新增埃博拉病例暴露美國應對機制缺陷

DALLAS — New shortcomings emerged Wednesday in the nation's response to the Ebola virus after it was revealed that a second nurse was infected with Ebola at a hospital here and that she had traveled on a commercial flight the day before she showed symptoms of the disease.

達拉斯——週三，美國應對埃博拉病毒的工作暴露出了新不足。據透露，達拉斯一家醫院出現了第二名護士感染埃博拉病毒的情況，而且這名護士在出現埃博拉病狀的前一天，曾乘坐商業航班。

The nurse, Amber Joy Vinson, 29, was on the medical team that cared for the Ebola victim Thomas Eric Duncan after he was admitted to the hospital on Sept. 28 and put in isolation. Ms. Vinson should not have traveled on a commercial flight, federal health officials said, when she boarded Frontier Airlines Flight 1143 on Monday, en route from Cleveland to Dallas-Fort Worth.

29歲的護士安貝爾·喬伊·文森(Amber Joy Vinson)是照看埃博拉患者托馬斯·埃裏克·鄧肯(Thomas Eric Duncan)的團隊成員。鄧肯於9月28日入院，並被隔離。聯邦衛生官員表示，文森週一登上了邊疆航空(Frontier Airlines)從克利夫蘭飛往達拉斯-沃思堡機場(Dallas-Fort Worth)的1143航班，她當時不應該乘坐商業航班。

One official said Ms. Vinson had called federal health officials before boarding the plane to report having a slightly elevated temperature but was allowed to fly.

一名官員表示，文森在登機前曾給聯邦衛生官員打電話，報告稱自己體溫略高，但她獲准乘坐飛機。

A second case of Ebola among the nearly 100 doctors, nurses and assistants who treated Mr. Duncan for 10 days at Texas Health Presbyterian Hospital was not unexpected. For days, federal health officials have warned that in addition to Nina Pham, the first nurse confirmed with the disease, other cases were likely.

在德克薩斯長老會醫院(Texas Health Presbyterian Hospital)醫治鄧肯的10天期間，有將近100名醫生、護士及助手參與，醫護人員中出現第二例感染病例並不出人意料。數日來，聯邦衛生官員警告稱，除了第一名確診感染埃博拉病毒的護士妮娜·範(Nina Pham)之外，還有可能出現其他病例。

But the appearance of a new Ebola patient replayed a public-health drama that unfolded in this city twice before in a two-week period. The day also provided more signs of concern about the ability of federal officials to control the spread of the disease, particularly to health care workers, — and indications that the issue was becoming politicized.

但新埃博拉患者的出現，重演了一場公共衛生事件，過去兩週時間裏，類似的事件在這座城市已經出現了兩次。這段時期還出現了更多跡象顯示，人們對聯邦官員控制埃博拉病毒傳播的能力感到擔憂，特別是病毒向醫護人員的傳播。還有跡象顯示，這個問題已經政治化。

President Obama on Wednesday canceled a trip to a fund-raiser in New Jersey and a campaign rally in Connecticut so he could convene a meeting of officials to coordinate the government's response to the spread of the Ebola virus. Cities and states adopted heightened security measures, and Ms. Vinson was being treated at Emory University Hospital in Atlanta rather than in Dallas — all signs of the heightened focus on the disease and the fears it has stirred.

週三，奧巴馬總統取消了前往新澤西州參加募捐活動、前往康涅狄格州參加競選集會的行程，以便能夠召集官員開會，協調政府應對埃博拉病毒的工作。各城市、各州也加強安全了措施，文森在亞特蘭大埃默裏大學醫院(Emory University Hospital)接受治療，而不是達拉斯，這些都說明人們高度關注該疾病，併爲此感到擔憂。

Speaker John A. Boehner of the House on Wednesday became the highest-profile Republican to urge Mr. Obama to consider a ban on travel to the United States from West African countries where the Ebola virus is spreading rapidly. The same point has been raised by several Republican candidates in tight Senate races, including David Perdue of Georgia, Mike Rounds of South Dakota and Joni Ernst of Iowa.

週三，衆議院議長約翰·A·博納(John A. Boehner)呼籲奧巴馬考慮頒佈禁令，禁止埃博拉病毒迅速蔓延的西非國家的乘客前往美國，博納成爲了提出此類要求的知名度最高的共和黨人。幾名激烈角逐參議院席位的共和黨候選人也提出了同樣的意見，比如喬治亞州的戴維·珀杜(David Perdue)、南達科他州的邁克·朗茲(Mike Roundds)，以及艾奧瓦州的約尼·厄恩斯特(Joni Ernst)。

At Kent State University in Ohio, where Ms. Vinson studied nursing and her mother and two other relatives worked, officials issued a statement asking her three family members to stay off campus for the next three weeks, "out of an abundance of caution." Frontier Airlines said it had put the two pilots and four flight attendants on Flight 1143 on paid leave.

文森曾在俄亥俄州肯特州立大學(Kent State University)學習護理，她的母親及另外兩名親屬也都在該大學工作。該大學的管理人員發表聲明稱，“出於高度謹慎考慮”，該大學要求文森的三名親屬在接下來三週的時間裏遠離校園。邊疆航空表示，該公司已經讓1143航班上的兩名飛行員及四名乘務員帶薪休假。

The Frontier jet that carried Ms. Vinson on Monday made five flights after her trip before it was taken out of service, according to . Frontier, which is based in Denver, said it grounded the plane as soon as it was notified, about 1 a.m. Wednesday, about the Ebola patient.

網站上顯示，文森週一的旅程結束後，她所搭乘的這架邊疆航空的客機又飛行了五次才停止運營。總部位於丹佛的邊疆航空稱，公司在週三凌晨1點左右接到了機上有埃博拉患者的通知後，立即停飛了這架飛機。

The first nurse infected, Ms. Pham, 26, remained in good condition, the hospital said. Ms. Vinson was ill but stable, as she was transferred Wednesday to Emory, one of four hospitals in the United States that have special containment units for isolating patients with dangerous infectious diseases.

醫院方面稱，首位感染埃博拉的美國護士妮娜·範一直狀況良好。妮娜·範現年26歲。文森身體不適，但病情穩定，於週三被轉到了艾默裏大學醫院，這所醫院是設有特殊隔離單元，可以隔離危險傳染病患者的四家美國醫院之一。

Though Ms. Vinson had traveled on Monday, the day before she reported symptoms, she had been among a group of hospital workers at Presbyterian who were being monitored after Ebola was diagnosed on Sunday in Ms. Pham. And although her temperature did not meet the fever threshold of 100.4, Ms. Vinson reported to health officials that her temperature at the time she traveled was 99.5 degrees.

文森在旅行後第二天就出現了埃博拉症狀。而在她週一出行時，她已經是長老會醫院受到監控的醫護人員之一，監控是妮娜·範週日被確診之後開始的。此外，雖然文森的體溫當時沒有達到華氏100.4度（攝氏38度）的發熱標準，但是文森對衛生官員報告，自己旅行時的體溫已經達到99.5度（攝氏37.5度）。

"Because at that point she was in a group of individuals known to have exposure to Ebola, she should not have traveled on a commercial airline," the C.D.C. director, Dr. Thomas R. Frieden, said. "The C.D.C. guidance in this setting outlines the need for what is called ‘controlled movement.' That can include a charter plane, that can include a car but it does not include public transport." Hours after Dr. Frieden spoke, a federal health official who spoke on condition of anonymity because he was not authorized to speak publicly, said that because it was thought that Ms. Vinson's protective gear would have kept her safe and because the temperature was only mildly elevated, she fell into a category not covered by C.D.C. guidelines.

“因爲她當時是已知接觸過埃博拉患者的人員之一，她本不應該乘坐商業航班出行，”CDC主任托馬斯·R·弗裏登(Thomas R. Frieden)說。“CDC針對這種情境的指導規範中提到了，需要採取所謂的‘受控出行'措施，即可以乘坐專機或私人汽車，但不能乘坐公共交通工具。”在弗裏登發表上述言論的幾個小時後，一名聯邦衛生官員稱，文森的防護服據信可以保護她的安全，而且她只是輕度發熱，因此文森的情況不在CDC的指導規範之內。由於無權公開發表言論，此人要求不具名。

"I don't think we actually said she could fly, but they didn't tell her she couldn't fly," the official said. He said the error was on the part of the C.D.C., not the nurse. "She called us," he said. "I really think this one is on us."

這名官員稱，“我不認爲我們說過她可以飛，但他們也並沒有告訴她不能飛。”他說，有過失的是CDC，而不是這名護士。“她給我們打過電話，”他說。“我真的認爲，這是我們的責任。”

Because of the proximity between the evening flight Monday and her first report of being ill on Tuesday morning, the C.D.C. asked all 132 passengers on the flight to call a C.D.C. hotline. The flight landed at 8:16 p.m. Monday at Dallas-Fort Worth International Airport. Dr. Frieden stressed that the passengers were a low-risk group. Because Ms. Vinson did not have a fever and did not experience nausea or vomiting on the plane, the risk "to any around that individual on the plane would have been extremely low," he said.

由於週一晚間航班飛行的時間，與她週二上午首次報告患病的時間相隔很短，CDC要求機上的全部132名乘客撥打該機構的熱線。這架航班於週一晚間8點16分降落在達拉斯-沃思堡機場。弗裏森強調，乘客感染埃博拉的風險不大。他說，因爲文森沒有發燒，在飛機上也沒有噁心或嘔吐，她“周圍乘客的風險微乎其微”。