1 Subject content and scope of application

This standard stipulates the blockade and isolation of human plague epidemic areas, the treatment of epidemic areas, the treatment of patients and their direct contacts, and the lifting of blockade and isolation.

This standard is applicable to people's governments at all levels, health authorities, medical and health institutions, health and epidemic prevention institutions and units, households and individuals involved in the treatment of epidemic areas.

2 terminology

2. 1 human plague epidemic area

Divided into historical epidemic areas and current epidemic areas. Historical epidemic areas refer to areas or places that have been designated as plague foci, where human plague has occurred, and have stopped or no human plague epidemic; Epidemic area refers to the area or place where human plague is occurring in the plague focus.

2.2 Treatment of epidemic areas

Various technical countermeasures and responsibilities taken by epidemic areas, including the treatment and management of patients, the dead and direct contacts.

2.3 Blockade and isolation

Plague patients and their direct contacts, as well as people and articles in areas or places that may be polluted, shall be isolated from people and articles in unpolluted areas or places.

2.4 Health isolation

Isolate people who have direct contact with plague patients, corpses and various articles contaminated by Yersinia pestis, including those who have never suffered from plague in a small isolation circle.

2.5 direct contact

People who are in direct contact with plague patients, corpses, articles contaminated by Yersinia pestis and air.

3. Standards for blockade and isolation of human plague epidemic areas

3. 1 Anyone who is identified as a suspected plague patient (or corpse) shall be treated as a plague patient before the patient (or corpse) is excluded from suffering from plague.

3.2

The epidemic area diagnosed as a plague patient (or corpse) must be delineated with a small isolation circle. Taking the residence of plague patients (or corpses) as the center, the polluted neighbors around them are designated as small isolation circles. People in small isolation circles should be isolated healthily.

3.3

When pneumonic plague patients (or corpses) occur in sparsely populated mountainous areas or pastoral areas, only a small isolation circle is delineated; When it happens in densely populated and densely populated places, it is necessary to delimit large and small isolation circles. Taking the houses of plague patients as the center, part or all of their villages and streets are divided into large isolation circles.

3.4 In densely populated areas, when human plague occurs at multiple points at the same time, it is not necessary to draw a large isolation circle, and the whole village or several villages can be divided into blockade isolation areas according to the distribution of patients.

3.5 When a plague patient occurs during a trip or in a hospital, the carriage where the patient is located, the polluted places such as stations or hospitals should be quickly blocked and isolated, and immediately separated from the personnel in non-polluted places.

3.6 Quickly identify the direct contacts of plague, and isolate them on the spot for detention.

See appendix a for the above contents.

4. Standards and principles for handling human plague epidemic areas

4. 1 Plague patients, suspected plague patients and their direct contacts must set up separate wards and isolation rooms. Pneumonic plague of plague patients,

Set up a separate ward for patients with intestinal plague. People in the isolation circle or area are not allowed to go out and check twice a day, morning and evening 1 time.

4.2

The small isolation circle for patients with pneumonic plague and intestinal plague must be disinfected first; Disinfect expectoration and excreting dirt in time; Rodents and fleas in large and small isolation zones or isolation zones; Disinfect or burn contaminated places, articles, cookers and tableware; All kinds of articles are prohibited from being transported abroad.

4.3 Kill fleas and rats in the isolation circle of bubonic plague and other types of plague, and disinfect wards and isolation rooms every day 1 time.

4.4 To control the cats and dogs in various plague isolation circles or areas, so that cats and dogs can kill fleas.

4.5 When the epidemic area is blocked and isolated, it is necessary to quickly carry out epidemiological investigation, trace the source of infection, and find out the direct contacts, pollutants and pollution scope.

4.6

When the source of infection is an animal, it must be handled according to the provisions of the plague prevention and control manual; When people peel off and eat infected animals, their skins, greasy meat, bones, contaminated items and places must be disinfected or burned.

4.7 Plague corpses and their contaminated parts must be disinfected, deratization and flea extermination. After disinfection, the corpses should be burned or buried underground. It is forbidden to hold any form of funeral.

See appendix b and appendix c for details.

5. Standards and handling principles for removing the isolation between patients and direct contacts.

5. 1 To rescue and treat plague patients quickly, give special care, pay attention to the change of illness, and adjust the treatment plan in time.

5.2

After treatment, the body temperature of patients with pneumonic plague returned to normal, and the symptoms and signs were obviously improved. After 3-5 days of treatment, after stopping treatment, the sputum and throat secretions were continuously examined for Yersinia pestis for 3 times, every 3 days 1 time. When they are all negative, the isolation can be lifted.

5.3 After treatment, patients with bubonic plague and other types of plague return to normal body temperature, their systemic symptoms disappear, swollen lymph nodes are completely absorbed or there are small induration residues, and isolation can be lifted.

5.4 For patients with cutaneous plague and swollen lymph node rupture, after the wound surface is cleaned and basically healed, Yersinia pestis should be examined for three times in a row, and isolation can be lifted if it is negative every three days 1 time.

5.5

Direct contacts must be isolated on the spot, detained and treated for 9 days; Those who go to other places should be traced quickly and isolated for 9 days for preventive treatment; After 9 days, when there are no new plague patients and suspected plague patients, the isolation will be lifted; If there are new plague patients during the detention period, their direct contacts will be re-isolated for 9 days, and if there are no new plague patients after 9 days, the isolation will be lifted.

6 standards for lifting the blockade and isolation of human plague epidemic areas

6. 1 The quarantine area reached the standard of killing rats and fleas, and finally 1 patient was cured without new plague patients and suspected patients; Terminal disinfection of wards, isolation rooms, pollutants and polluted places can lift the blockade and isolation.

6.2

If the plague patient has not recovered, only the patient and his ward will be blocked and isolated, and the isolation circle or isolation area can be lifted as scheduled. When the patient is cured, the clothes in the ward must be disinfected at last before the blockade and isolation can be lifted.