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黑死病死灰复燃
Medieval diseases are making a grim comeback

来源:FT中文网    2017-11-07 07:20



        The Black Death was little short of a bacterial apocalypse. The outbreak of bubonic plague, imported along the Silk Road, is thought to have killed between 25m and 50m people as it rampaged through 14th-century Europe. The disease thence resurfaced sporadically: the Great Plague of London, for example, felled a fifth of city dwellers in the 1660s.        当年黑死病几乎算得上一场细菌末日了。这种从丝绸之路传入的腺鼠疫在14世纪的欧洲猖獗横行,据信夺走了2500万到5000万人的生命。这种疾病之后偶有再发:比如,17世纪60年代的伦敦大瘟疫杀死了这座城市五分之一的居民。
        While the plague seems to us a medieval affliction, it has never fully disappeared. On average, about 500 cases are documented globally each year, mostly in Africa, South America and India. The infection is treatable with antibiotics if caught early.        尽管对我们而言,黑死病似乎是一种中世纪的疾病,但它从未彻底消失。全球平均每年录得大约500起病例,其中大多数发生在非洲、南美和印度。如果发现较早,这种疾病可用抗生素治疗。
        Now the World Health Organization has noted an unusually large outbreak of plague in Madagascar. One case has also been reported in the Seychelles. The threat is very likely to be contained but the resurgence of this historic pestilence demonstrates the fragile biological stand-off between human and bacterium.        最近世界卫生组织(WTO)注意到黑死病在马达加斯加出现了不同寻常的大爆发。塞舌尔也报告了一个病例。这一威胁很有可能得到控制,但这一年代久远的瘟疫死灰复燃,表明了人与细菌之间脆弱的生物学对峙。
        Plague is caused by the bacterium Yersinia pestis, which is usually carried by rat fleas and passed on to humans through biting. The resulting infection adheres to a gruesome timetable. It takes between one and seven days for a fever and nausea to develop; then come the dreaded “buboes”, or swellings in the groin and armpits, which give bubonic plague its name. If the bacteria invade the bloodstream, necrosis sets in; the limbs darken as they rot. Left untreated, the condition carries a 30-60 per cent chance of death.        黑死病是由鼠疫耶尔森氏杆菌引起的,通常由鼠蚤携带并通过叮咬传染人类。感染者的病情遵循一个可怕的时间表。感染者将在1至7天后出现发烧和恶心;然后患上可怕的“腹股沟淋巴结炎”,也就是腹股沟和腋窝处肿大,这也是这种疾病被称为腺鼠疫的由来。如果细菌侵入血液,就会发生坏死;四肢腐烂、变黑。如果得不到治疗,黑死病的致死率达到30%到60%。
        Should the infected pus reach the lungs, bubonic plague can become pneumonic plague. This rare form, even deadlier than its bubonic cousin, is highly infectious because it can be transmitted through airborne droplets.        如果受感染的脓液到达肺部,腺鼠疫就可能转化为肺鼠疫。这种少见的类型比腺鼠疫更为致命,并且具有高度传染性,因为它能够通过飞沫传播。
        The epidemic in Madagascar is, alas, mostly pneumonic: it totals nearly 700 cases, 57 deaths and 11 distinct strains of Yersinia pestis. It garnered special attention because it arrived in August, earlier than expected (the endemic plague season usually runs from September to April) and because cases appeared in historically unaffected regions. The WHO has released        糟糕的是,在马达加斯加爆发的流行病大多是肺鼠疫:总共近700起病例,57例死亡,涉及11种鼠疫耶尔森氏杆菌变种。这引起了特别关注,因为此次疫情在8月爆发,早于预期(这种流行病的流行季节通常是从9月到次年4月),还因为病例出现在历史上从未受到感染的地区。世卫组织已投入资金提供抗生素和进行疫情监测。
        funding for antibiotics and surveillance.        该病已蔓延到岛外,一名来自塞舌尔的访客已在其原籍国被确定为肺鼠疫的疑似病例。与他接触过的人已注射了抗生素。同时,塞舌尔航空(Air Seychelles)已经暂停了往来马达加斯加的航班。
        The disease has spread beyond the island: a visitor has been identified, in his home country of the Seychelles, as a probable case of pneumonic plague. His contacts have received antibiotics. Meanwhile, Air Seychelles has suspended flights to and from Madagascar.        马达加斯加爆发此次瘟疫之前,2016年该国一个动荡的偏远地区曾发生过一场怪异的瘟疫。Befotaka地区位于马达加斯加东南部,到这里需要两天车程外加三天步行。2016年,卫生官员和科学家两次到访Befotaka采集样本、治疗病人,并进行病虫害防治——传播这种疾病的黑老鼠有时会被发现出没于当地居民家中。两次访问都不得不被缩短,因为团队受到了威胁。今年的第三次走访发现了126起疑似鼠疫病例。
        The Madagascan outbreak follows a puzzling 2016 episode that unfolded in a remote, unstable part of the country. Reaching the region, Befotaka in southeastern Madagascar, requires a two-day drive and three days of walking. In 2016, health officials and scientists twice visited Befotaka to take samples, treat patients and carry out pest control (the black rats known to spread the plague can sometimes be found living in houses). Both visits had to be cut short because the teams received threats. A third visit this year revealed 126 suspected cases of plague.        鼠疫在Befotaka找到肥沃的滋生环境并非巧合,该地区的特点是缺乏清洁水、电力、营养以及基本卫生条件。历史表明,自然灾害、贫穷和战争,加上保护性基础设施缺乏或被破坏,会危及我们阻止病原体入侵的能力。
        It is no coincidence the disease has found fertile pickings in a troubled part of the country characterised by the lack of clean water, electricity, nutrition and basic health provision. History shows that natural disaster, poverty and war, along with the absence or destruction of protective infrastructure, threaten our ability to keep pathogens at bay.        当今世界印证了这一点,饱受战争摧残的也门深陷现代最严重的霍乱疫情。70多万也门人——主要是儿童——被感染,其中许多人营养不良,加大了治疗的复杂性。
        The world bears this out today: war-torn Yemen is in the grip of the worst cholera epidemic of modern times. More than 700,000 Yemeni, mostly children, are affected. Many of them are malnourished, complicating treatment.        与此同时,世界各地都出现了耐药性肺结核。未接种疫苗的儿童——特别是在冲突地区和贫困地区——不断死于脊髓灰质炎(小儿麻痹症)和风疹等已经被克服的疾病。可怕的事实是,未来世代仍在被昔日的疾病夺走生命。
        Meanwhile, drug-resistant forms of tuberculosis have emerged worldwide. Unvaccinated children, particularly in conflict zones and impoverished regions, are succumbing to conquerable diseases such as polio and rubella. The haunting truth is that future generations are still being struck down by diseases of the past.        译者/何黎
                
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