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How Progress Makes Us Sick 人类进步如何使得我们无法摆脱病魔

已有 934 次阅读2009-5-8 11:46 |

How Progress Makes Us Sick


Geoffrey Cowley



Advances that make life more comfortable can also make it more dangerous.


[1] SARS [= Severe Acute Respiratory Syndrome] may have dominated the headlines last week [in May,2003], but it wasn’t the only weird disease on the World Health Organization’s radar screen. 上周[原文中指2003年5月],非典可能占据了各家报纸的头版头条, 然而,它并非世界卫生组织所监测到的惟一怪病。In central Africa, an outbreak of the dreaded Ebola fever had stretched into its fifth month. 在非洲中部,爆发了致命的埃博拉出血热,并已持续了5个月;In Belgium and the Netherlands, a virulent new strain of avian flu was wiping out entire chicken farms. 在比利时和荷兰,一种新的恶性的禽流感病毒株系席卷了所有的养鸡场。Dutch farmers recently slaughtered 18 million birds in hopes of stopping the outbreak. 为阻止该病的爆发,荷兰的农场主最近宰杀了1800万只家禽。Yet the bird flu has spread to several provinces and jumped from poultry to pigs and even people, causing 83 human cases. 然而, 禽流感已蔓延到几个省,并已从家禽传染到猪,甚至人也受到传,目前已有83人发病。 Most of the infected people have suffered only eye inflammation, but some have developed respiratory illness. 大多受感染的病人只是眼睛发炎,但有些人还并发呼吸系统疾病。One of them, a 57 year old veterinary surgeon, recently died of pneumonia. 其中一位受感染者是一名五十七岁的老兽医,他最近死于肺炎。 “Bird flu virus was ... found in the lungs,” according to an April 19 statement from the Dutch Agriculture Ministry, “and no other cause of death could be detected.” 据荷兰农业部(2003年)4月19日的报告称,“在死者肺部发现了禽流感病毒,但并未查出任何其他致死病因。”Sound familiar? 这种说法听起来很耳熟,不是吗?
     [2] SARS. Ebola. Avian flu. 非典,埃博拉出血热,禽流感。The parade of frightening new maladies continues, each one confirming that our species, for all its cleverness, still lives at the mercy of the microbe. 可怕的新病层出不穷。而每种疾病都证实:尽管人类极其聪明,却仍处于微生物的摆布之中。It didn’t seem that way 30 years ago — not with smallpox largely defeated, AIDS still undreamed of and medical science evolving at an unprecedented clip. 三十年前人们并不这样认为。原因在于:当时天花已基本灭绝,“艾滋病”还闻所未闻,而医学也正以前所未有的速度在发展。But even as optimists proclaimed victory over the germ, our megacities, factory, farms, jet planes and blood banks were opening broad new avenues for infection. 然而,正当乐观派宣告我人类们战胜了细菌之时,我们的大都市,工厂,农场,喷气式飞机,以及血库,却在为疾病传染开辟新的渠道。The dark side of progress is now unmistakable: many of the advances that have made our lives more comfortable have also made them more dangerous. 现在看来,社会进步所带来的负面影响是千真万确的了:许多方面的进步使我们生活得更加舒适,但同时也使我们的生活更加危险。Some 30 new diseases have cropped up since the mid 1970s — causing tens of millions of deaths — and forgotten scourges have resurfaced with alarming regularity. 20世纪70年代以来,已出现了大约30种疾病,夺走了千千万万人的生命。 而现在,那些已被遗忘的种种灾难又正在以惊人的规律性卷土重来。“Infectious diseases will continue to emerge,” the Institute of Medicine declares in a new report, warning that complacency and inaction could lead to a “catastrophic storm” of contagion. 医疗学会在一份新的报告中宣称“传染病将会继续出现,”该报告还警告说,安于现状和无动于衷将会导致传染病的“灾难性风暴”。So what’s to be done? 那么,该采取什么措施呢? As the SARS outbreak has shown, surveillance is critical. 正如非典突发所表明的那样,监控至关重要。By spotting new infections wherever they occur, and working globally to contain them, we can greatly reduce their impact. 不管一些新的传染病在何处发生,只要通过及时发现病源,并全球通力合作去控制它们,我们就能极大地削弱它们的影响力。But is preparedness our ultimate weapon? 但是,做好防备就是我们的上上策了吗?Do we know enough about the genesis of new diseases to prevent them? 我们是否对新疾病的起源有足够的了解以便控制它们? Could we avert the next SARS? 我们能否避免另一种像非典那样的新疾病的爆发? The next AIDS? 我们能避免另一种像艾滋病那样的新疾病的爆发吗?What would a reasonable strategy look like? 明智的应对方案应该是什么样子?
     [3] We don’t hold all the cards in this game. 在对付传染病的战斗中我们并没有绝对的优势可言。Most new diseases begin when a person catches something from an animal — a transaction shaped by chance or even the weather. 大多数新的疾病源于人从动物身上所感染的某种病毒 —— 这种传染是偶然的,甚至是由天气所致。When healthy young adults started dying of a SARS like syndrome in New Mexico 10 years ago, it took health experts several weeks of intensive lab work to identify the culprit. 十年前,当新墨西哥州健康的年轻人开始死于类似非典的症状时,医疗卫生专家在实验室中深入研究了几周才找到病因。To the scientists’ amazement, it wasn’t a human pathogen at all. 令科学家们惊讶的是:它根本不是人类的病原体。It was a novel member of the hantavirus family, a group of rodent viruses that sometimes spread through the air after rats or mice shed them in their urine. 这是汉坦病毒类群中的一种新类型。汉坦病毒是一组啮齿动物病毒,由田鼠或老鼠从尿里排出,有时通过空气传播开来。The previous outbreaks had occurred in Asia. 以前曾在亚洲多次爆发。So why were people dying in New Mexico? 那么,为什么在美国的新墨西哥州会有人死亡呢? Scientists now believe the American mice had harbored the virus all along but had never been populous enough to scatter infectious doses in people’s tool sheds and basements. 科学家们现在认为, 病毒一直就潜伏在美洲的老鼠身上, 但其数量还没多到能在工具房和地下室里传染给人类的程度。What changed the equation that year was El Nino. 那年是厄尔尼诺现象打破了这种平衡。The ocean disturbance causes an unusually warm winter in the Southwest. 海洋洋流的异常导致了美国西南地区非同寻常的暖冬天气。 The mouse population exploded as a result—and the hantavirus got a free ride. 结果,老鼠数量激增,从而导致汉坦病毒趁势泛滥成灾。
     [4] Until someone harnesses the jet stream, such accidents are sure to happen. 除非人类能控制海洋洋流,否则此类事件肯定还会发生。But quirky weather isn’t the greatest threat we face. 然而,异常的天气并非我们面临的最大威胁。 As ecologists study the causes of disease emergence, they’re finding that human enterprise is a far more significant force. 当生态学家们研究疾病发生的原因时, 他们发现人类活动的作用显得更为重要。Almost any activity that disrupts a natural environment can enhance the mobility of disease causing microbes. 几乎任何一种破坏生态平衡的行为都能增强致病细菌的活动性。 Consider what happened in the 1980s, when farmers in Venezuela’s Portuguesa state cleared millions of acres of forest to create cropland. 想一想在20世纪80年代所发生的事吧:当时委内瑞拉波图格萨州的农民砍伐了几百万英亩森林来开辟出农田。The farms drew as many rats and mice as people, and the rodents introduced a deadly new virus into the region. 农场吸引来了很多人,而同样多的大小老鼠也接踵而来。这些老鼠把一种新的致命的病毒带到了这个地区。The so-called Guanarito virus causes fever, shock and hemorrhaging. 被称之为瓜纳瑞托的病毒引起发热,休克和出血。It infected more than 100 people, leaving a third of them dead. 有一百多人被传染,其中1/3的人死亡。
     [5] Malaysian pig farmers had a similar experience in 1999, after they started pushing back the forest to expand their operations. 1999年, 当马来西亚养猪场的场主们为扩大养猪业而砍伐森林以后, 他们也曾有过类似的经历。As barns replaced forestland, displaced fruit bats started living in the rafters, bombarding the pigs’ drinking water with a pathogen now known as the Nipah virus. 猪舍取代了森林以后,无处安身的狐蝠开始栖身到猪舍屋椽上, 并以大量的致病菌污染了猪的饮用水。这种病毒就是现在所知的尼巴病毒。“The pigs developed an explosive cough that became known as the one mile cough because you could hear it from so far away,” says Mary Pearl, president of the Wildlife Trust in Palisades, N.Y. 纽约州巴利塞得的保护野生动物基金组织主席马利普尔说,“猪群中当时爆发了一种严重的咳嗽。 像爆炸一样的咳嗽声大得使人在相隔一英里处都可听到,因此得名‘一英里咳’。”The virus soon spread from the pigs to their keepers, causing extreme brain inflammation and killing 40 percent of the affected people. 病毒迅速由猪传染给了饲养员,引起了严重的大脑炎,感染的人群中有40%丧命。The outbreak ended when Malaysian authorities closed eight farms and slaughtered a million pigs. 马来西亚政府封闭了8个养猪场,宰杀了100万头猪后,流行病才停止蔓延。


[6] The point is not that rain forests are dangerous.问题的关键并不在于雨林本身的危险性。It’s that blindly rearranging ecosystems can be hazardous to our health — whether we’re in the Amazon Basin or the woods of Connecticut. 无论我们是在亚马孙河流域还是在美国的康涅狄格州的林地,关键问题是,盲目改变生态系统会对我们健康造成威胁。That’s where Lyme disease emerged, and it, too, is a product of the way we use our land.,而康涅狄格州的林地正是莱姆病的发生地。疾病的起因还是因为我们使用土地的方式不当。Borrelia burgdorferi, the bacterium that causes Lyme, lives in the bodies of deer and white footed mice, passing between those animals in the heads of biting ticks. 莱姆病的致病菌伯氏舒螺旋体寄生在鹿和白爪鼠体内,通过吸血虱的头部在这类动物当中传播。People have crossed paths with all these critters for generations, yet the first known case of Lyme disease dates back only to 1975. 人类世世代代与这些动物接触,但直到1975年才发生第一例莱姆病病例。Why did we suddenly become vulnerable? 为什么我们突然变得如此脆弱了呢?Richard Ostfeld, an animal ecologist at the Institute of Ecosystem Studies in Millbrook, N.Y., has tied the event to suburban development. 纽约州密尔布鲁克生态系统研究所的一位动物生态学家里查德·奥思特菲尔德把该病和城市向郊外扩张联系了起来。In open woodlands, foxes and bobcats keep a lid on the Lyme agent by hunting the mice that carry it. 在开阔的林地里,狐狸和美洲野猫捕食携带病菌的老鼠,从而起到了阻止疾病传播的作用。But the predators vanish when developers chop woodlands into subdivisions, and the mice and their ticks proliferate unnaturally. 但是,当郊区开发者将大片林地砍伐成小片林地时,老鼠的天敌随之消失,结果老鼠和其身上的虱子就泛滥成灾。In a recent survey of woodlots in New York, Ostfeld found that infected ticks were some seven times as prevalent on one? and two?acre lots as they were on lots of 10 to 15 acres. 最近,奥思特菲尔德在对纽约的林地调查中发现,携带病菌的虱子在1~2英亩林地上的数量大约是10~15英亩林地上的7倍。His bottom line: “You’re more likely to get Lyme disease in Scarsdale than the Catskills.” 他的基本论点是:“你在斯卡斯代尔[郊区小片林地]比在卡茨基尔山[大片林地]更容易得莱姆病。”

     [7] Fortunately, you’re not likely to spread it in either place. 所幸的是,无论在哪一个地方,人们都不会把莱姆病传给别人。Even when a microbe succeeds at leaping from one species to another, the new host is often a dead end. 即使病菌从一个物种传染到另一物种,新的病菌携带者基本不会继续传染给别人了。Neither Nipah nor Guanarito can spread from person to person. 尼巴病毒和瓜纳瑞托病毒都不会在人群中传播。The hantaviruses have the same problem. 汉坦病毒也一样。And a tick could suck on a Lyme disease patient all day without getting enough bacteria to infect its next host. 一个虱子可以在一个莱姆病人身上吸一整天的血也不能获得足够的病菌去感染下一个人。The infections we get from primates and pigs are a whole different story. 而我们从灵长类动物和猪那里传染来的疾病则情况完全不同。When the Ebola virus jumps from an ape into a person, it often races through a family or a hospital before burning itself out. 当埃博拉病毒从猿传到人,在它失去活力之前,往往会在短期内迅速感染病人全家或整个医院。And HIV is still spreading steadily after three decades of person to person transmission. 在人群中传染了30年后,HIV(人体免疫缺陷病毒即艾滋病病毒)如今仍然在人群中持续传染。It has infected some 60 million people since crossing over from chimpanzees, and its emergence was no fluke of the weather. 艾滋病病毒从黑猩猩传染给人后, 已有大约6000万人受到感染。而艾滋病的出现却并非因为气候异常。We placed ourselves in the path of the virus, we moved it around the world, and we’re well poised to do it again. 相反,是我们人类自身将自己置身在了病毒的传播途径中,并把它传遍了全世界。而如今,我们似乎还要泰然自若地一而再、再而三地重复这一过程。

     [8] The human AIDS viruses are descended from simian pathogens known as SIVS. 人类艾滋病病毒来源于叫做SIVS 的猴子致病菌。HIV-1 is essentially a chimpanzee virus, while HIV-2 (a rarer and milder bug) comes from the sooty mangabey ( a monkey). HIV-1本质上是一种黑猩猩病毒,而HIV-2则是一种少见的,而且毒性也小一些的病毒,来自白眉猴。How did the chimp virus make its way into humans? 那么,黑猩猩病毒又是怎样传染给人类的呢?The best guess is that African hunters contracted it while butchering animals, and then passed it on through sexual contact. 很有可能是非洲的猎人在捕杀黑猩猩的时候被感染的,然后通过性接触传给别人。Until a few decades ago, that hunting accident would have been a local misfortune, a curse played out in a few rural villages. 几十年前,这类捕猎时的偶发传染还只是一种地方性的不幸,在当地的一些农村里引发了祸患。What turned it into a holocaust was not just a new infectious agent but a proliferation of roads, cities and airports, a breakdown of social traditions, and the advent of blood banking and needle sharing. 把这种小范围传染变成全球杀手的并非是一种新的传染媒介,而是剧增的道路,城市和机场,社会传统习俗的破坏,血库的使用,以及注射器的共用。Those conditions virtually sealed HIV’s success, and they continue to rocket obscure bugs into every corner of the world. 这些条件实际上注定了HIV的成功传播,而它们还正持续不断地把我们还不确知的其他病菌飞速送到地球的每一个角落。“The volume and speed of travel are unprecedented,” says Dr Mary Wilson of Harvard. “We are interconnected in ways that weren’t true a century ago.” “游客的数量和旅游的速度都达到历史最高水平。”哈佛大学的马利威尔孙博士说,“如今人们相互交往联系的方式是一个世纪前无法想象的。”

     [9] SARS is only the latest reminder of how powerful those connections can be. 非典再一次提醒我们这种密切联系的威力有多大。The novel coronavirus that causes the syndrome emerged from Guangdong, the same Chinese province that delivers new flu viruses to the world most years. 新的致病的冠状病毒源于广东。这一中国省份常常向全球传播流感病毒。Pigs, ducks, chickens and people live cheek by jowl on the district’s primitive farms, exchanging flu and cold germs so rapidly that a single pig can easily incubate human and avian viruses simultaneously. 在那个地区的原始农场,猪,鸭,鸡和人亲密地生活在一起,导致流感和感冒病毒的交叉感染非常迅速,以至于在一头猪身上就能很轻易地同时培育出人类病毒和禽流感病毒。The dual infections can generate hybrids that escape antibodies aimed at the originals, setting off a whole new chain of human infection. 这样的双重感染会产生病毒的杂种,导致针对原来病毒的抗体无效, 从而就引发了了一轮全新的人际感染。The clincher is that these farms sit just a few miles from Guangzhou, a teeming city that mixes people, animals and microbes from the countryside with travelers from around the world. 关键是这些农场距广州市只有几英里。这座热闹的城市把南来北往的人群,来自农村的动物和细菌与来自世界各地的游客混杂在一起。You could hardly design a better system for turning small outbreaks into big ones.要想把一个小规模发病演变成大规模疾病爆发,几乎再也想不出比广州更好的环境了。

     [10] For all the fear it has caused, SARS clearly isn’t the big one, at least not in its current incarnation. 尽管非典带来异常恐慌,它显然不是大恐慌,至少从它目前的情况看。The coronavirus that causes it is as nasty as any flu virus, but it doesn’t get around very easily. 引发非典的冠状病毒和流感病毒同样可怕,但它并不太容易传染。And as University of Louisville evolutionist Paul Ewald points out, an epidemic can’t sustain itself unless each patient infects more than one other person. 正象路易威尔大学的进化学家保罗埃威尔德指出的那样, 除非每个病人传染的人数超过一人, 否则这种流行病就流行不下去。“If each SARS case were generating even two others,” he says, “we would have seen hundreds of thousands by now.” “倘若一个非典病人会传染两个人,” 他指出,“我们现在就会看到几十万的患者了。”A doomsday flu virus would approach the virulence of the SARS agent, but it would infect people by the roomful. 一种致命的流感病毒会具有和非典病毒相当的毒性,但它所感染的人却是成批成批的。

     [11] Such pandemic flu viruses have emerged in the past, and many experts believe it’s only a matter of time until it happens again. 过去就有过这类大范围流行的流感病毒,许多专家们认为迟早还要再次爆发。How can we lessen the danger? 我们怎样减少这种危险呢?A long term strategy would have to include modernizing the world’s farms, improving basic health care and stockpiling vaccines and antiviral drugs. 长期的战略应包括实现全球农场的现代化,改善基本的卫生保健,以及储备疫苗和抗病毒药物。As science illuminates the ecology of infectious disease, it may also inspire wiser, safer approaches to land use and wilderness preservation. 科学已经为我们揭示了传染病的生态学,科学照样可以激发我们明智、安全地使用土地和维护生态平衡。Until then, surveillance will be doubly important. 只有到了这一刻,监控才显得更为重要。The good news is that the forces making microbes so mobile are also making them easier to track. 好在使病毒能快速传播的各种因素现在同样也能使我们更易于找到疾病的病因。Ten years ago, quick communication was still a problem for many health departments, says Stephen Morse, director of the Center for Public Health Preparedness at Columbia University’s Mailman School of Public Health. 十年前, 许多卫生部门还不能进行快速的信息交流,哥伦比亚大学公卫邮电学院的公共卫生预防中心主任斯缔芬莫丝说。“A colleague in Russia had a fax but no fax paper. “在俄罗斯的同事有传真机,却没有传真用纸。A colleague in Ghana had telex but no fax. 在加纳共和国的同事有电传机,但没有传真机。In other places they had a telephone but no telex.”其他地方的人有电话可没有电传机。”Today even the most remote surveillance stations are tied into the Web based Program for Monitoring Emerging Diseases. 如今,甚至处于最边远的监控站也使用联网的程序监视正在出现的疾病。 The world’s largest health agencies have created similar systems for sharing scientific research. 世界上最大的一些卫生机构已经创建了相似的网络系统以分享科研成果。Such systems are only as good as the openness and good will of their users. 这种系统只有当人们显示出他们的坦诚和善意才能发挥作用。If anything good has come of the SARS scare, it is a renewed commitment to those ideals. 如果说非典带来的恐慌有什么积极作用的话,那就是人们再次承诺一定要实现上述的那些理想。How far they’ll take us is still anyone’s guess. 究竟要多久才能兑现仍然是个未知数。

[from Newsweek, May, 2003](赵拴科 翻译摘自美国《新闻周刊》2003年5月号)






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