Between December 2010 and January 2011, 16 children presented to a mission hospital, in what at the time was, the Brong Ahafo Region (BAR) of Ghana, with unusual forms of seizure and paralysis. Initial testing suggested that the cause was B virus, a zoonotic monkey-borne virus not previously seen in Africa. These unexpected and concerning results spurred national public health authorities to deploy a field epidemiology team from the capital. Although short-lived, the findings from their investigation implicated a local monkey population occupying a forest belt which stretched along all of the affected communities. Newly collected samples were sent to a foreign reference laboratory for confirmatory testing, but no results were reported back. In the interim, several transnational research coalitions were formed to investigate the outbreak further. One did manage to obtain some confirmatory testing and the results suggested that B virus was not the cause of the outbreak. This prompted the remaining research coalitions to consider other potential causative agents and animal hosts. Over time it became clear, however, that the reports of a monkey-filled forest were also incorrect and that the clinical picture had not supported an infectious aetiology as definitely as first thought.1 Despite the mounting evidence suggesting it was not a zoonotic outbreak, more likely explanations for the outbreak, specifically that it had a toxic aetiology, went unexplored. After 2 years, all of the investigations into the outbreak had petered out. No meaningful public health interventions had taken place nor a compelling explanation for the event developed. However, if you read the draft and published manuscripts describing the outbreak authored by the investigators during that time, you would be left with the opposite impression. A more exact account of the investigations into the BAR outbreaks is presented in a recent article exploring the processes of …

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困在“现场”：为什么应用流行病学需要回家

2010 年 12 月至 2011 年 1 月期间，16 名儿童因不寻常的癫痫发作和瘫痪被送往当时位于加纳布朗阿哈福地区 (BAR) 的一家教会医院。初步测试表明，病因是 B 病毒，这是一种人畜共患的猴传播病毒，以前在非洲从未见过。这些出乎意料且令人担忧的结果促使国家公共卫生当局从首都部署了一个现场流行病学小组。尽管持续时间很短，但他们的调查结果表明，当地的猴子种群占据了沿着所有受影响社区延伸的森林带。新采集的样本被送往国外参考实验室进行确认检测，但没有返回结果。在此期间，多个跨国研究联盟成立，以进一步调查疫情。其中一项确实设法获得了一些确认性检测，结果表明 B 病毒不是疫情爆发的原因。这促使其余的研究联盟考虑其他潜在的病原体和动物宿主。然而，随着时间的推移，人们逐渐发现，关于充满猴子的森林的报道也是不正确的，而且临床情况并不像最初想象的那样明确支持传染性病因。1 尽管越来越多的证据表明这不是人畜共患疾病的爆发，对于此次疫情的更可能的解释，特别是其具有毒性病因，尚未得到探索。两年后，所有针对疫情的调查都逐渐停止。没有采取任何有意义的公共卫生干预措施，也没有对这一事件做出令人信服的解释。然而，如果你读过调查人员当时撰写的描述疫情的草稿和已发表的手稿，你会留下相反的印象。最近的一篇文章对 BAR 疫情的调查进行了更准确的描述，探讨了……的过程。