刚果已记录超过5200例埃博拉病例
Over 5,200 Ebola cases recorded in Congo

原始链接: https://www.afro.who.int/countries/democratic-republic-of-congo/news/over-5200-cases-recorded-democratic-republic-congocrosses100-days-ebola-outbreak-declaration

刚果民主共和国正面临其有史以来增长最快的埃博拉疫情,目前距离疫情宣布已过去100天。由于病毒传播速度超过了防控工作,疫情已蔓延至六个省份,伊图里省仍是震中。令人担忧的是,近期60%的死亡病例发生在社区内,这表明早期发现和治疗仍存在巨大障碍。 尽管面临地区冲突、局势不稳定及社区抵触等严峻挑战,但防控工作已取得显著改善。实验室检测能力大幅提升,床位供应量激增,接触者随访率已从9%提高到84%。此外,临床试验和诊断检测的进展也提供了重要的科学基础。 世界卫生组织领导层强调,这是一个“决定性时刻”。尽管进展显而易见,但渐进式的增长已不足以应对当前局势。要控制疫情,必须大规模扩大行动规模、持续开展社区参与,并加强国家及国际间的协作。最重要的是,在持续的冲突中确保受灾地区的安全准入至关重要。未来几个月将是弥补运营缺口并有效遏制病毒传播的关键时期。

近期 Hacker News 上关于刚果民主共和国爆发大规模埃博拉疫情的讨论中,出现了关于其是否可能引发全球性大流行的辩论。 多数评论者认为,埃博拉病毒不太可能引发像新冠肺炎那样的全球性危机。他们强调,埃博拉主要通过直接体液接触传播,且往往因宿主病亡过快,难以实现广泛的无症状传播。尽管一些人承认高死亡率病毒会带来严重的人道主义危机和区域不稳定的风险,但他们将其与快速传播的全球性空气传播大流行区别开来。 讨论还涉及了在医疗基础设施薄弱地区遏制病毒的挑战,指出围绕逝者的文化习俗以及对西方卫生当局的不信任,使得防控工作更为复杂。一些参与者主张增加国际援助并采取强有力的公共卫生措施,而另一些人则对外国干预持怀疑态度。最终,共识凸显了一个鲜明的区别:虽然当前局势被视为一场“可怕的”地方性紧急事件,但在生物学和流行病学层面,它被普遍认为与近年来出现的呼吸道传播威胁有着本质不同。
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原文

Kinshasa—One hundred days have passed since the Democratic Republic of the Congo declared the ongoing Ebola outbreak, which has now become the country's fastest growing. Transmission is outpacing control efforts, requiring a substantial scale-up across all areas of response to halt the spread of the virus. 

A daily average of around 90 confirmed cases has been recorded in the first three months, markedly higher than the rate observed in the same period during the 2014–2016 West Africa and the 2018–2020 Democratic Republic of the Congo outbreaks. The outbreak has now expanded to a sixth province, with Ituri remaining the epicentre, accounting for about 85% of cases and 79% of deaths.  

“We can bring the Ebola outbreak under control but only through scaled-up action in affected communities that is led by national, provincial and local leaders and the affected communities, sustained by needed resources and backed by committed collaboration by all partners in DRC and beyond,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO and partners will continue to support the DRC government, communities and neighbouring countries in delivering the response needed to end the outbreak.” 

Mortality is high both in communities and among patients in treatment facilities. Community deaths—those occurring outside Ebola treatment centres—accounted for around 60% of the 260 weekly fatalities recorded over the past six weeks. This highlights the persistent challenges in early detection, referral and access to treatment, while mortality among patients reaching treatment facilities may reflect late admission and severe stage of the disease. 

The response needs to be rapidly ramped up and adapted to local transmission patterns and operational gaps. All response partners need to reinforce operations in areas with high virus transmission and community deaths, as well as in high-risk areas and in areas reporting new cases.   However, the response faces many challenges such as insecurity and recurrent conflict, population displacement, attacks on health facilities, community reluctance and difficult access. Scaling up and adapting the response requires intensified action and resource intense mobilization, stronger disease surveillance, preparedness and coordination across provinces, along the Congo River and national borders. 

“This outbreak has reached a defining moment. The progress made over the past three months shows that stronger action delivers results, but it also reminds us that incremental gains will not be enough. We now need to significantly step up the response: moving faster to detect cases, reaching communities sooner and strengthening operations where they are needed most. The choices we make now will determine how quickly we can bring this outbreak under control, protect and save lives,” said Dr Mohamed Janabi, WHO Regional Director for Africa. 

Despite the challenges, important outbreak response efforts have been made over the past three months. Laboratory capacity has expanded from one testing site to 19 laboratories capable of processing more than 3000 samples a day. Treatment capacity has increased from fewer than 10 beds to more than 1300, while over 900 health facilities have received infection prevention and control support. Community engagement activities have reached more than 2.5 million people and contact follow-up has improved from 9% during the first week of the outbreak to 84% as of 18 August.  

Scientific efforts are also advancing, including clinical trials of potential treatments, evaluation of candidate vaccines and deployment of the first emergency-listed molecular diagnostic test for Bundibugyo virus disease. In countries neighbouring the Democratic Republic of the Congo and beyond, preparedness is being reinforced through closer cross-border collaboration, harmonized disease surveillance, information sharing and joint planning to detect and contain imported cases. 

National authorities, supported by WHO and partners, are reinforcing disease surveillance and contact tracing, expanding laboratory testing and clinical care, strengthening infection prevention and control, and working with communities to encourage early reporting, care-seeking and safe and dignified burials. WHO has deployed over 260 experts, delivered more than 330 tonnes of essential medical and operational supplies. 

Bringing the outbreak under control will require sustained national leadership, strong community engagement, secure access to affected communities, regional and global solidarity and continued investment to rapidly strengthen response operations where they are needed most. A halt in conflict is also critical to enable frontline teams to reach affected communities. The coming months will be critical to building on the gains made over the first 100 days, closing remaining operational gaps and accelerating efforts to contain the outbreak. 

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