
非洲埃博拉疫情扩散范围创历史新高 卫生官员紧急追踪尼日利亚首例病例源头今年早些时候在刚果民主共和国爆发的埃博拉疫情已达到一个严峻的新里程碑,疫情现已蔓延至非洲大陆的第三个区域,成为有记录以来扩散范围最广的埃博拉疫情。
Ebola Outbreak in Africa Reaches Widest Expansion Ever Health officials are urgently seeking answers about the origins of a case newly identified in Nigeria, the first in that West African nation. The Ebola epidemic that began in the Democratic Republic of Congo earlier this year has achieved a grim new milestone, turning up in a third region of the African continent, the widest footprint of any Ebola outbreak to date.
本周,卫生官员在尼日利亚首都阿布贾确诊一例新病例,该地距离中非疫情中心超过2000英里。同一天,东非国家肯尼亚也宣布确诊第九例埃博拉病例。
This week, health officials identified a new case in Abuja, Nigeria, more than 2,000 miles west of the outbreak’s epicenter in Central Africa. The news came the same day as the announcement of a ninth case of Ebola in the East African country of Kenya.
非洲疾病预防控制中心总干事让·卡塞亚博士周三在接受采访时表示,他正召集所有非洲卫生部长于10月28日召开会议。他说,如果他们无法想出遏制疫情的办法,“整个大陆都可能受到影响”。自5月发现首例病例以来,刚果已记录确诊病例9700多例、死亡病例4600多例,使这成为增长最快的埃博拉疫情。在刚果境内,疫情已蔓延至八个省份,约70%的新增病例发生在社区,表明存在大规模未被发现的传播。
Dr. Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, said in an interview on Wednesday that he was calling for a meeting of all African health ministers on Oct. 28. If they cannot come up with ways to stamp out the outbreak, he said, “the whole continent can be affected.”Since the first case was identified in May, Congo has recorded more than 9,700 confirmed cases and more than 4,600 deaths, making the outbreak the fastest growing Ebola epidemic ever. Within Congo, the disease has spread to eight provinces, and about 70 percent of new cases occur in the community, suggesting widespread undetected transmission.
针对本次疫情所涉邦迪布焦型埃博拉病毒的疫苗临床试验正在进行中,但预计还需数月才能投入使用。而且这些疫苗不适用于5岁以下儿童,而这一群体占病例近四分之一、死亡病例近三分之一。
Clinical trials of vaccines against Bundibugyo, the type of Ebola in this outbreak, are underway, but the shots are not expected to be available for many more months. And they leave out children under 5, who account for nearly one in four cases and one in three deaths.
尼日利亚是非洲人口最多的国家,其首都阿布贾是全球旅行枢纽,每月有数千名国际旅客往来。
Nigeria is Africa’s most populous country, and Abuja, its capital, is a hub for global travel, with thousands of international passengers each month.
这名在尼日利亚的患者近期曾从乌干达旅行归来,引发了关于该国是否也再次出现活跃病例的疑问。乌干达今年早些时候确认了20例病例和2例死亡病例,但世界卫生组织在8月宣布乌干达的疫情已结束。
The patient in Nigeria had recently returned from a trip to Uganda, raising questions about whether that country, too, has active cases again. Uganda confirmed 20 cases and two deaths earlier this year, but the World Health Organization declared in August that Uganda’s outbreak had ended.
波士顿大学新发传染病中心主任纳希德·巴德利亚博士表示,无论病例源头如何,“我认为尼日利亚的这例病例反映了疫情增长已变得多么失控。”
Regardless of its origin, “I see the Nigeria case as a reflection of how uncontrolled the growth has become,” said Dr. Nahid Bhadelia, the director of Boston University’s Center on Emerging Infectious Diseases.
巴德利亚博士说,她更担心埃博拉病毒在可能与受影响国家接壤的非洲国家未被发现地传播,而不是担心其蔓延到其他大陆。“我每天都在为南苏丹担忧,”她说。
Dr. Bhadelia said she was more worried about Ebola spreading undetected in African countries that may share borders with affected countries than about it moving to other continents. “I worry about South Sudan every day,” she said.
一些公共卫生专家对尼日利亚病例缺乏清晰信息感到担忧。该患者是一名乌干达公民,与丈夫——一名瑞士外交官——居住在阿布贾。
Some public health experts were alarmed by a lack of clarity about the Nigerian case. The patient is a Ugandan national who lives with her husband, a Swiss diplomat, in Abuja.
乌干达卫生部表示,这名女子因公前往刚果,返程途中经过了乌干达回到尼日利亚家中。“途经乌干达并不能确定感染发生在这里,”该部称。
The Ugandan health ministry has said the woman traveled to Congo on business and passed through Uganda on her way back home to Nigeria. “Travel through Uganda does not establish that infection occurred here,” the ministry said.
但据卡塞亚博士透露,这名女子告诉卫生官员,她并未前往刚果,而是在乌干达首都坎帕拉度过了两周假期。
But according to Dr. Kaseya, the woman told health officials she did not travel to Congo and had been in Kampala, the Ugandan capital, on a two-week holiday.
“这是她的说法,但我们需要继续调查,因为她肯定是在某处感染了埃博拉,”他说。
“This is what she said, but we need to continue investigation because for sure she got Ebola somewhere,” he said.
提到乌干达可能存在持续病例的可能性,他补充道:“如果我们不知道这位女士的完整情况,要对此发表评论并得出结论是非常困难的。”该患者的旅行日期也不清楚。世界卫生组织非洲办事处称,她于10月7日出现症状,即返回阿布贾后的第四天。但尼日利亚疾控中心的一位官员表示,她于10月5日抵达阿布贾,出现症状前两天。
Referring to the possibility of ongoing cases in Uganda, he added: “It’s so difficult to comment and to have a conclusion on that if we don’t know the full story from the lady.”The dates of the patient’s travel are also unclear. The World Health Organization’s Africa office said she developed symptoms on Oct. 7, four days after returning to Abuja. But an official from the Nigeria C.D.C. has said she arrived in Abuja on Oct. 5, two days before symptoms emerged.
她于10月11日因类似疟疾的症状就医,但医生在一周多的时间里并未怀疑埃博拉是她患病的原因。她于10月20日被确诊感染了邦迪布焦病毒。据尼日利亚官员称,在此期间,她接触了至少44人,其中包括许多医护人员,这些人目前正在接受密切监测,以观察是否出现病症迹象。但专家表示,随着官员进一步掌握她确诊前的行踪,这个数字可能会增加。
She sought care for malaria-like symptoms Oct. 11, but doctors did not suspect Ebola as the cause of her illness for more than a week. She was diagnosed as being infected with Bundibugyo on Oct. 20. During that time, according to Nigerian officials, she came into contact with at least 44 people, including many health care workers, who are now being closely monitored for signs of illness. But that number is likely to grow as officials learn more about her whereabouts before she was diagnosed, experts said.
在肯尼亚,目前已确诊的八例新增病例均为首例病例的接触者,首例患者为一名刚果籍患者,他在抵达内罗毕前曾途经乌干达。该患者于10月5日确诊,当晚即死亡。
In Kenya, eight new cases identified so far are all contacts of the first, a Congolese patient who traveled through Uganda before arriving in Nairobi. The patient was diagnosed on Oct. 5 and died the same night.
世界卫生组织总干事谭德塞博士表示:“通过迅速追踪接触者,单一输入性病例是可以得到控制的。真正的危险在于社区内的持续传播。”尼日利亚在2014年疫情期间曾应对过一例输入性埃博拉病例,并在几个月内遏制了由此引发的病例聚集,部分得益于其消灭小儿麻痹症的基础设施。
“One imported case can be contained by quickly tracing contacts,” said Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization. “The real danger is sustained spread within communities.”Nigeria contended with an imported case of Ebola during the 2014 outbreak, but was able to snuff out the resulting cluster of cases within a couple of months, in part by relying on its infrastructure for polio eradication.
巴德利亚博士表示,她对尼日利亚能再次迅速遏制埃博拉持乐观态度。她称,自己更担忧的是乌干达政府缺乏关于前往肯尼亚和尼日利亚的患者可能留下的感染传播链的信息。
Dr. Bhadelia said she was hopeful Nigeria would once again be able to contain Ebola quickly. She said she was more concerned about the lack of information from the Ugandan government on the potential trails of infection left behind by the patients who traveled to Kenya and Nigeria.
她说:“我们没有听到足够多关于接触者追踪的情况,也没有听到主动调查以寻找这两例病例周围可能产生的任何传播链的情况。”
“We’re not hearing enough about the contact tracing, or active investigations to look for any chains of transmission that may have resulted around these two cases,” she said.
阿普尔瓦·曼达维利为《纽约时报》报道科学与全球健康,重点关注传染病与大流行以及试图应对它们的公共卫生机构。
Apoorva Mandavilli reports on science and global health for The Times, with a focus on infectious diseases and pandemics and the public health agencies that try to manage them.