
刚果的埃博拉疫情本周跨过一个严峻的里程碑——确诊病例达到1万例,并引发了人们的疑问:卫生当局是否正在失去控制疫情的能力。
The Ebola outbreak in Congo passed a grim milestone this week — 10,000 confirmed cases — and spurred questions about whether health authorities are losing their ability to contain it.
纽约 迈克·斯托贝——刚果的埃博拉疫情本周跨过一个严峻的里程碑——确诊病例达到1万例——并引发了人们的疑问:卫生当局是否正在失去控制疫情的能力。
MIKE STOBBE NEW YORK — The Ebola outbreak in Congo passed a grim milestone this week — 10,000 confirmed cases — and spurred questions about whether health authorities are losing their ability to contain it.
此次疫情中近半数感染者已经死亡,一些专家表示,有理由担心这可能演变成历史上最严重的埃博拉疫情。其他人则认为不会达到那种程度。研究人员目前正在研究更新的预测。
Nearly half the infected people in this outbreak have died, and some experts say there are reasons to worry this could grow into the worst Ebola outbreak in history. Others don’t think it will reach that level. Researchers are currently working on updated projections.
一些研究人员表示,目前的情况表明,疫情不太可能在大多数其他国家引发严重问题。但其他国家已经出现了约30例确诊病例。北卡罗来纳大学研究传染病疫情动态的研究员贾斯汀·莱斯勒表示,如果疫情得不到控制,刚果以外出现更多病例的风险将会上升。
Current circumstances suggest it’s unlikely to spark significant problems in most other countries, some researchers said. But about 30 confirmed cases have already popped up in other nations. And the risk that more will appear outside Congo will grow if the outbreak isn’t tamed, said Justin Lessler, a University of North Carolina researcher who studies the dynamics of infectious disease outbreaks.
专家们还抱有希望,认为明年将会有一种有助于控制疫情的疫苗问世。
Experts also are hopeful that a vaccine will become available next year that could help control it.
在周三举行的非洲卫生部长虚拟峰会上,非洲疾控中心主任让·卡塞亚博士表示,非洲大陆在抗击埃博拉的斗争中“没有获胜”,在疫情蔓延到多个非洲国家之后,需要做更多的工作。“我们共同商定,要让每个国家都做好准备,跨境协调,并在密切监视的同时保持边境开放,”卡塞亚写道。病例数保持稳定引发对疫情蔓延至刚果以外的担忧。
At a virtual summit of African health ministers on Wednesday, Africa CDC Director-General Dr. Jean Kaseya said the continent is “not winning” the fight against Ebola and needs to do more after it spread to multiple African countries“Together, we agreed to prepare every country, coordinate across our borders and keep those borders open while watching them closely,” Kaseya wrote on Steady case numbers raise concerns about spread beyond Congo About 400 to 500 new confirmed cases have been reported in Congo each week, and that number seems to be holding steady.
刚果每周报告约400至500例新增确诊病例,这一数字似乎保持稳定。埃默里大学传染病专家博胡马·蒂坦吉博士表示,“病例没有呈指数级增长”是好消息,至少目前如此。
It’s good news that “cases are not rising exponentially,” at least for the moment, said Dr. Boghuma Titanji, an Emory University infectious disease specialist.
“但它们也没有下降,”她说。“它处于一个平台期。而这个平台期处于一个非常、非常高的设定点。”刚果面临的一大挑战是有限的接触者追踪以及与受影响社区的协作;卫生工作者有时花在试图说服当地人与他们合作上的时间,比提供护理的时间还多。
“But they’re not coming down, either,” she said. “It’s at a plateau. And the plateau is at a very, very high set point.”A major challenge in Congo is limited contact tracing and collaboration with affected communities; health workers sometimes spend more time trying to convince locals to work with them than giving care.
不到四分之一的新病例来自已知与感染者有过接触的人,这表明存在卫生当局并不知晓的持续传播链。
Fewer than a quarter of new cases are coming from people known to have been in contact with an infected person, showing there are ongoing chains of transmission that health authorities are not aware of.
泰坦吉和其他专家表示,随着病例不断增加,更多感染者前往其他国家的可能性也在增大。法国、肯尼亚、尼日利亚和乌干达也报告了与刚果疫情相关的病例。
As cases mount, the likelihood grows that more infected people travel to other countries, Titanji and other experts said. France, Kenya, Nigeria and Uganda also have reported cases tied to the Congo outbreak.
像美国实施的那种旅行限制,可能会使病毒更难离开非洲。专家表示,在许多旅行者感染可能浮现的地方,卫生官员应当能够迅速隔离感染者并找到任何接触者。
Travel restrictions like those imposed by the U.S., can make it harder for the virus to leave Africa. And in many places where a traveler’s infection may surface, health officials should be able to quickly isolate an infected person and find any contacts, experts say.
“就目前而言,它对美国构成的直接风险,我会说非常接近于零,”莱斯勒说。
“The direct risk it poses to the U.S. at this point, I’d say, is very close to zero,” Lessler said.
但莱斯勒说,埃博拉可能在卫生系统薄弱的贫困和受冲突困扰的地方暴发——例如南苏丹。引起埃博拉病的病毒通过接触呕吐物、血液和精液等体液传播。
But Ebola could flare in poor and conflict-stricken places with weakened health systems — like South Sudan, for example, Lessler said. Viruses that cause Ebola disease spread through contact with bodily fluids such as vomit, blood and semen.
此次疫情已位列第二大。自1976年首次发现该疾病以来,已报告了数十起埃博拉疫情。最大且最致命的一次发生在2014年至2016年的西非,有2.8万例感染和超过1.1万例死亡。
The outbreak already ranks as the second largest Dozens of Ebola outbreaks have been reported since the disease was first discovered in 1976. The largest and deadliest occurred in West Africa in 2014 to 2016, with 28,000 infections and more than 11,000 deaths.
目前的疫情已位居第二,自宣布以来,其病例数和死亡人数至少是西非疫情期间的三倍。卫生官员于5月宣布疫情暴发,但医学证据表明感染在数月前就已发生。原因之一是过去的疫情几乎都是由埃博拉病毒引起的。最初的检测针对的是该病毒——而不是实际上导致疾病的相关的、但不同的本迪布焦病毒。
The current outbreak already ranks second, and has had at least three times the number of cases and deaths in the time since it was declared compared with the West Africa outbreak. Health officials declared the outbreak in May, but medical evidence suggests infections were occurring months earlier One reason is that past outbreaks were almost all caused by the Ebola virus. Initial testing was geared toward that virus — not the related, but different, Bundibugyo virus that was actually causing illnesses.
专家表示,一系列其他挑战也损害了应对工作,包括一些疫情地区的武装冲突、卫生系统的缺口、不信任、错误信息以及全球援助削减。
A series of other challenges have hurt the response, including armed conflict in some outbreak areas, gaps in the health system, mistrust misinformation and global aid cuts, experts say.
研究人员和应对工作人员表示,刚果各地情况不一,这解释了为什么一些地方的病例可能稳定或下降,而另一些地方则可能呈上升趋势。
Conditions vary in Congo, which explains why cases can be stable or falling in some places but can be trending up in others, researchers and response workers say.
国际救援委员会埃博拉应对主任凯蒂·托马斯-坎菲尔德在一份声明中说:“只有我们与社区合作,挨家挨户、一个村庄一个村庄地打破传播链,阻止这种致命的升级,检测、护理和接触者追踪才能发挥作用。”
“Testing, care and contact tracing only work if we work with communities, going door to door, village by village to break the chain of transmission and stop this deadly escalation,” said Katie Thomas-Canfield, the International Rescue Committee’s Ebola response director, in a statement.
美国传染病学会主席温迪·阿姆斯特朗博士表示,她认为情况将会恶化。“这远未得到控制,”她说。
Dr. Wendy Armstrong, president of the Infectious Diseases Society of America, said she thinks the situation is going to get worse. “This is very far from being controlled,” she said.
科学家正在更新预测。专家预计疫情将持续到今年年底,但蒂坦吉对2027年抱有希望。这是因为针对本迪布焦病毒的疫苗正在测试中,她乐观地认为有效的疫苗将在未来12个月内问世。
Scientists are updating projections Experts expect the outbreak will continue through the end of the year, but Titanji is hopeful about 2027. That’s because vaccines are being tested against the Bundibugyo virus, and she is optimistic an effective shot will become available in the next 12 months.
她指出,在2014-2016年西非疫情暴发初期,尚无疫苗可用。当然,预测疫情很困难,但科学家们一直在努力。
She noted no vaccines were available early in the 2014-2016 West Africa outbreak. Forecasting the outbreak is difficult, of course, but scientists have been trying.
今年5月,美国疾病控制与预防中心公布了一系列由计算机模型生成的预测情景。当时,非洲疾病控制与预防中心报告的确诊病例为400例。美国疾控中心的模型估计,三个月内的病例增长可能在1万例到2万多例之间。
In May, the U.S. Centers for Disease Control and Prevention published a range of scenarios generated by computer models. At the time, the Africa Centers for Disease Control and Prevention was reporting 400 confirmed cases. The U.S. CDC models estimated the growth in cases over three months could run from 10,000 to more than 20,000.
美国疾控中心正在更新其建模工作。但该机构拒绝让美联社就疫情发展趋势采访其科研人员。
The CDC is updating its modeling work. But the agency declined to let The Associated Press interview staff scientists about how the outbreak is trending.
东北大学的疾病建模专家亚历山德罗·韦斯皮尼亚尼一直在与美国及国际卫生官员共同监测疫情趋势。
Alessandro Vespignani, a Northeastern University disease modeler, has been monitoring trends with U.S. and international health officials.
他说,目前并没有出现那种“每周病例数持续下降、让我们看到隧道尽头曙光”的局面。
There’s not been the kind of “decay in the number of cases weekly that we need to see the light at the end of the tunnel,” he said.