特朗普、泰诺与自闭症

这是你需要解读的头条新闻。

It's your headline to unpack.

这是你每周都要跟进的一个故事。

It's your one story to follow week by week.

这是你需要破解的Wordle谜题。

It's your Wordle to work through.

这是你需要追踪的队伍。

It's your team to track.

这是你用来探索的36小时。

It's your thirty six hours to explore.

这是你需要掌握的腌料配方。

It's your marinade to master.

这是你需要理清的观点。

It's your opinion to figure out.

这是你升级床垫的时候了。

It's your mattress to upgrade.

今天是你了解圣母院还需要什么的日子。

It's your day to know what else you need to Notre Dame.

《纽约时报》。这是你理解世界的窗口。更多信息请访问nytimes.com/yourworld。

The New York Times. It's your world to understand. Find out more at nytimes.com/yourworld.

我是《纽约时报》的迈克尔·比尔巴罗。这里是《每日新闻》。在周一晚间一场非同寻常的电视新闻发布会上，特朗普总统多次提出未经证实的医学建议，将自闭症与泰诺和儿童疫苗联系起来。今天，我的同事阿齐姆·格拉吉将探讨特朗普究竟声称了什么，数十年的科学研究实际告诉我们什么，以及总统现在造成的困惑。今天是9月23日，星期二。

From the New York Times, I'm Michael Bilbaro. This is The Daily. During an extraordinary televised news conference on Monday night, President Trump repeatedly gave out unproven medical advice that linked autism to Tylenol and childhood vaccines. Today, my colleague, Azim Gerajji, on what exactly Trump claimed, what decades of scientific research actually tells us, and the confusion that the president has now created. It's Tuesday, September 23.

阿齐安，感谢你抽空接受采访。在漫长的一天后，我们在晚上9点联系到你。

Azian, thank you for making time for us. After a very long day, we're reaching you at 9PM.

很高兴来到这里。谢谢

I'm happy to be here. Thanks for

邀请我。我认为很难夸大今天我们要讨论的这场新闻发布会有多么不寻常，有时甚至令人瞠目结舌，我是和你一起观看的。

having me. I think it's hard to overstate just how unusual and at times literally jaw dropping this news conference that we're gonna be talking about today was to watch, and I watched it alongside you.

是的。我想说的是，我从未见过这样的场景。总统表现得像个医生，但他说的很多话与我们已知的医学知识完全脱节。根据许多观看的医生的说法，这甚至可能很危险。所以这确实非常不寻常。

Yeah. I mean, I want to say that I've never seen anything like it. The president was acting like he was a doctor, but much of what he was saying was totally untethered from what we know from medicine. And it was potentially dangerous according to a lot of the doctors who watched it. So it was truly remarkable.

那么，我想请你先描述一下这次新闻发布会的背景。

Well, I wonder if you can start by just describing the context for this news conference.

对我来说，这要追溯到四月份，当时CDC公布了美国儿童自闭症患病率的最新数据。他们发现数字持续了长期增长的趋势，现在美国每31个孩子中就有一个被诊断为自闭症。这个数字比CDC在二月份刚开始收集数据时高出五倍。显然，这个消息令人担忧，尤其是对我们的新任卫生部长小罗伯特·肯尼迪来说，他的职业生涯中大部分时间都在关注自闭症，甚至多次将自闭症与疫苗联系起来。

So I think for me, this goes back to April when the CDC announced its latest data on the prevalence of autism among kids in The United States. And they found basically that the numbers had continued a really long running trend of increasing. That now one in thirty one kids in The United States have an autism diagnosis. And that number is five times higher than what the CDC found when it first started collecting this data in just February. So this is obviously news that is concerning, especially to our new health secretary, RFK Jr, who, you know, has spent much of his career focused on autism and even connecting autism repeatedly over his career to vaccines.

上任几个月后，他召开了这次大型新闻发布会，声称自闭症是一种流行病，而且完全可以预防。作为美国卫生部长，他的职责就是找出导致自闭症增加的原因。他承诺将在九月之前向美国公众公布这个问题的答案。

And months into his tenure, he holds this big press conference, where he says that autism is an epidemic and it is entirely preventable. And it is his job now as the health secretary of The United States to find out what is causing it to increase. And he promises that he will come to the American public with answers to that question by September.

有点随意地定在九月。

Somewhat arbitrarily by September.

是的。那些研究自闭症几十年的人对此非常怀疑，也很担忧，因为这个问题是许多人毕生研究的课题。而他能在五个月内拼凑出答案的想法让人有些不安。

Yeah. Which everyone who has been studying autism for decades was incredibly skeptical of this and pretty worried because this has been a question that people have been studying their entire careers. And the idea that he could whip something together in five months was a little concerning.

没错。但到了周一，正如承诺的那样，在九月，我们迎来了一场新闻发布会，肯尼迪也在场。但很快就能明显看出，特朗普总统将主导这场发布会。

Right. But here we were on Monday, as promised, by the September, and we get a news conference, and Kennedy is there. But right away, it's pretty clear that president Trump is going to be dominating this news conference.

是的。

Yes.

非常感谢。实际上，我等这次会议已经等了二十年。

Thank you very much. So I've been waiting for this meeting for twenty years, actually.

特朗普总统是会议的首位发言人。他算是开了个头，然后立刻就开始相当随意地即兴发挥。

President Trump is the first speaker at the conference. He kind of kicks things off, and he immediately starts riffing pretty wildly.

我听说了。我对自闭症及其成因一直有非常强烈的看法。我只是想提醒一下。在几个

I heard it. I always had very strong feelings about autism and how it happened. I just wanna flag. At several

特朗普演讲的关键时刻，他说了一些没有科学依据、甚至与科学相悖的话。因此，在讨论他所说的内容之后，我们将详细核实他的言论。

key moments in Trump's speech here, he says things that are not grounded in science, in fact, that science contradicts. And so we're going to fact check what he said in a lot of detail after we talk about what it is he said.

没错。所以他开始了新闻发布会。

Yeah. So he he starts off the press conference.

自闭症的急剧增加是历史上最令人担忧的公共卫生事件之一。前所未有。

Meteoric rise in autism is among the most alarming public health developments in history. There's never been anything like this.

他说，你知道，这是一场极其可怕的危机。然后很快，他就谈到了他认为导致这种情况上升的原因。

He says that, you know, this is a horrible, horrible crisis. And pretty quickly, gets to what he thinks is behind this rise.

立即生效，FDA将通知医生对乙酰氨基酚的使用。对乙酰氨基酚。这样可以吗？

Effective immediately, the FDA will be notifying physicians that the use of Acetaminophen. Acetaminophen. Is that okay?

也就是对乙酰氨基酚，这是一种非常常见的家用止痛药泰诺中的活性成分。

Which is Acetaminophen, the active ingredient in the very common household pain killer, Tylenol.

所以服用泰诺并不好。好吧。我直说吧，它不好。

So taking Tylenol is not good. Alright. I'll say it. It's not good.

他开始建立他所说的泰诺及其在孕期使用与儿童自闭症之间的明确联系。并且他反复强调

And he starts to establish what he says is a clear link between Tylenol and its use in pregnancy and autism in children. And he says repeatedly that

但是泰诺，别吃它。别吃它。

But with Tylenol, don't take it. Don't take it.

孕妇不应该服用这个。不要

Pregnant women should not take this Don't

服用泰诺。

take Tylenol.

他说，你知道的，别吃这个药。

He says, you know, don't take it.

拼命抵抗别吃它。咬牙挺住。也许到了某个时刻你不得不吃，那时你得自己权衡决定，所以别吃泰诺。医生还说了其他注意事项。

Fight like hell not to take it. Tough it out. There may be a point where you have to and that you'll you have to work out with yourself, so don't take Tylenol. Other things Doctor.

他确实给出了非常明确、非黑即白的警告，让孕妇远离唯一被推荐用于妊娠期的止痛药。

He's really giving explicit, very black and white warnings to pregnant women to stay away from the only pain killer really recommended for use in pregnancy.

这就是我的看法。长期以来我对这个立场非常坚定。要知道，生活也需要常识判断。

That's the way I feel. I've been very strong on this subject for a long time. You know, life is common sense too.

他还强调说，我嘛，你知道的，我不是医生。

And he's also saying, I'm, you know, I'm not a doctor.

这里面有很多常识性的道理。

And there's a lot of common sense in this.

这就是我的感受。我身后的那些人，RFK、Marty Makary，可能会不同意这一点，因为他们还在等待研究结果。

This is how I feel. The people behind me, RFK, Marty Makary, might disagree with this because they're waiting for the studies.

但我希望在推荐过程中能稍微加快一点速度，因为这样做并无害处。

But I'd like to be a little bit more a little speedier in the process of a recommendation because there's no harm in

但他却说，听我说。我是总统。这是我给你的医疗建议。

your But he's saying, listen to me. I'm the president. Here's my medical advice to you.

对我来说，为了接种疫苗去看医生四五次非常重要。

And it's so important to me to take see the doctor four times or five times for a vaccine.

然后他也开始谈论疫苗。

And then he starts talking about vaccines too.

分开注射。分开注射，因为液体太多，种类太多。

Just break it up. Break it up because it's too much liquid, too many different

他说，你知道，儿童免疫计划给孩子们注射了太多疫苗。

things He says that that, going into you know, the the childhood immunization schedule is loading up kids with too many vaccines.

这就像是80种不同的疫苗，甚至不止80种。

It's like 80 different vaccines and beyond vaccines and 80.

给婴儿注射太多不同的东西，这个数字太大了。

Too many different things going into babies are too big a number.

所以让这些疫苗分开接种。而乙肝是通过性传播的。

So let those be taken separately. And then hepatitis B is sexually transmitted.

他谈到了乙肝疫苗。

He talks about the hepatitis B vaccine.

没有理由给一个刚出生的婴儿接种乙肝疫苗。

There's no reason to give a baby that's almost just born hepatitis B.

你知道吗，他说这种疫苗不应该给12岁以下的儿童接种。他一直在说这个。

You know, and says that it shouldn't be given to children until they are 12. He goes on and on.

顺便说一下，我认为可以说有些人群不接种疫苗，也不服用任何药物，他们没有自闭症。

And by the way, I think I can say that there are certain groups of people that don't take vaccines and don't take any pills that have no autism.

他甚至还说，不接种疫苗的人不会得自闭症。

And he, you know, even says that people who don't get vaccinated don't get autism.

没错。他还举例说，比如阿米什人不接种疫苗所以不得自闭症，我亲自去核实了这个说法。我知道我们会在评论后核实事实。但这两个说法都不属实。不过我并不太在意。

Right. And he suggests that, for example, the Amish don't get vaccines and therefore don't get autism, which I went and fact checked myself. I know we're gonna fact check after we get these remarks. And and neither of those statements is true. But I'm not so careful.

是啊。

Yeah.

这些都不是真的。

They are not true.

还有其他那些小事，比如分散安排接种时间等等。我要感谢大家，今天是个非常重要的日子，非常感谢。

And do all those other things, little things, just spread out your visits, etcetera, etcetera, on the vaccine. And I wanna thank everybody. This is a very important day. Thank you very much.

美国国立卫生研究院和FDA的负责人，他们也会发表演讲，比特朗普简短克制得多。但最终都不同程度地质疑孕期服用泰诺的做法，并重申这可能存在风险，或许与自闭症有关。让我们放大视角，谈谈科学证实的事实。我们会全面分析特朗普的言论，但先从泰诺、孕妇和自闭症的问题说起。

AIDS who run the National Institutes of Health and the FDA, they give speeches of their own, much shorter, far more restrained than Trump. But, ultimately, they all cast some level of doubt on the practice of taking Tylenol during pregnancy and reaffirm the idea that it's risky, maybe linked to autism. So let's zoom out and talk about what we really know to be true and based on science. And we're gonna cover all of what Trump said, but let's start with the question of Tylenol, pregnant women, and autism.

是的。首先必须明确，目前没有任何研究表明孕期服用泰诺会导致儿童自闭症。我们看到的是部分研究显示泰诺与儿童自闭症存在正相关性。简单解释下...

Yeah. So first off, no study has shown that Tylenol use in pregnancy causes autism in children. I want to be very clear about that. What we have seen are some studies that have shown a positive association between Tylenol and childhood autism. And just explain

正向关联与因果关系之间的区别。

the distinction between a positive association and a cause.

是的。所以这是一种相关性。我们无法对孕妇进行随机对照试验。普遍认为这样做是不道德的。因此，研究人员必须做的是查看孕妇的数据，她们在怀孕期间做出的选择，她们的经历，并观察她们孩子的结果。

Yeah. So it's a correlation. We can't conduct randomized controlled trials on pregnant women. It is widely held to be unethical to do something like that. So what researchers have to do is look at data on pregnant women, the choices that they make during their pregnancies, the experiences that they have, and look at the outcomes in their children.

这些被称为观察性研究。观察性研究的问题在于，可能有很多其他因素在背后影响着我们在结果中看到的关系。事实上，我与一位流行病学家有过一次非常有趣的对话，他是一项研究的主要作者，RFK在这次新闻发布会上多次引用这项研究，因为他确实发现了孕期使用泰诺与自闭症之间的正向关联。而他实际上非常明确地警告不要从中得出任何因果结论。他举了夏季冰淇淋销量上升和暴力犯罪增加的例子。

These are called observational studies. And the problem with the observational studies is that there can be lots of other things going on that might be underlying the relationships that we end up seeing in the results. In fact, I had a really interesting conversation with an epidemiologist who was lead author on a study that RFK actually cited multiple times in this press conference because he did find a positive correlation between Tylenol use in pregnancy and autism. And he actually warned very explicitly against drawing any sort of causal conclusions here. He brought up the example of rising ice cream sales and rising violent crime in the summertime.

他说，你知道，假设冰淇淋销售导致暴力犯罪是错误的。实际上，导致这两者的原因是高温。因此，假设孕期使用泰诺实际上导致自闭症是错误的，当可能有其他潜在因素在起作用，比如母亲有哪些潜在的健康问题？她的遗传因素是什么？为什么她在怀孕期间反复服用泰诺？

And he said that, you know, it would be a mistake to assume that ice cream sales are causing violent crime. That actually the thing that's causing both of those things is the heat. So it would be a mistake to assume that Tylenol used during pregnancy is actually causing autism when there might be other underlying things at play like what underlying health issues does the mother have? What are her genetics? Why is she actually taking Tylenol repeatedly over the course of her pregnancy?

是为了治疗多次发烧吗？研究人员需要提出这类问题，才能真正在这些研究中区分因果关系。

Is it to treat multiple fevers? These are the sort of questions that researchers need to be asking to actually tease apart cause and effect in these studies.

换句话说，在那个冰淇淋销量和夏季暴力增加的比喻中，泰诺与自闭症增加的关系可能类似于冰淇淋销量或暴力增加，它可能不是真正的潜在原因。它可能不是高温。

In other words, in that metaphor of ice cream sales and violence going up in the summer, Tylenol's relationship to rising autism could be akin to either the ice cream sales or the violence going up, it may not be the real underlying cause. It may not be the heat.

对。完全正确。我们知道自闭症、多动症和其他神经发育障碍有很大的遗传成分。因此，一些研究人员试图在这些观察性研究中考虑这一点，实际上进行所谓的兄弟姐妹匹配对照。所以他们比较同一母亲所生的兄弟姐妹。

Right. Exactly. And we know that autism, ADHD, other neurodevelopmental disorders have a big genetic component. So there have been some researchers who have attempted to account for that in these observational studies and actually do what's called a sibling matched control. So they compare siblings born from the same mother.

当他们这样做时，会发现泰诺使用与自闭症之间的关联性实际上消失了。这表明，在这个情境中，遗传因素可能是关键。

And when they do that, they see that the relationship, that the correlation between Tylenol use and and autism actually goes away. So that suggests that, you know, the genetics might be the heat in this scenario.

但必须明确一点，当特朗普总统对美国及美国孕妇说‘不要服用泰诺’时——根据你的报道和你刚才描述的所有研究——这似乎完全不符合当前的科学依据。

But just to be very clear, when president Trump says to America and to America's pregnant women, do not take Tylenol. That does not, based on your reporting, based on all the research that you have just described, seem at all grounded in the current science.

是的，确实不符合。我认为

No. It's not. I think

总统还提出了另一个问题：‘不服泰诺有什么坏处？’他在记者会上多次询问这点，并暗示孕妇避免服用泰诺没有负面影响。关于这点研究怎么说？

something else the president raised was this question of, well, what's the downside of not taking Tylenol? He asked that a few times during this press conference, and he seemed to say there's no downside of pregnant women avoiding Tylenol. What does the research say about that?

没错。他实际上说的是‘咬牙忍忍’。但研究结果非常明确：孕期发烧对母亲和胎儿都有极大风险。事实上，记者会期间美国妇产科学院就发表声明强调，该组织认为对乙酰氨基酚（泰诺）是安全的。

Yeah. I mean, he actually says, you know, to tough it out. But the research on this is very clear. You know, fevers in pregnancy come at great risk to both the mother and the fetus. In fact, during the news conference, the American College of Obstetricians and Gynecologists issued a statement stressing that the organization considers acetaminophen safe.

他们指出，孕期使用对乙酰氨基酚治疗的病症远比任何理论风险更危险，可能对孕妇和胎儿造成严重发病率和死亡率。我咨询过的每位医生、每个今天回应此事的医疗团体都明确表示，孕期发烧绝不应放任不管。所以在这个问题上，不要听总统的。

And they said that the conditions people use acetaminophen to treat during pregnancy are far more dangerous than any theoretical risks and can create severe morbidity and mortality for the pregnant person and the fetus. You know, every doctor I spoke with, every medical group that, was responding to this issue today has made clear fevers are not things that should be left untreated during a pregnancy. So in this case, do not listen to the the president.

阿齐姆，我还想核实总统关于疫苗的说法。我们节目和《纽约时报》的报道多次证实，儿童疫苗与自闭症之间没有确凿关联。但特朗普仍坚持暗示存在联系，他特别针对——如你之前提到的——乙肝疫苗和麻腮风三联疫苗，这两种都是新生儿常规接种的疫苗。

I also, Azim, wanna fact check the president's claims about vaccines. It's been firmly established, and we've talked about it a lot on the show and throughout Times journalism, that there's no documented link between childhood vaccines and autism. But Trump insisted on suggesting that there was. He specifically targeted, as you mentioned earlier, the hepatitis B vaccines and the MMR vaccines. Both are extremely common vaccines given to newborns.

嗯，是的。目前没有任何数据表明麻疹、腮腺炎和风疹疫苗（MMR疫苗）或乙肝疫苗与儿童自闭症之间存在关联。而且，我们有三十年的研究证实了这一点。然而今天，我们又听到美国总统再次对疫苗表示怀疑。

Mhmm. Yeah. So there has been no data connecting the MMR vaccine, the vaccine against measles, mumps, and rubella, or connecting the hepatitis B vaccine to autism in children. And, you know, we have three decades of studies that have shown this. And yet today, we heard the president of The United States casting doubt on vaccines yet again.

没错。考虑到你刚才列举的情况——总统多次发表与医疗团体观点、现有科学研究相悖的强硬且具体的医疗建议，在某些情况下甚至直接传播错误信息。我们该如何理解他这种行为背后的动机？

Right. I mean, as in given everything you just walked through, the number of times that the president issued forceful and specific medical advice that contradicts what medical groups have said, what existing scientific research says, in some cases, the outright misinformation he put forward. What should our understanding be of why he would do this?

我认为这个问题涉及特朗普长期关注的几个核心叙事：他的反体制思维，比如'专家们早知道真相却隐瞒'、'制药公司靠你们家庭的痛苦牟利'，而他要充当真相揭露者。真正关键的是要注意特朗普及其健康顾问今天回避的内容——关于自闭症发病率上升的真实原因。这些科学解释不符合特朗普鼓吹的反体制叙事，而是与过去几十年自闭症定义和诊断标准的变化密切相关。

I think this question feeds into a lot of pet narratives that Trump is focused on all the time. You know, his anti establishment thinking, you know, the experts knew this and they were hiding this from you that, you know, the pharmaceutical companies have actually been profiting off of your family's pain and I'm gonna be the one to to be the truth teller in this situation. I think what's really important is to to look at what Trump and his health advisers on that stage today actually didn't say, which is what we do know about the causes behind the rise in autism. And those answers don't feed the sort of anti establishment narrative that Trump is seizing on here. Those answers have a lot more to do with how autism has been defined and diagnosed over the last several decades.

我们稍后继续。

We'll be right back.

我是托马斯·吉本斯内夫，《纽约时报》记者，曾在美国海军陆战队担任步兵。前线报道的许多基本原则与军事行动相通：你需要研究行进路线图。

My name is Thomas Gibbonsneft. I'm a journalist at The New York Times. I served in the Marine Corps as an infantryman. When it comes to reporting on the front line, a lot of the same basics are at play. You're looking at the map of where you're going.

无论柏油路还是野战道路，都要确认附近是否有医院，防弹衣是否配有急救包，每个人是否知道急救包位置。抵达军事据点后，我下车时——

If you're on a paved road, field roads, know, is there a hospital nearby? Is your body armor affixed with a first aid kit? Does everyone know where that first aid kit is? We arrive into a military position. I get out of the car.

会查看手表设定不超过一小时的计时，监听无人机和喷气机动静，与团队确认状态。只有当所有人都表示没问题，我们才会继续行动。

I look at my watch. You know, I set a timer no more than an hour. I'm listening for drones, jets, check-in with the team. Is everyone comfortable? And if they are, then we proceed.

前线报道充满危险，但我认为没有什么比直接接触当事人更重要——倾听他们的故事，并将这些故事传递给千里之外的读者。任何能让这类报道更具人情味的努力，在我看来都值得冒险。《纽约时报》的订阅者让我们得以持续进行这类重要报道。如需订阅，请访问nytimes.com/subscribe。

Frontline reporting is dangerous, but I think nothing is more important than talking to the people involved, you know, hearing their stories and being able to connect that with people thousands of miles away. Anything that can make something like this more personal, I think, is well worth the risk. New York Times subscribers make it possible for us to keep doing this vital coverage. If you'd like to subscribe, you can do that at nytimes.com/subscribe.

那么Azine，在休息前你提到自闭症发病率上升的一个重要已知原因是诊断标准的变化。请具体解释这一点，以及为何周一的新闻发布会没有提及这个因素。

So, Azine, right before the break, you mentioned that a big well understood cause of autism's rise is how it's been diagnosed. So just explain that and why that was not something mentioned in Monday's news conference.

是的。过去几十年来，我们对自闭症的定义范围已大幅扩展。自闭症过去仅指那些有严重功能障碍的幼儿，比如存在严重语言发育迟缓、无法说话、常伴有智力障碍且难以独立生活的人群。但随着时间推移，我们将症状较轻的人群也纳入了自闭症诊断范畴，并把包括阿斯伯格综合征在内的其他诊断归类到我们现在统称的自闭症谱系障碍之下。

Yeah. So over the last several decades, what we actually consider to be autism has broadened a lot. Autism used to only refer to young children who had really severe impairments, people with severe language delays or, you know, who couldn't speak or who often had intellectual disabilities and couldn't live or function really independently. But over time, we have brought in the diagnosis of autism to include people with much less severe impairments. And we've folded other diagnoses, including something called Asperger's under one umbrella that we now refer to as autism spectrum disorder.

这个谱系的一端是存在严重功能障碍的人群，另一端则可能是虽有社交沟通障碍但智力超群的人士。埃隆·马斯克就常被作为公开承认患有阿斯伯格综合征的典型案例提及。

So it's a spectrum from on the one end, people who really have these profound disabilities to on the other end, people who maybe have some social and communication challenges but might be even highly intelligent. You know, Elon Musk is always brought up as an example of someone who has spoken about having an Asperger's diagnosis.

这种更广泛的诊断标准、更大的自闭症谱系范围，在多大程度上解释了美国自闭症患者数量的激增——用特朗普的话说就是'爆炸式增长'？

And just how much is this broader diagnosis, this bigger spectrum of autism seen as accounting for the growth in autism in The US, this meteoric rise as Trump puts it?

这是增长的主要原因，但并非全部。美国疾控中心发布的数据显示，虽然重度自闭症（即功能障碍最严重的儿童）的确诊数量在过去几十年略有上升，但所谓'高功能'儿童的确诊增速实际上要快得多。这显然是我们目前看到的自闭症诊断数量激增的重要推手。

It is a lot of the rise, but it is not the whole thing. The CDC has actually published data showing that while the number of diagnoses of kids with profound autism, so those are the kids with the most severe impairments, that those diagnoses have increased a little bit over the last couple decades, The increase in diagnosis among kids who are quote unquote higher functioning is actually increasing a lot more quickly. So that seems to be very clearly a big driver in the increased diagnoses that we're seeing in

这个

this

国家。然而，与我交谈过的每位研究者都表示，这并非唯一的原因。目前我们已经识别出数百个与自闭症相关的基因，知道这些基因会相互影响，同时也以某种方式与环境相互作用。

country. However, every researcher I've spoken to has said that that is not the only thing that is going on here. We've identified now hundreds of genes that are associated with autism. We know that those genes interact with each other. We also know that they interact in some way with the environment.

至于环境因素可能产生的影响，我们有证据表明某些因素确实在起作用。空气污染是其中之一。已知某些有毒化学物质会与基因互动并导致自闭症发病率上升。另一个非常明确的因素是高龄生育，随着人们推迟生育年龄，这种现象越来越普遍。所有这些因素都有关联，但仍有许多未知领域。

And in terms of what environmental factors could be doing that, we have some evidence of things that are definitely playing a role. Air pollution is one. We know certain toxic chemicals interact with genes and contribute to a rise in autism. A very clear other factor is people having children later in life, which we know is happening more and more as people delay having kids. So all of those things are linked, but there's still a lot we don't know.

科学家们总是最先承认，环境中极有可能存在我们尚未发现的其他风险因素。

And scientists are always gonna be the first to say that it's very, very possible that there are other risks out there in the environment that we don't know about yet.

但如果我们确实知道自闭症诊断标准的扩大是发病率上升的重要因素。虽然你提到了其他潜在因素，但这点似乎无可争议。为什么卫生部长或总统不在新闻发布会上重点讨论这个问题？

But if we do know that this expanded diagnosis of autism is a pretty big factor in the rise in autism. I know you mentioned other potential factors, but this one seems kind of indisputable. Why wouldn't the health secretary or the president focus on that in this news conference?

是的。实际上RFK此前一直淡化诊断标准对美国自闭症发病率增长的影响。我们之前讨论过，这个解释背后没有阴暗的制药公司操纵，也没有专家向公众隐瞒真相。坦白说，这个答案更偏向乏味的程序性解释。

Yeah. I mean, RFK has actually been pretty dismissive of the role of diagnosis and increasing incidence of autism in The US before. I mean, we talked about this earlier, but it is not an answer that has a shadowy pharmaceutical company behind it. It is not an answer that has, you know, experts concealing things from the public. It's a lot more boring and procedural, frankly.

我理解你的意思是，像特朗普总统、小RK这样的人更喜欢'银弹理论'，即'有人害了你'的阴谋论。而医学界过去25年对自闭症更广泛的诊断标准不符合这种叙事。现在我想回到周一的新闻发布会，既然总统在缺乏因果关系证据的情况下如此强调泰诺的作用，接下来会发生什么？总统及其团队已开始根据这种所谓的关联拟定一系列行动计划。

What I hear you basically saying is that people like president Trump, people like RK junior, prefer the silver bullet theory, the somebody did you wrong theory. And a broader diagnosis by the medical community of autism over the past twenty five years doesn't fit into that. I wanna return now to Monday's news conference and what happens next. Now that the president is putting so much weight on Tylenol despite any evidence of causality when it comes to autism. The president and those around him started to outline a series of actions that would seem to flow from that alleged link.

所以请你为我们梳理下后续发展。

And so I want you to walk us through what comes now.

从今天的新闻发布会来看，他们宣布了四项措施来应对美国的自闭症问题。首先，RFK表示FDA将启动程序，为对乙酰氨基酚（扑热息痛）添加新标签。预计这将是类似警告标签的内容，提醒患者可能存在这种关联性。FDA今天还向全美医生发了一封信，说明孕期使用对乙酰氨基酚与自闭症之间的潜在联系。值得注意的是，这封信的措辞比总统的言论要谨慎得多。

So coming out of today's press conference, they announced four actions that they were gonna take to address autism in The United States. The first thing that they do is RFK says that the FDA is going to be initiating the process to put a new label on acetaminophen. So presumably, this will be something like a warning label on Tylenol to warn patients that there is this possibility of a link. The FDA also sent a letter to doctors across The US today about the possible link between acetaminophen use during pregnancy and autism. Really interestingly, they were far more measured, in this letter than the president's remarks.

信中非常明确地指出，因果关系尚未确立，并表示这是科学界持续讨论的议题。尽管如此，他们仍建议医生告知患者存在这种可能性，并提醒除非高烧情况，否则不应服用泰诺。

The letter says really explicitly that, you know, a causal relationship has not been established and they say that the matter is an ongoing area of scientific debate. But nevertheless, they still urge doctors to warn patients that there is the possibility of this link and that they shouldn't take Tylenol except in the case of high fevers.

没错。这和总统直接说'怀孕期间不要服用泰诺'截然不同。

Right. Very different than the president saying do not take Tylenol when you're pregnant.

是的，完全不同。第三项措施是FDA宣布将批准一种自闭症新疗法——名为Leukavorin的药物。这是一种基于B族维生素的药物，在极小规模研究中显示出效果。

Yes. Very different. And then the third thing that they did was that the FDA announced that it was going to be approving a new treatment for autism. It is this drug called Leukavorin. It is a b vitamin based drug and it has shown in very small studies.

我们说的是每个试验只有几十名参与者的情况下，该药物可能对自闭症儿童有积极益处，比如改善交流能力等。但在如此有限的数据支持下就推动批准，这种做法非常反常。

So we're talking about, you know, just dozens of participants in each that it could have some positive benefits for children with autism. So improving communication, things like that. But this is very unusual for them to be pushing through an approval like this, you know, with so little data to back it.

你对此怎么看？

And what do you make of that?

这种药物仅在几十人身上测试过，现在政府却想在如此重大的平台上公开背书，批准其作为自闭症治疗手段。

That this drug has only been tested in dozens of people, and yet now the government wants to approve it for use as a treatment for autism and is talking about it and endorsing it on such a giant platform.

是的。我认为这无疑是在向人们传递一个信号，即这可能会带来治愈的希望。而那些真正在研究亚叶酸钙作为潜在治疗方法的科学家们，他们最先表明我们的发现还处于非常早期的阶段。这些发现虽然充满希望，但还远未达到联邦政府推动FDA药物审批的程度。最后，他们宣布已确定了5000万美元新联邦拨款的受赠者，这些资金将用于研究自闭症的成因。

Yeah. I mean, I think it it is absolutely projecting to people that this is possibly going to lead to a cure. And the scientists who are actually researching leucovorin as a possible treatment, they are the first to say like our findings are really early days. You know, they are promising, but this is not something that should be at the level of the federal government pushing through a drug approval of the FDA. And the last thing is that they announced that they had determined the recipients of, you know, $50,000,000 of new federal grants that would be used to study the causes of autism.

而且，这是个复杂的情况。确实有合法研究者获得了这笔资金，我们将深入研究遗传学与环境之间的相互作用。但RFK也明确表示，尽管已有大量研究未能证明疫苗与自闭症发展之间存在联系，他们仍将再次探讨这种可能性。

And, it's this mixed bag. There are absolutely legitimate researchers who have received this funding. We're gonna be looking into the genetics and the interplay with the environment. But RFK also made clear that they're also going to be looking again, despite the many, many studies that have failed to show a link at the possibility that vaccines play a role in development of autism.

我们应该如何看待周一发生的事情？一方面，白宫正在为自闭症患者提供支持，以或许前所未有的方式提升了对自闭症的重视。但尤其是特朗普的做法，似乎在某些情况下完全测试甚至超出了我们认为负责任的公共卫生行为的界限。为了强调这一点，我们的同事克里斯蒂娜·朱厄特收到了纽约大学医学院（纽约一所相当知名的医学院）医学伦理负责人的电子邮件。

I mean, how should we think about what happened on Monday? On the one hand, the White House is giving people with autism something. They're elevating autism in a way perhaps no administration has ever done before. But the way, especially Trump did that, seems to absolutely test and, in a few cases, absolutely exceed the bounds of what we think of as responsible public health. And just to put a point on that, our colleague, Christina Jewett, got an email from the head of medical ethics at NYU's medical school, pretty prestigious medical school here in New York.

在观看了这次新闻发布会后，他给她写了这样的话：引用，‘关于自闭症的公告是我所见过的权威人士声称了解科学的最悲哀的展示——缺乏证据、谣言、循环旧神话、赤裸裸的谎言和危险建议的集合。’那么，我们该如何看待这与特朗普政府可能认为是在为自闭症家庭提供答案的行为之间的对比？

And after watching this news conference, this is what he wrote to her. Quote, the announcement on autism was the saddest display of a lack of evidence, rumors, recycling old myths, outright lies, and dangerous advice I have ever witnessed by anyone in authority in the world claiming to know anything about science. So how should we think about that stacked up against what may be what the Trump administration thinks is providing an answer to families with autism?

我在进行这项报道的过程中与许多自闭症患者及其家庭交谈过，自闭症群体并非铁板一块。有些人从头到尾都认为RFK的行为是有害的。但我也与那些孩子有最严重障碍的父母交谈过，他们明确表示对RFK及当前美国自闭症状况感到非常矛盾。他们非常感激他关注自闭症、投入研究资金寻找原因并谈论他们的经历，但他们也非常挣扎并担忧这些行为伴随着已被证明是错误的关于自闭症的理论的循环。

I mean, I have spoken to many autistic people, many families of autistic people in the process of doing this reporting, and the autistic community is not a monolith. There are people who are viewing what RFK is doing and from beginning to end see it as harmful. But then I've spoken with the parents of kids with the most severe impairments, and they have really made clear that they're so torn about RFK and and this moment for autism in this country. They absolutely appreciate that he is spotlighting autism, that he's throwing research money to find out the causes, that he is talking about their experience. But they really, really struggle with and are really worried about the fact that that comes with recycling these theories about autism that have been just proven to be false.

这还伴随着更多针对孕妇的恐吓，以至于如果她们确实有一个自闭症孩子，她们可能会认为是自己在怀孕期间做了什么，是她们的错，是她们没有坚持到底。他们看到RFK和特朗普这样做，却不知如何应对。他们感激这种关注，但真的担心这种关注可能带来的后果。

That it comes with a lot more fear mongering directed towards pregnant women so that, you know, if they do have a child with autism that they somehow think that it was something they did during pregnancy, that it was their fault, that, you know, they didn't tough it out. They see RFK and Trump doing that, and they they kinda don't know what to do with it. They appreciate the focus, and they really struggle with what the consequences of what that focus might be.

好的，我明白了。非常感谢。我们很感激。

Well, I was in. Thank you very much. We appreciate it.

谢谢，迈克尔。

Thanks, Michael.

我们马上回来。

We'll be right back.

以下是今天你还需要知道的其他消息。周一，ABC电视台表示，尽管深夜节目主持人吉米·坎摩尔对查理·柯克遇刺事件的言论引发保守派的强烈抗议，他仍将于今晚起重返荧屏。这一逆转发生在好莱坞工会及数百名演员导演谴责ABC的决定是对言论自由的背叛之后。但至少ABC电视台的主要所有者之一辛克莱广播集团表示不会播放坎摩尔的节目，将用新闻取而代之。本期节目由亚历克斯·斯特恩、妮娜·费尔德曼和罗布·齐普科在亚历山德拉·李·杨的协助下制作完成。

Here's what else you need to know today. On Monday, ABC said that the late night host Jimmy Kimmel would return to its airwaves beginning tonight despite the fierce outcry from conservatives over his comments about the assassination of Charlie Kirk. The reversal came after Hollywood unions and hundreds of actors and directors condemned ABC's decision as a betrayal of free speech. But at least one major owner of ABC stations, the Sinclair Broadcast Group, said that it would not run Kimmel's show and would instead replace it with news. Today's episode was produced by Alex Stern, Nina Feldman, and Rob Zipko with help from Alexandra Lee Young.

由莉兹·O·巴林和迈克尔·伯努瓦编辑，阿丽莎·莫克斯利负责技术制作。以上就是本期《每日新闻》的全部内容。我是迈克尔·比拉尔，明天见。

It was edited by Liz O. Balin and Michael Benoit and was engineered by Alyssa Moxley. That's it for The Daily. I'm Michael Bilal. See you tomorrow.