[2009.4.27] An unwelcome Mexican wave 不受欢迎的墨西哥潮

Global health
世界健康

An unwelcome Mexican wave
不受欢迎的墨西哥潮

Apr 27th 2009 | NEW YORK
From Economist.com

A mysterious new virus is spreading from Mexico. Could it spark a global pandemic?
神秘新病毒从墨西哥蔓延开来：这会引发一场全球性流感疫情吗？

AFP

THE football stadiums and cathedrals in Mexico City were empty this weekend for the first time in living memory. But these are not ordinary times for the nearly 20m chilangos that live in this sprawling metropolis. Mexican officials shut down all schools, banned large public gatherings and otherwise discouraged human interaction in order to control an emerging global viral scourge that by Monday April 27th had claimed over 100 lives. As the threat spread to other parts of North America and beyond, officials at the World Health Organisation (WHO) and at America’s Centres for Disease Control (CDC) declared public-health emergencies.

本周末墨西哥城的各足球场和大教堂空无一人，这在世人的记忆中还是第一次。但是对于生活在这座布局杂乱的大都市中的2000万墨西哥人而言，这并不是普通的时刻。墨西哥当局下令关闭了所有学校，禁止大型的公共集会以及其他减少人与人接触的指令，以此来控制突发地全球性病毒灾难：截止4月27日星期一，猪流感病毒已经夺走100条生命。随着威胁传到北美其他地区甚至更远，美国疾病控制中心以及世界卫生组织的官员宣布处于公共卫生紧急状态。

The culprit is an unusual new virus known as A/H1N1, which is a form of swine flu that has made its way from pigs into humans. Mexican officials began to notice in late March that an unusually high number of patients were suffering from pneumonia and other respiratory illnesses. After preliminary investigations, it was concluded this month that the cause is not seasonal influenza but rather an entirely new hybrid strain composed of pig, bird and human viruses.

罪魁祸首是一种被称之为A/H1N1的非寻常新型病毒，该病毒是变异为能从猪身上传染给人类的一种猪流感病毒。墨西哥官方在3月底就开始注意到，感染肺炎以及其他呼吸道疾病的病人数量异常之多。初步调研后的结论表示，这些病症并非季节性流感所致，而是因为一种由猪、鸟、人类病毒组成的全新杂交病毒链。

They raised the alarm after being flooded with cases that, at least on the surface, appear to be connected with this virus. Over 1,500 Mexicans have been afflicted with symptoms that may be the result of this new virus. But it is not confirmed whether the root cause of most of these cases was A/H1N1 or commonplace strains of influenza. With help from WHO experts, local laboratories are furiously testing genetic samples to verify how many did indeed fall victim to this new virus.

在看似感染这种病毒（至少从症状来看）的人数急剧增加之后，墨西哥提升了预警级别。超过1500名墨西哥人受到可能是这种新病毒所致症状的折磨。但是，还不能确定是否大多数病例都是由A/H1N1病毒所致，还是感染了普通的流感病毒。在世界卫生组织专家们的帮助下，墨西哥当地实验室正紧张地对基因样本进行检测，以确认实际感染猪流感病毒的人数。

Despite Mexican efforts at containment, five American states—California, Texas, Kansas, Ohio and New York—have confirmed mild cases of A/H1N1. So too has Canada, which was overwhelmed by the deadly SARS (severe acute respiratory syndrome) outbreak a few years ago. Other suspected cases have surfaced in Britain, Israel and New Zealand.

尽管墨西哥在控制病毒方面的努力，加利福尼亚、德克萨斯、堪萨斯、奥尔良以及纽约这5个美国州也已经确认有A/H1N1病毒温和感染的疫情。几年前被致命性SARS病毒暴发肆虐的加拿大也确认出现了猪流感疫情。在英国，以色列以及新西兰，猪流感感染也已浮出水面。

In response, many countries are becoming more vigilant and increasing stocks of antiviral medicines. Some are making noises about banning North American pork, despite assurances from the WHO that eating cooked pork does not transmit swine flu. China and Russia are moving to quarantine visitors with suspicious symptoms. Asian airports have turned on their heat-sensing equipment to detect sick incoming passengers (kit that they had installed after earlier scares resulting from outbreaks of avian flu and SARS). The WHO moved a meeting scheduled for Tuesday to Monday to decide whether to raise its pandemic threat warning level by a notch, from 3 to 4 (on a scale of 6).

作为回应，许多国家都越来越警惕，同时增加抗病毒药物的存量。尽管世界卫生组织保证，熟食猪肉不会传染猪流感，但还是有一些国家吵嚷着要禁止进口北美地区的猪肉。中国和俄罗斯开始隔离出现疑似症状的游客。亚洲的各大机场已经将发热感应设备打开，以此来检测发热的到来旅客（这些设备在受到早前的禽流感以及SARS恐吓之后就已安装）。世界卫生组织将一项会议安排从周二提前到周一，会上将确定是否将其流行病威胁预警调高一个等级，从3调至4（总共有6个等级）。

It is too early to say whether A/H1N1 is a dangerous pandemic in the making. Until all of the Mexican cases are properly examined, authorities cannot know whether patients suffering from flu-like symptoms actually got this new bug or merely some older, less worrisome one. Without that information, it is also impossible to determine the new disease’s virulence, fatality rates and so on. Officials are likely to make such determinations in coming days, but until then how worried should the globally mobile punter be?

A/H1N1从本质上而言是否是一种危险的传染病，目前还言之过早。在墨西哥的所有病例都妥善检查之后，官方才能得知这些出现流感症状的病人患有的是否真的是这种新型病毒还是仅仅只是一些较老型的、不是那么好担忧的流感病毒。而且如果没有这些诊断信息，也根本不可能决定这种新型病毒的毒性及致死率等。有关当局很可能在未来的几天就这些疑问做出定断，但是在此之前，这个可在全球范围传播扩散的病毒应该引起多大的担忧呢？

There is both bad news and good news. Unlike typical flus, which usually hit the old and weak, the young and healthy appear to be falling victim to this new disease. Because most people do not have regular contact with pigs, much of the world’s population may lack immunity against swine flu. Those two factors suggest a pandemic, if it happens, may spread easily. There is no vaccine to prevent the spread of A/H1N1, and even if officials were to start work on one today it would take months to produce—by which time the virus may well have mutated.

真可谓喜忧参半。年轻健康的人似乎成为了这种新病毒的易感人群，而不像普通的流感病毒那样，通常是年老体衰的人感染。因为大多数人都没有经常和猪接触，所以世界上的许多人都对此病毒缺乏免疫力。这两个因素合起来则很有可能引起一场大规模的病毒感染，而如果真是这样的话，那么将会扩散的非常迅速。现在还没有预防A/H1N1病毒传播的疫苗，就算有关当局从现在开始开发一种疫苗也将耗去好几个月的时间才能进行该疫苗的生产，而到了那个时侯，病毒早就已经发生变异了。

On the positive side this virus is, at least for now, responding to common antiviral treatments such as Tamiflu. The WHO has an emergency stockpile of 5m or so antiviral drugs, which it plans to make available for the hardest-hit countries. The United States has 50m treatments in its stockpile, and officials have just authorised the domestic release of a quarter of that hoard. Other countries also have their own stocks on hand.

猪流感病毒好的一面是，至少目前来讲，像特敏福这种常规的抗病毒药物治疗对其有效。世界卫生组织拥有5百万左右的抗病毒药物存量，计划供疫情最严重的国家使用。美国也有5千万的药物储备，同时美国有关当局已经批准在国内下发其中的四分之一。其他的国家也同样有自己的抗病毒药物储备，随时可用。

Also encouraging is that all of the cases confirmed outside Mexico seem to be mild ones. Most of the suspected deaths in Mexico appear to be the result of patients waiting until they were very sick before going to hospital. That suggests even if this virus becomes a pandemic, it need not be a deadly one—early intervention may well quash the bug. That points to the most important reason for cheer, even in the midst of uncertainty.

同样令人欣慰的一点是，墨西哥之外的所有确诊病例似乎都还病性温和。墨西哥的多数疑似死亡病例看似都是由于病人拖到病情非常严重采取就诊所致。这意味着，就算这种病毒在全球范围内泛滥，那也不会具有致命性：因为提前治疗很可能会击退该病毒。而这也是值得兴奋的最重要原因，虽然具体如何，现在还未能知晓。

The world is much better prepared today to handle a pandemic than it was just a few years ago. Thanks to the painful lessons learned by Hong Kong, Toronto and other global centres hit by earlier outbreaks, many countries now have emergency protocols in place and are more wary. Also the WHO’s members have agreed on a sensible set of protocols for pandemic preparedness, sharing of genetic samples and other ways of co-ordinating a global response. Thus far, the new system seem to be working well—but it will take some time to know whether it is good enough to cope with A/H1N1.

在应对流行性疾病方面，与几年前相比，世界各国如今准备更加充分。这还得多亏了香港、多伦多以及其他早前病毒爆发的中心地区所得到的苦痛教训，现在许多国家都有紧急情况规定，而且也更加警惕。世界卫生组织各成员国也同意了一系列合理的关于流行病准备措施完善度、基因样品共享以及其他全球应对的合作措施的国际规约。因此，就目前而言，这项新的流行病应对体系似乎运转良好：但是这是否好到能够应对A/H1N1？还需要一些时日来发现。

 

译者/chrisshou: http://www.ecocn.org/bbs/viewthread.php?tid=18923