跟进：刚果（金）埃博拉死亡人数突破5000人：确诊10351例、三分之一死者未及接受救治

据美联社报道，刚果民主共和国（刚果（金））卫生部10月31日公布的最新数据显示，本轮埃博拉疫情造成的死亡人数已突破5000人，达到5026人，感染总人数为10351人，病死率接近50%。

本轮疫情由 Bundibugyo 病毒引起，今年5月中旬宣布暴发时出乎当局预料。该病毒尚无已知的疫苗或特效疗法，医护人员只能按症状对患者进行救治。目前已有2788人康复。这已是史上第二致命的埃博拉疫情，仅次于2014年至2016年西非疫情，当年多个国家共11000人死亡。

疫情集中在刚果（金）东部：Ituri 省与 North Kivu 省是震中，两省合计确诊9782例、死亡4792人。自5月以来，病毒已扩散到全国26个省中8个省的67个卫生区，占全国178个卫生区的三分之一以上，其中50个卫生区仍有活跃病例。

防控端出现两个危险信号。据非洲疾病预防控制中心数据，约80%的新增病例来自卫生部门监测的接触者链条之外，意味着绝大多数感染来自未知的传播链。世卫组织项目区域主管 Patrick Otim 表示，记录在案的死者中约有三分之一是在治疗中心之外、尚未接受病毒检测时死亡的。

「这是一个非常悲惨的里程碑，因为它不只是一个数字，」Otim 说，「它是被这场疫情摧毁的家庭与社区。这个数字也显示了这场疫情的严重程度。」他说：「这些人我们从来没有机会去尝试挽救他们，这是本轮疫情中我们最担心的问题之一。我们怎样才能尽早触及人们、让他们来到卫生设施，获得活下去的机会？」

一线救治也在承压。10月30日（周五），位于 Ituri 的 Tchomia 一家埃博拉治疗中心的医护人员停工，追讨被拖欠四个月的工资；该中心目前收治着5名确诊患者与10名疑似病例。参与停工的 Moise Mugenyi 对美联社说：「我们已经厌倦了不断讨薪。他们想付就会付……如今，能养活自己的家人都成了一个现实问题。」Ituri 应急行动代理负责人 Justin Mukonkole 呼吁医护人员耐心等待政府回应。此外，刚果（金）东部政府军与多个武装团体（以卢旺达支持的 M23 为首）之间的冲突、针对医护人员与卫生设施的袭击，也限制了防控工作的抵达范围。

跨境传播方面，Kenya 在10月确认8例确诊、2例死亡；Nigeria 唯一的确认病例已撤往瑞士治疗。连同此前报告病例的 Uganda，本轮疫情成为首个在非洲三个地区均有记录、也是该大陆地理分布最广的一次埃博拉疫情。

关联：跟进：刚果（金）埃博拉确诊10,274例、死亡4,992人：在刚中国公民须尽快撤离四省高风险地区

Follow-Up: Congo Ebola Deaths Top 5,000, With 10,351 Infected and a Third of the Dead Never Reached Care

Deaths in the Democratic Republic of Congo's Ebola outbreak have topped 5,000, reaching 5,026 out of 10,351 people infected, a lethality rate of nearly 50 percent, according to the latest data released by Congo's Ministry of Health on Saturday, the Associated Press reported.

The outbreak, caused by the Bundibugyo virus, was declared in mid-May and caught authorities by surprise. The virus has no known vaccine or treatment, and health workers care for patients based on symptoms. So far 2,788 people have recovered. It is already the second-deadliest Ebola outbreak in history, behind only the 2014-2016 West Africa outbreak, which killed 11,000 people across multiple countries.

The virus has been concentrated in eastern Congo: Ituri and North Kivu provinces are the epicenters, with 9,782 confirmed cases and 4,792 deaths between them. Since May, the disease has spread to 67 of the country's 178 health zones in eight of its 26 provinces, and 50 of those zones still have active cases.

Two warning signs stand out. According to the Africa Centers for Disease Control and Prevention, about 80 percent of new cases are coming from outside the chain of monitored contacts, meaning most infections come from transmission chains unknown to health authorities. Dr. Patrick Otim, a programme area manager with the World Health Organization, said about one-third of recorded deaths were people who died outside treatment centers, before being tested for Ebola.

'It is a very tragic milestone because it is just not a number,' Otim said. 'It is families and communities that have been devastated by this outbreak. The number also shows the severity of this outbreak.' He added: 'These are people we never had opportunity to try to save them and it is one of the biggest concerns for us in this outbreak. How do we try to reach people early to get them to come to health facilities to get a fighting chance to survive?'

Frontline care is also under strain. On Friday, workers at an Ebola treatment center in Tchomia, in Ituri, downed tools demanding four months of unpaid wages; the center currently cares for five confirmed patients and 10 suspected cases. 'We are tired of requesting our salaries. If they want to pay us, they will. … Today, being able to feed our families has become a real problem,' Moise Mugenyi, one of the striking workers, told the AP. Dr. Justin Mukonkole, acting head of response operations in Ituri, urged the workers to be patient while the government responds. Conflict in eastern Congo between the government and armed groups — most prominently the Rwanda-backed M23 — and attacks on health workers and facilities have further limited the reach of the response.

On cross-border spread, Kenya confirmed eight cases and two deaths in October, while Nigeria's sole confirmed case was evacuated to Switzerland. Together with earlier cases in Uganda, the outbreak is the first recorded in three African regions and the continent's most geographically widespread Ebola outbreak.

Related: Follow-Up: Congo Ebola Cases Reach 10,274 With 4,992 Deaths; Chinese Nationals Urged to Leave Four High-Risk Provinces

来源：GSM·美国（原文链接）

图片来源：图：埃博拉治疗单元内景（资料图，2014年摄于 Liberia 的 Monrovia 医护人员治疗单元）。美国陆军发布，公共领域，经 Wikimedia Commons。 / Inside an Ebola treatment unit (file photo, Monrovia Medical Unit, Liberia, 2014). U.S. Army photo, public domain, via Wikimedia Commons.

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