First Hospital of Lanzhou University, also received the same health certificate issued by the Lanzhou expert team as Ms. Wang—"After reviewing the Brucella antibody on July 31, your antibody is still It is positive, with a titer of 1:100+++, and it is assessed by the expert group that there is no harm to health. It is hereby certified".
Mr. Zhang was very angry about this: "I had a high fever in September last year, for more than 40 days, I went to see a doctor, took medicine, and bought a lot of medicine. Since then, people have started to feel fatigued, muscle aches, and knee pain a little. According to the announcement, I hurried to the Gansu Provincial People's Hospital for an examination. The doctor at the Brucellosis Clinic gave a diagnosis and prescribed medicine."
Ms. Li, who lives not far from the Lanzhou Biopharmaceutical Factory, has had fever and sweating symptoms since September last year. She tested positive for Brucella at the beginning of this year; she started to suffer from joint pain in May of this year. Ms. Li went to Lanzhou The local hospital was clearly told that it was not brucellosis.
Ms. Li's inspection report from the Inner Mongolia International Mongolian Medical Hospital (photographed by Ren Mengyan, a reporter from China Central Radio and Television Station)
Because brucellosis is a zoonotic disease, and there are many pastoral areas in Inner Mongolia, the incidence of brucellosis is relatively high, and the treatment is more mature. In June of this year, Ms. Li went to a third-class hospital in Hohhot City-the "clothing of the Inner Mongolia International Mongolian Medical Hospital" After the examination of the Disease and Joint Department, on June 18, the chief physician De Sheng diagnosed that Ms. Li was suffering from brucellosis.
The "Health Certificate" issued by the Lanzhou expert team received by Ms. Li (photographed by Ren Mengyan, a reporter from China Central Radio and Television)
Like everyone else, Ms. Li also obtained the "Health Certificate" issued by the Lanzhou expert group-"Assessed by the expert group, there is no harm to health, hereby prove that".
Ms. Li questioned, why did the Lanzhou expert group just say that "antibody is positive and there is no health effect", and once they went to Inner Mongolia for investigation, they were diagnosed with brucellosis?
If you don't come to the hospital for treatment, isn't it a delay in treatment?
She said: "Until May, my fingers started to hurt and my knees hurt. I went to the hospital for a rheumatism check. After the test, I told about bruises. I said I was Yanchangbao (Lanzhou Bio Around the pharmaceutical factory). The doctor immediately said, “You go to the next department for an examination, you are not this.” I was really in pain, so I went to Inner Mongolia, and the doctor confirmed the diagnosis of brucellosis.”
Last summer, Mr. Xu, who worked around the Lanzhou Biopharmaceutical Factory, told reporters that after learning about the Lanzhou Biopharmaceutical Factory incident, he went to the Gansu Provincial Hospital of Traditional Chinese Medicine, the hospital designated by the Lanzhou Municipal Health Commission, for examination. It was positive, and the results of the re-examination at Lanzhou Pulmonary Hospital in June were: test tube agglutination test was negative and Tiger Red plate agglutination test was positive. The doctor told him, "It's all right."
Mr. Xu's diagnosis at the outpatient department of the CDC in Bayannaoer, Inner Mongolia (photographed by Ren Mengyan, a reporter from China Central Radio and Television)
But Mr. Xu, who is still suffering from fatigue and joint pain, went to the outpatient department of the Bayannaoer City Center for Disease Control in Inner Mongolia in October this year. On October 20, Mr. Xu’s diagnosis result came out, and was tested by Lanzhou Pulmonary Hospital. The results were different. He was still "double positive." The reporter saw on the medical certificate: Luo Jianchang, a doctor in the outpatient department of the Bayannaoer CDC, diagnosed Mr. Xu as having brucellosis, and the treatment advice was rest and medication.
Mr. Xu questioned why the Gansu Provincial Hospital of Traditional Chinese Medicine, which is a designated testing hospital for brucellosis in Lanzhou, diagnosed him as okay, but was only "antibody positive", but the outpatient department of the Bayannaoer CDC could confirm that he was a brucellosis patient?
"Night sweats, drowsiness, joint pain, these symptoms have not disappeared, I was flustered. I was only getting a test list at the Gansu Provincial Hospital of Traditional Chinese Medicine. The hospital reported to the CDC here, but did not follow me. Said how to treat. I didn’t know what to do. Then I went to Inner Mongolia because they said that treatment is safer there. They went to the Bayannaoer CDC outpatient clinic. After a blood test, the doctor’s surname Luo said I got brucellosis, the medicine he prescribed for me." Mr. Xu said.
While in Lanzhou, the reporter interviewed a number of patients with similar conditions. Their common question was: why they have been diagnosed as brucellosis patients by the hospital, but they still received the “only positive and no adverse reactions” health status issued by the Lanzhou expert group. prove?
Why is it that he has been diagnosed with the disease, but is still denied by the expert team?
More than a year has passed since the incident occurred last summer. Will they be delayed for treatment?
Some patients said: "'Antibody positive is not equivalent to brucellosis.' We believed this before. However, judging from the reactions of the majority of patients, the symptoms are consistent with brucellosis, and we go to the hospital in other places. Everyone can diagnose us as brucellosis, but when we arrive in Lanzhou, we are only positive. We don’t know what the situation is now."
The reporter came to the post-treatment work point of the Brucella antibody-positive incident of Lanzhou Veterinary Research Institute. Here, the expert in charge explained that the local people were exposed to the bacteria-containing aerosol discharged by the Lanzhou Biopharmaceutical Factory, not directly from cattle, sheep, etc. Livestock is exposed to bacteria, so even if the antibody is positive, it is not a brucellosis.
An expert at the scene who was responsible for answering questions told reporters that the reason why it was judged to be "positive" instead of "bru disease" was because the residents around the Lanzhou Biopharmaceutical Factory had no epidemiological contact history and they had to have contact with cattle and sheep. Wait for the livestock.
Expert: The contact history is directly infected with Brucella, not the Brucella vaccine antibody.
What leaked was the Brucella antibody vaccine for veterinary use, not Brucella.
Reporter: Where to evaluate?
All have a history of exposure, are positive, have symptoms, what else is needed?
Expert: This is not in my control, I only consult and tell you about the health status.
Reporter: Who is in charge?
Isn't this "health certificate" issued by the expert group?
Expert: This is not for me.
However, there is a concept you have to know, Brucella vaccine antibodies (positive) and Brucella are two different things.
At the Lanzhou Pulmonary Hospital, the doctor explained to the "brucella positive patients" for the same reason.
It can be seen in the video sent by a hospitalized "positive person" to reporters that the doctor in charge of treatment said that because the epidemiological history is not correct, even if they live near the drug factory, they are not getting brucellosis. ,no need to worry.
Positive person: Why are we not sure that it is brucellosis now that we always say that the antibody is positive?
Doctor: The diagnosis of brucellosis requires finding the pathogen. You cannot match the epidemiological history. If you are engaged in contact with beef and mutton, you will be able to match it immediately because it is a live bacteria.
The epidemiological history given to you now is that, so it is two concepts.
Don't go for treatment if you don't need treatment. The medicine you use is for sterilization. It doesn't make sense to use the medicine without bacteria.
Pain is another thing for you.
Can't diagnose brucellosis without contact with livestock?
What are the consequences if brucellosis is not treated in time?
The reporter interviewed a number of authoritative experts. They believe that the epidemiological investigation of brucellosis can only be diagnosed by contact with cattle, sheep and other livestock. Contact with unsterilized fur products, laboratory infections and improper use of vaccines can all lead to Brucellosis.
The reporter saw in the health industry standards that the reporter saw that for the diagnosis of brucellosis, the required epidemiological history is in addition to “the patient had a history of close contact with livestock and livestock products suspected of brucellosis infection, or raw food There is another item of “being engaged in the cultivation and testing of Brucella or the production and use of Brucella vaccine” outside of the “brucella epidemic area”.
During the interview, Qin Enqiang, deputy director of the infection center of the Fifth Medical Center of the PLA General Hospital, told reporters that brucellosis is indeed the most common infection through animals, but there are also cases of infection through other contact methods.
He said: "First of all, this disease can infect animals. The most common ones are raising sheep, raising cattle, and raising pigs. Once an animal is infected, it is especially vulnerable to infection if it is not protected by itself. In addition, contact with animal fur is also It is contagious. There is no history of exposure, but it is positive. At this time, it is necessary to evaluate carefully. Generally speaking, the possibility of no history of exposure to brucellosis is extremely small. Lanzhou (that incident) must have exposed the pathogen, and no exposure History will not be infected out of thin air." Qin Enqiang said.
Desheng, the attending physician of the Brucellosis and Joint Department of Inner Mongolia International Mongolian Medical Hospital who has received Ms. Li, said that in addition to contact with cattle and sheep, laboratory infections and infections through improper use of vaccines are also common.
"Some people in the laboratory got it, and some people in this ranch or when the common people have brucellosis vaccine, they touch it with their hands, and get them in the eyes, nose, and mouth, and they can also be infected through the vaccine."
Qin Enqiang said that if patients with brucellosis are not treated in time, they will become chronic or even in the late stage, and treatment will be more difficult by then.
He said: "The most common manifestations of this disease are fever, sweating, headache, and joint pain. In addition, it can cause whole body such as hepatosplenomegaly, which can cause systemic multiple organ damage, so this disease should be treated in time. If If not treated in time, some patients, such as long-term fever, sweating, and especially severe joint pain, may be very difficult to treat in the chronic stage or in the late stage. In severe cases, it may also affect fertility."
Li Tong, deputy chief physician of the Department of Infectious Diseases of Beijing You’an Hospital, once introduced that brucellosis has a relatively mature treatment plan. If it is treated in time, it will not leave serious sequelae; if the treatment is not timely, even if the bacteria in the body is removed, It will cause damage to the body, especially the joints.
He said: "The so-called'lazy man's disease', the sequelae are left because the treatment is too late. In the past, there were some places where the understanding of the disease was insufficient, and after the disease became chronic, it was treated until the joint destruction had occurred. Even if the brucella is eliminated from the body through treatment, it is difficult to recover from the dead joints. It is indeed called sequelae."
In the Brucella antibody-positive event in Lanzhou, did anyone suffer from brucellosis?
How many people have such situations?
Can they get timely and standardized treatment?
Why is the statement of the Lanzhou expert group so different from the statements of many other hospitals and medical professionals?
The reporter made a special trip to Lanzhou to contact the Lanzhou Municipal Health Commission on this, and made many requests for interviews. As of press time, no response has been received.
The Voice of China will continue to monitor the progress of the incident.