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1). The Ebola Epidemic■On August 8th, the World Health Organization (WHO) Director- General Margaret Chan declared the West Africa Ebola crisis a“public health emergency of international concern,”triggering powers under the 2005 International Health Regulations (IHR).■Ebola virus disease (EVD) has 3 species of human significance: Zaire, Sudan, and Bundibugyo.The West Africa outbreak is from a new strain of the Zaire species, with a reported case-fatality rate of 55%.Infection can cause fever, vomiting, diarrhea, and generalized bleeding as well as death.■Fruit bats likely carry Ebola virus, with humans infected by close contact with infected body fluids and“bushmeat”of primates, forest antelope, wild pigs, and bats.Human-to-human transmission occurs only by close contact with infected body fluids.Importantly, no airborne transmission between humans has been demonstrated.Early EVD symptoms are similar to those of malaria and typhoid fever- -as well as endemic hemorrhagic fevers such as Lassa- rendering symptomatic differential diagnosis difficult.■Before the current outbreak began in December 2013，West Africa had no recorded Ebola deaths.Yet this outbreak is the largest, with the crisis worsening.As of August 8th, WHO reported 1, 779 Ebola cases, with 961 deaths.Cases were first reported in Guinea on March 23rd, followed by Liberia, Sierra Leone, and Nigeria (due to an infected airline passenger from Liberia).Of greatest concern is the potential urban spread,including capital cities.Previously Ebola was concentrated in rural areas, where the public health response was sufficiently rapid to prevent spread to populated cities.■Since 1976 more than 15 Ebola outbreaks have erupted in sub- Saharan Africa， yet therapeutic options remain undeveloped.There are no licensed vaccines or specific antiviral or immune mediated treatments for ill patients or for post exposure prophylaxis.The U.S.National Institutes of Health is supporting the first phase 1 clinical trial of a new prototype experimental vaccine expected to begin in September 2014.■Fueling disquiet about global justice, 2 U.S.aid workers infected in Liberia were treated with an experimental anti-Ebola antibody prior to being transported to Atlanta.This serum had been previously used only in nonhuman primates.Even though the serum′s safety and efficacy remain unknown, it sparked an international controversy.Should U.S.workers receive a drug in extremely scarce supply when Africans are affected in far greater numbers? Balanced against this sense of injustice is the ethical concern of administering an experimental drug to African patients that has not undergone any safety testing in humans.■On August 11th, WHO convened an expert committee to assess the bioethical implications of withholding or providing early access to experimental treatments.If a scarce treatment offers benefits to patients, the ethical question is who should have priority access Society, for example, owes a duty to health workers who place themselves at heightened risk.Other ethical considerations could grant priority to patients most likely to benefit, as well as targeting the drug to prevent spread in hospitals or the community.Moreover, who should decide whether an experimental treatment should be administered?Liberian officials apparently did not approve the use of an investigational drug administered in their territory.National leaders also would need to be part of future decision making processes for allocating scarce vaccines and medications.Two U.S.aid workers infected in Liberia have recovered after treatment.( )
A.Right
B.Wrong
C.Not mentioned

正確答案：C

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