刚果的埃博拉疫情正在迅速蔓延至多个新疫区，而这些地区的患者几乎得不到任何医疗援助。
The Ebola outbreak in Congo is spreading rapidly to new hot spots where patients have little or no support.
据医疗工作者及官方人士称，刚果的埃博拉疫情正催生出多个新疫区，当地患者、救援人员均缺乏必要的支持。卫生部门承认，要彻底控制这种已导致逾4000人死亡的疫情，恐怕仍需漫长努力。
CHINEDU ASADU Ebola outbreak in Congo is creating new hot spots where there’s little to no support for patients, responders and officials say, as health workers admit there could still be a long way to go in fighting the disease that has killed over 4,000 people.
非洲疾控中心主任让·卡塞亚博士向美联社透露，目前超过70%的新增病例均来自已知接触者范围之外，至少60%的死亡病例发生在治疗中心外。“还有许多感染者尚未接受检测、治疗或被记录在案，”卡塞亚周二说道。
More than 70% of new cases are still coming from outside of known contacts and at least 60% of deaths are outside of treatment centers, Africa CDC Director-General Dr. Jean Kaseya told The Associated Press. “There are so many other people who are becoming sick, who are not tested, treated, or listed,” said Kaseya on Tuesday.
饱受冲突困扰且地处偏远的北基伍省如今已成为新的疫情中心，该省新增确诊病例占刚果全国总数的40%左右，而8月底这一比例仅为24%。无国界医生组织项目协调员斯蒂芬妮·霍夫曼指出，当地的防疫工作仍处于“混乱状态”。“目前缺乏协调与组织机制，实地参与救援的人员也严重不足，”霍夫曼对美联社说道。
conflict-battered, remote North Kivu province which has emerged as the new epicenter, now accounts for around 40% of all newly confirmed cases in Congo, compared with 24% at the end of August. But the response on the ground is “chaotic,” said Stephanie Hoffmann, a project coordinator with Doctors Without Borders (MSF). “There is a lack of coordination and organization, but there’s certainly a lack of actors present here,” Hoffmann told the AP.
此次疫情由邦迪布焦病毒引发，目前尚无获批的疫苗或治疗方案。由于大规模人口流动、武装叛乱、民众信任度低下以及一线防疫人员待遇恶劣等多重不利因素，这场疫情于5月份在刚果爆发，成为该国历史上致死人数最多、应对难度最大的埃博拉疫情。
Congo’s deadliest Ebola outbreak — caused by the Bundibugyo virus, which has no approved vaccine or treatment — was declared in May under some of the most challenging conditions imaginable fueled by mass population movements, rebel violence, mistrust and poor welfare of front line workers.
根据刚果政府数据，此次疫情已累计报告8500多例确诊病例，是迄今为止传播速度最快、致死人数最多的埃博拉疫情。周二，肯尼亚报告了首例埃博拉确诊病例：一名从刚果入境的男子在接受治疗过程中不幸去世。
Congo has recorded more than 8,500 cases in the outbreak, according to government data, making it the fastest-growing Ebola outbreak on record and the country’s deadliest. On Tuesday, Kenya reported its first Ebola case a man who arrived from Congo and died while receiving treatment.
卡耶萨博士指出，目前面临的最大挑战就是接触者追踪工作。迄今为止，只有23%的埃博拉患者潜在接触者被成功追踪到。该疾病正在刚果的一个地区蔓延，由于经济活动、冲突导致的流离失所以及采矿业发展，该地区人口流动十分频繁；同时当地民众对政府缺乏信任，关于病毒的错误信息也广泛流传。
The biggest challenge to date is contact tracing, Dr. Kayesa said. Only 23% of expected contacts of Ebola patients have so far been traced. The disease is spreading in a region of Congo with intense population movements due to economic activities, conflict displacement and mining, and where there’s deep mistrust with the government and misinformation about the virus.
“除非我们采取以村庄为核心的防控策略，否则我无法预测疫情何时能够得到控制，”非洲疾控中心负责人说道。他呼吁让各村庄及当地领导人直接参与接触者追踪、死者遗体处理以及患者隔离工作。
“I’m unable to tell you when we can stop this outbreak unless we implement the village-centered approach,” the Africa CDC chief said, calling for direct involvement of villages and local leaders in contact tracing, burials of deceased patients and isolation of cases.
多家埃博拉治疗中心不堪重负，其他医疗机构也纷纷提供支援 世界卫生组织称，北基伍省的众多埃博拉治疗中心正饱受医护人员与医疗物资短缺之苦，这进一步导致患者死亡率上升。
Treatment centers overwhelmed as other health facilities support Many Ebola treatment centers in North Kivu are struggling with shortages of health workers and supplies, contributing to more deaths among patients, the World Health Organization has said.
北基伍省的病例死亡率高达58%，在刚果受疫情影响的七个省份中位居首位。目前疫情已扩散至该省34个卫生区中的半数。根据卫生部数据，在受影响的17个卫生区中，有9个区域超过半数的确诊患者均已死亡。
North Kivu’s case fatality rate of 58% is the highest among Congo’s seven affected provinces. The disease has spread to half of its 34 health zones. In nine of those 17 affected zones, more than half of patients with confirmed infections have died, according to Health Ministry data.
无国界医生组织表示，由于急需治疗，北基伍省部分地区的患者只能求助于普通医疗机构。
Desperate for care, patients in some parts of North Kivu have turned to regular health facilities, MSF said.
“当地医护人员承受的压力最大，因为他们必须在两种选择间做出抉择：是让社区里的患者回家等死，还是冒着风险在自己的诊所里为他们提供治疗，”无国界医生组织驻北基伍省布滕博市的埃博拉治疗中心协调员霍夫曼说道。
“Local healthcare workers are the ones feeling this the most because they have to make the decision between sending their community members home to potentially die by themselves or putting themselves at risk to help treat them in their health center,” said Hoffmann, coordinator of MSF’s Ebola treatment center in Butembo, North Kivu.
部分家属不愿上报死亡情况 疫情宣布近五个月后，在北基伍省的部分地区疫情追踪工作变得愈发困难。布滕博市国家生物医学研究所的米歇尔·恩吉巴指出，当地居民至今仍“难以相信这种疾病真的存在”。
Some families are reluctant to report a death Nearly five months after the outbreak was declared, it has become harder to track in parts of North Kivu, where residents still have “a hard time believing the disease exists,” said Michel Ngimba of the National Institute of Biomedical Research in Butembo.
他列举了一些案例：有些家属不愿报告亲人去世的消息，也不允许从出现埃博拉症状的死者身上采集样本。恩吉姆巴称，还有些家属“希望尽快安排葬礼”，这样一来就可能引发新的传播链，因为死于埃博拉的患者的遗体具有极强的传染性。
He described cases in which families were reluctant to report a death or allow a sample to be taken from someone who died with Ebola symptoms. In other cases, families “want to arrange the funeral quickly,” Ngimba said, potentially creating new chains of transmission because the bodies of people who die from Ebola are highly contagious.
“目前的监测工作愈发困难， surveillance部门必须应对那些变化极快、有时甚至难以记录的疫情情况，”他说。美联社记者塞巴斯蒂安·基察·穆萨伊从刚果贝尼发回报道。
“The situation has become more difficult to monitor (and) surveillance has to deal with situations that are highly fluid and sometimes difficult to document,” he said. AP writer Sebastien Kitsa Musayi in Beni, Congo contributed.