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Lessons Found in History of Flu Pandemics


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


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.


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


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


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


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


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


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


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


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.


"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."


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



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