这篇文章的题目,翻译严重错误,这本身就是误导呀!
原文是这样的
Is respiratory protection appropriate in the Ebolaresponse?
我的翻译:“应对埃博拉,采用呼吸道防护,是否合适?” 以下是作者的信函 We write to express our concern about one aspect of theresponse to the current epidemic of Ebola that has, so far, received littleattention,1 lacks anevidence base, and might be counterproductive. The primary mode of transmission of Ebola virus isthrough contact with infected patients’ secretions (such as blood, vomit, orfaeces) directly and indirectly (for example, from contaminated needles). Thistransmission occurs via close family contact or in health-care settings,particularly when placing orotracheal intubation or when caring for a patientwho is vomiting or bleeding. Ebola is rarely transmitted via an airborne route.2 Although these routes of transmission are well known,3,4 most agencies, including governmental agenciesresponsible for repatriating western patients, apply infection- controlmeasures appropriate for airborne diseases. Excessive precautions could offer reassurance to thoserespon- ding to Ebola, yet complete respiratory protection is expensive,uncomfortable, and unaffordable for countries that are the most affected.Worse, such an approach suggests that the only defence is individual protectiveequipment, which is inaccessible to the general population. Moreover, the imageof workers with spectacular protective clothing might contribute to the panicin some communities. If this leads people to flee affected areas it couldincrease the spread of infection. It also reinforces the view that some livesare more valuable than others, already engendered by decisions about the use ofexperimental Ebola drug ZMapp.5 We contend that the systematic application ofprecautionary measures that protect health-care personnel and others from direct 4 contact (ie, gloves andwaterproof smocks, goggles, masks, and individual rooms or wards in thehospital) are sufficient to manage most patients (who do not experiencehaemorrhage or vomiting). In fact, goggles and masks might not even benecessary to speak with conscious patients, as long as a distance of 1–2 metresis maintained (the maximum distance that infectious droplets might reach).Exceptional precautions, such as pressurised suits with oxygen tanks, should bereserved for interventions that generate aerosols (invasive explorations or intubations),specific situations (eg, massive haemorrhage), or in laboratories where thevirus is cultivated. They are unnecessary in the settings where the virus ismost rampant. In western Africa nowthere is a need for rational and efficient use of protective equipment. Thiscan only be achieved by communicating a consistent message that the disease isessentially transmitted through direct contact. In control of infectiousdiseases, more is not necessarily better and, very often, the simplest answer isthe best. Wedeclare no competing interests.
*Jose MMartin-Moreno, Gilberto Llinás, Juan Martínez Hernández dr.martinmoreno@gmail.com
Departmentof Preventive Medicine and Public Health, University of Valencia, 46010Valencia, Spain (JMM-M, GL); and Preventive Medicine and Public Health Service,Hospital La Paz-Carlos III, Madrid, Spain (JMH)
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