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不明病毒抑或心理隐患 公共卫生管理需介入
http://www.sina.com.cn 2011年04月24日 23:43 《新世纪》－财新网
这个人群大多有过高危性行为，认为自己感染了未知病毒，官方调查无法令其释然。这究竟是什么公共卫生问题？
□ 本刊见习记者 蒋昕捷 | 文
神
秘病毒、阴性艾滋病、内地患者数千人、血液口水传播……这些骇人的关键词配上一篇回顾SARS疫情的短文，你会觉得恐慌吗？
香港《东方日报》4月4日以“惊世阴滋病杀入港”为题刊发报道，很快在微博等网络平台传播，引起广泛关注。卫生部迅速反应，两天后即在官方网站公布针对该人群的两次调查结果，称他们未感染艾滋病或其他传染病。
4月11日，卫生部新闻发言人邓海华在一次记者发布会上再度否认“阴性艾滋病”说法。中国疾控中心性病艾滋病中心主任吴尊友表示，不排除其中一些人有精神疾患和心理疾病。多位临床医生亦认为，这属于“艾滋病恐惧症”。
官方说法无法消除很多“阴性艾滋病感染者”或“不明病毒感染者”口中迁延日久的“顽疾”。在网络论坛上，他们对卫生部的结论表达了痛苦和愤怒之情。以寻找真相为名的相关QQ群至今仍有十余个，成员超过千人，每天都有新人加入。
是“恐艾症”还是不明病毒
4月6日晚，卫生部发布调查通告后不久，网友“天空”加入了QQ群中的“蓝丝带家园6区”。他称自己一次“找小姐”后，出现低热、皮疹等症状，但艾滋病病毒（HIV）检测呈阴性。简单询问之后，一位网友断言，“你中招了”。另有网友附和，“我们又多了个兄弟。”
在网络中聚集的这群人以二三十岁的男性居多，大多有过高危性行为。尽管HIV检测呈阴性，但他们仍担心自己感染了症状类似艾滋病、传染性很强的“阴性艾滋病”或不明病毒。
据27岁的杨诚自述，2010年7月9日有过高危暴露，第二天出现肠鸣、低热、恶心、厌食和皮疹，一个月后又出现浑身乏力、关节响等。这些症状拿到网上搜索，要么指向艾滋病论坛，要么指向“不明病毒感染者”群体。两次HIV检测呈阴性后，他相信自己染上了不明病毒。他还说，有三名同事在吃饭时被自己传染，出现干咳和关节响症状，而对方仍不知情。
不过，中国疾控中心流行病学首席科学家曾光指出，该人群多数无明显器质性病变，少数生化检查异常者亦与其主诉临床症状不符。针对有人担心亲友被传染的情况，卫生部2011年年初在六省市组织的第二次调查中包含入户调查，但大多数参加调查者拒绝了这一要求，电话联系上的部分亲属也否认自己染病。
2009年7月，一些四处上访的“病友”找到曾光寻求帮助。不久后，曾光及其同事通过QQ等渠道招募59名“自述疑似艾滋病感染者”，做第一次调查。
接受调查者的血液标本，还被送至美国加州大学旧金山分校实验室。据称，该实验室的病毒芯片可检测到1.5万种左右的病毒。2011年3月下旬，美方表示已检测三分之一的标本，尚未发现任何病毒感染的证据。
最终，这个群体被怀疑染上艾滋病恐惧症，即“恐艾症”。卫生部艾滋病专家咨询委员会临床组组长李太生2007年曾撰文指出，恐艾症最早于上世纪80年代被国外报道，患者长期处于担忧之下会出现低热、皮疹等症状。
卫生部发出通告之后，有媒体援引中科院上海巴斯德所莫筱卫博士的说法，称其所在研究团队从五名自述不明病毒感染者的血液中，发现一种并非艾滋病病毒的疑似病毒。而邓海华在4月11日说，官方渠道了解的结果是媒体误报，当事人表示从来没说过这个问题。
当财新《新世纪(21.38,-0.63,-2.86%)》记者接通莫筱卫电话时，她以低沉的声音连说两遍“以卫生部通报为准”，即挂断电话。
一位康复者的自白
四川某高校35岁的教师赵则是59位接受第一次调查的人士之一。他说：“我那时特别羡慕街上的乞丐，虽然生活苦一点儿，但是没病，真好。”
2006年夏天的一个夜晚，趁着酒劲，赵则发生了高危性行为。此后他担心自己是不是得了艾滋病，到不同的医院做初筛检查，近20次检查都是阴性。
这期间，他出现了网络上传说的阴性艾滋病或不明病毒的诸多症状：盗汗、乏力、皮疹、关节响、肠鸣等，他开始和一些“病友”成天泡在论坛里。
曾光对财新《新世纪》记者介绍，精神科医生通过专业量表，对首批59名参与调查者中的多数人做过心理测评，表明他们的心理健康水平明显低于一般人群。国内最早研究艾滋病或公共卫生的知名人士都接触过类似人群。该人群通过互联网聚合起来，互相影响，与其猜疑相反的话很难听得进去。
在一次体检中，赵则被检查出患有丙肝，感觉“总算查出病来了”。不过，他又在网上查资料，担心自己可能是丙肝和艾滋病合并感染。
随着丙肝治疗的结束，他的身体各种症状随之消去。此后，他成家生子，小孩和家人都很健康。
据悉，中国疾控中心已先后接到五位人士的来信，称自己摆脱心理阴影，回归正常生活。
公共卫生关注什么
赵则说，他在北京接触的那批“病友”构成很复杂，有的人像自己当时那样存在艾滋病恐惧心理；有的人情绪偏激，认准了就是有不明病毒；也有人身体上能看到明显的疾病症状，比如一位“病友”腿关节确实显得畸形。
实际上，这个群体中的很多人至今相信不明病毒的存在，并不认可自己是恐艾症。在论坛里，有病友称感染了“一种无法检测的、可以唾液传播的、攻击人类免疫系统的类HIV病毒”，有人说是超级细菌，有人说是慢病毒，还有人解读为敌对势力的阴谋。
一些网络空间甚至出现相约自杀、报复社会等言论。早期牵头人之一、50岁的林军表示，尽管大多数“病友”反对并制止，但自杀、恶意献血和通过性行为传播“病毒”的人确实存在。
林军说，一位大学毕业生出于对高危性行为的懊悔和对艾滋病的恐惧，辞去工作两年了没敢回家，并于去年4月一天夜里割脉自杀，被“病友”们劝止，手腕上留下疤痕。
在中国疾控中心介入调查之前，有关方面曾就此问题组织过研讨。当时，有专家认为这不属于公共卫生问题。“但我认为公共卫生关注的就是可能威胁公众健康的所有问题，包括传言也需要去回应和干预。”曾光说。
在曾光看来，向“病友”通报客观的医学检查结果、启发大家在另一方向上思考，都是一种积极干预，目的在于不要让更多人加入这个群体；如果认为有其他疾病，应及时找临床大夫诊断治疗。
然而，这却不是很多“自述疑似不明病毒感染者”期待的答案。曾光一度让他们满怀期待，现在又成了他们抱怨最多的对象。有人开始联系在抗击SARS战争中赢得赞誉的医学专家钟南山。
钟南山近期接受媒体采访时表示，他不认为这个人群感染了艾滋病。同时他指出，那些因为身体不适、存在“恐艾”心理的人不一定就没有其他疾病，需做深入分析。
林军觉得，钟南山绝对有这个能力“找出病毒”。杨诚则表示：“如果他的结论跟卫生部一样，我们还会寻求其他的机构。”
文中所有自述患者均为化名
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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Unknown virus or the psychological risks involved in public health management needs
http://www.sina.com.cn 2011 年 04 月 24 日 23:43 "New Century" - Finance new network
Most of this population had high-risk sexual behavior, that they are infected with an unknown virus, the official investigation can not make it relieved. What is the public health problem?
□ ZHANG Xin Jie Jiang trainee reporter | text
God
Secret virus, HIV-negative, the mainland thousands of patients, blood saliva spread ... ... The key words accompanied by a terrible epidemic SARS review essay, you will feel panic?
Hong Kong "Oriental Daily" on April 4 as "stunning shade AIDS reached the port" in the title published reports, quickly spread microblogging platforms such as network, causing widespread concern. Ministry of Health, rapid response, two days after publication in the official website for the results of two surveys of the population, say they are not infected with AIDS or other infectious diseases.
April 11, Health Ministry spokesman Deng Haihua told a press conference once again in denial "HIV negative" view. China CDC, said Mr Wu, director of STD and AIDS, does not rule out some of them have mental disorders and mental illness. Many clinicians also believe that this is "AIDS phobia."
Officially can not eliminate the many "HIV negative" or "unknown viral infection," persistent course of time the mouth of the "ills." In online forums, the Ministry of Health concluded that they expressed pain and anger. To find the truth in the name of the relevant QQ group, there are still more than ten, more than a thousand members, with new members joining every day.
Is the "fear of AIDS disease" or unknown viruses
The evening of April 6, notice of the Ministry of Health survey released shortly after the netizen "sky" to join the QQ group "Blue Ribbon Home 6 Zone." He calls himself a "looking for lady", the low fever, rash and other symptoms, but the AIDS virus (HIV) test was negative. After a simple inquiry, a netizen asserted, "You're caught out." Another netizen echoed, "we've got a brother."
Gathered in the network to two or three-year-old group of people mostly men, most of them had high-risk sexual behavior. Although the HIV test was negative, but they still worry about symptoms similar to HIV infection, highly contagious "negative AIDS" or unknown viruses.
27-year-old Yang Cheng, according to the readme, 9 July 2010 had a risk exposure, the next day there bowel, fever, nausea, anorexia and rash, occurred a month later whole body fatigue, joint ring and so on. These symptoms get online search, or point to the AIDS Forum, or point to "unidentified viral infection" group. Tested negative for HIV twice, he believes he was infected with the unknown virus. He also said that three colleagues at the dinner by their own infection, symptoms of dry cough and joint ring, and the other party even know it.
However, chief scientist of China CDC epidemiologist who light that the majority of the population had no organic disease, a small number of biochemical abnormalities Zheyi not match clinical symptoms with the chief complaint. Some people worry that friends and relatives for the case of infection, in early 2011 the Ministry of Health organized in six provinces and cities in the second survey included household surveys, but most of the survey participants rejected the request, telephone contact on the part of relatives denied their disease.
July 2009, a number of petitions around the "patients" find the light had to seek help. Soon after, he and his colleagues through the light channels such as the recruitment of QQ 59 "readme suspected AIDS", to do the first survey.
Surveyed the blood samples were also sent to the University of California, San Francisco laboratory. Allegedly, the laboratory can detect the virus chip to about 15,000 kinds of viruses. In late March 2011, the United States has detected that one third of the specimens, has not yet found any evidence of infection.
Ultimately, this group is suspected of having contracted AIDS phobia, that "fear of AIDS disease." Expert Advisory Committee Ministry of Health AIDS Clinical Team Leader Li Taisheng has written that in 2007, fear of AIDS disease as early as the 80s of last century by foreign reports, the patients under long-term worry is there will be fever, rash and other symptoms.
After the Ministry of Health issued a circular, the media quoted the Shanghai Institute Pasteur Dr. Mo Xiaowei statement, saying the team where the readme from the five blood of unknown HIV, the AIDS virus is not found a suspected virus. And Deng Haihua, said in April 11th, the result of official channels to understand the media misrepresentation, the party that never said this.
When the new fiscal, "New Century (21.38, -0.63, -2.86%)," Guardian reporter Xiao Mo turned the phone, her deep voice even said it twice, "subject to the Ministry of Health," that hang up.
Confessions of an ex-
Sichuan, a university teacher Zhao, 35, is the 59 who received one of the first survey. He said: "I was especially envious of street beggars, while the miserable life a little bit, but not sick, nice."
One night in the summer of 2006, taking advantage of Jiu Jin, Zhao high-risk sexual behavior occurred. Since then, he worried that he is not got AIDS, to a different hospital screening examination, nearly 20 inspections were negative.
During this period, he appeared on the legendary network of negative or unknown virus, many HIV symptoms: night sweats, fatigue, skin rashes, joint ring, bowel and so on, he began, and a number of "patients" all day long soak in the forum.
Choi had a new light on the "New Century" reporters, psychiatrists through professional scale involved in the investigation of the first 59 people who did the majority of psychological evaluation, that their mental health was significantly lower than the general population. AIDS or the earliest of prominent public health groups have similar access. The crowd through the Internet brought together, interact, and its hard to hear the words of suspicion into the opposite.
During a physical examination, were diagnosed with hepatitis C Zhao, feeling "sick to finally find out the." However, he was on the Internet to find information, worried that she may be hepatitis C and HIV co-infection.
With the end of hepatitis C treatment, the symptoms of his body along with elimination. Since then, he married children, children and families are healthy.
It is reported that China CDC has received five people have a letter and said that he get rid of psychological shadows and return to normal life.
What public health concern
Zhao said that his contacts in Beijing, the batch of "patients" constitute a very complex, and some portraits themselves, as there was fear of AIDS; some sentiment extreme, look for is an unknown virus; it was also able to see the body obvious symptoms of the disease, such as a "patient" does seem abnormal leg joints.
In fact, this group has a lot of people believe in the existence of an unknown virus, is the fear of AIDS does not recognize their own symptoms. In the forum, said patients infected with "an inability to detect and can spread saliva, attacks the human immune system type HIV virus", was said to be super-bacteria, was said to be slow virus, was also interpreted as hostile forces conspiracy.
Meet some of the network space and even suicide, revenge and social views. One of the early lead, the military said 50-year-old forest, although most of the "patients" against and stop, but the suicide, blood and sexually transmitted malicious "virus" did exist.
Lin Jun, said a high-risk sexual behavior of college graduates out of remorse and fear of AIDS, did not dare quit his job two years back home, and one night last April suicide cutting vein was "patients" are discouraged, leave a scar on the wrist.
Prior to the Chinese CDC in the investigation, the authorities concerned have organized seminars on this issue. At that time, some experts believe that this is not a public health problem. "But I think public health concern is the possibility of a threat to public health of all issues, including the need to respond to rumors and intervention." Zeng Guang said.
In the light seems to have been to the "patients" informed of objective medical findings to inspire other up in thinking we are an active intervention aimed not to allow more people to join this group; if there are other diseases that should be Clinical diagnosis and treatment of the doctor in time to find.
However, this is not a lot of "Read persons suspected of an unidentified viral infection" looking forward to the answer. Light once they have been filled with hope, now became the object of their biggest complaints. Some people started to contact in the fight against SARS war Zhong Nanshan, award-winning medical experts.
Zhong Nanshan, a recent media interview that he did not think the people infected with the AIDS virus. He also pointed out that because of physical discomfort, there is "fear of AIDS," Psychology is no other diseases were not required to do in-depth analysis.
Lin Jun view, Zhong Nanshan definitely have the ability "to identify the virus." Yang Cheng said: "If he concluded with the Ministry of Health, we will seek other institutions."
All patients were in the readme text pseudonym
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