【英语中国】中国禽流感:应当关注 无需惊恐

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2013-4-27 00:41

小艾摘要: TEVI TROYThe outbreak of avian flu in China has killed at least 22 people and infected more than 108─including a man in Taiwan who had traveled in the eastern Chinese city of Suzhou. For two months a ...

The outbreak of avian flu in China has killed at least 22 people and infected more than 108─including a man in Taiwan who had traveled in the eastern Chinese city of Suzhou. For two months airline stocks have been buffeted and officials have raised concerns about a possible pandemic. So why does the American public seem so unconcerned?

There are some good and some bad reasons for the relatively blasé reaction. Most obvious is that the disease seems far away. In addition, talk of pandemics is often overblown. The 2009 swine flu was bad but nowhere near the disaster that some experts feared.

On the positive side, public health has made significant advances in dealing with flu. These suggest cause for optimism about this outbreak and possible future ones.

The first major improvement is in the cooperative posture of the Chinese government─a far cry from the unfortunate experience with the SARS virus a decade ago. Back then, Beijing kept outside organizations such as the World Health Organization in the dark about the outbreak, which ultimately infected 8,000 people and killed about 800.

SARS spread across the Pacific (to Canada) and cost the global economy as much as $50 billion. A quicker and more open Chinese response could have limited the outbreak.

This time, by contrast, China is sharing information with the World Health Organization, closely monitoring the disease and aggressively culling flocks of chickens that could be infected.

Not that we should all sing kumbaya. Shanghai, where this flu began, is a relatively open part of China, which may account for some of the government's new transparency. In addition, the current director-general of the World Health Organization is China's own Margaret Chan. Her successors may not be viewed as favorably by Beijing.

Another positive story has to do with vaccine development and production. Thanks in large part to a push for greater vaccine capacity during the Bush administration, the United States now has a more reliable annual supply of the regular flu vaccine. Researchers in the U.S. have also seen improvements in cell-based vaccine technology that can supplement and perhaps even supplant traditional egg-based vaccines─meaning that vaccine quantity wouldn't be limited by the supply of eggs and wouldn't risk harming people with food allergies.

Regarding this outbreak's particular strain (H7N9), Chinese authorities have shared the virus with international flu labs, and U.S. health officials are developing lab strains that would allow American manufacturers to produce large amounts of a vaccine if needed.

The U.S. Biomedical Advanced Research and Development Authority and Novartis NOVN.VX +0.58% have a partnership that enabled them to start creating a vaccine before H7N9 even left China, based on the posted genetic sequence. This virus is particularly concerning because the H7 strain is hard for vaccine makers to match (and this year's flu vaccine had a not atypical effectiveness rate of only 62%). Still, Americans are much better off than they were just a decade ago.

The third cause for optimism is that there have been no recorded cases of so-called sustained human-to-human transmissions, meaning the movement of the virus from a single infected person to more than one other person. That occurred with SARS but not in previous cases of avian flu. If it did, it would be the nightmare scenario for public-health officials.

We aren't out of the woods just yet. While China has been tracking severe cases, it is unknown whether any individuals are mildly affected─having few symptoms but still being contagious. A recent World Health Organization report revealed that 40% of those infected had no obvious interactions with poultry, but they must have been infected somehow. The source of those transmissions is unknown.

Because of the uncertainties about transmission, the difficulties in matching H7 strains, and concerns about asymptomatic transmitters, the H7N9 outbreak bears careful watching. But the global public-health system is far more capable of dealing with flu than it was 10 years ago. Here's hoping that the current outbreak doesn't spread and test the limits of this improved system.

Mr. Troy is a senior fellow at the Hudson Institute and a former deputy secretary of Health and Human Services.



AFP/Getty Images上周,上海市中心的通勤者戴着口罩。这种相对来说漠不关心的反应原因众多,有好有坏。最明显的理由是,这种疾病似乎离美国人很远。除此而外,疫病大规模流行的说法常常言过其实。2009年的猪流感远远没有达到一些专家所担忧的程度。


第一个重大进步是中国政府的合作姿态,这种表现与10年前非典(SARS)病毒流行时令人遗憾的经验大不相同。当时,中国政府向世界卫生组织(World Health Organization)等外部机构隐瞒了非典爆发的情况,非典最终导致8,000人感染,大约800人死亡。






生物医学高级研究和发展管理局(Biomedical Advanced Research and Development Authority)和诺华(Novartis)结成了伙伴关系,它们因此能够在H7N9离开中国前,根据公布的基因序列开始研发疫苗。H7N9病毒尤其令人担忧,因为疫苗制造商很难匹配H7型毒株(今年的流感疫苗的有效性仅为62%,这并不是什么特例)。不过,美国人的状况比10年前要好得多。




(TEVI TROY是哈德逊研究所(Hudson Institute)的高级研究员,也是美国卫生及公共服务部(Department of Health and Human Services)前副部长。)


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