备注:2026年5月初,大西洋某邮轮发生汉坦病毒感染事件,一时间成为街头巷尾的谈资。余波未静,一场来自非洲的更大疫情早已悄然登场。2026年4月下旬,刚果共和国,某地的医护人员出现埃博拉病例。随后疫情进一步扩散,感染人数增长迅速,并传入邻国乌干达。截至2026年5月16日,官方报道有200多例疑似病例,包括80例死亡病例。2026年5月17日,WHO官宣,确定此次疫情为国际关注的突发公共卫生事件(public health emergency of international concern)。 据媒体报道,WHO总干事谭德塞24日在社交媒体透露,刚果已发现超过900例疑似病例,其中101例确诊。
此情此景下,多国政府提高了防控级别,并相继加强了的防控措施。全球化背景下,病毒在不同国家和地区的传播,就是一次航班的事。近半个世界以来,在能感染人的生物安全4级病毒中,埃博拉病毒的生命活跃度最高,在人类世界的曝光度也最高。它们不断扰动人类,一直试图将人群作为它们基因能够稳定传递的载体,就如新冠病毒那样。作为一种完全寄生的有生命的存在者,病毒在基因复制天性的驱动下,在与其它不同生命体相互作用下,不断演化,未来结果如何,很难预测,这可能取决于病毒自身,也取决于我们人类的观念和行为。一、埃博拉病毒因何得名?埃博拉本来是一条河的名字。埃博拉河(the Ebola River)地处刚果盆地北缘赤道地带,是刚果民主共和国北部刚果河支流蒙加拉河的源头,绵延约250公里。土著的恩巴恩迪语(Ngbandi )称为莱格巴拉河(Legbala River),意为“白水”。这里曾经是法国的殖民地,埃博拉(Ebola)这个名字是莱格巴拉(Legbala)的法语讹音。
1976年,在刚果民主共和国(当时叫扎伊尔共和国)北部蒙加拉省的一个名为亚布库(Yambuku)的小镇,与苏丹的恩扎拉几乎同时发生高死亡率疫情。科学家在亚布库患者体内发现了引起疫情的一种新病毒。为避免发病村镇被污名化,美国病毒学家卡尔·约翰逊(Karl M Johnson,1929 –2023)建议以距该镇111公里的埃博拉河的名字命名该病毒。在科学领域,也要避免特定人群被污名化,这反映了上世纪后半叶新自由主义思潮对现世的深刻影响,如今已成为许多国家的不容质疑的“政治正确”。
二、埃博拉病毒的家族成员目前有哪些?自1976年埃博拉病毒首次进入人类经验世界以来,不断引发人类疾病暴发,其家族成员的生物多样性也逐渐显示。国际病毒分类与命名委员会(ICTV)将埃博拉病毒归于丝状病毒科(Filoviridae)正埃博拉病毒属(Orthoebolavirus)。目前正埃博拉病毒属有6个病毒种,包括扎伊尔正埃博拉病毒(Orthoebolavirus zairense)、苏丹正埃博拉病毒(O. sudanense)、塔伊正埃博拉病毒(O. taiense)、雷斯顿正埃博拉病毒(O. restonense)、本迪布焦正埃博拉病毒(O. bundibugyoense)和邦巴利正埃博拉病毒(O. bombaliense)。上述是学术性命名,在日常实践中,这些病毒通常被称为埃博拉病毒(Ebola virus,EBOV)、苏丹病毒(Sudan virus,SUDV)、塔伊森林病毒(Taï Forest virus,TAFV;原称科特迪瓦病毒,Ivory Coast virus)、雷斯顿病毒(Reston virus,RESTV)、本迪布焦病毒(Bundibugyo virus,BDBV)和邦巴利病毒(BOMV)。这些病毒的在基因组进化、抗原性以及致病性等方面存在明显差异。可以预见,未来会有更多的病毒进入人类的经验世界,丰富正埃博拉病毒清单上的名录。三、哪些埃博拉病毒能够引起人类发病?
埃博拉病毒自1976年出现以来,不断触及人类的终极焦虑,反映在多种艺术作品中。
但事实上,并非所有的正埃博拉病毒都对人群有高致病性。目前已知只有4种正埃博拉病毒可引起人类疾病,包括埃博拉病毒(EBOV)、本迪布焦病毒(BDBV)、苏丹病毒(SUDV)和塔伊森林病毒(TAFV;原称科特迪瓦病毒, Ivory Coast virus)。历史上,在非洲发生大规模疫情主要由前3种病毒引发。
1.埃博拉病毒(EBOV),1976年发现,是最经典的正埃博拉病毒,也是致死率最高的病毒,死亡率高达90%。历史上,该病毒引发多次疫情,特别2014年至2016年的西非疫情,是迄今为止规模最大的埃博拉疫情,报告病例超过28600例。
2.苏丹病毒(Sudan virus),与EBOV一起,在1976年的疫情中被发现,致死率约为50%。该病毒在乌干达以及南苏丹和刚果边境附近引发了多次疫情。
3.本迪布焦病毒(BDBV),2007年被发现,死亡率约为30%。历史上曾引发2起大规模疫情,一起发生在刚果,另一起发生在刚果与乌干达的边境地区。
今年(2016年),BDBV第三次从丛林中走出,正在刚果和乌干达的人群中复制它们的基因,目前看有愈演愈烈之势。
4.塔伊森林病毒(TAFV),较为少见,1994年仅在科特迪瓦发生1例感染病例。
我们知道,除了必要的公共卫生非药物干预措施以外,疫苗和药物是控制和治疗病毒性疾病的不二首选。与其它病毒相比,EBOV的暴发频次和更高,致病性更强,因此作为首选的疫苗和药物研发对象。目前已经有针对EBOV的疫苗和治疗性单抗(详见下文WHO资料)。但遗憾的是,现在暴发疫情的病毒是BDBV,已有的疫苗和单抗对BDBV可能无效。
面对今年BDBV的流行,我们不必苛责疫苗和药物科学研究团体的判断失误。根本上看,这是我们人类的有限性和世界的无限性之间的有恒张力。人类运用科学和理性所作的关于未来的预测和准备,在发生的现实面前经常会落空。未来是由各种可能的事件构成的,人们的预测只是针对一种可能,这种可能是基于以往经验做出的贝叶斯归纳。经验性的归纳不具有普遍必然性,我们见到的天鹅都是白色的,据此我们不能断定天下所有的天鹅都是白色的。我们的经验世界,没有绝对性的存在,万物流变,无物常驻。当未来到来时,以往的大概率事件可能成为小概率乃至消失,而以往的小概率事件也可能成为大概率的现实。
笔者相信,人类科技已进入AI时代,对于像埃博拉病毒这样的病原体,我们的认知边界会极大扩展,也会有更多防控技术成为现实。
笔者将WHO关于埃博拉病毒的一些基础性知识放在这里,字字珠玑,是对该病毒研究进展的精准总结。
附录有英文版以及一些笔者认为有趣的图片,仅供有兴趣者参考。
2026年5月27日 东望府
, 埃博拉病
2025年4月24日
(https://www.who.int/zh/news-room/fact-sheets/detail/ebola-disease)重要事实.埃博拉病是一种严重且往往致命的人类疾病。.已知有三种不同的病毒会导致大规模埃博拉病疫情:埃博拉病毒、苏丹病毒和本迪布焦病毒。.埃博拉病的平均病死率约为50%。在以往的疫情中,病死率从25%到90%不等。.及早通过补液和对症治疗进行重症监护支持可提高生存率。.目前已批准的疫苗和治疗方法仅适用于其中一种病毒(即埃博拉病毒),针对其他病毒的疫苗和治疗方法正在开发中。.疫情控制依赖一套干预措施,包括:对患者的重症监护支持、感染预防和控制、疾病监测和接触者追踪、实验室服务、安全和体面的埋葬、适用的疫苗接种以及社会动员。概述
埃博拉病是一种罕见但严重的人类疾病(1)。它往往是致命的。
埃博拉病系由丝状病毒科正埃博拉病毒属的病毒所引起(2)。迄今为止,已确定了六种正埃博拉病毒,其中三种已知可引起大规模疫情:.引起埃博拉病毒病的埃博拉病毒.引起苏丹病毒病的苏丹病毒.引起本迪布焦病毒病的本迪布焦病毒。
埃博拉病于1976年首次出现在两起同时暴发的疫情中:一起是苏丹病毒病疫情,发生在现今南苏丹境内的恩扎拉;另一起是埃博拉病毒病疫情,出现在现今刚果民主共和国境内的亚布库。后一起疫情因发生在埃博拉河附近的一个村庄而得名。
虽然已有针对埃博拉病毒病的获许可疫苗和治疗方法,但没有针对其他埃博拉病(如苏丹病毒病或本迪布焦病毒病)的获准疫苗或治疗方法。候选产品正在开发中。
及早通过补液和对症治疗进行重症监护支持可提高生存率。及早就医可以挽救生命。
传播
据认为,狐蝠科的果蝠是正埃博拉病毒的天然宿主。该病毒可在人们密切接触受感染动物,如患病或死亡的或是热带雨林中的果蝠、黑猩猩、大猩猩、猴子、森林羚羊或豪猪等的血液、分泌物、器官或其他体液时进入人体。
人们可以通过直接接触(即经由破损的皮肤或粘膜)从他人那里感染病毒,这种接触包括:.埃博拉病患者或死者的血液或体液;以及.被该病的患者或死者的体液(如血液、粪便、呕吐物)污染的物体或表面。
该病毒的感染者只有在出现症状后才会传播疾病,只要其血液中含有此种病毒,他们就会一直具有传染性。
卫生和照护工作者经常在治疗埃博拉病患者期间受到感染。如果不严格执行感染控制和预防措施,就会通过与患者的密切接触而发生感染。
在葬礼上与死者尸体直接接触也会助长埃博拉病的传播。
症状
疾病潜伏期或从被感染到出现症状的时间为2至21天。
埃博拉病的症状可能突然出现,包括发烧、疲劳、不适、肌肉疼痛、头痛和喉咙痛。随后出现呕吐、腹泻、腹痛、皮疹以及肾和肝功能受损的症状。卫生和照护工作者必须注意这些症状。
尽管认为出血是一种常见症状,但这种情况并不经常出现,而且可能在疾病后期发生。有些患者可能会出现内出血和外出血,包括呕吐物和粪便中有血,以及鼻子,牙龈和阴道出血。针头刺破皮肤的部位也可能发生出血。
对中枢神经系统的影响可导致意识混乱、易怒和攻击性。诊断
临床上可能很难将埃博拉病与其他传染病,如疟疾、伤寒、志贺氏菌病、脑膜炎及其他病毒性出血热区分开来,因为疾病早期的症状相似。
可采用以下诊断方法来确认是否感染正埃博拉病毒:.逆转录聚合酶链反应试验.抗体捕获酶联免疫吸附试验.抗原捕获检测法.通过细胞培养进行病毒分离。
从患者身上采集的样本具有极高的生物危害风险;对未灭活样本的实验室检测应在最高级别的生物防护条件下进行。在国内和国际范围内运输时,所有未灭活生物标本均应使用三重包装。参见埃博拉病和马尔堡病的诊断检测。
治疗
多年来,世卫组织和合作伙伴制定了指导和培训,概述了如何为患者提供尽可能最好的护理并提高其生存机会,无论是否使用特定的治疗方法。这被称为优化的支持性护理,涵盖应实施的相关检测,管理疼痛、营养和合并感染(如疟疾)的方法,以及让患者走上最佳康复道路的其他方法。
对于埃博拉病毒病,世卫组织强烈建议使用mAb114(ansuvimabTM)或REGN-EB3(InmazebTM)进行治疗,这两者都是单克隆抗体。对于其他埃博拉病,如苏丹病毒病或本迪布焦病毒病,目前尚无获批准的治疗方法,但候选产品正在开发中,并且已有用于临床试验的核心规程。
疫苗
针对埃博拉病毒病:.有两种疫苗获得了批准:Ervebo(默沙东)以及Zabdeno和Mvabea(杨森制药)。建议将Ervebo疫苗作为疫情应对措施的一部分,参见2024年7月免疫战略咨询专家组的建议。.如果确认暴发埃博拉病毒病疫情,可通过国际疫苗供应协调小组获得Ervebo疫苗。.对于卫生保健和一线工作人员的预防性疫苗接种,可以通过全球疫苗免疫联盟预防性埃博拉疫苗接种项目申请Ervebo疫苗。
针对苏丹病毒病等其他埃博拉病:.几种候选疫苗正处于不同的开发阶段。.作为疫情应对措施的一部分,可以使用核心规程来评价候选疫苗的安全性、耐受性、免疫原性和效力。预防和控制
社区参与是成功控制所有疫情的关键。疫情控制依赖于一系列干预措施,例如临床护理、监测和接触者追踪、实验室服务、卫生机构中的感染预防和控制、安全和体面的埋葬、疫苗接种(仅针对埃博拉病毒病)以及社会动员。
提高人们对风险因素及个人能够采取的防护措施的认识可以有效减少人际传播。旨在降低风险的宣传工作应该侧重于以下几个因素:.减少因接触受感染的果蝠或猴子/猿以及食用其生肉而导致的从野生动物向人传播的风险。.减少由于直接或者密切接触感染者(尤其是其体液)而出现的人际传播风险。应避免与埃博拉患者的近距离身体接触。患者应在指定的治疗中心隔离,以便接受早期护理,避免在家传播。.社区应充分了解疾病本身情况和如何控制疫情。最好的做法是让社区参与应对工作,并进行公开讨论。.疫情控制措施包括安全和体面地埋葬死者,找到可能与埃博拉病感染者接触过的人并对其健康状况进行21天监测,将健康者与患者分开以防止进一步传播,并为确诊患者提供护理。保持良好的个人卫生和清洁的环境也很重要。控制卫生保健机构中的感染
无论推定的诊断结果如何,卫生保健工作者在医治和护理患者时应始终采取标准预防措施。这些预防措施包括基本手卫生、呼吸卫生、使用个人防护装备(防止飞溅或以其他方式接触受到感染的物品)、采用安全注射方法以及安全和体面的埋葬方法。
照护疑似或确诊埃博拉病患者的卫生保健工作者应采取额外的感染控制措施,以防止接触患者的血液和体液以及衣物和被褥等受到污染的表面或材料。埃博拉病和马尔堡病感染预防和控制指南。
实验室工作人员也面临风险。用于调查正埃博拉病毒感染的人类和动物样本应由训练有素的工作人员在配有适当设备的实验室中进行处理。
幸存者的护理
所有幸存者、其伴侣和家人都应得到尊重、尊严和同情。世卫组织不建议对血液检测结果呈正埃博拉病毒阴性的康复患者进行隔离。幸存者可能会遭受临床和心理后遗症。世卫组织鼓励受影响国家考虑制定一个护理规划,以减轻后遗症,支持重返社区,提供咨询和进行生物检测。
已知正埃博拉病毒会在一些康复者的免疫豁免部位持续存在。这些部位包括睾丸、眼睛内部和大脑。如果没有再次感染,埃博拉病康复患者出现疾病症状反复是一种罕见的情况,但有相关记录。造成这种现象的原因尚不完全清楚。
有记录表明,埃博拉病毒可通过受感染的精液传播,时间可长达临床恢复后15个月。为了降低这种传播的风险,应实施精液检测规划,以便:.向男性幸存者及其性伴侣提供咨询,告知他们潜在的风险,并支持他们坚持更安全的性行为(包括提供安全套以及保持良好的手卫生和个人卫生);.提供每月一次的精液检测,直到连续两次检测结果呈阴性;以及.在连续两次检测结果为阴性后,幸存者可以安全地恢复正常的性行为,此时病毒传播的风险已降至最低。
在没有精液检测规划的情况下,男性幸存者应在12个月当中采用更安全的性行为做法。
正埃博拉病毒可能在怀孕期间受到感染的妇女的胎盘、羊水和胎儿中持续存在,也可能在感染该病毒的哺乳期妇女的母乳中持续存在。幸存者护理规划应包括对康复后的孕妇和哺乳期妇女的护理。
世卫组织的应对
世卫组织与各国合作,通过持续开展监测工作和支持高风险国家制定准备计划,预防埃博拉疫情。以下文件为控制埃博拉和马尔堡病毒疫情提供了总体指导:埃博拉和马尔堡病毒病疫情:准备、警报、控制和评估。
在发现疫情时,世卫组织通过支持疫情应对、发现疾病、社区参与、接触者追踪、疫苗接种、疫苗和疗法试验、病例管理、实验室服务、感染控制、物流以及对安全和体面的埋葬做法进行培训和提供援助的方式来应对疫情。
参考文献
1.《国际疾病分类》第十一次修订本,2024年:《国际疾病分类》。
2.国际病毒分类委员会:https://ictv.global/report/chapter/filoviridae/filoviridae/orthoebolavirus附录:附录1-英文版;附图1-附图11附录1:英文版 Ebola disease
24 April 2025
Key facts
Ebola disease is a severe, often fatal illness in humans.
Three different viruses are known to cause large Ebola disease outbreaks: Ebola virus, Sudan virus and Bundibugyo virus.
The average Ebola disease case fatality rate is around 50%. Case fatality rates have varied from 25–90% in past outbreaks.
Early intensive supportive care with rehydration and the treatment of symptoms improves survival.
Approved vaccines and treatments are only available for one of the viruses (Ebola virus) and are under development for the others.
Outbreak control relies on a package of interventions including intensive supportive care of patients, infection prevention and control, disease surveillance and contact tracing, laboratory services, safe and dignified burials, vaccination if relevant, and social mobilization.
Overview
Ebola disease (EBOD) is a rare but severe illness in humans (1). It is often fatal.
Ebola disease is caused by viruses that belong to the Orthoebolavirus genus of the filoviridae family (2). Six species of Orthoebolaviruses have been identified to date, with three known to cause large outbreaks:
Ebola virus (EBOV) causing Ebola virus disease (EVD)
Sudan virus (SUDV) causing Sudan virus disease (SVD)
Bundibugyo virus (BDBV) causing Bundibugyo virus disease (BVD).
Ebola disease first occurred in 1976 in two simultaneous outbreaks: one outbreak was of Sudan virus disease in Nzara in what is now South Sudan, and the other outbreak was of Ebola virus disease in Yambuku, in what is now the Democratic Republic of the Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
While there are licensed vaccines and therapeutics for Ebola virus disease, there is no approved vaccine or treatment for other Ebola diseases, such as SVD or BVD. Candidate products are in development.
Early intensive supportive care including rehydration and treatment of specific symptoms, can improve survival. Seeking early care can be lifesaving.Transmission
It is thought that fruit bats of the Pteropodidae family are natural hosts of the Orthoebolavirus. The virus can get into the human population when people have close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats, chimpanzees, gorillas, monkeys, forest antelope or porcupines found ill or dead or in the rainforest.
People can get infected with the virus from another person by direct contact (through broken skin or mucous membranes) with:
the blood or body fluids of a person who is sick with or has died from Ebola disease; and
objects or surfaces that have been contaminated with body fluids (like blood, feces, vomit) from a person sick with the disease or who has died from the disease.
People cannot transmit the disease before they have symptoms, and they remain infectious as long as their blood contains the virus.
Health and care workers have frequently been infected while treating patients with Ebola disease. This occurs through close contact with patients when infection control precautions are not strictly practiced.
Burial ceremonies that involve direct contact with the body of a person who has died can also contribute to the transmission of Ebola disease.Symptoms
The incubation period or interval from infection to onset of symptoms varies from 2 to 21 days.
The symptoms of Ebola disease can be sudden and include fever, fatigue, malaise, muscle pain, headache and sore throat. These are followed by vomiting, diarrhoea, abdominal pain rash, and symptoms of impaired kidney and liver functions. It is important for health and care workers to be on the lookout for these symptoms.
Despite a perception that bleeding is a common symptom, this is less frequent and can occur later in the disease. Some patients may develop internal and external bleeding, including blood in vomit and faeces, bleeding from the nose, gums and vagina. Bleeding at the sites where needles have punctured the skin can also occur.
The impact on the central nervous system can result in confusion, irritability and aggression.Diagnosis
It can be difficult to clinically distinguish Ebola disease from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers because symptoms at early stage of the disease are similar.
Confirmation that the person has an Orthoebolavirus infection is made using the following diagnostic methods:
reverse transcriptase polymerase chain reaction (RT-PCR) assay
antibody-capture enzyme-linked immunosorbent assay (ELISA)
antigen-capture detection tests
virus isolation by cell culture.
Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All non-inactivated biological specimens should be packaged using the triple packaging system when transported nationally and internationally See Diagnostic testing for Ebola and Marburg diseases.Treatment
Over the years, WHO and partners have developed guidance and training that outline how to provide the best possible care for patients and increase their chance of survival, whether or not specific treatments are being used. Called optimized supportive care, this covers the relevant tests to administer, how to manage pain, nutrition and co-infections (such as malaria), and other approaches that put the patient on the best path to recovery.
For Ebola virus disease, WHO made strong recommendations for treatment with mAb114 (ansuvimabTM) or REGN-EB3 (InmazebTM) that are both monoclonal antibodies. For other Ebola diseases, such as SVD or BVD, there are no approved therapeutics, but candidate products are under development and a CORE protocol for clinical trials is available.Vaccines
For Ebola virus disease:
Two vaccines are approved: Ervebo (Merck & Co.) and Zabdeno and Mvabea (Janssen Pharmaceutica). Ervebo vaccine is recommended as part of outbreak response, see SAGE recommendations of July 2024.
In case of a confirmed Ebola virus disease outbreak, Ervebo vaccines can be accessed through the International Coordinating Group on vaccine provision.
For preventive vaccination of health-care and frontline workers, request of Ervebo vaccines can be made through Gavi Preventive Ebola vaccination.
For other Ebola diseases, such as SVD:
Several candidate vaccines are at different stages of development.
As part of outbreak response, a CORE protocol to evaluate the safety, tolerability, immunogenicity, and efficacy of vaccine candidates is available.Prevention and control
Community engagement is key to successfully controlling any outbreak. Outbreak control relies on using a range of interventions, such as clinical care, surveillance and contact tracing, laboratory services, infection prevention and control in health facilities, safe and dignified burials, vaccination (only for Ebola virus disease) and social mobilization.
Raising awareness of risk factors and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:
Reduce the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat.
Reduce the risk of human-to-human transmission arising from direct or close contact with infected people, particularly with their body fluids. Close physical contact with Ebola patients should be avoided. Patients should be isolated in a designated treatment center for early care and to avoid transmission at home.
Communities should be well informed, both about the disease itself and how to control the outbreak. This is done best when they are involved in the response and there is open discussion.
Outbreak containment measures include safe and dignified burial of the deceased, identifying people who may have been in contact with someone infected with Ebola disease and monitoring their health for 21 days, separating the healthy from the sick to prevent further spread and providing care to confirmed patients. Maintaining good hygiene and a clean environment are also important.Controlling infection in health-care settings
Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe and dignified burial practices.
Health-care workers caring for patients with suspected or confirmed Ebola disease should apply extra infection control measures to prevent contact with the patients’ blood and body fluids and contaminated surfaces or materials such as clothing and bedding. Infection prevention and control guideline for Ebola and Marburg diseases.
Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Orthoebolavirus infection should be handled by trained staff and processed in suitably equipped laboratories.Care for survivors
All survivors, their partners and families should be shown respect, dignity and compassion. WHO does not recommend isolation of recovered patients whose blood has tested negative for Orthoebolavirus. Survivors might suffer from both clinical and psychological sequelae. WHO encourages affected countries to consider the establishment of care programme to alleviate sequelae, support to community reintegration, counselling and biological testing.
Orthoebolaviruses are known to persist in immune-privileged sites in some people who have recovered. These sites include the testicles, the inside of the eye and the brain. Relapse-symptomatic illness in the absence of re-infection in someone who has recovered from Ebola disease is rare but has been documented. Reasons for this phenomenon are not yet fully understood.
Ebola virus transmission via infected semen has been documented up to fifteen months after clinical recovery. To mitigate the risk of this transmission, a semen testing programme should be implemented to:
offer counselling to male survivors and their sexual partners to inform them of the potential risk and support them adhering to safer sex practices (including condom provision and good hand and personal hygiene);
offer monthly semen testing until they have had two consecutive negative test results; and
after two consecutive negative tests, survivors can safely resume normal sexual practices with minimized risk of virus transmission.
In the absence of a semen testing programme, male survivors should follow safer sex practices for 12 months.
Orthoebolavirus may persist in the placenta, amniotic fluid and fetus of women infected while pregnant, and in the breast milk of breastfeeding women who are infected with the virus. Survivor care programmes should encompass care for pregnant and breastfeeding women after their recovery. WHO response
WHO works with countries to prevent Ebola outbreaks by maintaining surveillance and supporting at-risk countries to develop preparedness plans. The following document provides overall guidance for control of Ebola and Marburg virus outbreaks: Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation
When an outbreak is detected, WHO responds by supporting outbreak response, disease detection, community engagement, contact tracing, vaccination, vaccine and treatment trials, case management, laboratory services, infection control, logistics, and training and assistance with safe and dignified burial practices.
References
International Classification of Disease, ICD-11, 2024 : International Classification of Diseases (ICD)
International Committee on Virus Taxonomy, ICTV : https://ictv.global/report/chapter/filoviridae/filoviridae/orthoebolavirus
附图1:WHO关于埃博拉病毒的常识介绍。
附图2:埃博拉河图示。(图片来自网络)
附图3:俯瞰下的埃博拉河。(图片来自网络)
附图4:埃博拉病毒粒子模式图(https://viralzone.expasy.org/)。
附图5:电镜下的埃博拉病毒粒子:丝状结构长约970 nm,直径约80nm(https://viralzone.expasy.org/)。
附图6:埃博拉病毒粒子编码蛋白模式图(https://viralzone.expasy.org/)。
附图7:埃博拉病毒基因组:负链RNA,长约18-19 kb,编码7个蛋白(https://viralzone.expasy.org/)。
附图8:(A) 丝状病毒颗粒示意图。GP三聚体嵌入膜中,形成从病毒体延伸出的刺突状结构。膜下方的基质主要由VP40组成。核糖核蛋白复合物(RNP)由L、NP、VP30和VP35组成。(B) 埃博拉病毒(EBOV)电镜图像。左图为EBOV的透射电镜(TEM)图像。病毒从细胞膜出芽,在细胞外形成多形性病毒颗粒(比例尺=1 μm)。右图为EBOV的二维冷冻电镜(cryo-EM)图像。注意丝状病毒形态特征性的线状弯曲(比例尺=100 nm)。(Emanuel J, Marzi A, Feldmann H. Filoviruses: Ecology, Molecular Biology, and Evolution. Adv Virus Res. 2018;100:189-221.)。
附图9:数字着色扫描电子显微照片显示,大量丝状埃博拉病毒颗粒(蓝色)从慢性感染的 VERO E6 细胞(黄绿色)中出芽。图片来源(NIAID)
附图10:自感染埃博拉病毒的非人灵长类动物卵巢的彩色透射电镜照片。细胞间存在特征性的丝状埃博拉病毒颗粒(鲜红色)。在卵巢间质细胞内可见胞质内埃博拉病毒包涵体,形成晶体状排列(深红色)。图片来源: (NIAID)
附图11:A) 扫描电镜图像显示,埃博拉病毒颗粒(蓝色)从受感染的绿猴(Chlorocebus aethiops (Linnaeus, 1758))Vero E6细胞中出芽。B) 透射电镜图像显示,埃博拉病毒颗粒(蓝色)既存在于细胞外,也存在于受感染的Vero E6细胞中出芽。图像已着色以使其更清晰(https://ictv.global/report/chapter/filoviridae/filoviridae/orthoebolavirus)。