历史上你所不知道的流感大流行

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历史上你所不知道的流感大流行

Lessons Found in History of Flu Pandemics


只要回顾一下令人恐惧的致命流感大流行,以及没有形成大流行的可怕流感疫情那难以置信不可预测的历史,就能理解为什么政府部门对于迅速发展的猪流感危机的反应时而胆大敢为,时而谨慎小心了。


To understand the sometimes bold, sometimes nervous governmental reactions to the rapidly growing swine flu crisis, one need only look at the incredibly unpredictable history of horrifically deadly flu pandemics and the frightening outbreaks that did not become pandemics.


传染病、瘟疫和鼠疫困扰着整个人类历史。近日里,我们应对猪流感所采取的策略就吸取了现代流感疫情及其大流行的历史教训。这段历史中发生的大事件可以追溯到1918年。Pandemics, plagues and pestilence have beset humans throughout history. But the strategy and response to swine flu unfolding in recent days is rooted in what has been learned from modern flu outbreaks and pandemics going back to the colossal 1918 event.


过去几年里人类体内出现的几种新型流感病毒(包括上世纪九十年代末期出现的H5N1“禽流感”病毒)表明,研究人员每年都面临着设法追踪、控制迅速演变的流感病毒,并研制新的流感疫苗的挑战。The appearance of several new flu strains in humans over the past few years — including the H5N1 "avian flu" strain in the late 1990s — illustrates the challenges faced annually by researchers trying to track, contain and develop vaccines for the fast-evolving virus known as influenza.


1918:“西班牙流感”H1N1大流行 1918: "Spanish flu" H1N1 Pandemic


最具破坏性的现代流感大流行,导致五十万美国人以及大约全球五千万人丧生,大约有20%至40%的世界人口受到感染。


The most devastating flu pandemic in modern times, killing more than 500,000 people in the United States, and some 50 million people worldwide. Somewhere between 20 and 40 percent of the global population was ill.


有些人早上感觉还不错,到中午病倒,傍晚就死了。


Some people who felt well in the morning became sick by noon and were dead by nightfall.


那些头几天还撑得住的病人,往往死于由细菌引起的流感并发症(比如肺炎)。那次的流行感冒不像典型的季节性流感,它不仅折磨着年幼和年老的人群,而且导致许多健康的年轻人的死亡。年龄在20至五十岁的成年人死亡率最高。


Those who did not succumb to the disease within the first few days often died of complications from the flu (such as pneumonia) caused by bacteria. Rather than just preying on the very young and old, as seasonal flus typically do, this one killed many healthy young adults, too: Mortality was highest among adults 20 to 50 years old.


1957-58:“亚洲型流感”H2N2大流行1957-58: "Asian flu" H2N2 Pandemic


该病毒首先在中国得到确认,粗略估算导致七万美国人死亡。该病毒自1968年起就没在人类中间流行了,因此,三十岁以下的人都不具备该病毒的免疫力。得益于先进的科学技术,这种病毒很快得到确认,至1957年8月,就能有限制地供应疫苗了。虽然如此,在1957年秋季及1958年1至2月还是爆发了两次传染高潮。老年人死亡率最高。


First identified in China, this virus caused roughly 70,000 deaths in the United States. Because this strain has not circulated in humans since 1968, no one under 30 years old has immunity to it. The virus was quickly identified, due to advances in scientific technology, and a vaccine was available in limited supply by August 1957. Still, two waves of infection struck, in the fall of '57 and then January-February of '58. The elderly had the highest death rates.


1968-69:“香港型流感”H3N2大流行1968-69: "Hong Kong flu" H3N2 Pandemic


该病毒首先在香港被检测出来,在1968-69年流行期间大约导致三万四千美国人死亡。H3N2病毒如今仍在循环流行。那些年龄在65岁以上的病人最有可能死亡。这种病毒很像1957-58年的“亚洲型流感”病毒,因此许多人已经有了一定的免疫力。First detected in Hong Kong, this virus caused roughly 34,000 deaths in the United States during the 1968-69 season. H3N2 viruses still circulate today. Those over the age of 65 were most likely to die. The virus was similar to the 1957-58 Asian flu, so some people may have had some level of immunity.


1977:“俄罗斯型流感”H1N1感染人类1977: "Russian flu" H1N1 Infects Humans


在中国北方分析出的这种病毒与1957年以前传播的病毒相似,因此,1957年以前出生的人一般都有了抵抗力,而在那年之后出生的儿童和年轻人由于没有预先的免疫力而缺乏抵抗力。1978年这种病毒在世界各地传播开来,其中包括美国。这种病主要发生在孩子们身上,因此,这次流感没被看成是真正的大流行。1977-78年的流感季节,还没有及时地生产出控制病毒的疫苗,但是,1978-79年的流感疫苗就包含了这种病毒的疫苗。


Isolated in northern China, this virus was similar to the virus that spread before 1957. For this reason, individuals born before 1957 were generally protected, however children and young adults born after that year were not because they had no prior immunity. By January 1978, the virus had spread around the world, including the United States. Because illness occurred primarily in children, this event was not considered a true pandemic. Vaccine containing this virus was not produced in time for the 1977-78 season, but the virus was included in the 1978-79 vaccine.


1997:H5N1传染人类1997: H5N1 Infects Humans


首次发现直接由禽类传染人类的流感病毒,此病毒的传染与接触家禽市场有关。香港有六人死亡。这种病毒之所以不同,是因为它并没有通过传染猪,使猪成为中间宿主,而是直接由鸡传染给人类。另外,年轻人中感染最严重的病症有些与1918年“西班牙流感”病毒相似。


The first time an influenza virus was found to be transmitted directly from birds to people, with infections linked to exposure to poultry markets. Six people in Hong Kong died. This virus was different because it moved directly from chickens to people, rather than having been altered by infecting pigs as an intermediate host. In addition, many of the most severe illnesses occurred in young adults similar to illnesses caused by the 1918 Spanish flu virus.


1999:H9N2传染人类1999: H9N2 Infects Humans


第一次出现在人体内。禽类可能是病毒来源。Appeared for the first time in humans. It caused illness in two children in Hong Kong, with poultry being the probable source.


2002:H7N2传染人类2002: H7N2 Infects Humans


禽流感疫情爆发之后,在一个佛吉尼亚人身上发现了感染的迹象。Evidence of infection is found in one person in Virginia following a poultry outbreak.


2003:多起流感事件(人体中出现新的流感菌株)2003: Multiple Events (Appearance of new influenza strains in humans)


H5N1:导致访问中国大陆的香港一个家庭的两名成员住院治疗,其中33岁的一名男子死亡。(第三位家庭成员在逗留中国期间死于原因不明的呼吸疾病。)H5N1: Caused two Hong Kong family members to be hospitalized after a visit to China, killing one of them, a 33-year-old man. (A third family member died while in China of an undiagnosed respiratory illness.)


H7N7:首次报道人体感染该病毒菌的病例。荷兰有89例,大都是家禽饲养农场的工人,发病初期出现眼部感染或流感类症状。探访一家受影响的家禽饲养场的兽医死亡。H7N7: In the first reported cases of this strain in humans, 89 people in the Netherlands, most of whom were poultry workers, became ill with eye infections or flu-like symptoms. A veterinarian who visited one of the affected poultry farms died.


H7N2:导致一名纽约人住院。H7N2: Caused a person to be hospitalized in New York.


H9N2:导致一名香港儿童得病。H9N2: Caused illness in one child in Hong Kong.


2004:多起流感事件(人体中出现新的流感菌株)2004: Multiple Events (Appearance of new influenza strains in humans)


H5N1:所谓的“禽流感”导致泰国和越南47人得病,其中34人死亡。因为这种流感病毒相当致命,研究人员特别担心它会成为亚洲的地方病。H5N1: So-called Avian Flu causes illness in 47 people in Thailand and Vietnam, 34 of whom died. Researchers are especially concerned because this flu strain, which is quite deadly, is becoming endemic in Asia.


H7N3:据报告,首次出现在人体内的流感病毒,导致加拿大两名家禽饲养场工人得病。H7N3: Is reported for the first time in humans. The strain caused illness in two poultry workers in Canada.


H10N7:据报告,首次出现在人体内的流感病毒,导致两名埃及婴儿得病。其中一个孩子的父亲是家禽商人。H10N7: Is reported for the first time in humans. It caused illness in two infants in Egypt. One child’s father is a poultry merchant.


2005:H5N1“禽流感”恐惧上升2005: H5N1"Avian Flu" Fears Rise


当年二月,第一例感染H5N1病毒的人类病例出现在柬埔寨。到了五月,世界卫生组织报告了四个柬埔寨人感染致命流感病毒的病例。七月,印度尼西亚报告首例感染致命流感病毒的病例。随后三个月,在印度尼西亚发生了七例经实验室确认为H5N1病毒感染的病倒,其中四人死亡。截至12月30日,世卫组织报告经实验室确认的全球H5N1病毒感染病例的累计总数为142例,都在亚洲,其中74人死亡。被检测到有人感染H5N1病毒的亚洲国家有:泰国、越南|柬埔寨、印度尼西亚和中国。


The first case of human infection with H5N1 for the year arises in Cambodia in February. By May, WHO reports four Cambodian cases, all fatal. Indonesia reports its first case, which is fatal, in July. Over the next three months, seven cases of laboratory-confirmed H5N1 infection in Indonesia, and 4 deaths, occur. On Dec. 30, WHO reports a cumulative total of 142 laboratory-confirmed cases of H5N1 infection worldwide, all in Asia, with 74 deaths. Asian countries in which human infection with H5N1 has been detected: Thailand, Vietnam, Cambodia, Indonesia and China.


2006:H5N1“禽流感”漫延2006: H5N1 "Avian Flu" Spreads


据报告,一月初,土耳其东部农村地区出现两例人感染致命H5N1病毒的病例。至一月二十五日为止,中国共计报告10个感染病例,七人死亡。一月三十日,伊拉克向世界卫生组织报告其首例感染致命H5N1病毒的病例。三月,世卫组织确认阿塞拜疆七例人感染H5N1病毒病例,五人死亡。四月,世卫组织确认埃及四例人感染H5N1病毒病例,两例死亡。五月,世卫组织确认非洲国家吉布提一例人类感染H5N1病毒病例。这是首次确认在撒哈拉沙漠以南的非洲地区出现的病例。


In early January, two human cases of H5N1 infection, both fatal, are reported in rural areas of Eastern Turkey. Also in January, China reports new cases of H5N1 infection. As of Jan. 25, China reports a total of 10 cases, with seven deaths. On Jan. 30, Iraq reports its first case of human H5N1 infection, which was fatal, to the WHO. In March, the WHO confirmed seven cases of human H5N1 infection, and five deaths, in Azerbaijan. In April, WHO confirmed four cases of human H5N1 infection, and two fatalities, in Egypt. In May, the WHO confirmed a case of human H5N1 infection in the African nation of Djibouti. This was the first confirmed case in sub-Saharan Africa.


2007:H5N1“禽流感”仍然没有大流行2007: H5N1 "Avian Flu" Still No Pandemic


二月,世卫组织确认非洲国家尼日利亚和老挝民主人民共和国出现首例死于H5N1病毒感染的病例。In February, the WHO confirmed the first human deaths from H5N1 infection in the African nation of Nigeria and in Lao People's Democratic Republic.


2009:H1N1“猪流感”感染人类2009: H1N1 "Swine Flu" Infects Humans


在美国、墨西哥和加拿大涌现出一种融合了猪、禽和人类基因的新型H1N1流感病毒。至四月二十九日为止,已经有九个国家官方报告了148例这种“猪流感”病毒的感染病例,包括经实验确认的91例美国人病例,一人死亡。墨西哥已经报告了26例经实验确认的人感染H1N1病例,七人死亡。据报告,出现经实验确认但未死亡病例的还有:澳大利亚、加拿大、德国、以色列、新西兰、西班牙和英国。世界卫生组织发布了“第五阶段”疫情预警,标志着大流行的逼近。


A new H1N1 virus containing swine, avian and human genes emerges in the United States, Mexico and Canada. As of April 29, nine countries have officially reported 148 cases of this "swine flu," with 91 lab-confirmed cases in the United States and one death. Mexico has reported 26 lab-confirmed human cases, and seven deaths. Lab-confirmed cases, but not deaths, are also reported in Austria, Canada, Germany, Israel, New Zealand, Spain and the United Kingdom. The World Health Organization issues a "phase 5" alert on the outbreak, signaling that a pandemic is imminent.


然而,这些数字并未完全报告疫情。举例来说,墨西哥官方说,死亡人数可能已经接近150人,不过,这些病例还未被完全确认。The numbers don't tell the whole story, however. In Mexico, for example, authorities say the death toll is likely closer to 150 already, but the cases have not been fully analyzed.


北卡罗莱纳的美国三角国际研究中心专攻流感的公共健康研究员克里斯汀·莱顿说,“我认为局势有些混乱,因为那只反应了现实情况。说它是混乱的局势,因为报告、判断疾病并为其分类的方式是混乱的。”


"I think it's confusing because that is simply a reflection of the reality of the situation," said Dr. Christine Layton, a public health researcher who specializes in influenza at RTI International, an institute in North Carolina. "It's a confusing situation — the confusion of the way disease is reported and measured and classified."


政府官员仍在争先恐后地了解新病毒,他们说研发疫苗的努力可能还需要数月时间。


Officials are still scrambling to understand the new strain, and efforts to develop a vaccine could take months, they say.


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