新冠肺炎的「零號病人」是誰？Who is 'patient zero' in the coronavirus outbreak?－bubble50 DH Freelance 中翻英英翻中

Who is 'patient zero' in the coronavirus outbreak?

新冠肺炎的「零號病人」是誰？

24th February 2020[1]

2020年2月24日

As the cases of coronavirus increase in China and around the world, the hunt is on to identify "patient zero". But can singling out one person as causing an outbreak do more harm than good?

隨著中國與全球新冠肺炎(COVID-19，又稱武漢肺炎)病例的增加，開始有人在找誰是「零號病人」。但是，或許將這個導致疫情爆發的罪魁禍首找出來並沒有什麼好處。

Chinese authorities and experts are at odds about the origin of the ongoing coronavirus outbreak. More specifically, who is "patient zero" for the outbreak. Also known as an index case, patient zero is a term used to describe the first human infected by a viral or bacterial disease in an outbreak.

中國政府和專家對當前新冠肺炎疫情的源頭存有分歧。更確切地說，爭議點在於誰是疫情中的「零號病人」。零號病人又稱索引病例，是指第一個因為感染某種病毒或細菌性疾病而導致疾病迅速傳染開來的人。

Advances in genetic analysis now make it possible to trace back the lineage of a virus through those it has infected. Combined with epidemiological studies, scientists can pinpoint individuals who may have been the first people to start spreading the disease and so trigger the outbreak.

基因分析技術的進步使我們得以通過被感染的病人來追溯病毒的源頭。結合流行病學研究，科學家可以精準找出最早使疾病散播開來並因此引發疫情爆發的第一群病患。

Identifying who these people are can help address crucial questions about how, when and why it started. These can then help to prevent more people from getting infected now or in future outbreaks.

找出這些人是誰，有助於解決疫情是如何開始、何時開始，以及為什麼開始等關鍵問題，還能阻止當前及未來更多人被感染的可能。

Do we know who patient zero is in the Covid-19 coronavirus outbreak that started in China?

那麼，我們知道武漢肺炎的零號病人是誰了嗎？

The short answer is – no.

最直接的答案是:不知道。

Chinese authorities originally reported that the first coronavirus case was on 31 December and many of the first cases of the pneumonia-like infection were immediately connected to a seafood and animal market in Wuhan, in the Hubei province.

中國政府所通報的首位病例是在12月31日，而許多最初類肺炎的病例則與一間位於湖北省武漢市的海鮮與動物市場有關。

This region is the epicentre of the outbreak, with almost 82% of the 75,000-plus cases registered so far in China and globally are from here, according to statistics complied by Johns Hopkins University.

根據約翰霍普金斯大學（Johns Hopkins University）的統計，該地區是疫情爆發的中心，迄今為止，在中國和全球通報的75,000多起病例中，有近82％的病例都是從這裡出現。

However, a study, by Chinese researchers published in the Lancet medical journal, claimed the first person to be diagnosed with Covid-19, was on 1 December 2019 (a lot of earlier) and that person had "no contact" with the Huanan Seafood Wholesale Market.

然而，一項由中國研究人員發表在《柳葉刀》(The Lancet)醫學雜誌上的研究聲稱，早在2019年12月1日就已經出現第一位病例，但此人卻與華南海鮮批發市場「沒有任何接觸」。

Wu Wenjuan, a senior doctor at Wuhan's Jinyintan Hospital and one of the authors of the study, told the BBC Chinese Service that the patient was an elderly man who suffered from Alzheimer's disease.

武漢市金銀潭醫院的醫生，同時也是上述研究作者之一的吳文娟告訴BBC中國事務部，該患者是一名患有阿茲海默症的老人。

"He (the patient) lived four or five buses from the seafood market, and because he was sick he basically didn't go out,” Wu Wenjuan said.

吳文娟說：「他（病人）住在距離海鮮市場大約四、五站公車站的地方，而且因為生病了，所以他基本上沒有出過門。」

She also said that three other people developed symptoms in the following days – two of whom had no exposure to Huanan either.

她還說，接下來的幾天中另有三人出現武漢肺炎的症狀，其中兩人也沒有到過華南市場。

However, the researchers also found that 27 people of a sample of 41 patients admitted to hospital in the early stages of the outbreak "had been exposed to the market".

不過研究人員也發現，在疫情初期就入院的41名患者之中，有27人「去過該市場」。

The hypothesis that the outbreak started at the market and could have been transmitted from a living animal to a human host before spreading human-to-human is still considered the most likely, according to the World Health Organization (WHO).

根據世界衛生組織（WHO）的說法，目前被認為最有可能的假說仍然是疫情是從該市場開始，由動物傳給人類，再由人類傳給人類。

So can one person really trigger a massive outbreak?

那麼，真的有人能夠憑一己之力就引發這麼大規模的爆發嗎？

The 2014 to 2016 Ebola outbreak in West Africa was the largest since the virus responsible was first discovered in 1976. It killed in excess of 11,000 people and infected over 28,000, according to the World Health Organization.

根據世界衛生組織的資料顯示，2014年至2016年在西非爆發的伊波拉疫情是自1976年首次發現該病毒以來最大規模的傳染。該病毒造成超過11,000人死亡，並感染超過28,000人。

The outbreak lasted more than two years and was found in 10 countries, mostly in Africa but there were also cases reported in the US, Spain, the United Kingdom and Italy.

伊波拉疫情持續了兩年多並在10個國家中傳播，其中主要是在非洲，但在美國、西班牙、英國和義大利也有病例通報。

Scientists concluded this outbreak of a new strain of Ebola started with just one person – a two-year-old boy from Guinea – who may have been infected by playing in a hollow tree housing a colony of bats.

科學家得出的結論是，這種新型伊波拉病毒的爆發始於一個來自幾內亞的兩歲小男孩，他可能是因為在一棵蝙蝠群棲息過的空心樹裡玩耍，才會被感染。

They made the connection on an expedition to the boy's village, Meliandou, taking samples and chatting to locals to find out more about the Ebola outbreak's source before publishing their findings.

為了進一步了解伊波拉病毒的來源，他們對這個男孩居住的美良度村（Meliandou）進行訪查，包括採樣以及訪問當地人，最後再發表調查結果。

But perhaps the most well known “patient zero” is Mary Mallon, who earned the nickname Typhoid Mary for causing an outbreak of typhoid fever in New York in 1906.

不過，也許瑪麗·馬倫（Mary Mallon）才是最著名的「零號病人」，她更在1906年紐約爆發的傷寒中獲得「傷寒瑪麗」這個稱號。

Originally from Ireland, Mallon emigrated to the US, where she began working for rich families as a cook. After clusters of typhoid cases among wealthy families in New York, doctors traced the outbreak to Mallon. Anywhere she worked, members of the household started to develop typhoid fever.

馬倫最初從愛爾蘭移民到美國給有錢人當廚師。當紐約一些有錢人家出現傷寒案例之後，醫生將疫情追溯到了馬倫身上。她到哪裡工作，那個家庭就會染上傷寒。

Doctors called her a healthy carrier – someone infected by a disease but who display little or no symptoms of the disease, which means they often go on to infect many other people.

醫生稱她為「健康帶原者」，也就是雖然帶有某種疾病病原，卻很少或沒有出現該疾病症狀的人，這表示他們通常會不斷感染更多的人。

There is now growing evidence that some people are more "efficient" than others at spreading viruses and Mallon is one of the earliest recorded cases of a person having this "ability" known as a "super-spreader".

目前有越來越多的證據顯示，有些人會比其他人能更「有效率的」傳播病毒，馬倫正是史上最早具有此種「能力」的人之一，他們被稱為「超級傳播者」。

At that time the disease afflicted several thousand New Yorkers annually and had a 10% fatality rate.

當時，這種疾病每年折磨數千名紐約人，其死亡率為10％。

But the term “patient zero” comes loaded with meaning and stigma. Many health experts are against identifying the first documented case of an outbreak, for fear that it might lead to disinformation about the disease or even victimisation of the person.

但是「零號病人」這個詞卻已具備各種負面意義與汙名。許多醫衛專家都反對找出第一個有記錄的病例，就是擔心會傳出錯誤的疫情資訊，甚至使該病患受害。

A famous example is a man who was mistakenly identified as "patient zero" of the Aids epidemic.

一個著名的例子就是一個被誤認為是愛滋病「零號病人」的病患。

Gaetan Dugas, a Canadian homosexual flight attendant, is one of the most demonised patients in history, being blamed for spreading HIV to the US in the 1980s. But three decades later, scientists revealed he couldn't be the first case – a 2016 study showed the virus had moved from the Caribbean to America at the beginning of the 1970s.

加拿大同性戀空服員蓋爾坦·杜加(Gaëtan Dugas)是史上最被妖魔化的病人之一，人們一直認為是他在1980年代將HIV傳到美國。但是三十年後，科學家發現他不可能是第一個病例，因為在2016年的一項研究顯示，HIV早在1970年代初就已經從加勒比海地區傳到美國了。

Curiously, it was during the HIV epidemic that the term patient zero was accidently created.

奇怪的是，正是在愛滋病流行期間，才意外創造出「零號病人」這個詞。

Whilst investigating the spread of the disease in Los Angeles and San Francisco in the early 80s, researchers from the Centers for Disease Control and Prevention (CDC) used the letter "O" to refer a case of someone "outside the state of California".

在1980年代初期調查愛滋病在洛杉磯和舊金山傳染的情形時，美國疾病控制與預防中心（CDC）的研究人員使用字母「O」來指稱「加州以外的」某個病例。