Two recent anthrax cases in Shandong province, including a fatal one, underscore the need to increase awareness about the disease and improve training for grassroots medical workers, a report said.
A 14-year-old student died on Aug 6 after voluntarily leaving a large urban hospital, said the report published last week on China CDC Weekly, an academic platform established by the Chinese Center for Disease Control and Prevention.
On July 28 and 30, the student, who was experiencing fever and diarrhea and other symptoms, visited a rural clinic in Binzhou, Shandong. The student was transferred to an urban hospital on July 31 after suddenly losing consciousness.
The other case involved a 35-year-old man who had slaughtered sick cattle at the student's home on July 25, the report said. He was confirmed as being infected with the bacteria and is receiving treatment at a hospital.
The cattle suspected of carrying the anthrax were purchased from the northeastern province of Jilin in early July. Investigations found "black blood flowed on the ground, and internal organs emitted a peculiar smell during the slaughtering process", the report said.
It called for greater efforts to promote knowledge about preventing anthrax and strengthening training of workers at primary medical institutions, to promptly detect and diagnose anthrax cases.
Anthrax mainly affects herbivorous animals such as cattle, but can also cause severe illnesses in humans. Those involved in breeding, slaughtering and selling livestock or processing hides are more at risk of exposure to the bacteria, according to a recent notice issued by the China CDC.
The bacteria can spread through contact with the skin, breathing it in or ingesting it and can attack the skin, intestines and lungs. Pulmonary anthrax, the most lethal form, has a fatality rate of more than 90 percent, said the notice. Human-to-human transmission is possible but very rare, it said.
Last year, China reported 224 anthrax cases and no deaths.
This year, 18 provincial-level regions have had confirmed anthrax infections. Disease control workers in Tongliao in the Inner Mongolia autonomous region said in a recently issued statement that several suspected cases had been detected in the city.
According to the CDC report, health workers in Shandong tracked down and isolated all close contacts of the two confirmed cases and screened more people in the region they came from. As of Aug 24, no new cases had been reported.
Environmental samples collected from the two patients' homes, a local processing plant and cold storage facility tested positive for anthrax. The affected areas have been disinfected, beef products disposed of and animal immunization carried out, it added.
Li Tongzeng, an infectious diseases doctor at the Beijing Youan Hospital, said the majority of anthrax infections occur on the skin and can be treated. However, it is difficult to wipe out the bacteria in livestock breeding areas, as spores can lie dormant in soil or animal carcasses for decades and remain infectious.