PBS高端访谈:刚果启动接种埃博拉疫苗行动（在线收听）

HARI SREENIVASAN: The Ebola outbreak is the tent in the Democratic Republic of Congo since the disease was first reported there in 1976. One of the world's experts on this disease and the development of vaccines to prevent it joins me now from Washington D.C. Anthony Fauci is director of the National Institute of Allergy and Infectious Diseases. Dr. Fauci how much harder is this to treat considering that it's happening in a war zone?

DR. ANTHONY FAUCI: Well, it's certainly much more difficult because you don't have free access to the people who are known to be infected. And as importantly and perhaps even more importantly, that when you have to put the lid on an outbreak and identify people who might be exposed and you want to treat them as they get infected, that you don't have access to them because you don't know who they are or where they are because the chain of contacts gets broken when you can't geographically or physically get into a place where you know the contacts are. Because it's blocked off because of the hostilities that are going on.

HARI SREENIVASAN: Even if you get into those areas, isn't there a threat of the spread of a virus from a deceased person that might have been killed in the war?

DR. ANTHONY FAUCI: Well, certainly if the person was killed in the war and had Ebola, there can be infected if you don't properly take care of the body with that personal protective equipment that is used to protect the people both the physicians, the health workers and even the people who are the undertakers, who take care of the dead bodies.

HARI SREENIVASAN: What about the fact that this is the 10th outbreak in this area? I mean, why is it so hard to to stop this in this region?

DR. ANTHONY FAUCI: Well, that's a very good question but it's something that you really cannot do very much about because this is a virus that doesn't stay among the human populations chronically forever. It goes up and down. But there's a reservoir in animals. Bats clearly can get infected. We don't know whether they're the primary reservoir. Non-human primates and forest animals can get infected. So if this were a virus that only infected humans, once you got to all the humans, either treated them or vaccinated them, you would be done. But the reason you get these continual blips is that this virus is there perpetually in the environment in animal reservoirs.

HARI SREENIVASAN: Let's talk a little bit about the vaccine. How did we come to this. How does it work?

DR. ANTHONY FAUCI: Bottom line is the vaccine works by inducing the person who gets vaccinated, of response that is able to contain, stop and kill the virus. So if I got vaccinated against this particular Ebola strain with this vaccine that referred to as VSV, that vaccine will induce in me a protective response so that when I get exposed to Ebola, my immunological or my protective response is going to prevent that Ebola virus from infecting me. So it really is the way most vaccines work. So when you get vaccinated against polio, the polio vaccine induces a response in you that protects you against polio. When you get vaccinated against measles, the same thing. You get vaccinated, you make your response and you're protected.

The vaccine against Ebola works exactly that same way. It induces in the body a response that's protects you against exposure to the virus itself.

HARI SREENIVASAN: I realize there are different strains of Ebola. How far away are we from having almost the equivalent of a cure or something that can respond rapidly to an outbreak?

DR. ANTHONY FAUCI: Well, there are two things that we're working with right now. One of them is a vaccine. More than one, a couple of vaccine candidates, which really look quite promising in the field. That's one approach. The other approach is the treatment of a person who has been infected with Ebola and several of those candidates are now being treated, being used in the DRC and will ultimately be used in a clinical trial to see which one is the best. So at the end of all of this, it will take some time. We will hopefully have one or more therapies to treat a person who is infected with Ebola and a good vaccine, which has been proven to protect people from getting infected with Ebola. So even though these outbreaks keep coming and so they're obviously very concerning in the country where the outbreak is going on, the science and the development of what we call interventions or countermeasures in the form of either vaccines or treatments is moving along really rather well.

HARI SREENIVASAN: All right. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, thanks so much for joining us today.

DR. ANTHONY FAUCI: Good to be with you.

哈里·斯瑞尼瓦桑：自从1976年刚果民主共和国首次出现埃博拉的报道以来，这种疾病就一直阴霾不散。今天，我们邀请到了研究埃博拉病毒及其疫苗的几位专家，他们特地从华盛顿特区赶到我们的节目现场。安东尼·福西是国立变态反应与传染病研究所的主任。福西博士，您觉得在战区治疗这种疾病比其他地方的难度要大多少呢？

安东尼·福西博士：当然难度会更高些，因为我们无法与已经干扰埃博拉患者随意接触。而重中之重的是：必须抑制住疾病的爆发，然后找到那些暴露于病毒环境中的人，并把他们视为患者来进行治疗，但问题是我们接触不到他们，因为我们不知道他们是谁、身在何处。联系的链条断了，是因为无法亲身到你知道会有联系人的地方去，因为敌意四起的原因，你想去的地方会被封锁起来。

哈里·斯瑞尼瓦桑：即便能到战区，在战争中死去的患者还是可能会传播病毒吧？

安东尼·福西博士：当然，如果一个患有埃博拉的人在战争中死去的话，还是有可能传染给其他人的，除非能够妥善处理尸体，穿上防护设备，保护医生、保健人员，甚至是殡仪人员，因为他们都会料理后事。

哈里·斯瑞尼瓦桑：但这是该地区第10次爆发埃博拉病毒了，对吗？我想请教，为什么这种疾病在该地区如此难以抑制呢？

安东尼·福西博士：这是个好问题，但这件事大家真的无能无力。因为埃博拉病毒不会长期存在于人类之间。这种病毒的活动是一阵一阵的，动物体内也存在这种病毒，而蝙蝠显然不会感染这种病毒。我们不知道蝙蝠是不是埃博拉病毒的源头。非人灵长类动物和森林里的动物也会受到感染。所以，如果这种病毒只能感染人类的话，那么一旦接触这些受感染者，那么要么对他们进行治疗，要么给他们打疫苗，否则就会感染。但之所以埃博拉可以引起持续的躁动是因为这种病毒在环境里、在动物体内一直存在。

哈里·斯瑞尼瓦桑：我们来谈谈疫苗吧。我们当初是如何研制出疫苗的，疫苗的功效如何呢？

安东尼·福西博士：我们底线是疫苗应该要起到免疫的作用，要能抑制、阻止甚至杀死埃博拉病毒。也就是说，如果我能免疫这种特殊埃博拉病毒，方式是注射这种名为VSV的话，这种疫苗就能在我体内产生保护性的反应， 这样一旦我接触到埃博拉病毒，我就会产生免疫和保护性的反应，就能阻止埃博拉病毒干扰我。其实大多数疫苗都是这样运作的。再比如，如果注射了小儿麻痹症的疫苗，那么疫苗就能产生一种保护性的反应，保护人不会患有小儿麻痹症。同理，麻疹疫苗也是如此。一旦得到免疫了，就能产生反应，然后保护人体不受感染。埃博拉疫苗也是如此。这种疫苗能在人体内产生反应，保护人在暴置于病毒的环境中时也不会感染。

哈里·斯瑞尼瓦桑：我发现埃博拉病毒也有很多种类。我们多久之后才能在新的埃博拉爆发之后进行快速治疗或者做出快速响应呢？

安东尼·福西博士：现在我们能做的有两件事。一个是研制疫苗。不只要研制一种疫苗，而是研制很多个储备着，这几种疫苗必须是治疗埃博拉很有希望的备选。这是一件事。另一件事是治疗埃博拉患者。有几名患者已经在接受埃博拉的治疗了，疫苗也在刚果民主共和国开始使用了，最后要用于临床试验，看看哪种更好。要实现这些，需要一段时间。我们有希望能得到至少一种疗法，来治疗埃博拉患者。以及一种功效甚好的疫苗，可以保护人不感染埃博拉病毒。所以，埃博拉病毒还在不断爆发，大家都很关切在这种环境下的刚果民主共和国的情况，干预措施的科学发展是以疫苗和治疗的形态出现的，而且进行得十分顺利。

哈里·斯瑞尼瓦桑：我们今天的节目就告一段落了，让我们感谢国立变态反应与传染病研究所的安东尼·福西博士加入我们的讨论。

安东尼·福西博士：我也很高兴能来到现场。