曾經等同於宣判死刑的10大疾病(上)

When it comes to medicine, times have changed more than most of us realize. At the tender age of 4, I (and most of my friends) dealt with the itchy, feverish misery that is chicken pox. My dad's generation lived in fear of polio, and his mother dealt with rampant scarlet fever. Thanks to modern medicine, these and many other diseases have been rendered preventable, treatable or are simply far less common than in their heyday. In fact, many diagnoses that were once grimly given are now handled with relative ease, sometimes outright curable. Early detection, pharmaceuticals, vaccines and cutting-edge surgeries have completely revolutionized health care as we know it, making infectious or acquired diseases far less dire than they used to be. Sadly, the Catch-22 of many of these diseases is that treatments exist, but aren't always available in developing nations. So, even if they're curable in the United States or Western Europe, millions still unnecessarily lose their lives elsewhere due to lack of medical care or drug availability. Public health organizations are continuing to chip away at this issue, but it'll likely be a long process.

說到醫學，其演變進化的程度可以說超出大多數人的認知。在我還是一個4歲孩童時，水痘會讓我痛苦不堪，全身發熱、發癢難耐。對我父親那一代人來說，小兒麻痹症是可怕的。對於祖母而言，駭人的就是她們那個年代肆虐氾濫的猩紅熱了。多虧了現代醫學的發展，許許多多的疾病都已經可以預防和治療，最不濟的也不若從前一般猖獗。事實上，如今人類已經可以相對輕鬆的治療那些從前讓人感到害怕的疾病，甚至有一些可以完全治癒。正如我們所知，早期檢測、藥物、疫苗和先進手術等醫學手段完全革新了醫療事業的發展，使得傳染病及其他後天疾病不再像從前那樣棘手。然而令人遺憾的是，我們仍然面臨一個兩難的處境：儘管擁有相關的治療技術，但是身處發展中國家的患者們並非都能享有相應的治療服務。所以，在美國或西歐國家，患有疾病的人可以得到診治；而在其他缺乏醫療條件、藥物供給不足的地區，無數的人因身患疾病而白白地喪失性命。公衆健康組織一直在爲改善這一局面而進行不懈的努力，只不過路漫漫其修遠兮。

Nevertheless, progress has been made. We'll look at 10 diseases that used to spell death for patients, but not so anymore, starting with one that's fairly recent in origin.

不論如何，事情總歸是朝着良好方向發展的。接下來，讓我們來看看10個曾經屬於致命的疾病，就先從離我們年代較近的說起吧。

10.艾滋病

You probably know the basics of human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Back in the disease's terrifying heyday of the 1980s and early '90s, even experts knew precious little about how to treat HIV, which is usually transmitted through unprotected anal or vaginal sex or by sharing drug needles. Common symptoms include rashes, fever, enlarged lymph nodes and a sore throat. Over time, if untreated, a body with HIV loses the ability to fight off infections, which leads to AIDS. Contracting HIV used to be a death sentence, but not anymore, thanks to the introduction of antiretroviral drugs in the mid-1990s. "In the early days, people diagnosed with HIV had a life expectancy of about eight years," says John Brooks, M.D., medical officer in the Division of HIV/AIDS Prevention of the Centers for Disease Control and Prevention (CDC). "Today, a person who is promptly diagnosed with HIV and appropriately treated can look forward to a close-to-normal life span." Modern antiretroviral therapy can be administered in as little as one pill per day, eliminating symptoms, but stopping short at actually curing the disease, of course.

你或許瞭解艾滋病（獲得性免疫綜合症AIDS）的病因——人類免疫缺陷病毒的作用機理。19世紀80年代及90年代初期是艾滋病的發病高峯，那時即使是專家們也對應對HIV病毒知之甚少。這種病毒通常是通過共用針管或不衛生的性交方式造成傳染。一些常見的患病症狀包括起疹子、發熱、淋巴結異常增大和喉嚨疼痛。感染病毒者一旦沒有及時的接受治療，之後就會喪失抗傳染能力，進而發展成爲艾滋病患者。HIV病毒過去對人類來說就是一個死亡信號，不過隨着19世紀90年代中期抗逆轉錄病毒藥物的問世，它已不再對生命構成威脅。來自疾病控制和防禦中心，HIV/AIDS部門的醫學人員約翰·布魯克博士說，過去感染HIV病毒的人只能活8年左右。而如今，感染者及時接受治療將有望恢復如健康人一般。在現代抗逆轉錄病毒療法的幫助下，病人只需每天服用一片藥即可消除病症，切實達到治療目的。

In 2010, AIDS was the seventh leading cause of death among the 25-44 age bracket in the U.S., having peaked at No. 1 in both 1994 and 1995. Yet, the epidemic is far from over, with about 34 million people in 2014 infected around the globe, often unaware they even have HIV or AIDS.

2010年，艾滋病已經成爲美國25—44週歲患病者中的第七大致死病因。在1994年及1995年，它更是致命性疾病中的頭號殺手。然而，這個傳染病的消亡之日還遠遠沒有到來。2014年，全球感染艾滋病者數量增至3400萬人，很多人甚至對自己患有HIV或艾滋病渾然不知。

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9.肺結核

Ever seen a period movie where the heroine coughs droplets of blood into a hanky? You've witnessed a re-enactment of the disease that was a leading cause of death in the U.S. and Europe in the late 1800s and early 1900s.

你是否看過這樣一部電影，裏面有主角往手帕裏咳出很多血的情節？如果是的話，那你算是見識過人們被這個疾病折磨的樣子了。在18世紀末及19世紀初期的歐美國家，它可是主要的致命性疾病之一。

Back in 1892, tuberculosis (TB) was responsible for one out of seven deaths in the U.S. Also known as consumption, TB spreads when a person infected with Mycobacterium tuberculosis coughs, sneezes or otherwise transmits droplets through the air to someone else. Roughly a third of the global population is infected with latent TB, which yields no symptoms and is not contagious in that stage, but probably will be in time. Once it evolves into TB disease, the bacteria usually wages war on the lungs; hence the notoriously bloody cough, as well as chills, night sweats and fever. Antibiotics and upgraded living conditions have significantly contributed to the decline of TB in modernized countries. Unfortunately, it continues to plague developing countries, with roughly 95 percent of TB diagnoses and deaths situated squarely in their borders. However, treatment and containment efforts are making a dent; the worldwide death rate from TB dropped 45 percent between 1990 and 2012. Nevertheless, multi-drug resistant TB is at very high levels.

1892年，每7個喪命的美國人中就有一個是死於肺結核病。肺結核又稱癆病。一旦患有結核分枝桿菌的人咳嗽、打噴嚏或通過其他方式將自身液體藉由空氣傳播給他人，病毒就會發生擴散。大概全球人口的三分之一都患有潛在性肺結核病，這種疾病沒有臨牀表現也暫時不具傳染性，不過未來怎樣還尚未可知。一旦這種潛在性病症演化爲完全的肺結核，病毒就會對人體的肺部造成極大傷害，從而導致人們大量咳血、全身發冷、夜裏盜汗和發高燒。在發達國家，抗生素的發明及生活條件的改善極大降低了肺結核的發病率。不幸的是在一些發展中國家，人們依然深受此病困擾，約有95%的肺結核患者及死亡案例來自較爲落後的國家。然而，對於肺結核疾病的治療和遏制工作仍取得了顯著進步。在1990至2012年間，其致死率下降了45個百分點。只不過，對於多重抗藥性肺結核病的治療工作就困難重重了。

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8.狂犬病

If you're ever bitten by a dog, bat, raccoon or other angry animal, you should hustle to a hospital with haste. Even if the animal is more bad-tempered than rabid, this disease isn't something you want to take a chance on. Once symptoms appear, rabies is transformed into a painful illness that fatally attacks the central nervous system, causing confusion and delirium and eventually death.

一旦被狗狗、蝙蝠、熊或是其他任何兇猛的動物咬傷過，哪怕連滾帶爬的，都請你以最快的速度前去醫院就診。同他們的壞脾氣相比，狂犬病真的可怕多了，這種病可不是你能冒險嘗試的。一旦症狀爆發，狂犬病就會即刻轉變成爲一種令人痛苦的疾病，它將對你的中樞神經系統造成致命的侵害，導致你思維混淆、精神錯亂，直至最終死亡。

However, rabies is very treatable as long as it's caught before symptoms emerge. Most people know when they've been bitten by an animal, making the risk easy enough to assess, and post-exposure treatments and vaccines are available to stop symptoms before they start. Awareness and treatment are credited with keeping the U.S. death toll at two or three people per year, down from 100 in the early 1900s.

然而，只要在症狀出現之前及時的遏制住病情，狂犬病還是在可控範圍之內並可醫治康復。大多數人都知道，當被動物咬傷之後，他們可以直觀預估咬傷的風險程度，及時採取暴露後治療措施，迅速前往醫院注射疫苗，以期在病症爆發前穩定住病情。早在20世紀90年代初，得益於人們對此疾病的認識加深和治療普及，使得美國狂犬病死亡人數從每年100人逐漸降至每年2至3人。

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7.淋巴腺鼠疫

Also known as the Black Death, the bubonic plague seems too terrifying to be true, but the sad fact is that it killed more than 75 million people in 1300s. The horrific spread began in Asia and worked its way into Europe, where about one-third of the continent's population was infected, suffering through myriad symptoms like apple-sized swellings that oozed blood and pus, aches, pains, vomiting, fever and chills, before dying. Although the initial phase wound down around the 1350s, the disease has continued to periodically pop up around the world.

鼠疫，即爲我們所熟知的黑死病，其可怕程度根本無法想象。更可悲的事實是，14世紀因鼠疫而死亡的人數高達7500萬人。這一可怕的現象更是逐漸蔓延至整個亞洲，同時滲透至歐洲的各個角落，在那些地方，幾乎三分之一的大陸人口都被感染致病。患上鼠疫的人們飽受病症的折磨，蘋果般大小的腫塊不斷從中滲出膿血。無法忍受的疼痛，無止盡的陣痛，不斷地嘔吐，持續的高燒以及陣陣發寒的身體，直至他們死亡痛苦才得以終止。儘管在14世紀中期，這一惡症已逐漸被人們所掌控，可在世界各地仍會出現週期性的爆發。

We now know that bubonic plague is spread by infected fleas and rats, and is best kept under control with public health and improved sanitation efforts. That doesn't mean it's history. More than 10,000 people contracted the disease in the Congo between 2000 and 2009. Even in the U.S., 56 people caught the plague during that same period (seven died). Antibiotic treatment can now quickly cure this once definite death sentence, but it must be done fast. If the bacteria reach the lungs, it becomes pneumonic plague, which can rapidly turn fatal.

我們知道，鼠疫通過受感染的跳蚤和老鼠傳播，通過公共衛生情況的提高以及環境衛生的改善，可以對疫情達到良好的控制。但歷史上可並非如此。2000年至2009年，剛果感染鼠疫的人數超過了一萬人！甚至在美國，同一時期也有56例市民感染鼠疫的案例，其中有7人因病情嚴重致死。現代的抗生素治療法已可以治癒當年被譽爲絕症的疾病，但還是需要在病症爆發前期儘早治療。一旦細菌進入肺部，確診爲鼠疫，將會以超快的速度致死。

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6.天花

One of the oldest diseases in the world (Ramesses V of Egypt, who died in 1157 B.C.E. apparently had it), smallpox killed 300 million people worldwide in the 20th century. The condition got its name to distinguish it the "great pox" (aka as syphilis). This contagious disease is spread by face-to-face contact with an infected person. Symptoms include fever, headache and severe back pain followed by telltale red pustules all over the body, which leave pitted scars.

天花是世界上最古老的疾病之一（埃及拉美西斯五世在公元前1157年去世，有着明顯的天花症狀），它在20世紀使全球3億人喪命。爲了與梅毒相區別，取名爲天花。天花是一種傳染病，和病人面對面接觸就會被傳染。症狀有發熱、頭痛和嚴重的背痛，緊接着紅色膿包就會長滿全身，留下疤痕。

Smallpox was also the first disease for which a vaccination became available. Britain's Dr. Edward Jenner had heard that milkmaids who had contracted the mild disease of cowpox never developed smallpox. In 1796, he tested the theory by injecting a boy with some pus from a cowpox pustule and saw that it gave him immunity to smallpox. The breakthrough was enormous and paved the way for the science of vaccination. In 1959, the World Health Organization decided to eradicate the disease from the planet by isolating smallpox patients and vaccinating everyone in an area where smallpox was detected. In 1980, the organization declared victory; smallpox was no more.

同時天花也是第一個可以接種疫苗預防的疾病。英國愛德華·詹納醫生聽說那些患有輕微牛痘的擠奶女工從未感染上天花。1796年，他做了個測試，將牛痘膿包的膿水注射入一個男孩體內，然後觀察到他對天花有了免疫。這個突破發現的意義是巨大的，它爲接種醫學奠定了基礎。1959年，世界衛生組織決定隔離天花病人，並給所有感染天花地區的居民接種，以此來徹底消除天花病毒。1980年，世界衛生組織宣佈計劃成功，天花已不復存在。

審校：Fiona 編輯：listen 來源：前十網