宾夕法尼亚州官员已确认四例麻疹相关死亡病例。据报道，其中两例为儿童。卫生与公众服务部部长小罗伯特·F·肯尼迪因如何界定疫情状况的措辞问题，陷入了一场公开的语义之争。对于全国其他地区而言，这场争论掩盖了一个更为显而易见的问题：麻疹——一种传染性极强、可通过疫苗预防且有时致命的疾病——正在蔓延。
By The Editors Pennsylvania officials have confirmed four measles-related deaths. Two, according to reports, are children. Health and Human Services Secretary Robert F. Kennedy Jr. has been embroiled in a public battle of semantics over how to characterize the circumstances. To the rest of the nation, the debate obscures a more obvious problem. Measles — a highly contagious, vaccine-preventable and sometimes fatal disease — is on the rise.
宾夕法尼亚州的麻疹聚集性疫情是全国范围内疫情反弹的一部分。多年来，幼儿园儿童的疫苗接种率持续下降，且仍低于防止社区传播所需的95%阈值。目前病例数已达到35年来的最高水平。
The measles cluster in Pennsylvania is part of a nationwide resurgence. Vaccination rates for kindergarteners have been declining for years and remain below the 95% threshold needed to prevent community transmission. Cases are at their highest level in 35 years.
所谓“群体免疫”的减弱使所有婴儿面临风险。麻疹疫苗通常需接种两剂，第一剂一般在12至15月龄时接种。当社区疫苗接种率较高时，传播率较低，未接种者——包括年长儿童和成人——也能得到保护。（正如一位研究人员所言，单例麻疹病例“就像火星落在潮湿的地面上”。）然而，当社区疫苗接种率下降时，未接种者便变得易感。麻疹极易传播——一人可感染多达18人，而埃博拉病毒仅为3人。因此，看似微小的疫苗接种率下降，可能会带来严重甚至致命的后果。
Weakening so-called herd immunity puts all infants at risk. The first of a two-dose measles shot typically is given at around 12 to 15 months of age. When community vaccination is high, the rate of transmission is low and the unvaccinated — including older children and adults — are protected. (As one researcher puts it, a single measles case would be “like an ember falling onto damp ground.”) When community vaccination falls, however, the unvaccinated become vulnerable. Measles is easily transmissible — with one person capable of infecting up to 18 others, compared with three for Ebola. Thus, what may seem like a minor drop in vaccination rates can have serious, sometimes deadly, consequences.
麻疹是一种凶险的疾病。典型症状包括皮疹、高烧、咳嗽和流鼻涕。重症病例可能导致肺炎和脑水肿。麻疹不仅在感染期间削弱免疫系统，还会损害人体对抗既往接触过的细菌和病毒的能力，使患者在数年内都处于易感状态。
Measles is a nasty disease. Typical symptoms include rash, high fever, cough and a runny nose. More severe cases can lead to pneumonia and brain swelling. Measles not only weakens the immune system during infection, but it also can impair the body’s ability to fight bacteria and viruses it has encountered before, leaving patients vulnerable for years.
宾夕法尼亚州记录的首两例死亡病例均为婴儿：其中一名婴儿出生时携带可能致命的基因缺陷，另一名婴儿则因脾脏破裂而死亡。尽管这两名婴儿的检测结果均显示他们感染了麻疹病毒，但初步报告并未将麻疹确定为他们的死因；因此，宾夕法尼亚州卫生部门将这些病例归类为“与麻疹相关的死亡病例”（这是符合常规做法的）。然而，肯尼迪却利用了这一信息差异，在社交媒体上声称这些死亡病例是“被伪造的”。随后，他要求美国疾病控制与预防中心（CDC）将这些病例从官方统计报告中删除；CDC的新任主任埃里卡·施瓦茨遵从其要求，将相关数据从网站上移除了。
The first two deaths recorded in Pennsylvania were infants: one was born with a potentially fatal genetic defect; the other died of a ruptured spleen. Although both tested positive for measles, early reports didn’t establish measles as the causeof death. Pennsylvania health officials reported them as “measles-associated.” (This is normal.) Kennedy nevertheless exploited the discrepancy. In a social media post, he initially suggested the deaths had been “fabricated.” According to news reports, he then directed the Centers for Disease Control and Prevention — which had, per agency standards, posted the deaths to its website based on state reporting — to remove them. Erica Schwartz, the newly confirmed director, obliged.
几天后，CDC更新了死亡病例统计数据，并在相关条目中添加了星号（*），表示该机构没有记录到2026年因麻疹导致的死亡病例。本周，在与宾夕法尼亚州卫生部门之间的争议加剧后，CDC最终将这起死亡病例重新纳入了统计范围（不过该条目上的星号仍未被删除）。CDC在其官方网站上表示，他们正在与州卫生部门合作，制定“针对麻疹相关死亡的标准化病例定义”。不过，宾夕法尼亚州在报告这些病例时使用的术语其实并无不妥之处——因为麻疹很少是导致死亡的直接原因，它通常会引发其他危及生命的并发症；此外，CDC的职责也不在于确定具体死因，他们主要依赖各州卫生部门的报告数据。
Days later, the CDC’s death count was updated with an asterisk, indicating the agency had no death records from 2026 with measles as the “underlying cause.” This week, after a deepening dispute with Pennsylvania officials, the agency included one death in its tally. (The asterisk remains.) The CDC, according to its website, is working with state epidemiologists to “develop a standardized case definition for deaths due to measles.” Yet there was nothing unusual about Pennsylvania’s terminology. For starters, measles is seldom the direct cause of death. Rather, it leads to other life-threatening complications. More to the point, the CDC isn’t in the business of establishing causation. It tends to rely on reporting from state health officials.
然而，故意制造对统计数据及定义的怀疑往往是一种有效的手段，用于削弱公众对疫苗的信任。多年来，肯尼迪一直宣扬已被科学界驳斥的谬论，即疫苗（包括麻疹疫苗）可能导致自闭症。与此同时，他上个月还签署了一项行政命令，试图限制儿童的疫苗接种计划，但这一决定缺乏任何科学依据。在这种情况下，公众感到困惑或怀疑也在情理之中。
Sowing doubt about statistics and definitions, however, is often an effective way to undermine vaccines. For years, Kennedy has promoted the debunked notion that vaccines, including the measles shot, may cause autism. The president, meanwhile, issued an executive order last month that seeks to limit the childhood vaccine schedule with little in the way of supporting evidence. The public can hardly be blamed for feeling uncertain.
在她的确认听证会上，施瓦茨表示她在疾病控制与预防中心（CDC）的首要任务是通过“彻底的透明度”来重建公众的信任。作为一名经验丰富的公务员，施瓦茨应该明白：该机构真正需要的其实只是清晰、一致的数据而已。她有责任向公众解释最近报告标准的变化；而国会则应该对她的工作表现进行监督和问责。
In her confirmation hearing, Schwartz said her first priority at the CDC would be to restore public trust through “radical transparency.” A longtime public servant, Schwartz should know there’s nothing radical about what’s needed at the agency: clear, consistent data. She owes the public an explanation about recent changes to reporting standards. Congress, for its part, should hold her accountable.
肯尼迪或许希望公众认为他通过揭露疫苗的危害是在为国家做贡献，但实际上他正在掩盖事实——没有任何一个孩子应该因为麻疹而死亡。公众真正需要的是“双倍的诚实”（即既要提供准确的信息，也要坦诚面对事实）。
Kennedy might like the public to believe he’s doing the nation a great service by revealing the dangers of vaccines. In reality, he’s burying the facts: No child should die of measles. A double dose of honesty is what the public needs.
如需联系负责《彭博观点》（Bloomberg Opinion）社论的资深编辑蒂莫西·L·奥布莱恩（Timothy L. O’Brien），请发送邮件至 tlobrien@bloomberg.net。
To contact the senior editor responsible for Bloomberg Opinion’s editorials: Timothy L. O'Brien at tlobrien@bloomberg.net