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健康 · 西伯利亚鼠疫疑云

俄罗斯称鼠疫实验室员工并非死于鼠疫,却仍隔离了近200人

一名28岁女子在西伯利亚一家抗鼠疫研究所工作后死亡。莫斯科称其为不明原因肺炎并排除鼠疫,但没有公开的实验室结果支持任何一种说法。

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  1. 第 1 次更新俄罗斯称鼠疫实验室员工并非死于鼠疫,却仍隔离了近200人当前位置

俄罗斯卫生监管部门表示,一名在西伯利亚抗鼠疫研究所工作的28岁女子并非死于鼠疫。与此同时,近200名与她有过接触的人被置于医学观察之下,医院病区停止常规收治,该监管部门负责人据报已飞往当地。否认与如此大规模的应对措施难以相容,而迄今公布的信息都无法解释这一落差。2 1

以下内容需要注意一点:几乎全部都依据官方表态、未经证实的报道和匿名消息来源。

关键事实

  1. 约200据俄罗斯报道,接受医学观察的接触者人数 41
  2. 28死亡员工的年龄 2
  3. 0公布的指明鼠疫或任何病原体的实验室结果 27

莫斯科的说法

监管部门Rospotrebnadzor称她的病症为病因不明的肺炎。该部门表示,对她的样本进行的扩大检测未发现与她工作相关的微生物。该部门称,一个委员会发现研究所未发生涉及病原体的事故,此前十天内员工中没有传染病病例,伊尔库茨克州、伊尔库茨克市和舍列霍夫的局势稳定。11 12 6

该部门对接触者的检测汇总显示,有两例新冠肺炎和两例鼻病毒感染,未发现其他传染源。后来的一份汇总称,约60%接触者的监测已经结束。伊尔库茨克州州长伊戈尔·科贝夫表示,已确认的接触者没有发病迹象,实验室结果为阴性。该监管部门前负责人根纳季·奥尼先科表示,这很可能不是鼠疫,即便是,传播的可能性也不大。44

10月5日,克里姆林宫的德米特里·佩斯科夫称Rospotrebnadzor是主管机构,并呼吁公众不要理会谣言和猜测。41

仔细解读,这一否认是一项否定性结论。它说的是未发现与工作相关的微生物,也没有发生事故,但没有指明究竟是什么导致她死亡。“病因不明”是对无知的承认,而不是对鼠疫的排除。这一点很重要,因为安抚性表态和隔离措施都建立在一个无人确认的病因之上。

案情

据报道,这名女子名叫达里娅·希皮洛娃,但拼写不一。她在伊尔库茨克卫星城舍列霍夫的研究所工作。报道称,她于9月29日因重症肺炎住院,使用了呼吸机,并于10月2日凌晨去世。一些说法称是10月1日至2日夜间。目前没有公布任何病历。4 9

她去世前后的几天

  1. 9月29日,周二

    据报道,她因不明原因的重症肺炎住院,并使用了呼吸机。

    4
  2. 10月2日,周五

    凌晨在舍列霍夫去世;据报道,该研究所已被封锁。

    9
  3. 10月2日至3日

    据报道,俄罗斯联邦消费者权益保护和公共福利监督局(Rospotrebnadzor)负责人安娜·波波娃加入了一个就疑似特别危险传染病召开的地区紧急委员会。

    44
  4. 10月3日,周六

    舍列霍夫的一家铝厂出于预防订购口罩。

    9
  5. 10月4日,周日

    俄罗斯联邦消费者权益保护和公共福利监督局表示,未发现与工作相关的病原体,也未发生事故。

    6
  6. 10月5日,周一

    克里姆林宫呼吁公众不要理会谣言;伊尔库茨克的几家医院否认已被关闭。

    41

官方口径如何变化

我们掌握的最早材料在10月5日时已有约一天,其中只有一条极简的官方说法:一家鼠疫研究中心的一名员工患有不明原因的肺炎,部分接触者正在接受观察且没有症状,未报告其他感染,局势稳定。5 数小时内,情况已扩大为一例死亡、大规模隔离和约200名接触者。

令人费解的细节是波波娃的行程。据报道,她参加了一个因疑似特别危险传染病病例而召开的紧急防疫委员会,而该机构的措辞后来又退回到“不明原因肺炎”。邻近的布里亚特共和国负责人阿列克谢·齐登诺夫据报道起初写道她死于鼠疫,随后将帖子改为“可能”,并否认她曾到过布里亚特。44 官员或许只是先升级应对,待检测结果出来后再降级。这是一种合理的解读,但只有公布检测结果才能证明。

两种无法调和的说法

关于死因,NBC新闻10月5日报道称她死于疑似肺鼠疫,而俄罗斯当局称其为不明原因肺炎。法新社旗下法国24电视台同日报道称,监管部门未发现她所接触的病原体导致此事的证据。1 2 鼠疫的说法来自未经证实的报道。

关于实验室事故,《独立报》报道称她在采集样本时打碎了一支装有病原体的试管,该报对这一说法的确定性评级为中等。ABC新闻报道称,俄罗斯传染病管理机构否认发生任何事故,并称未检出其他感染。4 3 当地媒体“贝加尔湖人”(Lyudi Baikala)援引匿名消息来源,称试管事件发生在9月25日,此外还流传着一则有关出国旅行的早先报道。官方对两者均未证实。44

一场没人能画出范围的隔离

人数与关闭情况对不上。俄罗斯报道称,正在接受观察的人略少于200人,其中100多人在医院病区。一份并非官方统计的地区明细列出约197名接触者和约189名住院者:一家医院约114人,另一家63人,研究所12人。4 44

舍列霍夫市长马克西姆·莫金证实,区医院的住院部已被隔离,不办理常规收治或出院,而门诊部仍然开放。至少三家医院告诉ABC,它们已被隔离。44 3 有媒体报道称伊尔库茨克市的几家医院实行为期三周的隔离,但10月5日其中数家医院公开否认关闭,并称市内未确认肺鼠疫。43 一则针对舍列霍夫的旅行警告被发布后又被删除。44

俄罗斯独立媒体称,该研究所自10月2日起被封锁,约60名员工睡在地板和椅子上。这只是单一来源的报道,官方尚未证实。2 10

国外:密切关注,但不惊慌

世界卫生组织表示,正与俄罗斯官员联系,以核实该事件、事发经过和实验室检测。根据非官方信息,世卫组织称对普通人群的风险似乎较低。美国国务院表示正与疾控中心一道监测,许多细节尚未得到证实,并已敦促俄罗斯迅速、公开地分享准确信息。18 40 欧盟委员会正与欧洲疾病预防控制中心一道监测。哈萨克斯坦称其风险极低,但已加强边境卫生管控。44

我认为这不值得惊慌,但值得关注。

马尔科·卢比奥 17

传染病专家阿梅什·阿达尔贾表示,鼠疫可用抗生素治疗,主要担忧是俄罗斯的透明度。1 华盛顿和世卫组织都没有将此视为疫情暴发,而没有任何继发病例的报道也支持这种克制。但这种没有病例的情形同样有另一面:应对如此之重,结论却如此之少,外界只能依赖莫斯科的说法。

已知

  • 俄罗斯联邦消费者权益保护和公共福利监督局称诊断为病因不明的肺炎,并表示死因不是鼠疫。 1112
  • 据报道,这名28岁的研究所员工于9月29日住院,10月2日凌晨去世。 49
  • 市长证实,舍列霍夫区医院的住院部已被隔离。 44
  • 世卫组织和美国国务院表示正在监测和核实;两者均称情况尚未完全得到证实。 1840

未知

  • 她的死因是什么,因为没有公开的实验室结果指明任何病原体。
  • 是否发生过实验室事故,鉴于试管一说未经证实且官方予以否认。
  • 有多少人被隔离,以及哪些医院实际被关闭。
  • 研究所员工是否被限制在现场。

后续

  • 公布的实验室结果或病原体鉴定。
  • 更多接触者人数和解除隔离的情况,包括任何为期三周的隔离。
  • 向世卫组织或公众作出更充分的披露,以及任何接触者发病的情况。

术语

俄罗斯联邦消费者权益保护和公共福利监督局(Rospotrebnadzor)
俄罗斯联邦消费者权益保护和公共卫生监管机构,即就此案正式发声的机构。
肺鼠疫
鼠疫的肺部形式,由鼠疫耶尔森菌引起,可用抗生素治疗。此处仅在未经证实的报道中被怀疑为该病。
舍列霍夫
伊尔库茨克的卫星城,研究所设在此地。
播出原貌 13 行
  1. A 28-year-old anti-plague institute worker is dead, and nearly 200 people are in medical isolation.
  2. The institute works on plague, and Russia's health watchdog insists she did not die of it. Yet hospital wards are locked down, and the watchdog's chief reportedly flew to the region.
  3. So what killed her, and why is the response so much bigger than the official explanation?
  4. Just under 200 people are under medical observation, and more than 100 of them are being monitored in hospital wards. One regional breakdown, not an official count, lists about 197 contacts and about 189 hospitalized for observation: roughly 114 in one hospital, 63 in another and 12 at the institute. The watchdog's summary of tests among contacts found two COVID-19 cases, two rhinovirus infections and no other infectious agents, and monitoring has already ended for about 60 percent of them.
  5. She was hospitalized on September 29 with severe pneumonia of unknown cause, put on a ventilator, and died in the early hours of October 2. Some accounts say the night of October 1 to 2. She is reported as Darya Shipilova, though spellings vary, and she worked at the institute in Shelekhov, a satellite town of Irkutsk. No medical record has been published.
  6. The official account has hardened into a flat denial. The watchdog says expanded testing of her samples found no microorganisms connected with her work, a commission found no accident involving pathogens at the institute, and there were no infectious-disease cases among staff in the previous ten days. It calls the situation in the Irkutsk region, Irkutsk and Shelekhov stable. Governor Igor Kobzev says identified contacts show no signs of illness and have negative lab results. Kremlin spokesman Dmitry Peskov told the public to disregard rumors and speculation, and a former watchdog head, Gennady Onishchenko, says it was most likely not plague and that even if it were, spread would be unlikely.
  7. The official line has not always been this firm. Watchdog head Anna Popova reportedly flew to Irkutsk and joined an emergency regional anti-epidemic commission convened over a suspected case of a particularly dangerous infection. The wording was later walked back to pneumonia of unknown cause. And the head of neighboring Buryatia, Alexey Tsydenov, first wrote that she died of plague, then edited his post to say possibly, and denied she had been in Buryatia.
  8. One account of how she fell ill involves a broken test tube of the plague pathogen. One local report dates that to September 25, citing unnamed sources, and a different story, about a trip abroad, also circulated. Officials have confirmed neither. The watchdog and Russia's infectious disease agency deny any accident.
  9. Which hospitals are actually shut is not settled. Shelekhov's mayor, Maxim Modin, confirmed the inpatient ward of the district hospital is under quarantine, with no routine admissions or discharges, while its outpatient clinic stays open. At least three hospitals have confirmed they are quarantined, and a maternity facility is reportedly closed too. One outlet reported three-week quarantines at several Irkutsk city hospitals, but on October 5 several of them publicly denied closure and said no pneumonic plague had been confirmed in the city. A travel warning against Shelekhov was posted, then deleted. The institute itself is reportedly locked down, with about 60 staff sleeping on floors and chairs, a claim officials have not confirmed.
  10. Abroad, the World Health Organization is in contact with Russian officials to verify the event, the circumstances and the lab tests. On unofficial information, it says the risk to the general population appears low. The US State Department is monitoring with the CDC, says many details are unconfirmed, and has urged Russia to share accurate information quickly and openly.
  11. Secretary of State Marco Rubio, who had voiced concern the illness could spread, struck that measured tone on October 5. The White House says it is monitoring and assessing options, and a US official notes travel between the two countries is limited. The European Commission is monitoring with the European Centre for Disease Prevention and Control, and Kazakhstan, calling its own risk very low, has tightened sanitary controls at its border. Infectious disease expert Amesh Adalja says plague is treatable with antibiotics, and that the main worry is Russia's transparency.
  12. So what killed her? Nobody has shown. No public lab result identifies a pathogen, and plague is neither confirmed nor ruled out by any independently verifiable test. The gap between an official denial and a response that isolates roughly 200 people remains unexplained.
  13. Four developments would settle it: a published lab result, the release of isolated contacts, fuller disclosure from Russia or the World Health Organization, and whether any contact falls ill.

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