锡莱特，孟加拉国，10月17日 - 孟加拉国正努力遏制全球最严重的麻疹疫情，这一危机因数据薄弱、宣传不足和疫苗接种缺口而加剧，专家表示，这为其他国家敲响了警钟：免疫接种率下降所带来的致命风险不容忽视。
SYLHET, Bangladesh, Oct 17 - Bangladesh is battling to contain the world’s worst measles outbreak, a crisis exacerbated by weak data, inadequate outreach and vaccination gaps that experts say offers a warning to other nations about the deadly risk of falling immunisation rates.
世界卫生组织表示，自今年3月中旬疫情爆发以来至10月9日，孟加拉国报告疑似麻疹病例202,000例，其中22,000例经实验室确诊 — — 这是全球今年疑似病例最多的国家。
Bangladesh, whose routine vaccination programme faltered in 2025, reported 202,000 suspected measles cases – 22,000 of them laboratory-confirmed – since the start of the outbreak in mid-March to October 9, the World Health Organization said.
截至目前，已有1,147人死于这种高度传染性疾病，其中94%的死亡病例发生在五岁以下儿童中，世界卫生组织称。
That’s more suspected cases than any other country this year. So far, 1,147 people have died of the highly contagious disease, with 94% of reported deaths among children under five years old, the WHO said.
孟加拉国的经验表明，当疫苗接种覆盖率低于95%时，遏制疫情将面临巨大挑战 — — 世界卫生组织指出，这一比例是防止疫情爆发所必需的。近年来，孟加拉国一度接近这一目标，但2025年接种率出现下降。
Bangladesh's experience shows the challenge of containing an outbreak when vaccination coverage falls below 95%, a level the WHO says is needed to prevent outbreaks. Bangladesh almost achieved that in recent years but in 2025 coverage dropped.
路透社对世界卫生组织文件的审查，以及对十余名科学家、卫生工作者和官员的访谈显示，孟加拉国的应急响应同样受到数据遗漏数百万儿童、准备工作不足以及未能触达足够家长的影响。
A Reuters review of WHO documents, alongside interviews with more than a dozen scientists, health workers and officials, shows Bangladesh was also hampered in its emergency response by data that left out millions of children, shortcomings in preparation and a failure to reach enough parents.
“这对每个国家来说都是一个真实的警告，”世界卫生组织疫苗顾问、纽约大学全球公共卫生学院教授马克·吉特说。
"This is a real warning to every country," said Mark Jit, a WHO vaccine adviser and professor at the School of Global Public Health at New York University.
他表示，通过疫苗接种预防疫情比应对紧急情况更容易、更便宜、也更安全。
Preventing an outbreak through vaccinations was easier, cheaper and safer than responding to an emergency, he said.
“应对措施最终会制止疫情，但在此期间，许多人将会感染麻疹，有些人甚至会因此死亡，”他说。
"The response will stop the outbreak eventually, but in the meantime, many will have had measles, and some will have died," he said.
孟加拉国总理塔里克·拉赫曼的卫生事务特别助理齐亚乌丁·海德尔在9月接受路透社采访时表示，政府正在尽其所能终止疫情。政府未对10月份就本文发出的进一步提问作出回应。“他们只在我埋葬儿子之后才来。”
Ziauddin Hyder, special assistant on health affairs to Prime Minister Tarique Rahman, told Reuters in September the government was doing everything it could to end the outbreak. The government did not respond to further questions sent in October for this article. ‘THEY CAME ONLY AFTER I BURIED MY SON’
在人口1.78亿的国家，东北部锡莱特地区是疫情最严重的地区之一。两岁的阿曼·侯赛因于7月未接种疫苗死亡，住院治疗前24小时，其家人通过出售三轮自动三轮车筹集了治疗费用。他的四岁未接种疫苗的姐姐幸存下来。
In the northeast Sylhet region, one of the worst-hit areas in the nation of 178 million people, two-year-old Arman Hossain died unvaccinated in July, 24 hours after admission to hospital for treatment paid for by selling the family's three-wheeled auto rickshaw. His unvaccinated four-year-old sister survived.
他的父亲阿敏·米亚，26岁，表示没有卫生工作者及时来到他们锡莱特偏远的村庄提供疫苗接种。“他们只在我埋葬儿子之后才来，”他说。
His father Amin Mia, 26, said no health workers came to their remote village in Sylhet to offer vaccinations in time. "They came only after I buried my son," he said.
世界卫生组织表示，麻疹通常每1000例病例中会导致两到三人死亡，但在较贫穷的国家，由于营养不良等因素，该病可能更具致命性。
Measles usually kills two or three people in every 1,000 cases, the WHO says, but the disease can be more deadly in poorer nations because of factors such as malnutrition.
在锡莱特地区的另一个城镇恰塔克，30岁的木匠胡马尤恩·拉希德的女儿于6月未接种疫苗死亡，年仅九个月。拉比巴·阿克特本来可以在4月接种疫苗，当时一个紧急项目将疫苗接种年龄从九个月降低到了六个月。“没有卫生工作者来告诉我们，”她的父亲说。
In the town of Chhatak, also in the Sylhet region, the daughter of 30-year-old carpenter Humayun Rashid died unvaccinated in June aged nine months. Labiba Akter could have received an inoculation in April when an emergency programme lowered the vaccination age to six months from nine. "No health worker came to tell us," her father said.
5月，卫生部长萨达尔·姆·萨赫瓦特·胡赛因表示，紧急接种行动已将热点地区的病例“几乎降至零”，疫情处于可控状态。
In May, Health Minister Sardar Md. Sakhawat Husain said the emergency drive had brought cases in hotspots "almost to zero" and the outbreak was under control.
然而，9月，孟加拉国报告称麻疹新增病例日均达到1,198例，这种疾病会引发高烧、咳嗽和典型皮疹。这是自5月以来的最高水平。
Yet in September, Bangladesh reported a daily average of 1,198 new cases of measles, which causes a high fever, cough and telltale rash. That was the highest total since May.
孟加拉国的疫情爆发正值疫苗犹豫情绪上升之际，特别是在较富裕的国家，这种情绪受到诸如美国卫生部长罗伯特·F·肯尼迪 Jr. 等人物的倡导推动。在孟加拉国，疫苗的可及性和认识是更大的障碍，专家表示。
The Bangladesh outbreak comes as vaccine hesitancy is rising, particularly in wealthier nations, amid skepticism championed by figures such as US Health Secretary Robert F. Kennedy Jr. In Bangladesh, access to inoculations and awareness are bigger hurdles, experts said.
直到最近，孟加拉国一直是疫苗接种的成功故事。世界卫生组织和联合国儿童基金会（UNICEF）估计，2024年该国首剂疫苗覆盖率达到96%，第二剂覆盖率达到93%。第二剂疫苗是为了捕捉那些在第一剂后未产生免疫力的少数儿童。
Until recently, Bangladesh had been a vaccination success story. The WHO and the United Nations children’s agency UNICEF estimated that in 2024 it achieved 96% coverage for the first vaccine dose and 93% for the second, which is given to capture the small percentage of children who don't develop immunity after one shot.
但同年，爆发了抗议活动，终结了总理谢赫·哈西娜长达15年的统治。随之而来的政治动荡导致卫生工作者罢工，疫苗订单延迟，随访接种——通常伴随常规项目进行——被打乱。
But that same year, protests erupted that ended 15 years of rule by Prime Minister Sheikh Hasina. In the ensuing political turmoil, health workers went on strike, vaccine orders were delayed and follow-up vaccinations that usually accompany routine programmes were disrupted.
今年7月发布的一份报告中，世界卫生组织和联合国儿童基金会估计，2025年第一剂疫苗接种率已降至90%，而第二剂接种率为86%，比实现群体免疫所需的95%低了几个百分点。
In a report published in July this year, WHO and UNICEF estimated first-dose coverage in 2025 had fallen to 90%, while second-dose coverage was 86%, several percentage points below the 95% needed for herd immunity.
该报告还对2023年至2025年官方关于麻疹及其他疾病疫苗接种数据的质量提出质疑。
The report also raised questions about the quality of official data on vaccinations for measles and other diseases for the years 2023 to 2025.
报告称，初步数据有时显示接种人数超过目标人数的100%，表明在计算剂量或目标人数时存在错误。
It said preliminary figures sometimes showed numbers of those inoculated exceeded 100% of those targeted, indicating mistakes in counting doses or target numbers.
紧急项目未能覆盖数百万人 然而，当麻疹疫情爆发时，孟加拉国反应迅速，起初似乎正在赢得这场战役。
EMERGENCY PROGRAMME MISSED MILLIONS Still, when the measles outbreak erupted, Bangladesh responded swiftly and initially seemed to be winning the battle.
紧急项目启动后，在四月和五月近2000万儿童接种疫苗之后，新病例出现了初步放缓。政府表示，已覆盖六个月至五岁目标年龄段的每一名儿童。
An emergency programme was followed by an initial slowdown in new cases after almost 20 million children received a vaccination in April and May. The government said it had covered every child in the target age group of six months to five years.
但事实上，该项目未达标。这一点在六月另一次常规卫生干预中暴露出来——尽管覆盖相同的年龄段，其目标名单比麻疹运动多了400万儿童。
But in reality the programme fell short. This emerged when another routine health intervention in June had a target list with 4 million more children than the measles campaign despite covering the same age group.
“存在差距，”总理顾问海德尔在9月14日对路透社表示，当时麻疹病例再次上升，他将原因归咎于父母的疫苗犹豫或儿童疾病导致孩子无法接种。其他挑战也随之出现。
"There is a gap," prime ministerial adviser Hyder told Reuters on September 14, as measles cases rose again, blaming vaccine hesitancy by parents or child illnesses for keeping kids away. Other challenges have also emerged.
路透社审查的文件显示，政府、世界卫生组织及其他卫生合作伙伴在四月和八月的会议记录此前未被报道，这些记录表明，快速行动的努力可能导致了不足之处。
Documents detailing meetings in April and August between the government, the WHO and other health partners, reviewed by Reuters and not previously reported, show how efforts to act fast may have led to shortcomings.
4月19日的会议纪要概述了政府如何因时间限制而选择仅进行一次所谓的准备检查，而不是通常的四轮检查，以便启动其紧急疫苗接种计划。检查内容包括确保冰箱可用于保持疫苗冷藏，以及确定应为多少儿童接种疫苗。根据会议纪要，单轮检查表明大多数但并非所有地区已做好准备。最贫困的人“付出代价”“当准备检查没有做好时，往往是最贫困且最难以接触到的儿童错过了疫苗接种并付出代价，”流行病学家、孟加拉国麻疹和风疹消除国家验证委员会主席马赫穆德·拉赫曼教授说。
Minutes from the April 19 meeting outlined how the government opted for just one round of so-called readiness checks before launching its emergency vaccination programme due to time constraints, instead of the typical four rounds. Checks cover everything from ensuring fridges are available for keeping vaccines cool to determining how many children should be vaccinated. The single round of checks suggested most - but not all - districts were ready, according to the minutes. THE POOREST ‘PAY THE PRICE’"When preparedness checks are not done properly, it is often the poorest and hardest-to-reach children who miss out on vaccination and pay the price," said Professor Mahmudur Rahman, an epidemiologist and chair of Bangladesh's National Verification Committee for Measles and Rubella Elimination.
海德尔表示，4月的疫苗接种活动是在四周内启动的。然而，曾在2017年前负责孟加拉国免疫工作的塔吉乌尔·伊斯兰·阿卜杜勒·巴里表示，此类活动通常需要数月的规划。
Hyder said the April campaign was launched in four weeks. Yet Tajul Islam Abdul Bari, who led immunisation in Bangladesh until 2017, said campaigns usually demand months of planning.
到8月的会议时，疫苗接种推出过程中的不足之处已被发现。会议纪要指出，确诊麻疹病例中未接种疫苗的儿童比例在“活动前（82%）和活动后（85%）之间几乎没有变化……凸显了持续存在的覆盖缺口”。
By the August meeting, shortcomings in the rollout were identified. Minutes noted the proportion of children with confirmed measles cases who had not been vaccinated was "virtually unchanged between pre-campaign (82%) and post-campaign (85%) ... underscoring persistent coverage gaps".
世卫组织未就4月和8月的会议作出回应。但世卫组织驻孟加拉国副代表拉杰什·纳尔瓦尔博士表示，世卫组织决心支持政府实现为每一名处于风险中的儿童接种疫苗的目标。
The WHO did not respond to questions about the April and August meetings. But deputy WHO representative to Bangladesh, Dr Rajesh Narwal, said the WHO was determined to support the government in its goal of vaccinating every child at risk.
“常规免疫必须变得更有效和更具韧性，以免这些缺口再次出现，”他说。
"Routine immunisation must become more effective and resilient so that these gaps do not develop again," he said.
在锡尔赫特，官方记录显示有180名儿童死亡，路透社在9月采访的16个家庭中有8个表示他们未见过卫生工作人员提供疫苗接种。至少有6个家庭表示，卫生工作人员仅在其社区中有儿童死于麻疹后才前来。
In Sylhet, where official records show 180 children have died, 8 of 16 families Reuters interviewed in September said they had not seen health workers offering vaccinations. At least six families said health workers visited only after a child had died from measles in their community.
截至九月底，政府启动了一项新行动，针对此前漏掉的340万儿童。
At the end of September, the government launched a new campaign to target 3.4 million children previously missed.
“我们将动员全村人员，确保没有儿童被落下，”卫生部长在新闻发布会上表示。
"We will involve people across villages so that no child is left behind," the health minister told a news conference.
然而，要覆盖每一个儿童仍然是个挑战。联合国儿童基金会和孟加拉国统计局称，约有40%的儿童未登记，而政府数据显示约三分之一的卫生工作者岗位空缺。
Yet reaching every child remains a challenge. UNICEF and the Bangladesh Bureau of Statistics say as many as 40% of children go unregistered, while government data showed around a third of health worker posts are unfilled.
卫生专家也在敦促政府扩大计划，给五岁以上儿童接种疫苗。世界卫生组织称，该年龄段占麻疹病例的三分之一。
Health experts are also pushing the government to expand the programme to vaccinate children over five. That age group represents a third of measles cases, the WHO says.
此外，孟加拉国的科学家正在研究为何婴儿至约六个月时免疫力衰减速度快于预期。专家称，婴儿通常仍受母体抗体保护。
In addition, scientists in Bangladesh are studying why immunity is waning faster than expected in babies up to six months or so. They are usually still protected by maternal antibodies, experts say.
世界卫生组织表示，确保及时的医疗护理至关重要，这也是孟加拉国在抗击登革热疫情时面临的另一挑战。
Ensuring prompt medical care is vital, the WHO says, another challenge for Bangladesh as it also fights a dengue epidemic.
九月份，治疗麻疹的锡尔赫特市100床位的沙希德·沙姆苏丁·艾哈迈德医院的每个病区都显得人满为患。路透社到访当天，医院收治了178名患者。
In September, every ward in Sylhet's 100-bed Shahid Shamsuddin Ahmed Hospital, which is treating measles, appeared overwhelmed. On the day Reuters visited, 178 patients were admitted.