在微型杀手面前，我们应以守为攻

平昌冬奥会期间爆发的诺瓦克病毒、几内亚的拉沙热所造成的死亡，以及美国流感的大规模爆发之间有什么共同之处？除了时间点上的共同之处之外（每一场疫情都仍在发生或最近才发生），这些疫情都在提醒我们，与争夺地球霸主地位的微生物相比，人类是异常脆弱的。

全球公共卫生问题领域最有才华的作者劳瑞·格瑞特很快在foreignpolicy.com上发表了一篇耸人听闻的文章，讲述了诺瓦克病毒的肆虐让奥运村的运动员饱受折磨。有专家将这一病毒称为“完美的人患病原体”。格瑞特写道，虽然这种病毒很少夺走生命，但该病毒在繁殖时“传染性非常强，而且会引发严重的症状，基本上无法在人群密集的场所彻底消除”。病毒的表面附着能力特别强，尤为擅长通过各种物体进行传播，包括鞋和门把手，而且在病原体数量很少时依然具有传染性，如果举行一场细菌奥林匹克运动会，诺瓦克病毒将成为强有力的冲金选手。

最近几内亚发生的拉沙热死亡事件（《华盛顿邮报》称此次死亡事件在该国20年以来尚属首次）在很多方面都令人感到担忧，但其中一个是这名几内亚病人死亡的地点——邻国利比里亚。这一跨境死亡事件让人再度想起另一种出血热病毒——埃博拉。在2014年恐怖的西非埃博拉病毒爆发之际，该病毒自由地穿越了数个国界。（另一个让人感到担忧的是，卫生部门官员明显在很长一段时间之后才公开发布死亡事件。发布之时，受感染的病患已经在1月11日，也就是近一个月之前便已去世。）

流感呢？这种病毒年复一年地提醒着我们其致病和致死能力，然而，我们仍在年复一年地因其大规模的爆发而感到震惊。

这些肉眼看不到的微型猛兽，不管是基于RNA的诺瓦克病毒、拉沙热之类的沙粒病毒，还是流感病毒，都会像人类一样不断进化，而且进化的速度要快得多。其中的很多病毒都会附着在鞋履上进行全球旅行，像奔走于世界各地的首席执行官一样积累常旅里程。

对于那些好奇和无畏的人来说，美国国家卫生研究所（NIH）发布了通俗易懂的新发传染病（EID）清单，它根据威胁程度的不同将这些疾病划分为三大类。

从人口健康角度来看，最恐怖的EID并非是那些致死率最高的病毒，而是那些能够让众多人出现严重病情的病毒。这些病毒传播起来比较容易，而且按照卫生部门官员的话来说，“需要对诊断能力进行特定的改进”才能迅速地发现这些病毒，但对于众多新出现的传染病来说，人类并不具备这样的能力。

为什么我会在美好的周一清晨提到这个话题呢？是为了提醒人们（这里不仅指美国民众，也指世界民众）我们还没有行之有效的防御方案来应对这类威胁。夜间新闻提到的严重的季节性流感如今已扩散至美国全境，它已经迫使人们开始采取措施来制定（并资助）这一方案。

如果这一方案也未能奏效的话，而且寨卡病毒、埃博拉和SARS病毒在这一方案出台之前还没有肆虐地球的话，我不敢想象还会出现什么样的新病毒。（财富中文网）

译者：冯丰

审校：夏林

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.