18-year-old dies of measles in PA from severe neurological complication
18-year-old dies of measles in PA from severe neurological complication
宾夕法尼亚州一名18岁青年因麻疹引发严重神经系统并发症死亡
A fourth person in Pennsylvania has died of measles, the state health department confirmed Tuesday. The latest death was in an unvaccinated 18-year-old resident of Mifflin County. 宾夕法尼亚州卫生部周二证实，该州已有第四人死于麻疹。最新的一名死者是米夫林县（Mifflin County）一名未接种疫苗的18岁居民。
In the announcement, the state health department also confirmed a county coroner’s report over the weekend of the death of an unvaccinated 40-year-old woman in Jefferson County. The state had previously reported two deaths in Lancaster County; both were infants—a newborn boy and a 6-week-old girl, both too young to be vaccinated. 在公告中，州卫生部还证实了县验尸官周末发布的一份报告，确认杰斐逊县（Jefferson County）一名未接种疫苗的40岁女性死亡。此前，该州已报告兰开斯特县（Lancaster County）有两名婴儿死亡，分别为一名新生男婴和一名6周大的女婴，两人均因年龄太小而无法接种疫苗。
According to the Mifflin County coroner, Andrea L. Alcalde, the 18-year-old’s cause of death was determined to be acute disseminated encephalomyelitis (ADEM), which is a rare but known severe complication of measles. The condition is characterized by a rapidly progressing autoimmune disorder in which aberrant inflammation from an infection strips away the protective coverings of nerve cells in the brain and spinal cord. 据米夫林县验尸官安德里亚·L·阿尔卡尔德（Andrea L. Alcalde）称，这名18岁青年的死因被确定为急性播散性脑脊髓炎（ADEM），这是麻疹一种罕见但已知的严重并发症。该病症的特征是一种进展迅速的自身免疫性疾病，感染引发的异常炎症会剥离大脑和脊髓中神经细胞的保护层。
Before measles vaccines were widely used, ADEM was commonly associated with measles, though other viral infections can also spur its development. In a new release posted to the coroner’s Facebook page Tuesday, Alcalde said the death determination was made after a review of medical records and all available information. Alcalde said no other information would be released about the deceased. 在麻疹疫苗广泛使用之前，ADEM通常与麻疹有关，尽管其他病毒感染也可能诱发该病。阿尔卡尔德周二在验尸官的Facebook页面发布的新闻稿中表示，这一死亡判定是在审查了医疗记录和所有可用信息后做出的。阿尔卡尔德表示，不会再发布关于死者的其他信息。
The state health department released a statement confirming the measles death of the 18-year-old, as well as the death of the 40-year-old. The two deaths will be added to the state’s outbreak data dashboard Wednesday as part of the regular update, the department noted. 州卫生部发表声明，确认了这名18岁青年和40岁女性的麻疹死亡病例。该部门指出，这两起死亡病例将于周三作为定期更新的一部分，被添加到该州的疫情数据仪表板中。
So far, the state has reported 693 measles cases in 38 counties this year. There have been 99 cases reported in the last seven days. In all, 133 people have been hospitalized. 到目前为止，该州今年已在38个县报告了693例麻疹病例。过去七天内报告了99例。总计已有133人住院治疗。
“My thoughts are with the two families who lost loved ones to this highly contagious virus, as Pennsylvania faces the worst measles outbreak in more than three decades,” Pennsylvania Secretary of Health Debra Bogen said in a statement, referring to the two latest deaths. “We remain committed to working with our partners across Pennsylvania to stem this outbreak and prevent more deaths. That means ensuring people have the facts about measles and access to the MMR [measles, mumps, and rubella] vaccine—which kept measles outbreaks at bay for decades.” “在宾夕法尼亚州面临三十多年来最严重的麻疹疫情之际，我向失去亲人的两个家庭表示慰问，”宾夕法尼亚州卫生部长黛布拉·博根（Debra Bogen）在谈到最近两起死亡事件时发表声明称。“我们仍然致力于与宾夕法尼亚州各地的合作伙伴共同努力，遏制疫情并防止更多死亡。这意味着要确保人们了解有关麻疹的事实，并能够获得MMR（麻疹、腮腺炎和风疹）疫苗——正是这种疫苗在过去几十年里有效地控制了麻疹疫情。”
The deaths are unlikely to be quickly included in national data collected by the Centers for Disease Control and Prevention, which is under the tight control of anti-vaccine Health Secretary Robert F. Kennedy Jr. Amid Pennsylvania’s deadly outbreak, Kennedy has disputed deaths, spread misinformation about the MMR vaccine, and reportedly ordered the CDC director to exclude reports of the two babies’ deaths. 这些死亡病例不太可能被迅速纳入美国疾病控制与预防中心（CDC）收集的国家数据中，该中心目前处于反疫苗立场的卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）的严格控制之下。在宾夕法尼亚州致命疫情期间，肯尼迪曾对死亡病例提出质疑，散布关于MMR疫苗的虚假信息，并据报道下令CDC主任将两名婴儿的死亡报告排除在外。
The CDC has also changed how it counts measles deaths in national reporting. The agency previously relied on determinations and reporting from state and local health officials. Now, it says, it will only report death records received by the National Center for Health Statistics (NCHS), which is a system designed not to monitor ongoing outbreaks but to track death trends over long periods. The US Department of Health and Human Services, which oversees the CDC, did not respond to questions from Ars Technica about the new rule. CDC还改变了其在国家报告中统计麻疹死亡人数的方式。该机构此前依赖州和地方卫生官员的判定和报告。现在，它表示只会报告国家卫生统计中心（NCHS）收到的死亡记录，而该系统旨在追踪长期的死亡趋势，而非监测正在发生的疫情。负责监管CDC的美国卫生与公众服务部没有回应Ars Technica关于这一新规的提问。
Pennsylvania’s state health department noted in its announcement today that its determinations of measles-associated deaths were made after thorough investigations. The state uses a measles-associated death definition modeled after criteria for illness-associated death determinations set by the Council of State and Territorial Epidemiologists (CSTE). 宾夕法尼亚州卫生部在今天的公告中指出，其对麻疹相关死亡的判定是在经过彻底调查后做出的。该州使用的麻疹相关死亡定义，是参照州和地区流行病学家委员会（CSTE）制定的疾病相关死亡判定标准制定的。
Even with changes to the CDC’s measles data reporting and suspicions that many cases are going undetected, the CDC is still reporting nearly 3,300 measles cases this year. That’s higher than last year’s record tally of 2,289 cases, which led to three deaths. It’s also the highest total seen since 1991, when there were 9,643 cases. 尽管CDC改变了麻疹数据报告方式，且人们怀疑许多病例未被发现，但CDC今年仍报告了近3,300例麻疹病例。这高于去年创纪录的2,289例（导致3人死亡）。这也是自1991年报告9,643例以来的最高总数。
The US declared measles eliminated in 2000 after blocking domestic transmission over a 12-month period via high vaccination rates. With vaccination rates slipping well below the target of 95 percent, measles is roaring back, and the US is on track to lose its elimination status. 美国在2000年宣布消灭了麻疹，当时通过高疫苗接种率在12个月内阻断了国内传播。随着疫苗接种率大幅跌破95%的目标，麻疹正在卷土重来，美国正处于失去“消灭状态”的边缘。