С распространением эпидемии Сovid-19 исследователи пытаются определить первую человека, которая заболела на коронавирус. Зачем это выяснять и как вообще возник термин «нулевой пациент»?

Власти Китая и эксперты не пришли к согласию относительно того, откуда началась эпидемия, и кто первым заболел на новый вирус. Другими словами, кто является «нулевым пациентом» в эпидемии Covid-19.

Уровень генетического анализа сегодня позволяет проследить происхождение вируса через тех, кто им заразился. Вместе с эпидемиологическими исследованиями ученые могут определить людей, которые, возможно, заболели первыми и начали распространять болезнь, спровоцировав таким образом вспышка.

Но зачем их определять? Это может дать ответы на важные вопросы, как, когда и почему началась эпидемия. Это также может остановить распространение инфекции или предотвратить будущие вспышки.

Итак, мы знаем, кто является нулевым пациентом в эпидемии Covid-19, которая началась в Китае?

Короткий ответ — нет.

Власти Китая сначала сообщила, что первый случай коронавирус произошел 31 декабря. Многие из первых случаев вирусной пневмонии немедленно связали с рынком морепродуктов и животных в Ухане в провинции Хубэй.

Этот регион является эпицентром вспышки. Там зафиксированы почти 82% всех случаев (более 75 000 больных) в Китае и всем мире, по данным Университета Джона Хопкинса.

Оптовый рынок морепродуктов Хуанань, который связывают с первыми случаями коронавирус, теперь закрыт

Впрочем, исследование китайских ученых, опубликованное в медицинском журнале Lancet утверждает, что впервые диагноз Covid-19 поставили 1 декабря 2019 года (то есть намного раньше). И главное, этот человек не имел «контакта» с морепродуктами с рынка Хуанань.

Старшая врач в больнице Цзиніньтан в Ухане и одна из авторов исследования Ву Веньцзюань заявила китайской службе BBC, что пациентом был пожилой мужчина, который страдал болезнью Альцгеймера.

«Он жил за четыре-пять автобусных остановок от рынка морепродуктов и поскольку был болен, почти не выходил из дома», — говорит Ву Веньцзюань.

Она также рассказала, что в трех других людей в последующие дни возникли симптомы вируса, но двое из них также не имели никакого контакта с рынком Хуанань.

Исследователи также установили, что 27 из 41 пациента, которые попали в больницу на ранних стадиях вспышки, «имели отношение к рынку».

Сейчас наиболее вероятной остается гипотеза ВОЗ о том, что вспышка коронавирус начался на рынке, а сам Сovid-19, очевидно, передалось от живого животного человеку-хозяину, от которого потом началось распространение среди людей.

Так может на самом деле один человек спровоцировать массовую вспышку?

Эпидемия эболы в Западной Африке в 2014-2016 годах была крупнейшим вспышкой вируса с момента его обнаружения в 1976 году. По данным ВОЗ, от эболы умерли более 11 000 человек, были заражены — 28 000.

Вспышка длился более двух лет и зацепил 10 стран, преимущественно в Африке. Но отдельные случаи эболы также зафиксированы в США, Испании, Великобритании и Италии.

Эпидемию эболы, которая охватила Западную Африку, проследили до мальчика из Гвинеи, который, очевидно, заразился вирусом от летучих мышей

Ученые пришли к выводу, что вспышка нового штамма эболы начался всего лишь с одного человека — двухлетнего мальчика из Гвинеи. Он мог заразиться вирусом, когда играл в дупле дерево, в котором жила колония летучих мышей.

Ученые поехали до поселка Меліанду, где жил мальчик, взяли образцы генетического материала и пообщались с местными жителями, чтобы узнать больше об источнике вспышки инфекции.

Впрочем, пожалуй, самым «нулевым пациентом» была Мэри Меллон, которая получила прозвище «тифозная Мэри» за то, что вызвала вспышку брюшного тифа в Нью-Йорке в 1906 году.

Меллон переехала в США из Ирландии, где начала работать поварихой в богатых семьях. После вспышки случаев тифа среди состоятельных семей Нью-Йорка врачи проследили его источник — Мэри Меллон.

В каждой семье, где она работала, начинался брюшной тиф, при этом сама Мэри не болела.

Врачи назвали ее здоровым носителем — человеком, зараженным болезнью, которая не имеет ее симптомов или они мало заметны. Такие носители болезни обычно заражают многих людей.

Сейчас есть свидетельства того, что некоторые люди распространяют вирусы больше других. Меллон является одним из первых зарегистрированных случаев так называемых «суперпоширювачів».

В то время ежегодно несколько тысяч ньюйоркцев болели брюшным тифом, смертность от которого была 10%.

Мэри Меллон по прозвищу тифозная Мэри заразила брюшным тифом несколько десятков семей в Нью-Йорке в начале прошлого века

Термин «нулевой пациент», однако, окружен стигмой.

Многие эксперты в области здравоохранения против выявления первого подтвержденного случая болезни. Они опасаются дезинформации о болезни или даже виктимизации человека.

Известный пример — человек, которого ошибочно определили «нулевым пациентом» эпидемии Спида.

Гаэтан Дугас-канадский бортпроводник и гей, является одним из наиболее демонизированных пациентов в истории. Его обвиняли в распространении ВИЧ в США в 1980-х.

Лишь три десятилетия спустя ученые обнаружили, что у него не мог быть первый случай болезни. Исследования 2016 года показало, что вирус попал в Америку из Карибского бассейна в начале 1970-х.

Интересно, что сам термин «нулевой пациент» случайно появился именно во время эпидемии ВИЧ-инфекции.

Исследуя распространение болезни в Лос-Анджелесе и Сан-Франциско в начале 1980-х, сотрудники Центров по контролю и профилактике заболеваний использовали букву «O» на обозначения случаев «за пределами штата Калифорния» (outside the state of California).

Другие исследователи ошибочно трактовали букву как число 0 — так и появился термин «нулевой пациент».

Прочитать оригинал этой статьи на английском языке можно на сайте BBC Future.

Хотите поделиться с нами своими жизненными историями? Напишите о себе на адрес questions.ukrainian@bbc.co.uk и наши журналисты с вами свяжутся.

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Также на эту тему

  • Наука
  • Общество
  • коронавирус
  • Здоровья

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