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专家称猴痘病毒可以通过空气传播

Monkeypox Can Be Airborne, Too
专家称猴痘病毒可以通过空气传播

The Centers for Disease Control and Prevention updated its guidance last week for travelers wishing to protect themselves against monkeypox. This was one of its recommendations: “Wear a mask. Wearing a mask can help protect you from many diseases, including monkeypox.”

上周,美国疾病控制和预防中心针对希望保护自己免受猴痘感染的旅行者更新了指南。其中一个建议是:“戴口罩。戴口罩有助于预防许多疾病,包括猴痘。”

Late Monday night, that recommendation was deleted.

周一深夜,该建议被删除。
 

科学家们说,猴痘病毒可以通过空气传播,尽管这种传播途径只是其整体传播的一小部分。

“C.D.C. removed the mask recommendation from the monkeypox travel health notice because it caused confusion,” the agency said in a statement on Tuesday.

“疾控中心从猴痘旅行健康通知中删除了戴口罩的建议,因为它引发了困惑,”疾控中心在周二的一份声明中说。

However, the agency still says that in countries where monkeypox is spreading, “household contacts and health care workers” should consider wearing masks. That guideline also applies to “other people who may be in close contact with a person who has been confirmed with monkeypox.”

然而,疾控中心仍然表示,在猴痘传播的国家,“家庭接触者和医护人员”应该考虑戴口罩。该指南也适用于“其他可能与猴痘确诊者有密切接触的人”。

The turnabout hints at a little-discussed aspect of the current monkeypox outbreak: The virus can be airborne, at least over short distances. While airborne transmission is only a small factor in the overall spread, experts said in interviews, there are no firm estimates regarding how much it contributes.

这一转变暗示了当前猴痘疫情中一个极少被提及的方面:该病毒——至少在很短的距离内——可以通过空气传播。专家在采访中说,虽然空气传播只是整体传播的一个小因素,但没有确切估计它的比重有多大。

Since May 13, when the first case in the outbreak was reported, more than a thousand people in 31 countries have been diagnosed with the virus, and at least another thousand cases are being investigated. As of Tuesday, the United States had recorded 31 cases in 12 states and the District of Columbia.

自5月13日报告疫情首例病例以来,已有31个国家的1000多人被诊断出感染了该病毒,至少还有1000例正在接受观察。截至周二,美国已在12个州和哥伦比亚特区记录了31例病例。

In previous outbreaks, a majority of cases were reported in those who had close contact with an infected patient or animal. But in some instances, airborne transmission was the only explanation for the infections.

在以前的疫情中,大多数病例发现于与感染者或动物有密切接触的人。但在某些情况下,空气传播是感染的唯一解释。

Elsewhere on its website, the C.D.C. still urges monkeypox patients to wear a surgical mask, “especially those who have respiratory symptoms.” It also asks other household members to “consider wearing a surgical mask” when they are in the presence of the person with monkeypox.

在疾控中心网站的其他地方,它仍然敦促猴痘患者戴上外科口罩,“尤其是那些有呼吸道症状的人。”它还要求家庭成员在猴痘患者在场时“考虑戴上外科口罩”。

Monkeypox is assumed to behave much like its viral cousin, smallpox. In a 2012 review of smallpox transmission, Dr. Donald Milton, an expert on viruses at the University of Maryland, described several instances of airborne transmission.

人们认为猴痘的行为与它的同属“近亲”天花很相似。在2012年对天花传播的综述中,马里兰大学病毒专家唐纳德·米尔顿博士描述了几起空气传播的案例。

It was the only plausible explanation during a 1947 outbreak of smallpox in New York, he wrote, when one patient apparently infected another seven floors away in a hospital. Then, in 1970, a single patient infected several others on three floors of a hospital in Meschede, Germany, aided by air currents in the building.

他写道,这是1947年纽约暴发天花疫情唯一合理的解释,当时一名患者显然感染了医院相隔七层楼的一名患者。然后,在1970年,在德国梅舍德一家医院,经由大楼内的气流传播,一名患者感染了三个楼层的其他几名患者。

And scientists studying a 2017 outbreak of monkeypox in Nigeria observed cases of transmission within a prison and recorded infections in two health care workers who had no direct contact with patients.

研究2017年尼日利亚猴痘疫情的科学家观察了监狱内的传播病例,并记录了两名医护人员的感染情况,这两名医护人员与患者没有直接接触。

At a scientific conference last week organized by the World Health Organization, several researchers discussed the many unknowns about monkeypox, including its primary mode of transmission.

在世界卫生组织上周组织的一次科学会议上,几位研究人员就猴痘的许多未知方面进行了讨论,包括其主要传播方式。

“It’s very ambiguous what the true or dominant route of transmission is, and some of that can be addressed in animal models,” Nancy Sullivan, a researcher at the National Institute of Allergy and Infectious Diseases, said at the conference. “Probably that needs to take a front seat for some of the laboratory research.”

“真正的或主要的传播途径非常模糊,其中一些可以在动物模型中得到解决,”美国国家过敏和传染病研究所研究员南希·沙利文在会议上说。“也许这一点在一些实验室研究中需要占据优先地位。”

But in briefings with the press and with the general public, health officials have not explicitly addressed the possibility of airborne transmission or the use of masks for protection.

但在与新闻界和公众的简报中,卫生官员没有明确提到空气传播的可能性或使用口罩进行保护。

And in interviews, they emphasized the role of large respiratory droplets that are expelled from infected patients and drift onto objects or people. Monkeypox infection requires “really close sustained contact,” said Andrea McCollum, the C.D.C.’s leading expert on the virus.

在采访中,他们强调了较大呼吸道飞沫的作用,它们从感染患者体内排出并飘到物体或人身上。美国疾控中心病毒研究首席专家安德里亚·麦科勒姆说,猴痘感染需要“非常密切的持续接触”。

“This is not a virus that was transmitted over several meters,” she said. “That’s why we have to be really careful how to frame this.”

“这不是一种在几米内传播的病毒,”她说。“这就是为什么我们必须非常小心地表述这个问题。”

When asked whether health officials should make the possibility of airborne transmission more widely known, Ms. McCollum said, “It’s a fair point to make, and it’s something we certainly should consider moving forward.”

当被问及卫生官员是否应该让更多人了解空气传播的可能性时,麦科勒姆女士说:“这个问题有一定道理,我们今后当然应该考虑这一点。”

The C.D.C.’s swift about-face on masks for travelers concerned about monkeypox was reminiscent of its early denials that the coronavirus was airborne. In September 2020, the agency published guidance on airborne transmission of the virus and then abruptly withdrew it just days later.

疾控中心向担心猴痘的旅行者提出戴口罩的建议后迅速反转,这让人想起该机构早期曾否认新冠病毒是通过空气传播的。2020年9月,疾控中心发布了关于新冠病毒通过空气传播的指南,但几天后又突然撤回。

It was not until May 2021 that the agency acknowledged that the coronavirus could “remain suspended in the air for minutes to hours.”

直到2021年5月,疾控中心才承认新冠病毒有可能“在空气中悬浮几分钟到几小时”。

Most information about the monkeypox virus has been gleaned from studies on smallpox. For the past two decades, scientists have been studying how smallpox spreads, including its presence in tiny droplets called aerosols, in order to prepare for its potential use by bioterrorists.

大多数关于猴痘病毒的信息都是从对天花的研究中收集到的。在过去的二十年里,科学家们一直在研究天花是如何传播的,包括它存在于被称为气溶胶的微小液滴中,以便做好准备应对生物恐怖分子对它的利用。

“Most people think that smallpox usually is transmitted by large droplets, but it can, for whatever reason, occasionally be transmitted by small-particle aerosols,” said Mark Challberg, a virologist at the National Institute of Allergy and Infectious Diseases.

“大多数人认为天花通常是通过较大飞沫传播的,但它偶尔会——无论出于何种原因——通过小颗粒气溶胶传播,”美国国家过敏和传染病研究所的病毒学家马克·查尔伯格说。

Dr. Milton warned that planning for potential airborne transmission of monkeypox was particularly important in hospitals, because precautions to avoid the spread of viruses through aerosols are not universal.

米尔顿博士警告,规划预防猴痘潜在的空气传播在医院中尤为重要,因为防止病毒通过气溶胶传播的措施并不普遍。

As the monkeypox outbreak continues, many patients are isolating at home because their symptoms are mild. Members of those households may need to take the possibility of airborne transmission into consideration, experts said.

随着猴痘疫情的持续,许多患者因症状轻微而在家隔离。专家说,这些家庭的成员可能需要考虑空气传播的可能性。

Many unanswered questions about monkeypox remain, including why the current outbreak has produced only relatively mild cases. Scientists do not know whether people can transmit virus even in the absence of symptoms, how long the virus has been circulating in communities, and whether it can be transmitted in semen or vaginal secretions.

关于猴痘仍有许多悬而未决的问题,包括为什么当前的疫情只产生了症状相对较轻的病例。科学家们不知道无症状者是否会传播病毒,病毒已经在社区中传播了多长时间,以及是否可以通过精液或阴道分泌物传播。

There is evidence that a pregnant woman can pass the monkeypox virus on to her fetus. In an observational study of 216 patients in the Democratic Republic of Congo, the largest of its kind, four of five pregnant women had miscarriages. The researchers found the virus and viral lesions in the fetuses.

有证据表明,孕妇会将猴痘病毒传染给胎儿。刚果民主共和国的216名患者参与了一项观察性研究,这是同类研究中规模最大的一次,五名孕妇中有四名出现流产。研究人员在胎儿体内发现了病毒和病毒性病变。
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