Trafficked Malayan pangolins contain viral pathogens of humans.

Pangolins are the most trafficked wild animal in the world according to the World Wildlife Fund. The discovery of SARS-CoV-2-related coronaviruses in Malayan pangolins has piqued interest in the viromes of these wild, scaly-skinned mammals. We sequenced the viromes of 161 pangolins that were smuggled into China and assembled 28 vertebrate-associated viruses, 21 of which have not been previously reported in vertebrates. We named 16 members of Hunnivirus, Pestivirus and Copiparvovirus pangolin-associated viruses. We report that the L-protein has been lost from all hunniviruses identified in pangolins. Sequences of four human-associated viruses were detected in pangolin viromes, including respiratory syncytial virus, Orthopneumovirus, Rotavirus A and Mammalian orthoreovirus. The genomic sequences of five mammal-associated and three tick-associated viruses were also present. Notably, a coronavirus related to HKU4-CoV, which was originally found in bats, was identified. The presence of these viruses in smuggled pangolins identifies these mammals as a potential source of emergent pathogenic viruses.

Gunpowder explosion burns in fireworks factory: causes of death and management.

The mortality rate of gunpowder explosion burns from fireworks factory accidents was high. The aim of this study was to evaluate the impact of different managements on outcome of these burns patients and to optimize treatment measures and decrease the morbidity and mortality. During the period from January 1987 to December 1999 in our center, 44 patients burned in gunpowder explosions died. Fifty sex-, age-, TBSA- and full-thickness-matched patients who survived were selected randomly as a comparison group. Data on time and causes of death, fluid resuscitation, and management of inhalation injury, associated injuries and wound were collected. Half of the deaths occurred during the first week after burn. The commonest cause of death was sepsis (27 patients), followed by MODS (11 patients), then hypovolaemic shock (4 patients) and pulmonary infection (2 patients). Thirty-six dead patients and 10 surviving patients had received insufficient fluid resuscitation and developed severe shock. Prophylactic tracheotomy was undertaken in 15 patients, of whom 6 died. Thirty-two patients had undergone emergency tracheotomies, of which 29 died. All associated injuries had been well-managed and no death was related to associated injuries or their complications directly. In the group of patients who died, 20 had undergone early excision (within 1 week of injury) and grafting. The number of patients in the survivor group who underwent early excision and grafting was 31. These results indicate that the sepsis and MODS are the two commonest causes of death for the patients who sustained burns by gunpowder explosions in fireworks factory. The optimal managements of this type of burn are as follows: (1) sufficient fluid resuscitation and invasive monitoring if necessary; (2) prophylactic tracheotomy and mechanical ventilation for the patients whose upper-airway edema is present or airway patency is threatened; (3) early excision and grafting of lager-deep wounds and covering with allograft with microautograft (1:10); (4) life-threatening associated injuries must be treated immediately after admitting.

Burns due to gunpowder explosions in fireworks factory: a 13-year retrospective study.

The aim of this study was to evaluate the epidemiology of burns due to gunpowder explosions in fireworks factories. Three hundred and fifty-one patients having burns caused by gunpowder explosions in a fireworks factory were admitted to our center from 1 January 1987 to 31 December 1999 and the clinical notes of 339 patients were available for review. Data on age, sex, size, depth and sites of burn, incidence by month, inhalation injury, associated injuries, number of operations, length of hospital stay, morbidity, mortality, and causes of explosions were recorded. The majority of the patients were male, with a mean age of 36.7 years. The mean total burn surface area was 40.9%, mostly deep burns. The commonest areas of the body to be injured were the head and neck. One hundred and eighty-five patients (55%) were injured in December, November, and January. Sixty-five patients (19%) had an inhalation injury, 35 having tracheotomies and mechanical ventilation. Thirty-five patients (10%) had associated injuries, the commonest being the fracture of limbs (25 patients). Two hundred and thirty-two patients (68%) required operations while the number of operations including debridement and grafting, or tracheotomy, per patient were 2.7. The mean time in hospital of the survivors was 32 days with a range of 1-94 days. Acute respiratory distress syndrome (ARDS) and sepsis were the commonest complications during the early post-burn period (7 days or less) and the later period (>7 days), respectively. Forty-four patients died in this series giving a mortality rate of 13%. The commonest cause of death was sepsis (27 patients), followed by multiple organ dysfunction syndrome (MODS) (11 patients). Most accidents (71%) were caused by too much gunpowder put in at one time and accidents resulting from carelessness while making fireworks. Prevention measures are also discussed.