致命的矢量 - 媒体已经将2016年视为“ Zika年”

Flickr

“每个人都知道，瘟疫在世界上有一种反复出现的方式，但是我们以某种方式很难相信那些从蓝天崩溃的人。”

阿尔伯特·加缪（Albert Camus）在他的小说中The Plague（1928年）

Just asEbola in West Africais nearly out of the headlines, the media has already pegged 2016 “寨卡那一年”.

像中国月历，，，，each year seems to have its own deadly, emerging pathogen. But without a soothsayer, it is hard to pick from the over500 other arthropod-borne viruse在那里（更不用说许多病毒，细菌，真菌，寄生虫和寄生虫）可能已经争夺了2017年的头衔。

If I was a Victorian taxidermist, I would be envious of our modern ‘viral hunters’ (disease biologists and ecologists). They have a vast unseen microbiological frontier open to discovery and cataloguing. The problem for the rest of us is that discovery is only half the story; the messy world of global health and emerging diseases isn’t quite like the laboratory bench.

“艾德斯·阿吉普蒂”：致命的矢量

像埃博拉病毒和大多数其他新兴疾病一样，寨卡具有动物来源 -first detectedin a sick rhesus monkey in 1947 along the shores of Lake Victoria. But while we might be forgiven our关于寨卡的无知，这将是faux pas不知道其致命矢量，艾德斯·阿吉普蒂mosquito。

The notoriety of this little arthropod started way before Zika, as it1950年代的运输路线旅行，，，，and began breeding in the burgeoning urban cities of Asia and Latin America where it spread arboviruses causing diseases such as Dengue fever, yellow fever and chikungunya. Arecent studyestimated that there are nearly 400 million dengue infections every year.

但是与增加小头畸形病例在南美，寨卡似乎是另一种，更不可预测的野兽。当然可以迅速广播，理解和采取行动。

But the pandemonium around Zika has little to do with the majority of infections.Emerging on a series of Pacific Island Statessince 2007, Zika typically leads to mild febrile cases, with most being asymptomatic. In much of the tropics, inadequate diagnostic capacity and health services mean such illnesses are typically undiagnosed, unrecorded and forgotten about. Among local communities there is often a widely repeated, but incorrect, maxim that “每一个发烧都是疟疾”.

但是与增加小头畸形病例在南美，寨卡似乎是另一种，更不可预测的野兽。当然可以迅速广播，理解和采取行动。

这正是正在发生的事情。危机叙述，政治，媒体，不确定性，恐惧和政策处方和公民反应。科学和生物学与社会和政治融合。

一套全球挑战

With the summer Olympics a matter of months away, troops have been deployed on to the streets of Rio de Janeiro armed with fumigators, larvicide and information pamphlets. A new“war” against the mosquito已经开始。萨尔瓦多的卫生部长been more draconian, and advised women in this deeply Catholic country to未来两年的放弃怀孕，，，，妇女权利活动家have lashed out.

这是绝望的明显迹象，我们对这个看不见的敌人如何以及为什么出现的理解有限。美国疾病控制与预防中心（CDC）仅报道了寨卡案发生性传播的案例in Texas. Zika has also been linked to a严重的厄尔尼诺一年。

我们被告知疫苗是“at least” a decade away, if at all, and vector control will also be an uphill battle.艾德斯·阿吉普蒂令人难以置信的弹性。

我们被告知疫苗是“at least” a decade away如果有的话，矢量控制也将是一场艰苦的战斗。艾德斯·阿吉普蒂令人难以置信的弹性。To add insult to injury,阴谋理论家have begun crying foul, linking Zika emergence to a biotech experiment gone bad. Fears about GMOs have a new poster child.

It is clear that Zika virus has quickly become inseparable from a suite of other global challenges: unplanned urbanisation, poverty, women’s rights, social services for disabled newborns, climate change and dysfunctional political regimes. Entangled together, tensions mount and influence the different ways we respond.

一种健康方法

While differences abound, we have been here before. Many times. HIV/AIDS, Ebola, avian influenza, bovine spongiform encephalopathy (BSE), West Nile, Lyme disease, and the list goes on – albeit the characters and script are different.

过去告诉我们，我们需要采取一种新的方法来解决这些反复出现的瘟疫，我们不应该为不可避免的计划而感到惊讶，而是要计划。矛盾的是，“不可避免”也是不确定和复杂的。

我们需要一种“一种健康”方法，以整合人类，动物和生态系统的健康。

This is the central point of the huge body ofpost-Ebola literature这清楚地表明了我们如何加强全球监视，响应和准备系统以更好地处理新兴疾病。我们需要一个“One Health”整合人类，动物和生态系统健康的方法。

尽管这一切都是伟大而良好的，但仍可能阻碍这些愿望的主要学科和社会政治鸿沟。一旦尘埃落定和新闻相机离开，international pledges and lofty rhetoricto deal with the underlining ecological and social roots of these diseases tend to evaporate.

Power and politics

When social scientists talk about ‘political’ and ‘social’ dynamics we are not necessarily talking about exotic cultural practices. Power and politics are interwoven as much into the Vodou ritual dance as into the culture of global disease surveillance and response. This is becoming more and more accepted in public health circles, often under the rubric of “实施科学”.

考虑一种更具弹性，最终有效的新兴疾病方法，需要就优先事项以及科学和干预的结构提出困难，有时不舒服的问题。它要求深入全球和地方系统，政策和实践，科学，技术和公民参与以及不同形式的知识和专业知识之间的复杂关系（和紧张关系）。

但是，对社会和政治关系的关注又是故事的一半。社会科学家本身需要摆脱象牙塔。如果未来像过去一样，防止和应对未来的全球健康灾难将需要团队合作和自我反省 - 能够以创造力，政治敏锐度和对社会正义的奉献精神进行多个鸿沟工作。