Weeks into explosive diarrhea outbreak, sluggish CDC plans response team
Weeks into explosive diarrhea outbreak, sluggish CDC plans response team
爆发性腹泻疫情持续数周，疾控中心（CDC）应对迟缓，计划组建响应小组
The Trump administration continues to respond sluggishly to the explosive, nationwide outbreak of Cyclospora—a unicellular parasite spread from human feces that has now sickened nearly 23,000 people in 47 states, killing two and sending over 500 to the hospital. 特朗普政府对全国范围内爆发的圆孢子虫（Cyclospora）疫情反应持续迟缓。这是一种通过人类粪便传播的单细胞寄生虫，目前已导致47个州的近2.3万人患病，造成2人死亡，超过500人住院治疗。
Michigan health officials reported the two deaths Monday, and The Washington Post first reported Tuesday that federal health officials have expanded a list of states with linked cases from nine to 15. But those updates still have not appeared on public outbreak pages for the Centers for Disease Control and Prevention or the Food and Drug Administration, and Americans are struggling to understand the risk of eating fresh fruits and vegetables. 密歇根州卫生官员周一报告了这两起死亡病例，《华盛顿邮报》周二率先报道称，联邦卫生官员已将关联病例的州名单从9个扩大到15个。然而，美国疾病控制与预防中心（CDC）和食品药品监督管理局（FDA）的公共疫情页面上尚未更新这些信息，导致美国民众难以评估食用新鲜果蔬的风险。
In comments to Ars Technica on Monday, a spokesperson for the Department of Health and Human Services, which oversees CDC and FDA, said the outbreak information will be updated sometime “this week.” Sources for The New York Times said that the CDC plans to set up a “formal response team” for the outbreak sometime this week. 周一，负责监管CDC和FDA的美国卫生与公众服务部发言人在回应Ars Technica时表示，疫情信息将在“本周”内更新。《纽约时报》的消息来源称，CDC计划在本周内为此次疫情组建一个“正式响应小组”。
Cases in the outbreak began in June. Michigan has been one of the hardest hit states in the outbreak. As of August 5, it is reporting 12,218 cases since June 22. On Monday, the state’s health department reported the outbreak’s first and only deaths, which are rare for the parasite. 此次疫情始于6月。密歇根州是受灾最严重的州之一。截至8月5日，该州自6月22日以来已报告12,218例病例。周一，该州卫生部门报告了疫情中仅有的两起死亡病例，对于这种寄生虫而言，死亡病例非常罕见。
Cyclosporiasis infections are unquestionably miserable—causing explosive watery diarrhea, abdominal pain, nausea, bloating, and gas—but they’re rarely fatal. According to medical records, the two deaths occurred in people with “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” the state’s health department said. 圆孢子虫感染无疑是非常痛苦的——会导致爆发性水样腹泻、腹痛、恶心、腹胀和胀气——但极少致命。据密歇根州卫生部门称，根据医疗记录，这两名死者患有“严重的潜在健康问题，可能受到了圆孢子虫感染和脱水的影响”。
Michigan’s cases are linked to those in eight other states. FDA’s traceback investigations linked the cases in those nine states to Taylor Farms’ shredded iceberg lettuce grown in Mexico and distributed to Taco Bell restaurants, as well as other restaurants, retailers, and food distributors. The nine states in addition to Michigan are: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia. 密歇根州的病例与其他8个州的病例相关联。FDA的溯源调查将这9个州的病例与Taylor Farms公司在墨西哥种植并分销给塔可钟（Taco Bell）餐厅以及其他餐厅、零售商和食品分销商的切碎圆生菜联系了起来。除密歇根州外，这9个州还包括：伊利诺伊州、印第安纳州、堪萨斯州、肯塔基州、俄亥俄州、俄克拉荷马州、宾夕法尼亚州和西弗吉尼亚州。
The Post reported Tuesday that the CDC is now adding six more states to the list of linked cases: Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North Carolina. The Times independently confirmed the additions later Tuesday. Still, the new states have yet to be added to the FDA’s and CDC’s sites for the outbreak cluster, which still list nine states and no deaths as of publication time. (The CDC’s general cyclosporiasis surveillance page was updated at some point Tuesday to include the deaths.) 《华盛顿邮报》周二报道称，CDC现已将另外6个州加入关联病例名单：阿肯色州、爱荷华州、密苏里州、内布拉斯加州、新罕布什尔州和北卡罗来纳州。《纽约时报》随后在周二晚些时候独立证实了这些新增州。不过，截至本文发布时，FDA和CDC的疫情集群页面尚未更新这些新州，页面仍显示为9个州且无死亡病例。（CDC的圆孢子虫常规监测页面在周二某个时间点进行了更新，加入了死亡病例信息。）
Controversial links / 争议性的关联
All 15 states in the outbreak cluster linked to Taylor Farms lettuce are states the company identified as having received its lettuce. In a July 17 recall, Taylor Farms identified 27 states to which its lettuce was sent. But the company has refused to provide clear information about the recalled products, including how many pounds of product the recall covered, where those products were sold, and if distributors may have distributed the lettuce to additional states. 与Taylor Farms生菜相关的15个疫情集群州，均在该公司确认接收其生菜的名单内。在7月17日的召回公告中，Taylor Farms列出了其生菜销往的27个州。但该公司拒绝提供有关召回产品的明确信息，包括召回产品的重量、销售地点，以及分销商是否将生菜分销到了其他州。
The CDC’s updated surveillance information says 47 states have now reported cases. It’s possible that the nationwide cases encompass independent clusters with additional sources of contaminated produce. It’s also possible that as investigations continue, more states will be linked to the current 15-state cluster. CDC更新的监测信息显示，目前已有47个州报告了病例。全国范围内的病例可能包含多个独立的集群，且存在其他受污染农产品的来源。随着调查的深入，未来可能会有更多州被纳入目前的15州集群中。
Both Taylor Farms and the Trump administration have drawn significant scrutiny for the lack of clear information about the outbreak. In July, the FDA puzzlingly announced that a sample of Taylor Farms’ lettuce tested positive for Cyclospora, only to retract the claim the next day, calling it a false positive. Taylor Farms celebrated the retraction, giving the impression that it erased the company’s link to the outbreak—it didn’t; the link was based on the traceback investigation. The company further claimed the FDA had apologized to it, which FDA officials flatly denied. Taylor Farms和特朗普政府都因缺乏关于疫情的明确信息而受到严厉审查。7月，FDA曾令人困惑地宣布Taylor Farms的一份生菜样本圆孢子虫检测呈阳性，但次日便撤回了该声明，称其为假阳性。Taylor Farms对这一撤回表示庆祝，给人一种该公司与疫情的关联已被消除的印象——事实并非如此；关联是基于溯源调查得出的。该公司还声称FDA已向其道歉，但FDA官员断然否认了这一点。
The relationship between the Trump administration and Taylor Farms has also drawn scrutiny. Amid the misleading communication, it came to light that Taylor Farms directly appealed to the White House to delay announcing the recall. Further, financial records showed that Taylor Farms donated $1 million to a Trump-supporting super PAC, MAGA, Inc., in March, just days after the Trump administration delayed an FDA rule to strengthen food traceability regulations. Taylor Farms did not respond to Ars Technica’s request for comment on the donation, but it has updated its website to include a note saying it is not against traceability legislation. 特朗普政府与Taylor Farms之间的关系也引发了质疑。在误导性沟通的背后，有消息披露Taylor Farms曾直接向白宫游说，要求推迟宣布召回。此外，财务记录显示，Taylor Farms在3月份向支持特朗普的超级政治行动委员会“MAGA, Inc.”捐赠了100万美元，而就在几天前，特朗普政府刚刚推迟了一项旨在加强食品溯源监管的FDA法规。Taylor Farms未回应Ars Technica就该捐款的置评请求，但已更新其网站，声明公司并不反对溯源立法。
Meanwhile, Mexico’s health minister initially pushed back on the FDA’s finding that the US cases were linked to lettuce grown in Mexico. However, the link appears to be growing stronger. Last week, the UK Health Security Agency reported a “sharp rise” of cyclosporiasis cases in travelers returning from Mexico. Among 51 cases with travel information, 48 reported travel to Mexico, the agency said. 与此同时，墨西哥卫生部长最初反驳了FDA关于美国病例与墨西哥种植的生菜有关的调查结果。然而，这种关联似乎正变得越来越紧密。上周，英国卫生安全局报告称，从墨西哥回国的旅客中，圆孢子虫病例出现“急剧上升”。该机构表示，在51例有旅行信息的病例中，有48例曾前往墨西哥。
In the CDC’s updated surveillance data, the agency has tallied 10,468 lab-confirmed cases and more than 12,255 probable cases across 47 states. Since 2018, the US has been recording between 2,000 and 5,000 cases each year. 在CDC更新的监测数据中，该机构统计了47个州共10,468例实验室确诊病例和超过12,255例疑似病例。自2018年以来，美国每年记录的病例数在2,000至5,000例之间。