埃博拉病毒：你应该知道的12件事

In case you’ve missed it, the deadliest Ebola outbreak is spreading in Western Africa, taking at least 900 lives so far. The US Centers for Disease Control and Prevention (CDC) is sending 50 infectious disease specialists to the region in order to help quell the outbreak and provide much-needed resources and expertise. As the outbreak worsens, confusion—and panic—has grown.

To sort fact from doomsday fiction, we consulted current and former CDC members and infectious disease experts including Dr. Ron Behrens, of the London School of Hygiene & Tropical Medicine, and Amesh Adalija an infectious disease physician at the University of Pittsburgh Medical Center. Here are answers to common burning questions.

Where does the name “Ebola” come from?

The virus is named after the Ebola River in what is now the Democratic Republic of the Congo.That’s where the virus was discovered in 1976.

If there’s no vaccine or cure, what are doctors doing to treat Ebola patients?

For now, all doctors can do is treat the symptoms and provide supportive care like monitoring heart rate, blood pressure, and breathing while making sure the patients’ fluids are replenished. Sometimes patients are given antibiotics to treat other possible infections. The hope is to sustain the patient through the infection so their immune system can eventually clear the virus. This is harder to achieve in rural health systems in West Africa that are tasked with treating thousands of patients with insufficient resources.

How do some people recover if there’s no cure?

When the body is infected with a virus, it starts creating antibodies to attack it. The people who survive Ebola—or any virus—have created enough antibodies to neutralize it.

I hear you can only get Ebola through direct contact with an infected person’s bodily fluids. Does that mean you need to have an open wound or something?

A wound, sure, but the skin can also have microabrasions you can’t see. Additionally, the virus can get into your body through your eyes and mouth if those areas come into contact with something that contains the bodily fluids of an infected person. That’s why health care workers are supposed to keep themselves completely covered while treating patients. The doctors and health care workers in West Africa are working in rural clinics, where the proper protections are scarce. Infected people may be quarantined with other people infected with the disease, making this kind of contact easier.

Since the virus has a two-to-21-day incubation period, can you get the disease from someone who doesn’t have symptoms?

No. The CDC says people who are not symptomatic are not contagious.

Can Ebola spread through sweat?

Yes, the virus can be present in sweat.

What about sex?

Sure, though sex while infected with Ebola seems unlikely. In past Ebola outbreaks, men who survived the disease were told to refrain from sex or use condoms for about three months after recovery because the virus can be present in semen.

Why is there no vaccine or drug for Ebola?

There are several promising drugs and vaccines in development, but since Ebola is less common—and research about it is not well funded—there is no drug or vaccine that has been approved for use in humans. One experimental serum was used by the two American patients, but there’s not enough for widespread use yet. Many of the other drugs and vaccines have not yet been tested in humans. The WHO is meeting next week to discuss whether experimental treatments should be used during this outbreak.

What does the virus do to the human body?

The virus is systemic. That means it can move to and affect every part of the body causing direct damage to organs as well as internal bleeding. This causes shock, which drops a person’s blood pressure and causes multisystem organ failure.

How were the two American patients brought to the US safely?

The two Americans were evacuated out of Liberia in special planes equipped with the necessary medical equipment to sustain their health and keep them isolated. After the plane landed, they were taken in a similarly equipped ambulance to Emory University Hospital, which has a specially built isolation unit meant to treat patients who have been exposed to severe infectious diseases. For more details on their travel as well as photos, read TIME’s coverage of the travel here.

Why is it spreading so fast in Africa?

CDC director Dr. Tom Frieden has said that the health systems in Guinea, Sierra Leone and Liberia are severely lacking in resources, and health care workers may not have access to adequate protective clothing. There’s also been some pushback against healthcare workers. Since Guinea, Sierra Leone and Liberia share a border, it’s easier for people to move from one country to another, and increasing the risk for disease spread.

How did the virus start anyway?

The natural reservoir for Ebola remains unknown, but researchers hypothesize that the first infected in an outbreak likely becomes infected through contact with an infected animal. Bats are thought to be a carrier of the virus.

I am terrified about an outbreak in the US Am I overreacting?

Yes. The outbreak is happening in rural areas of developing countries. There’s a slim chance someone with Ebola could travel to the United States. If that happens, experts say that any hospital in the US would be able to successfully isolate them. The CDC says there will not be a spread of the virus akin to what we have seen in Guinea, Sierra Leone and Liberia because we have many ways to isolate a patient and treat their symptoms.

据《时代》周刊网站报道，现在，最致命的埃博拉（Ebola）病毒正在西非大地上蔓延，目前已造成至少900人死亡。美国疾病控制与预防中心（CDC）正向该地区派遣50名传染病专家以控制疾病的进一步爆发并提供继续资源和专业知识。随着事态每况愈下，困惑和恐慌也与日俱增。

为了同末日小说的场景相区分，我们咨询了包括伦敦大学卫生和热带医学学院（London School of Hygiene&Tropical Medicine）的罗恩·贝伦斯博士（Dr. Ron Behrens）以及匹兹堡大学医学中心传染病医生阿米什·阿达利亚（Amesh Adalija）在内的现任和前任疾控中心成员和传染病专家，以听取他们的意见。

以下便是关于埃博拉病毒常见问题的回答：

“埃博拉”这个名字起源何处？

埃博拉这个名字源于刚果民主共和国境内的一条同名河流。那里正是1976年埃博拉病毒被首次发现的地方。

如果没有疫苗和治愈药品，那么医生怎么治疗埃博拉病毒感染患者？

就目前来看，医生们能做的便是治疗当下症状并向患者提供如监测心率、血压、呼吸等维持疗法并确保患者的体液充足。有时患者可能会通过注射抗生素来治疗其他可能的感染，治疗的希望即在感染中维持患者生命体征从而使他们的免疫系统能够最终消除病毒。承担着在资源不足条件下治疗成千上万民患者的压力，这样的目标很难在西非农村卫生系统中得以实现。

在没有治疗药品的条件下，有些人是怎么自行恢复的？

当一个人感染了病毒之后，人体自身便会产生抗体来攻击病毒。那些感染埃博拉或是其他病毒却能自行恢复的人是在自身产生足够抗体之下才得以恢复。

我听说只有与感染者体液直接接触后才会感染上埃博拉病毒。这是不是意味着有裸露的伤口或是其他伤就会感染？

伤口是必然会感染的，还有皮肤上一些你看不到的细微擦伤也会导致感染。此外，病毒也可以从你与感染者的体液接触，通过眼睛和嘴巴进入你的身体。这就是卫生工作者们在对患者进行治疗的同时会把自己全副武装起来的原因。在西非的医生和卫生保健工作者们一般都在农村诊所工作，而诊所所能提供的保护措施非常稀有，感染者可能只会和其他疾病的感染者隔离起来，这就使得传染更为容易。

由于埃博拉病毒潜伏期为2—21天，那些并没有显示出症状的人会传染病毒么？

不能。疾控中心表示没有症状的人还不具有传染病毒的可能。

埃博拉病毒能通过汗液传播吗？

当然，病毒能够夹杂在汗液中传播。

埃博拉病毒会通过性传播感染吗？

虽然通过性传播传染埃博拉的可能性似乎不太大，但是性传播还是存在的。在过去几次埃博拉病毒爆发中，那些从病毒之下脱离虎口的人都曾告诫在康复后3个月应避免性生活或是使用避孕套，这是由于病毒可能会存活在精液之中。

为何还未研制出埃博拉病毒的疫苗或药物？

有几种前景良好的药物和疫苗还处于研发之中，但由于埃博拉病毒极为罕见且研究资金不足，因此用于人体的疫苗还尚未获得批准。两名美国患者正在试用实验血清但也没有获得足够的推广。许多其他药物和疫苗也尚未在人体得以测试，世界卫生组织将在下周开会讨论在疫情爆发的这段时间中是否应当使用实验性治疗手段。

病毒会对人体造成怎样的影响？

病毒是系统性的，这就意味着它可以在身体各个部位移动，影响部位器官从而造成内出血等直接损伤。这会导致人体休克，血压下降，最终导致多系统器官衰竭。

两名美国患者是怎样安全带回美国的？

两名美国人乘坐医疗设备齐全的专机撤离利比里亚从而维持身体健康并保持隔离。在飞机着陆之后，他们被带上了同样配备的救护车送往埃默里大学医院（Emory University Hospital），在医院中为严重传染病人而设立的隔离单元中进行隔离治疗。

为何在非洲能传染得如此之快？

疾控中心主任汤姆·弗莱登博士（Tom Frieden）表示几内亚，塞拉利昂和利比里亚的医疗资源严重缺乏，医护人员也无法获得充足的防护服装备。对于医护人员而言，也存在一些操作阻力，由于几内亚，塞拉利昂和利比里亚三国共享边境，人们很容易从一个国家便迁移到另一个国家，这样就会增加疾病传播的风险。

病毒究竟是怎样开始传播的？

埃博拉病毒的自然宿主仍然未知，但是研究人员推测第一次感染暴发很有可能是通过接触感染病毒的动物而传染的。而公认蝙蝠是埃博拉病毒的载体。

我很担心埃博拉病毒在美国暴发，这样是不是反应过度？

是的。此次病毒暴发发生在发展中国家的农村地区，因此埃博拉病毒感染者到美国来旅游的机会可谓渺茫。如果出现这种情况的话，专家们表示美国任何一家医院都能将患者成功隔离。疾控中心也表示就目前我们在几内亚，塞拉利昂和利比里亚看到的情况，由于我们有很多方法来隔离病人，治疗病症，因此病毒不会就此传播下去。