全世界應該放下屠刀 合力抗擊埃博拉病毒

As a terrifying outbreak of Ebola virus spreads across west Africa, the world is beginning to wake up to the threat of a public health disaster in the region – and possibly more widely – but efforts to contain the epidemic require much more local co-ordination and global support. With more than 1,100 cases and 660 deaths reported so far, this is not only the largest Ebola epidemic to date but also the first to threaten urban west Africa, where populations are larger and more mobile than in the relatively isolated central parts of the continent affected previously.

隨着可怕的埃博拉病毒在西非各地不斷蔓延，世界開始對西非（抑或更廣泛地區）爆發一場公共健康災難的威脅警覺起來，但遏制疫情需要當地更多的合作和全球的支持。迄今報道的感染人數超過1100人，死亡人數爲660人，這不僅是歷史上最嚴重的埃博拉疫情，而且還是該病毒首次威脅城鎮化率更高的西非地區——與此前爆發疫情的相對封閉的中非地區相比，西非人口更多，而且流動性也更強。

Ebola’s scary reputation is based on its lethality – the virus kills about 60 per cent of those it infects – and the lack of any effective treatment beyond making sure that patients are kept fully hydrated. But it is not as contagious as some other germs such as influenza that can spread considerable distances through the air. People catch Ebola by physical contact with an infected person or animal; scientists believe fruit bats, often eaten as bushmeat in Africa, are a reservoir of infection.

埃博拉病毒的可怕名聲源於其致死率（約爲60%），而且除了確保病人充分補水以外，目前還無其他有效的治療方案。但它的傳染性不如流感等其他病毒，後者可以通過空氣傳播至相當遠的地方。埃博拉病毒通過與受感染患者或動物的物理接觸傳染。科學家相信，在非洲常被當作野生動物食用的果蝠是埃博拉病毒的宿主。

Sophisticated healthcare, with quick diagnosis of suspected cases followed by barrier nursing and medical care, could halt the epidemic. The challenge is to provide that – or something closer to it than exists in much of west Africa today – in a region where the public health infrastructure is generally poor.

成熟的醫療衛生，加上對疑似病例的快速診斷，再加上隔離看護和治療，可能阻止疫情的傳播。挑戰在於，一個公共衛生基礎設施普遍匱乏的地區很難提供這些服務。西非大部分地區的醫療水平與之相距太大。

The World Health Organisation is already co-ordinating regional action with west African governments, and the medical assistance body Médecins Sans Frontières is active in the fight against Ebola, alongside some smaller western health charities. But they need more help from governments and agencies in the developed world, such as the US Centres for Disease Control and Prevention.

世界衛生組織(WHO)已在與西非各國政府協調地區行動，醫療援助機構“無國界醫生組織”(Medecins Sans Frontieres)與一些較小的西方醫療慈善機構一起，也積極參與到抗擊埃博拉病毒的行動中。但它們需要來自發達世界的政府和機構——比如美國疾病控制與預防中心(US Centres for Disease Control and Prevention)——的更多幫助。

The first requirement is for better and faster diagnosis so that doctors can tell as quickly as possible whether someone is infected with Ebola, which resembles many other illnesses in its early symptoms. Because samples from suspected Ebola patients are an extreme biohazard risk, they must be handled in high-containment testing facilities, which are in short supply in west Africa.

第一個需求是更快更好的診斷，讓醫生可以儘快確診某人是否感染埃博拉病毒。感染該病毒的初期症狀與其他許多疾病類似。由於從疑似感染埃博拉病毒患者提取的樣本的生物危害風險極大，因此必須在高防護的檢測中心檢測這些樣本，但這些設施在西非供應不足。

Then patients must be treated in complete isolation by staff wearing full protective clothing (masks, gloves, gowns and goggles), with all equipment sterilised and patients kept away from friends and family. The World Medical Association warned yesterday that serious shortages of protective equipment were putting the lives of doctors and nurses at risk in Guinea, Liberia and Sierra Leone; indeed several health workers, including two Americans, have already been infected. Health workers fighting bravely in the front line against Ebola deserve all the technical help they can get.

接下來病人必須接受完全隔離治療，由穿着全套防護服（面罩、手套、長袍和護目鏡）的醫療人員護理，對所有設備消毒，禁止病人與朋友和家人接觸。世界醫學會(World Medical Association)昨日警告稱，防護裝備嚴重短缺正讓幾內亞、利比里亞和塞拉利昂的醫生和護士的生命處於危險當中；實際上，包括兩名美國人在內的多名醫護人員已經受到感染。勇敢地戰鬥在抗擊埃博拉病毒第一線的醫護人員，理應獲得他們能夠獲得的所有技術援助。

While equipping and protecting staff properly is a matter of money and logistics, unhelpful social and cultural attitudes in west Africa will be harder to tackle – and will need assistance from local religious and political leaders.

爲醫護人員提供合適的裝備和保護是資金和後勤的問題，而更大的問題在於西非的社會和文化態度，它們對於抗擊疫情毫無幫助，這將需要當地宗教和政治領導人出手干預。

Many people in the region are suspicious of western healthcare and would rather take care of infected family members in the community than send them to an isolation hospital which they see as a place to die. Traditional death rituals, such as washing the body before a funeral, must also be suspended for Ebola victims.

該地區的許多人不相信西方的醫療保健，寧願在社區裏照顧受感染的家人，也不願送到被他們視爲死亡之地的隔離醫院。因感染埃博拉病毒而死亡的患者也不應舉行傳統的死亡儀式，比如在葬禮前清洗屍體。

While Ebola is primarily a health issue, it could quickly become an economic crisis, too, for the region. Travel restrictions are appearing; yesterday Liberia closed most of its border crossings in an effort to halve the spread of the disease and Arik Air, a leading Nigerian airline, stopped flying from Liberia and Sierra Leone. The threat to international business and investment in west Africa should add weight to the humanitarian arguments for more decisive action against Ebola.

儘管埃博拉病毒主要是一個健康問題，但它可能很快演變爲該地區的經濟危機。已經出現了一些旅遊禁令；昨日利比里亞關閉了大多數邊界通道，以努力阻止埃博拉病毒的傳播，尼日利亞主要航空公司Arik Air停飛了從利比里亞和塞拉利昂出發的航班。不論是出於人道主義，還是考慮到埃博拉對西非國際企業和投資造成的威脅，各方都應對埃博拉病毒採取更果斷的行動。