双语阅读 | 西非的埃博拉病毒病——最初9个月疫情和未来预测
2014/12/22 医学生

     英文原标题： Ebola Virus Disease in West Africa - The First 9 Months of the Epidemic and Forward Projections.

     作者：

     期刊名称：新英格兰医学杂志(NEJM)

     发表时间：2014-09-22

     索引：N. Engl. J. Med. 2014 Sep;

     中文摘要来源：麦毓麟翻译，徐贝审核

     【中文摘要】

     背景

     2014年3月23日，世界卫生组织(WHO)得知几内亚爆发埃博拉病毒病(EVD)。8月8日，WHO宣布该传染病为一“全球关注的公共卫生突发事件”。

     方法

     截至2014年9月14日，共报道4507例疑诊及确诊病例，包括来自西非五个国家——几内亚、利比里亚、尼日利亚、塞内加尔和塞拉利昂的2296例EVD(扎伊尔种)死亡病例。我们分析了截至9月14日收集自几内亚、利比里亚、尼日利亚和塞拉利昂的3343例确诊及667例疑诊病例的详细数据。

     结果

     大部分患者年龄介于15到44岁之间(49.9%为男性)，感染后已知临床结局的患者病死率估计为70.8%(95%置信区间[CI]，69-73]。感染的病程，包括症状和体征、潜伏期(11.4天)和系列间隔时间(15.3天)与以往报道的EVD爆发数据相似。以起始指数增长期为基础，几内亚的基本再生数(R0)约为1.71(95% CI，1.44-2.01)，利比里亚为1.83(95% CI，1.72-1.94)，塞拉利昂为2.02(95% CI, 1.79-2.26)。几内亚的当前再生数(R)约为1.81(95% CI，1.60-2.03)，利比里亚为1.51(95% CI，1.41-1.60)，塞拉利昂为1.38(95% CI，1.27-1.51)；几内亚的相应倍增时间为15.7天(95% CI，12.9-20.3)，利比里亚为23.6天(95% CI，20.2-28.2)，塞拉利昂为30.2天(95% CI，23.6-42.3)。假设该传染病的控制措施不变，到2014年11月2日，几内亚累计确诊及疑诊病例的报道数量预计为5740例，利比里亚为9890例，塞拉利昂为5000例，总数将超过20,000例。

     结论：本研究数据说明，如果不大力改进控制措施，预计EVD病例数及死亡人数将在未来数月从每周数百持续增加至每周数千例。

     【英文摘要】

     Background

     On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a "public health emergency of international concern."

     Methods

     By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa - Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14.

     Results

     The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total.

     Conclusions

     These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.

    

     阅读原文

    http://www.duyihua.cn
返回 医学生 返回首页 返回百拇医药