The deadly Ebola outbreak is proving difficult to control
The deadly Ebola outbreak is proving difficult to control
致命的埃博拉疫情正变得难以控制
EXECUTIVE SUMMARY The alert was raised on May 5. Four health-care workers in the Ituri Province of the Democratic Republic of the Congo had died from an unknown illness within four days. Rapid response teams were sent to investigate, and tests at a research center in Kinshasa revealed the culprit: the Bundibugyo virus, one of the viruses that cause Ebola. 执行摘要 5月5日，警报拉响。刚果民主共和国伊图里省（Ituri Province）的四名医护人员在四天内死于一种不明疾病。快速反应小组被派往调查，金沙萨研究中心的检测结果揭示了罪魁祸首：本迪布焦病毒（Bundibugyo virus），这是导致埃博拉病毒的病毒种类之一。
Suspected cases of the disease have snowballed in the last few weeks. By May 24, the WHO had estimated that 223 people had died from the disease. There were over 900 suspected cases. Today’s figures are likely to be higher. 在过去几周里，该疾病的疑似病例呈滚雪球式增长。截至5月24日，世界卫生组织估计已有223人死于该病，疑似病例超过900例。今天的数字很可能更高。
A couple of weeks ago, I covered the hantavirus outbreak aboard a cruise ship. Three people sadly died, but the outbreak itself was kept under control. There have been no further deaths, and passengers have been safely repatriated. The picture for Ebola is far bleaker. And there are several reasons why. 几周前，我报道了游轮上的汉坦病毒疫情。不幸的是有三人死亡，但疫情本身得到了控制。此后没有再出现死亡病例，乘客也已安全遣返。而埃博拉的情况则要严峻得多，原因有几个。
The most obvious is the disease itself. Ebola is a severe disease with an average 50% fatality rate. Previous outbreaks have resulted in thousands of deaths. (Hantavirus also has a high fatality rate, but it doesn’t usually spread as easily between humans.) Between 2014 and 2016, an Ebola outbreak in West Africa caused more than 11,000 deaths. A more recent outbreak, which took place between 2018 and 2020, caused 2,299 deaths before being brought under control with a vaccination campaign. 最明显的原因是疾病本身。埃博拉是一种严重的疾病，平均致死率高达50%。此前的疫情已导致数千人死亡。（汉坦病毒的致死率也很高，但它通常不会在人与人之间轻易传播。）2014年至2016年间，西非爆发的埃博拉疫情导致超过11,000人死亡。最近一次发生在2018年至2020年间的疫情，在通过疫苗接种运动得到控制之前，造成了2,299人死亡。
But those outbreaks were caused by the Zaire virus, which has a different genetic sequence. There is no vaccine for the Bundibugyo virus. We don’t know if the two vaccines approved for Zaire might also work for Bundibugyo. There’s a concern they might even make things worse by interfering with a person’s immune response to the virus. 但那些疫情是由扎伊尔型病毒引起的，其基因序列不同。目前还没有针对本迪布焦病毒的疫苗。我们不知道已获批用于扎伊尔型病毒的两种疫苗是否对本迪布焦病毒有效。人们担心，这些疫苗甚至可能通过干扰人体对病毒的免疫反应而使情况恶化。
Scientists are working on potential Bundibugyo vaccines. But the most advanced efforts are still months away from clinical trials. There are no specific antiviral treatments for the virus, either. So to control the outbreak, health-care workers are trying to stop the spread of the disease. 科学家们正在研发潜在的本迪布焦疫苗，但最先进的研发工作距离临床试验还有数月之遥。目前也没有针对该病毒的特效抗病毒药物。因此，为了控制疫情，医护人员正努力阻止疾病的传播。
Ebolaviruses can be transmitted to humans by animals including fruit bats, chimpanzees, and gorillas. They can then spread between people via contact with bodily fluids such as blood or vomit. That’s why the virus is often spread among family members, to health-care workers, and during some burial services. 埃博拉病毒可以通过果蝠、黑猩猩和大猩猩等动物传播给人类。随后，病毒可以通过接触血液或呕吐物等体液在人与人之间传播。这就是为什么该病毒经常在家庭成员之间、医护人员之间以及在某些葬礼仪式中传播的原因。
The WHO advises isolating people who have the virus in treatment centers. It also recommends safe burial measures that limit physical contact with the deceased, for example. Communities need to be informed about the virus and how it spreads, and health professionals should be on hand to diagnose cases and track them. That’s all easier said than done in an era of misinformation. 世界卫生组织建议将感染者隔离在治疗中心。它还建议采取安全的埋葬措施，例如限制与死者的身体接触。社区需要了解病毒及其传播方式，医疗专业人员应随时待命以诊断病例并进行追踪。但在一个充斥着错误信息的时代，这些说起来容易做起来难。
Some members of the community even doubt whether the disease is real. There have been three attacks on health-care facilities in the region in recent weeks. Last week, two treatment centers were burned down. The first incident occurred after relatives of a deceased man were prohibited from retrieving his (infectious) body. As a result of the second incident, 18 suspected cases reentered the community. A couple of days later, a group of men unleashed gunfire at Mongbwalu General Hospital, which was also treating people with Ebola. They were demanding the bodies of their deceased relatives. 一些社区成员甚至怀疑这种疾病是否真实存在。最近几周，该地区的医疗设施遭到了三次袭击。上周，两家治疗中心被烧毁。第一起事件发生在一名死者的亲属被禁止领回其（具有传染性的）遗体之后。第二起事件导致18名疑似病例重新进入社区。几天后，一群男子在蒙格布瓦卢（Mongbwalu）综合医院开枪，该医院也在收治埃博拉患者。他们要求领回已故亲属的遗体。
There are more causes for concern when it comes to the spread of the virus. The Ebola outbreak is thought to have originated in Mongbwalu, a high-traffic mining hub. People who caught the virus in Mongbwalu are thought to have sought care in neighboring districts. And the wider province borders both South Sudan and Uganda. So far, Uganda has reported seven confirmed cases and one death. South Sudan’s health ministry has said it will strengthen surveillance, but no cases have been reported in the country so far. 在病毒传播方面，还有更多令人担忧的原因。埃博拉疫情被认为起源于蒙格布瓦卢，这是一个交通繁忙的矿业中心。在蒙格布瓦卢感染病毒的人被认为曾前往邻近地区寻求治疗。而该省的更广阔区域与南苏丹和乌干达接壤。到目前为止，乌干达已报告了7例确诊病例和1例死亡病例。南苏丹卫生部表示将加强监测，但该国目前尚未报告任何病例。
Violence in the region is making it much harder to contain the spread of the virus, too. Conflict involving multiple armed groups, including deadly attacks on civilians, has hampered humanitarian and health-care efforts. Poor infrastructure and damaged roads make matters even worse. Food insecurity is ravaging the region as well—this year, nearly 10 million people in the region face acute hunger. 该地区的暴力冲突也使得控制病毒传播变得更加困难。涉及多个武装团体的冲突，包括针对平民的致命袭击，阻碍了人道主义和医疗工作的开展。基础设施落后和道路受损使情况雪上加霜。粮食不安全也在蹂躏该地区——今年，该地区有近1000万人面临严重的饥饿。
Together, these factors are making it “nearly impossible” to isolate people with Ebola and trace others who have been in contact with them, WHO director general Tedros Adhanom Ghebreyesus said in a statement earlier this week. 世界卫生组织总干事谭德塞（Tedros Adhanom Ghebreyesus）在本周早些时候的一份声明中表示，这些因素共同作用，使得隔离埃博拉患者并追踪接触者变得“几乎不可能”。
The dismantling of US aid programs hasn’t helped either. US government funding for international health projects has steeply declined since the start of President Donald Trump’s second term. These cuts have harmed disease surveillance systems, according to the International Rescue Committee, a humanitarian nonprofit. 美国援助项目的拆解也无济于事。自唐纳德·特朗普总统第二任期开始以来，美国政府对国际卫生项目的资助急剧下降。据人道主义非营利组织国际救援委员会（International Rescue Committee）称，这些削减损害了疾病监测系统。
“Funding cuts have left the region dangerously exposed,” Heather Reoch Kerr, the organization’s country director for the Democratic Republic of the Congo, said in a statement. “Years of underinvestment and recent funding cuts have left many health facilities without adequate protective equipment, surveillance capacity, or frontline support needed to respond quickly and safely.” “资金削减使该地区处于危险的境地，”该组织刚果民主共和国国家主任希瑟·里奥奇·克尔（Heather Reoch Kerr）在一份声明中表示。“多年的投资不足和近期的资金削减，导致许多医疗设施缺乏快速、安全应对疫情所需的充足防护设备、监测能力或一线支持。”
The US has mobilized emergency funding for the outbreak, and a spokesperson for the State Department has argued that none of the administration’s actions have hampered the Ebola response. But health experts counter that the damage has already been done. 美国已为此次疫情动员了紧急资金，国务院发言人辩称，政府的任何行动都没有阻碍埃博拉的应对工作。但卫生专家反驳说，损害已经造成。
On May 17, the WHO declared the Ebola outbreak a public health emergency of international concern. In a statement on Wednesday, Tedros described the situation as “a catastrophic collision of disease and conflict with the Ebola outbreak in Ituri province outpacing the response.” 5月17日，世界卫生组织宣布埃博拉疫情为国际关注的突发公共卫生事件。在周三的一份声明中，谭德塞将目前的局势描述为“疾病与冲突的灾难性碰撞，伊图里省的埃博拉疫情发展速度超过了应对速度。”
In an online appeal to residents on Wednesday, ahead of an in-person visit, Tedros pleaded for a ceasefire and commended the spirit of community members. He also acknowledged the steep challenges they face. “You are already carrying so much: malaria, hunger, insecurity, and the daily struggle to keep your families safe,” he wrote. 在周三进行实地访问之前，谭德塞在给居民的在线呼吁中恳求停火，并赞扬了社区成员的精神。他也承认了他们所面临的严峻挑战。“你们已经承受了太多：疟疾、饥饿、不安全，以及为了保护家人安全而进行的日常挣扎，”他写道。