Yumen City of China is Sealed off to outside world?, Did China just make a bizzare decision or a informed Right one as a Precaution?.

Updates!: One would expect more news or updates on this sealed off city in China, nothing came out after the initial news?...Whatever news came out on this issue was in the month of July?.

Plague is treatable disease, diligence and scientific approach is a must but not panicky and seal off of a city. Here is a NIH site with a treatment info:

Image on the left: This Flea is a carrier of Plague Bacteria.

at the bottom is the image of the bacteria: Yersinia Pestis
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PubMed Health: Plague Treatment

People with the plague need immediate treatment. If treatment is not received within 24 hours of when the first symptoms occur, death can result.
Antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin are used to treat plague. Oxygen, intravenous fluids, and respiratory support usually are also needed.
Patients with pneumonic plague should be strictly isolated from caregivers and other patients. People who have had contact with anyone infected by pneumonic plague should be watched carefully and given antibiotics as a preventive measure.

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City of Yumen, China

The following news piece is not related to our field of Neuromonitoring but to disease, medicine and general health care. The way this disease and a case of death has been dealt with a country as large as China is bit unusual and rather bizarre, why?.

What exactly is happening in Yumen City right now:

MSN News: The 30,000 people living in Yumen in the northwestern province of Gansu are not being allowed to leave, and police at roadblocks on the perimeter of the city are telling motorists to find alternative routes, state broadcaster China Central Television (CCTV) said. The 38-year-old victim died last Wednesday, the report said, and had been in contact with a dead marmot, a small furry animal which lives on grasslands and is related to the squirrel. "The city has enough rice, flour and oil to supply all its residents for up to one month," the report added. "Local residents and those in quarantine are all in stable condition."

"Live Science" in its latest news report published a piece (news headline and link posted below) about single case of "Plague" death in a small city called Yumen in China. According to the news sources, there is only one Plague death and no other reported case of death or ill (or perhaps the China media or govt did not say so?). Why would a country like China which has good research and science facility and medical facility will take a rather unscientific and scary decision to seal off the town/city. 

As per CDC and experts in the field, this is a treatable disease if the patient or victim is brought to the right treatment facility in the earlier stages of infection. Hope some Chinese experts in the field of infectious disease inform the authorities about this treatments. 

If it is a Bubonic Plague and if there is treatment available, why did the man died?, and why the city authorities sealing off the city?. It seems the man who died of Plague was interacted with more than 100s of people in that town, that is still not a reason to seal off an entire town, especially the kind of plague infected the dead person was Bubonic Plague, a less infectious and not transferable form of plague. Unless, he had died of other variants of Plague that can be transferred from one human to another, why would such a extreme decision to seal off the city was taken. Or are there more infections that news is not yet out to the public?. This is exactly why I call this Bizzare, this kind of actions will scare the people and create a fear, that is not at all inevitable given the circumstances of this disease, infact the US authorities say every now and then they come across rare cases of plague right here in USA!!. We don't seal off a town or city here...the patient gets the attention of right type of experts and doctors to provide treatment.

On a second thought, I am inclined to think the China is taking every precaution they can because of their past history of plague that devastated the nations.

Note: This Editorial is not to blame China or say insensitive thing about the nation or its actions, it is finally left to them to deal with the situation as it is appropriate, but a thorough scientific approach is a must.

Chinese Officials Seal Off 'Plague' City, Puzzling US Experts

by Rachael Rettner, LiveScience Staff Writer   |   July 22, 2014 06:20pm ET

EEG technique and Treatment of Rolandic Epilepsy treatment?.

Looking at the EEG patterns periodically at certain time difference, could be week or month in between, Yamanashi and his colleague found that there is a repetitive high frequency EEG waveform abnormality that can be used to strategies for treatment?. Although, it is a brief study on small number of children's, EEG recordings and the abnormal waveform morphology is one of the or the only way to ascertain what to do with such epileptic patient, actually, while referring to the recent reviews in this field, I found this compelling review article   by Dr.Markand, MD (see at the bottom after the Yamanashi's work).

What was their research model and study is about:

A total of ten children between the ages of three and ten with recurrent seizures and 12 patients aged between four and seven years who experienced isolated seizures were enrolled in the study, with seizure recurrence and prolonged high-frequency EEG paroxysm data being correlated by the scientists.
Repeated EEG recordings were taken every three months, with clinical and EEG follow-up performed for four or more years. It was discovered that seizure recurrence and extended periods of high-frequency paroxysmal EEG abnormalities for more than 6 months after onset were significantly linked.

New study shows how EEG can aid rolandic epilepsy treatment

Posted May 21 2014 in epilepsy in children and its treatment

A new study from Japan has shed light on how electroencephalogram (EEG) techniques can be useful in aiding the treatment of patients with rolandic epilepsy.

This form of epilepsy is generally associated with favourable outcomes, with a moderate proportion of cases characterised by isolated seizure events, meaning continuous treatment need only be considered only for those affected by frequent seizures.

As such, the new research from the University of Yamanashi aimed to identify EEG criteria related to seizure recurrence in rolandic epilepsy, in order to help guide treatment strategies for those in this patient group.


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The review article that I mentioned above:

a good read to get the background idea of how the neurophysiologist, neurologist or clinicians can discern the EEG patterns:

Seminars in Neurology

Pearls, Perils, and Pitfalls In the Use of the Electroencephalogram

Omkar N. Markand, MD, FRCPC

 An EEG is the most common and most useful test performed in evaluating patients suspected of epilepsy. There are many areas where an EEG has unique contributions. The value of an EEG lies in the fact that it not only shows specific ictal discharges during a clinical seizure but also characteristic epileptiform abnormalities in a high proportion of epileptic patients even in the interictal period. Furthermore, an EEG may be the only test demonstrating focal abnormalities responsible for the patient's epileptic seizures. Specific patterns in the EEG make it possible to classify the seizure type, which is an essential prerequisite to institute proper antiepileptic medication. An EEG is indispensable for the diagnosis of nonconvulsive epileptic status presenting as prolonged "twilight" state or a prolonged episode of abnormal behavior. In a patient with bizarre motor activity, the recording of an EEG during such an episode may be the only way to establish whether the abnormal behavior is due to an epileptic seizure or a nonepileptic event, physiologic or nonphysiologic. Finally, the EEG is indispensable to localize the epileptogenic (seizure producing) zone before resective surgery (excision of the epileptogenic zone) is undertaken in a patient with medically refractory focal epilepsy.

Epilepsy: Drug Resistent Focal Epilepsy & Surgical Resection treatments, two Epilepsia Reports

Brain and Spine, 2014 Research Reports:

Fig from-Link: Human Epilepsy Patterns, focal epilepsy,

The following two new research reports published in Epilepsia journal [quoted Epilepsy current]might be of interest to those Epilepsy doctors and professionals, ofcourse to Neurophysiologists and long term intraoperative monitoring field.

Quoted: Current Literature In Clinical Science
Are HFOs Still UFOs? The Known and Unknown About High Frequency Oscillations in Epilepsy Surgery

High-Frequency Oscillations, Extent of Surgical Resection, and Surgical Outcome in Drug-Resistant Focal Epilepsy.

Haegelen C, Perucca P, Chatillon CE, Andrade-Valenca L, Zelmann R, Jacobs J, Collins DL, Dubeau F, Olivier A, Gotman J.

Epilepsia 2013;54:848–857.

PURPOSE: Removal of areas generating high-frequency oscillations (HFOs) recorded from the intracerebral electroencephalography
(iEEG) of patients with medically intractable epilepsy has been found to be correlated with improved surgical outcome. However, whether differences exist according to the type of epilepsy is largely unknown. We performed a comparative assessment of the impact of removing HFO-generating tissue on surgical outcome between temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE). We also assessed the relationship between the extent of surgical resectionand surgical outcome.

Read the full abstract at: http://www.aesnet.org/files/dmfile/epcu_13.6_273_ClinicalCommentary_Jobst.pdf#!
And the Full article at Epilesia journal.

Ripple Classification Helps to Localize the Seizure-Onset Zone in Neocortical Epilepsy.

Wang S, Wang IZ, Bulacio JC, Mosher JC, Gonzalez-Martinez J, Alexopoulos AV, Najm IM, So NK.

 Epilepsia 2013;54:370–376.

PURPOSE: Fast ripples are reported to be highly localizing to the epileptogenic or seizure-onset zone (SOZ) but may not be readily found in neocortical epilepsy, whereas ripples are insufficiently localizing. Herein we classified interictal neocortical ripples by associated characteristics to identify a subtype that may help to localize the SOZ in neocortical epilepsy. We hypothesize that ripples associated with an interictal epileptiform discharge (IED) are more pathologic,since the IED is not a normal physiologic event.

For full abstract and article, refer as the previous.