歷史上你所不知道的流感大流行
　　Lessons Found in History of Flu Pandemics

　　只要回顧一下令人恐懼的致命流感大流行，以及沒有形成大流行的可怕流感疫情那難以置信不可預(yù)測(cè)的歷史，就能理解為什么政府部門對(duì)于迅速發(fā)展的豬流感危機(jī)的反應(yīng)時(shí)而膽大敢為，時(shí)而謹(jǐn)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.

　　傳染病、瘟疫和鼠疫困擾著整個(gè)人類歷史。近日里，我們應(yīng)對(duì)豬流感所采取的策略就吸取了現(xiàn)代流感疫情及其大流行的歷史教訓(xùn)。這段歷史中發(fā)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.

　　過(guò)去幾年里人類體內(nèi)出現(xiàn)的幾種新型流感病毒（包括上世紀(jì)九十年代末期出現(xiàn)的H5N1“禽流感”病毒）表明，研究人員每年都面臨著設(shè)法追蹤、控制迅速演變的流感病毒，并研制新的流感疫苗的挑戰(zhàn)。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

　　最具破壞性的現(xiàn)代流感大流行，導(dǎo)致五十萬(wàn)美國(guó)人以及大約全球五千萬(wàn)人喪生，大約有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.

　　有些人早上感覺還不錯(cuò)，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.

　　那些頭幾天還撐得住的病人，往往死于由細(xì)菌引起的流感并發(fā)癥（比如肺炎）。那次的流行感冒不像典型的季節(jié)性流感，它不僅折磨著年幼和年老的人群，而且導(dǎo)致許多健康的年輕人的死亡。年齡在20至五十歲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：“亞洲型流感”H2N2大流行1957-58: "Asian flu" H2N2 Pandemic

　　該病毒首先在中國(guó)得到確認(rèn)，粗略估算導(dǎo)致七萬(wàn)美國(guó)人死亡。該病毒自1968年起就沒在人類中間流行了，因此，三十歲以下的人都不具備該病毒的免疫力。得益于先進(jìn)的科學(xué)技術(shù)，這種病毒很快得到確認(rèn)，至1957年8月，就能有限制地供應(yīng)疫苗了。雖然如此，在1957年秋季及1958年1至2月還是爆發(fā)了兩次傳染高潮。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

　　該病毒首先在香港被檢測(cè)出來(lái)，在1968-69年流行期間大約導(dǎo)致三萬(wàn)四千美國(guó)人死亡。H3N2病毒如今仍在循環(huán)流行。那些年齡在65歲以上的病人最有可能死亡。這種病毒很像1957-58年的“亞洲型流感”病毒，因此許多人已經(jīng)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：“俄羅斯型流感”H1N1感染人類1977: "Russian flu" H1N1 Infects Humans

　　在中國(guó)北方分析出的這種病毒與1957年以前傳播的病毒相似，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兒童和年輕人由于沒有預(yù)先的免疫力而缺乏抵抗力。1978年這種病毒在世界各地傳播開來(lái)，其中包括美國(guó)。這種病主要發(fā)生在孩子們身上，因此，這次流感沒被看成是真正的大流行。1977-78年的流感季節(jié)，還沒有及時(shí)地生產(chǎn)出控制病毒的疫苗，但是，1978-79年的流感疫苗就包含了這種病毒的疫苗。

　　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傳染人類1997: H5N1 Infects Humans

　　首次發(fā)現(xiàn)直接由禽類傳染人類的流感病毒，此病毒的傳染與接觸家禽市場(chǎng)有關(guān)。香港有六人死亡。這種病毒之所以不同，是因?yàn)樗]有通過(guò)傳染豬，使豬成為中間宿主，而是直接由雞傳染給人類。另外，年輕人中感染最嚴(yán)重的病癥有些與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傳染人類1999: H9N2 Infects Humans

　　第一次出現(xiàn)在人體內(nèi)。禽類可能是病毒來(lái)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傳染人類2002: H7N2 Infects Humans

　　禽流感疫情爆發(fā)之后，在一個(gè)佛吉尼亞人身上發(fā)現(xiàn)了感染的跡象。Evidence of infection is found in one person in Virginia following a poultry outbreak.

　　2003：多起流感事件（人體中出現(xiàn)新的流感菌株）2003: Multiple Events (Appearance of new influenza strains in humans)

　　H5N1：導(dǎo)致訪問(wèn)中國(guó)大陸的香港一個(gè)家庭的兩名成員住院治療，其中33歲的一名男子死亡。（第三位家庭成員在逗留中國(guó)期間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：首次報(bào)道人體感染該病毒菌的病例。荷蘭有89例，大都是家禽飼養(yǎng)農(nóng)場(chǎng)的工人，發(fā)病初期出現(xiàn)眼部感染或流感類癥狀。探訪一家受影響的家禽飼養(yǎng)場(chǎng)的獸醫(yī)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：導(dǎo)致一名紐約人住院。H7N2: Caused a person to be hospitalized in New York.

　　H9N2：導(dǎo)致一名香港兒童得病。H9N2: Caused illness in one child in Hong Kong.

　　2004：多起流感事件（人體中出現(xiàn)新的流感菌株）2004: Multiple Events (Appearance of new influenza strains in humans)

　　H5N1：所謂的“禽流感”導(dǎo)致泰國(guó)和越南47人得病，其中34人死亡。因?yàn)檫@種流感病毒相當(dāng)致命，研究人員特別擔(dān)心它會(huì)成為亞洲的地方病。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：據(jù)報(bào)告，首次出現(xiàn)在人體內(nèi)的流感病毒，導(dǎo)致加拿大兩名家禽飼養(yǎng)場(chǎng)工人得病。H7N3: Is reported for the first time in humans. The strain caused illness in two poultry workers in Canada.

　　H10N7：據(jù)報(bào)告，首次出現(xiàn)在人體內(nèi)的流感病毒，導(dǎo)致兩名埃及嬰兒得病。其中一個(gè)孩子的父親是家禽商人。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”恐懼上升2005: H5N1"Avian Flu" Fears Rise

　　當(dāng)年二月，第一例感染H5N1病毒的人類病例出現(xiàn)在柬埔寨。到了五月，世界衛(wèi)生組織報(bào)告了四個(gè)柬埔寨人感染致命流感病毒的病例。七月，印度尼西亞報(bào)告首例感染致命流感病毒的病例。隨后三個(gè)月，在印度尼西亞發(fā)生了七例經(jīng)實(shí)驗(yàn)室確認(rèn)為H5N1病毒感染的病倒，其中四人死亡。截至12月30日，世衛(wèi)組織報(bào)告經(jīng)實(shí)驗(yàn)室確認(rèn)的全球H5N1病毒感染病例的累計(jì)總數(shù)為142例，都在亞洲，其中74人死亡。被檢測(cè)到有人感染H5N1病毒的亞洲國(guó)家有：泰國(guó)、越南|柬埔寨、印度尼西亞和中國(guó)。

　　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

　　據(jù)報(bào)告，一月初，土耳其東部農(nóng)村地區(qū)出現(xiàn)兩例人感染致命H5N1病毒的病例。至一月二十五日為止，中國(guó)共計(jì)報(bào)告10個(gè)感染病例，七人死亡。一月三十日，伊拉克向世界衛(wèi)生組織報(bào)告其首例感染致命H5N1病毒的病例。三月，世衛(wèi)組織確認(rèn)阿塞拜疆七例人感染H5N1病毒病例，五人死亡。四月，世衛(wèi)組織確認(rèn)埃及四例人感染H5N1病毒病例，兩例死亡。五月，世衛(wèi)組織確認(rèn)非洲國(guó)家吉布提一例人類感染H5N1病毒病例。這是首次確認(rèn)在撒哈拉沙漠以南的非洲地區(qū)出現(xiàn)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”仍然沒有大流行2007: H5N1 "Avian Flu" Still No Pandemic

　　二月，世衛(wèi)組織確認(rèn)非洲國(guó)家尼日利亞和老撾民主人民共和國(guó)出現(xiàn)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“豬流感”感染人類2009: H1N1 "Swine Flu" Infects Humans

　　在美國(guó)、墨西哥和加拿大涌現(xiàn)出一種融合了豬、禽和人類基因的新型H1N1流感病毒。至四月二十九日為止，已經(jīng)有九個(gè)國(guó)家官方報(bào)告了148例這種“豬流感”病毒的感染病例，包括經(jīng)實(shí)驗(yàn)確認(rèn)的91例美國(guó)人病例，一人死亡。墨西哥已經(jīng)報(bào)告了26例經(jīng)實(shí)驗(yàn)確認(rèn)的人感染H1N1病例，七人死亡。據(jù)報(bào)告，出現(xiàn)經(jīng)實(shí)驗(yàn)確認(rèn)但未死亡病例的還有：澳大利亞、加拿大、德國(guó)、以色列、新西蘭、西班牙和英國(guó)。世界衛(wèi)生組織發(fā)布了“第五階段”疫情預(yù)警，標(biāo)志著大流行的逼近。

　　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，這些數(shù)字并未完全報(bào)告疫情。舉例來(lái)說(shuō)，墨西哥官方說(shuō)，死亡人數(shù)可能已經(jīng)接近150人，不過(guò)，這些病例還未被完全確認(rèn)。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.

　　北卡羅萊納的美國(guó)三角國(guó)際研究中心專攻流感的公共健康研究員克里斯汀·萊頓說(shuō)，“我認(rèn)為局勢(shì)有些混亂，因?yàn)槟侵环磻?yīng)了現(xiàn)實(shí)情況。說(shuō)它是混亂的局勢(shì)，因?yàn)閳?bào)告、判斷疾病并為其分類的方式是混亂的。”

　　"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."

　　政府官員仍在爭(zhēng)先恐后地了解新病毒，他們說(shuō)研發(fā)疫苗的努力可能還需要數(shù)月時(shí)間。

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