Ringen Knut, Landrigan Philip J, Stull Jeffrey O, Duffy Richard, Melius James, McDiarmid Melissa A
Stoneturn Consultants, Seattle, Washington.
Department of Environmental Health, Icahn School of Medicine, Mount Sinai, New York.
Am J Ind Med. 2015 Jul;58(7):703-14. doi: 10.1002/ajim.22467. Epub 2015 May 7.
Even as the Ebola epidemic is finally showing signs of remitting, controversy continues regarding the modes of disease transmission, the understanding of which necessarily dictates methods of prevention. The initial public health response to the epidemic was based on assumptions formed during previous outbreaks, and in the belief that transmission was restricted to direct "contact" with other infected patients. However, the current Ebola outbreak differed from previous experiences in its intensity of transmission, speed of spread, and fatality rate and was also particularly unforgiving on health workers occupationally infected. Even with these differences, however, other modes of transmission were not considered by public health authorities, thus denying both the hard-hit health worker populations and the wider public more protective guidance. International Labor Conventions require employers to provide a comprehensive safety program that anticipates work-related risks and specifies strategies for protection against them. Such a precautionary approach is recommended in future epidemic planning, especially where evidence regarding transmission is incomplete.
即便埃博拉疫情终于显现出缓解的迹象，但围绕疾病传播方式的争议仍在继续，而对传播方式的理解必然决定着预防方法。对该疫情最初的公共卫生应对措施是基于以往疫情爆发时形成的假设，并且认为传播仅限于与其他感染患者的直接“接触”。然而，此次埃博拉疫情在传播强度、传播速度和死亡率方面与以往经历不同，而且对职业感染的医护人员尤为不利。即便存在这些差异，但公共卫生当局并未考虑其他传播方式，从而使深受打击的医护人员群体和更广泛的公众都未能获得更多的防护指导。国际劳工公约要求雇主提供一项全面的安全计划，该计划要预估与工作相关的风险，并明确针对这些风险的防护策略。在未来的疫情规划中建议采用这种预防性方法，尤其是在有关传播证据不完整的情况下。
