在微型殺手面前，我們應以守為攻

平昌冬奧會期間爆發的諾瓦克病毒、幾內亞的拉沙熱所造成的死亡，以及美國流感的大規模爆發之間有什么共同之處？除了時間點上的共同之處之外（每一場疫情都仍在發生或最近才發生），這些疫情都在提醒我們，與爭奪地球霸主地位的微生物相比，人類是異常脆弱的。

全球公共衛生問題領域最有才華的作者勞瑞·格瑞特很快在foreignpolicy.com上發表了一篇聳人聽聞的文章，講述了諾瓦克病毒的肆虐讓奧運村的運動員飽受折磨。有專家將這一病毒稱為“完美的人患病原體”。格瑞特寫道，雖然這種病毒很少奪走生命，但該病毒在繁殖時“傳染性非常強，而且會引發嚴重的癥狀，基本上無法在人群密集的場所徹底消除”。病毒的表面附著能力特別強，尤為擅長通過各種物體進行傳播，包括鞋和門把手，而且在病原體數量很少時依然具有傳染性，如果舉行一場細菌奧林匹克運動會，諾瓦克病毒將成為強有力的沖金選手。

最近幾內亞發生的拉沙熱死亡事件（《華盛頓郵報》稱此次死亡事件在該國20年以來尚屬首次）在很多方面都令人感到擔憂，但其中一個是這名幾內亞病人死亡的地點——鄰國利比里亞。這一跨境死亡事件讓人再度想起另一種出血熱病毒——埃博拉。在2014年恐怖的西非埃博拉病毒爆發之際，該病毒自由地穿越了數個國界。（另一個讓人感到擔憂的是，衛生部門官員明顯在很長一段時間之后才公開發布死亡事件。發布之時，受感染的病患已經在1月11日，也就是近一個月之前便已去世。）

流感呢？這種病毒年復一年地提醒著我們其致病和致死能力，然而，我們仍在年復一年地因其大規模的爆發而感到震驚。

這些肉眼看不到的微型猛獸，不管是基于RNA的諾瓦克病毒、拉沙熱之類的沙粒病毒，還是流感病毒，都會像人類一樣不斷進化，而且進化的速度要快得多。其中的很多病毒都會附著在鞋履上進行全球旅行，像奔走于世界各地的首席執行官一樣積累常旅里程。

對于那些好奇和無畏的人來說，美國國家衛生研究所（NIH）發布了通俗易懂的新發傳染?。‥ID）清單，它根據威脅程度的不同將這些疾病劃分為三大類。

從人口健康角度來看，最恐怖的EID并非是那些致死率最高的病毒，而是那些能夠讓眾多人出現嚴重病情的病毒。這些病毒傳播起來比較容易，而且按照衛生部門官員的話來說，“需要對診斷能力進行特定的改進”才能迅速地發現這些病毒，但對于眾多新出現的傳染病來說，人類并不具備這樣的能力。

為什么我會在美好的周一清晨提到這個話題呢？是為了提醒人們（這里不僅指美國民眾，也指世界民眾）我們還沒有行之有效的防御方案來應對這類威脅。夜間新聞提到的嚴重的季節性流感如今已擴散至美國全境，它已經迫使人們開始采取措施來制定（并資助）這一方案。

如果這一方案也未能奏效的話，而且寨卡病毒、埃博拉和SARS病毒在這一方案出臺之前還沒有肆虐地球的話，我不敢想象還會出現什么樣的新病毒。（財富中文網）

譯者：馮豐

審校：夏林

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What do an Olympic outbreak of norovirus in Pyeongchang, a death from Lassa fever in Guinea, and a severe eruption of flu in the United States have in common? Each—in addition to happening right now (or very recently)—is a reminder of how frail the human organism can be compared with the microorganisms that compete with us for earthly dominance.

Laurie Garrett, one of the globe’s most gifted writers on global public health issues, has a timely and scary essay on foreignpolicy.com about the nasty norovirus plaguing athletes in the Olympic village—a bug one expert calls the “perfect human pathogen.” Though the virus rarely kills people, it is “so contagious and causes such violent illness to further spread its progeny that is virtually impossible to eliminate…from a crowded human environment,” writes Garrett. Remarkably sticky on surfaces, brilliant at hitchhiking rides on everything from shoes to door handles, and infectious at even sparse concentrations of viral particles, noroviruses are truly Gold-medal favorites in the Germ Olympics.

The recent Lassa fever death in Guinea—the first in more than two decades, as the Washington Post notes—is worrisome for a number of reasons, but one of those is where the Guinean victim died: next door in Liberia. The cross-border fatality conjures up bad memories of another hemorrhagic fever, Ebola, which freely crossed borders in the horrific 2014 West African outbreak. (Also raising concern is how long it apparently took health officials to publicly report the death. The infected person died nearly a month ago, on Jan. 11.)

And the flu? Its power to sicken and kill is made clear year after year after year—and still we seem surprised by its morbid rage…year after year after year.

These little invisible beasts—whether they be RNA-based noroviruses, arenaviruses like Lassa, or influenza viruses—evolve as we do…only much, much faster. And many of them are world travelers to boot, collecting frequent flier miles as if they were globetrotting CEOs.

For those curious and intrepid, the NIH has a handy manifest of Emerging Infectious Diseases, or EIDs, which it breaks down into three categories, based on the priority of the threat.

The scariest of these EIDs, from a population health standpoint, aren’t the ones that kill the most, but rather the ones that get lots of people pretty darn sick. The pathogens on this list also disseminate with moderate ease and, say health officials, “require specific enhancements for diagnostic capacity” in order to identify them rapidly—a level of readiness we simply don’t have for many new infectious diseases.

Why do I bring this up on a beautiful Monday morning? To remind us that we—and I speak here of both the American “we” and the global “we”—don’t yet have a good defensive plan to deal with these threats. The nightly news reports about the brutal seasonal flu, now widespread across our great land, haven’t jumpstarted efforts to build (and fund) such a plan.

And if that hasn’t done it—and if Zika and Ebola and SARS didn’t do it before that—I don’t want to imagine what will.