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RominaLibster_2014X-_群体免疫的力量_
One of the first patients I had to see as a pediatrician was Sol , a beautiful month-old baby who was admitted with signs of a severe respiratory infection . 麻疹的爆发亦不会发生 是一个很美丽的弥月婴儿 她患有很严重呼吸道感染的征兆
patients:n.接受治疗者,病人;(patient的复数) pediatrician:n.儿科医师(等于pediatrist); Sol:n.溶胶;索尔(秘鲁的货币);全音阶中的第五音; severe:adj.极为恶劣的;十分严重的;严厉的;苛刻的; respiratory:adj.呼吸的; infection:n.感染;传染;(身体某部位的)感染;传染病;
Until then, I had never seen a patient worsen so fast. 直到那时为止
worsen:vi.恶化;变得更坏;更坏;vt.使恶化;使变得更坏;
In just two days she was connected to a respirator and on the third day she died. 只在两天里,她就要接驳呼吸器 第三天她就离世了
Sol had whooping cough . 索尔患上了百日咳
whooping cough:n.百日咳;
After discussing the case in the room and after a quite distressing catharsis , 在房间里经过一番讨论
distressing:adj.使人痛苦的;令人苦恼的;v.使忧虑;使悲伤;使苦恼(distress的现在分词) catharsis:n.[医]泻法,导泻;净化;精神发泄;
I remember my chief resident said to me, "Okay, take a deep breath. Wash your face. 我记得我的总住院医师曾经对我说: 「好了,深呼吸,洗个脸吧
resident:adj.居住的;住院医师;定居的;n.居民;
And now comes the hardest part: 现在才是最困难
We have to go talk to her parents." 我们要向她的父母解释。」
At that time, a thousand questions came to mind, from, "How could a one-month-old baby be so unfortunate?" 那时候,我脑海里出现很多问题 从「怎么一个弥月的婴儿会这么不幸？」
to, "Could we have done something about it?" 到「我们是否能做些甚么呢？」
Before vaccines existed, many infectious diseases killed millions of people per year. 在疫苗出现之前 很多传染病每年夺去数百万人的性命
vaccines:n.[药][计]疫苗; infectious:adj.传染的;传染性的;易传染的; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
During the 1918 flu pandemic 50 million people died. 1989年流感大流行时期 5千万人死亡
pandemic:adj.(疾病等)全国流行的;普遍的;n.流行性疾病;
That's greater than Argentina 's current population. 比阿限廷现在的人口还多
Argentina:n.阿根廷(位于拉丁美洲);
Perhaps, the older ones among you remember the polio epidemic that occurred in Argentina in 1956. 或许,在座有年纪大一点的会记得1956年在阿限廷 发生了一场脊髓灰质炎流行病
polio:n.小儿麻痹症(等于poliomyelitis);脊髓灰质炎; epidemic:n.流行病;蔓延;adj.传染病;流行性的; occurred:v.发生;出现;存在于;出现在;(occur的过去分词和过去式)
At that time, there was no vaccine available against polio. 在那时候,没有适合的疫苗对抗脊髓灰质炎
People didn't know what to do. They were going crazy. 人们都无计可施
They would go painting trees with caustic lime . 他们用生石灰画树
caustic:adj.[化学]腐蚀性的; n.[助剂]腐蚀剂; lime:n.石灰;酸橙;绿黄色;vt.撒石灰于;涂粘鸟胶于;adj.绿黄色的;
They'd put little bags of camphor in their children's underwear, as if that could do something. 他们将小包的樟脑放进小孩的内衣裤里 彷佛可以产生一些作用
camphor:n.莰酮,樟脑;
During the polio epidemic, thousands of people died. 在这场脊髓灰质炎流行病中
And thousands of people were left with very significant neurological damage. 有几千人死亡
significant:adj.重大的;有效的;有意义的;值得注意的;意味深长的;n.象征;有意义的事物; neurological:adj.神经病学的,神经学上的;
I know this because I read about it, because thanks to vaccines, my generation was lucky to not live through an epidemic as terrible as this. 我是因为阅读而知道这事件的 因为感激疫苗的出现 我们这世代很幸运
live through:度过;经受过;
Vaccines are one of the great successes of the 20th century's public health. 疫苗是20世纪公众健康
After potable water, they are the interventions that have most reduced mortality , even more than antibiotics . 自从有了可饮用的水 对降低死亡率有很大的幫助 甚至比抗生素还大
potable:n.饮料(常复数);adj.适于饮用的; interventions:n.[法]干预,干涉;处置(intervention的复数); mortality:n.死亡数,死亡率;必死性,必死的命运; antibiotics:n.抗菌素;抗生素(如青霉素);(antibiotic的复数)
Vaccines eradicated terrible diseases such as smallpox from the planet and succeeded in significantly reducing mortality due to other diseases such as measles , whooping cough, polio and many more. 疲苗杜绝地球上很多可怕的疾病 例如天花 因其他疾病造成的死亡率,例如麻疹 百日咳、脊髓灰质炎,还有更多
eradicated:adj.画着根的;v.摆脱;擦掉;连根拔起(eradicate的过去分词); smallpox:n.[内科]天花; significantly:adv.意味深长地;值得注目地; measles:n.[内科]麻疹;风疹;
All these diseases are considered vaccine-preventable diseases. 以上所有疾病都被视为
What does this mean? 这是甚么意思呢？
That they are potentially preventable , but in order to be so, something must be done. 即是它们是可预防的 但要预防,必需做一点东西
potentially:adv.可能地,潜在地; preventable:adj.可预防的;可阻止的;可防止的;
You need to get vaccinated . 你需要接种疫苗
vaccinated:v.给…接种疫苗;(vaccinate的过去分词和过去式)
I imagine that most, if not all of us here today, received a vaccine at some point in our life. 我经常想,如果今天我们都不在这儿 在我们人生中某个时候接种疫苗
Now, I'm not so sure that many of us know which vaccines or boosters we should receive after adolescence . 现在,我不确定 我们当中多少人知道长大成人后应该接受哪上疫苗或增压剂
boosters:n.支持者(booster的复数形式);拉拉队; adolescence:n.青春期;
Have you ever wondered who we are protecting when we vaccinate? 你有没有曾经想过当我们接种疫苗时
What do I mean by that? 我究竟想带出甚么意思？
Is there any other effect beyond protecting ourselves? 除了保护我们自身有没有带来其他影响？
Let me show you something. 让我告诉你一些事
Imagine for a moment that we are in a city that has never had a case of a particular disease, such as the measles. 试想像现在这一刻 我们身处在一个城市里 那里从没有发生任何一种疾病 譬如麻疹
This would mean that no one in the city has ever had contact with the disease. 即是说在城市里无一曾经和疾病扯上关系
contact:n.接触,联系;v.使接触,联系;
No one has natural defenses against, nor been vaccinated against measles. 无一拥有天然防御力能或者曾接种疫苗对抗麻疹
If one day, a person sick with the measles appears in this city the disease won't find much resistance and will begin spreading from person to person, and in no time it will disseminate throughout the community . 假若有一天,这个城市出现麻疹有一个人染了病 这个疾病的抗性不高 它会开始人传人 而且很快就会广泛地传播到整个社区
resistance:n.电阻;抵抗;阻力;抗力; in no time:立刻,很快; disseminate:vt.宣传,传播;散布;vi.散布;广为传播; throughout:adv.自始至终,到处;全部;prep.贯穿,遍及; community:n.社区;[生态]群落;共同体;团体;
After a certain time a big part of the population will be ill. 在一段时间之后 很大部分的人都会染病
This happened when there were no vaccines. 这种情形是发生在还没有疫苗的时候
Now, imagine the complete opposite case. 现在,想像一下完全相反的情况
We are in a city where more than 90 percent of the population has defenses against the measles, which means that they either had the disease, survived, and developed natural defenses; or that they had been immunized against measles. 我们身处在一个城市 那儿有超过9成人口 对麻疹是有防御能力的 意思即是要不他们是曾经患有麻疹,幸而存活 要不就是他们本身就已经对麻疹免疫
immunized:adj.免疫的;v.使免疫(immunize的过去式,过去分词形式);
If one day, a person sick with the measles appears in this city, the disease will find much more resistance and won't be transmitted that much from person to person. 假如有一天 城里有一个人罹患麻疹 疾病的抗性较高 不会那么容易在人与人之间传播
transmitted:v.传送;输送;发射;播送;传播;传染;(transmit的过去分词和过去式)
The spread will probably remain contained and a measles outbreak won't happen. 病情就可以受到控制 麻疹的爆发亦不会发生
outbreak:n.(战争的)爆发;(疾病的)发作;vi.爆发;
I would like you to pay attention to something. 我想请你们注意一点
pay attention to:注意
People who are vaccinated are not only protecting themselves, but by blocking the dissemination of the disease within the community, they are indirectly protecting the people in this community who are not vaccinated. 已接种疫苗的人 不单止保障了他们自身 更加阻止了疾病在社区内散播 他们间接保障了 社区里的未接种疫苗人
dissemination:n.宣传;散播;传染(病毒); indirectly:adv.间接地;不诚实;迂回地;
They create a kind of protective shield which prevents them from coming in contact with the disease, so that these people are protected. 他们创造了一个保护屏障 来避免疾病闯进接触到人们 因此那些人受到保障
protective:adj.防护的;关切保护的;保护贸易的; shield:n.盾;防护物;保护者;v.遮蔽;包庇;避开;保卫;
This indirect protection that the unvaccinated people within a community receive simply by being surrounded by vaccinated people, is called herd immunity . 这一种由已接种疫苗的人 包围群体内未接种的人 令他们简单地得到的间接保护 叫群体免疫
unvaccinated:adj.未注苗的;未接种的; herd:n.兽群,畜群;放牧人;vi.成群,聚在一起;vt.放牧;使成群; immunity:n.免疫力;豁免权;免除;
Many people in the community depend almost exclusively on this herd immunity to be protected against disease. 有很多在社群里的人 几乎只靠这种群体免疫来对抗疾病
exclusively:adv.唯一地;专有地;排外地;
The unvaccinated people you see in infographics are not just hypothetical . 你见到图像里未接种疫苗的人不只是个假设
hypothetical:adj.假设的;爱猜想的;
Those people are our nieces and nephews, our children, who may be too young to receive their first shots. 那些人是我们的侄女侄儿、我们的孩子 他们都可能因为年纪太小而不能接受首次疫苗注射
nieces:n.侄女;甥女;(niece的复数)
They are our parents, our siblings ,our acquaintances , who may have a disease, or take medication that lowers their defenses. 那些人或会是我们的父母、兄弟姊妹 我们认识的人却患有疾病 或者接受了药剂反而会减低他们的防御能力
siblings:n.兄;弟;姐;妹;(sibling的复数) acquaintances:n.认识的人;熟人;略有交情;(对某事物的)了解;(acquaintance的复数) medication:n.药;药物;
There are also people who are allergic to a particular vaccine. 此外还有一些对于某种疫苗会过敏的人
allergic:adj.对…过敏的;对…极讨厌的;
They could even be among us, any of us who got vaccinated, but the vaccine didn't produce the expected effect, because not all vaccines are always 100 percent effective . 甚至在我们当中 有些人注射了疫苗 但是疫苗达不到预期的效果 因为不是所有疫苗都百分之百有效
effective:adj.有效的,起作用的;实际的,实在的;给人深刻印象;
All these people depend almost exclusively on herd immunity to be protected against diseases. 这些人全部都几乎 只靠群体免疫来对抗疾病
To achieve this effect of herd immunity, it is necessary that a large percentage of the population be vaccinated. 要实现群体免疫的效用 必需要很大的人口比例接种疫苗
percentage:n.百分比;百分率;利润的分成;提成;
This percentage is called the threshold . 这个比例叫作阈值数
threshold:n.入口;门槛;开始;极限;临界值;
The threshold depends on many variables : 阈值数取决于很多变数
variables:n.[数]变量;
It depends on the germ's characteristics , and those of the immune response that the vaccine generates . 取决于种的特性 和疫苗产生的免疫反应
characteristics:n.特征;特点;品质;(characteristic的复数) immune response:n.免疫应答(机体对抗原的应答); generates:[计]生成;发生;
But they all have something in common. 但他们都有一个共通点
If the percentage of the population in a vaccinated community is below this threshold number, the disease will begin to spread more freely and may generate an outbreak of this disease within the community. 那就是,如果已接种疫苗社区的人口比例 低于这个阈值数 疾病会更自由无碍地扩散 可能会导致该社区爆发疫症
Even diseases which were at some point controlled may reappear . 即使之前已受控的疾病都可能再出现
reappear:vi.再出现;
This is not just a theory. 这个不止是理论
This has happened, and is still happening. 是有发生过,而且仍然在发生
In 1998, a British researcher published an article in one of the most important medical journals , saying that the MMR vaccine, which is given for measles, mumps and rubella ,was associated with autism . 在1998年,一个英国研究者于其中一本 很重要的医学期刊中刊登了一篇论文 当中提及专门预防麻疹、腮腺炎及风疹的 麻腮风三联疫苗跟自闭症有关
journals:n.学术期刊(journal的复数);日记;日记账; mumps:n.[内科]流行性腮腺炎;愠怒;生气; rubella:n.[内科]风疹; associated:adj.有关联的; v.联想; (associate的过去分词和过去式) autism:n.[心理][内科]孤独症;自我中心主义;
This generated an immediate impact . 这产生了即时性的影响
generated:v.产生;引起;(generate的过去式和过去分词) impact:n.影响;效果;碰撞;冲击力;v.挤入,压紧;撞击;对…产生影响;
People began to stop getting vaccinated, and stopped vaccinating their children. 人们开始停止接种疫苗,更不让他们的孩子接种疫苗
vaccinating:vi.接种疫苗;vt.给…注射疫苗;n.被接种牛痘者;
And what happened? 然后结果呢？
The number of people vaccinated, in many communities around the world, fell below this threshold. 全世界很多国家接种疫苗的人数 下跌至低于阈值数
communities:n.社区;社会;团体;共有(community的复数)
And there were outbreaks of measles in many cities in the world -in the U.S., in Europe. 世界各国 — 美国、欧洲都爆发麻疹
outbreaks:n.(战争的)爆发;(疾病的)发作;vi.爆发;
Many people got sick. 很多人患病
People died of measles. 很多人死于麻疹
What happened? 之后怎样呢？
This article also generated a huge stir within the medical community. 那篇论文在医学界亦牵起了巨大的轰动
stir:v.搅拌;搅动;激发;搅和;n.搅拌;搅动;震动;搅和;
Dozens of researchers began to assess if this was actually true. 许多研究人员开始着手评估这是否属实
assess:vt.评定;估价;对…征税;
Not only could no one find a causal association between MMR and autism at the population level, but it was also found that this article had incorrect claims . 不单没有一个找到麻腮风三联疫苗与 人口水平上自闭症的因果关系 更加发现那篇论文存在不实的言论
causal:adj.因果关系的;有原因的;n.表示原因的连词; association:n.协会;关联;联想;交往; claims:v.宣称; n.声明; (claim的第三人称单数和复数)
Even more, it was fraudulent . 更甚的是,它是骗人的
fraudulent:adj.欺骗性的;不正的;
It was fraudulent. 是欺诈的
In fact, the journal publicly retracted the article in 2010. 事实上,在2010年该期刊公开声明收回那篇论文
retracted:adj.可伸缩的;
One of the main concerns and excuses for not getting vaccinated are the adverse effects. 其中一个主要的顾虑和不接种疫苗的藉口 是不利的影响
concerns:n.关注; v.使关心(concern的三单形式); adverse:adj.不利的;相反的;敌对的(名词adverseness,副词adversely);
Vaccines, like other drugs, can have potential adverse effects. 疫苗,就像其他药物可以带来潜在的反面影响
Most are mild and temporary . 多数是温和及短暂的
mild:adj.温和的; n.(英国的一种)淡味麦芽啤酒; temporary:adj.暂时的,临时的;n.临时工,临时雇员;
But the benefits are always greater than possible complications. 但益处一般都比可能存在的併发症多
When we are ill, we want to heal fast. 当我们患病,一定要尽快医治
heal:v.复原;治疗(病人);使又愉快起来;(使)结束
Many of us who are here take antibiotics when we have an infection, we take anti-hypertensives when we have high blood pressure , we take cardiac medications . 许多人当被感染到传染病时会服食抗生素 当高血压时服用降压药 有时候服食心脏药
blood pressure:n.[医]血压; cardiac:n.强心剂;强胃剂;adj.心脏的;心脏病的;贲门的; medications:n.药;药物;(medication的复数)
Why? Because we are sick and we want to heal fast. 为甚么呢？因为我们生病,需要尽快治理
And we don't question it much. 我们不会对此存疑
Why is it so difficult to think of preventing diseases, by taking care of ourselves when we are healthy? 那为甚么当我们健康的时候将预防疾病 当作是照顾自己一样就变得这么困难呢？
We take care of ourselves a lot when affected by an illness, or in situations of imminent danger. 在我们患病时或者在危难迫近眉睫的情形时 我们懂得好好照顾自己
imminent:adj.即将来临的;迫近的;
I imagine most of us here,remember the influenza-A pandemic which broke out in 2009 in Argentina and worldwide . 我想在座各位很多都记得2009年 在阿根廷及世界各地爆发的流感大流行
worldwide:adj.全世界的;adv.在世界各地;
When the first cases began to come to light, we, here in Argentina, were entering the winter season. 当时第一批感染个案曝光时 我们在阿根廷正在步入冬季
We knew absolutely nothing. 当时我们一无所知
absolutely:adv.绝对地;完全地;
Everything was a mess . 简直是一团糟
mess:n.混乱;餐厅;杂乱;肮脏;v.使不整洁;弄脏;弄乱;随地便溺;
People wore masks on the street, ran into pharmacies to buy alcohol gel . 街上的人们都戴上口罩走到药房购买酒精液
pharmacies:n.药房(pharmacy的复数);制药业;药剂学; alcohol:n.酒精;乙醇;含酒精饮料; gel:vi.胶化;n.[物化]凝胶,胶体;
People would line up in pharmacies to get a vaccine, without even knowing if it was the right vaccine that would protect them against this new virus. 人们在药房外排队等候疫苗 他们甚至不知道那疫苗是否合适 是否能够保护他们对抗新病毒
We knew absolutely nothing. 我们完全是一无所知
At that time, in addition to doing my fellowship at the Infant Foundation , 当时,我除了处理我在婴幼儿基金会研究金的审查
in addition to:除…之外; fellowship:n.友谊;奖学金;研究员职位; Infant:n.婴儿;幼儿;未成年人;adj.婴儿的;幼稚的;初期的;未成年的; Foundation:n.基础;地基;基金会;根据;创立;
I worked as a home pediatrician for a prepaid medicine company. 我还在一间预付医药公司当家庭儿科医生
prepaid:adj.先付的,已支付的;v.预付(prepay的过去式和过去分词);
I remember that I started my shift at 8 a.m., and by 8, I already had a list of 50 scheduled visits. 我记得当时从早上8时当值至晚上8时 已经有50个预定探访的名单
shift:n.移动;变化;手段;轮班;v.移动;转变;转换;
It was chaos; people didn't know what to do. 那时一片混乱;大家都不知道怎么办
I remember the types of patients that I was examining. 我还记得我很留意为哪些类型的病人作檢查
The patients were a little older than what we were used to seeing in winter, with longer fevers. 那些病人比我们往常在冬季见到的年纪大一点 发烧的时间较长一点
And I mentioned that to my fellowship mentor , and he, for his part, had heard the same from a colleague , about the large number of pregnant women and young adults being hospitalized in intensive care , with hard-to-manage clinical profiles . 我向我研究金的导师提及这一点 他亦从他的同事听闻过相同的情况 大量孕妇及年轻成人 正在深切治疗部留医 他们的临床资料被归类为复杂个案
mentor:n.指导者,良师益友;vt.指导; colleague:n.同事,同僚; pregnant:adj.怀孕的;富有意义的; hospitalized:vt.住院;入院就医;(hospitalize的过去分词); intensive care:n.(医院里的)特别护理病房;重症监护; clinical:adj.临床的;诊所的; profiles:n.配置文件; v.扼要描述;
At that time, we set out to understand what was happening. 在那时候,我们着手瞭解究竟发生甚么事
First thing Monday morning, we took the car and went to a hospital in Buenos Aires Province, that served as a referral hospital for cases of the new influenza virus. 在星期一早上 我们驾车到布宜诺斯艾利斯省的一家医院 那儿被划为新型流感病毒个案的转诊医院
referral:n.参照;提及;被推举的人;转诊病人; influenza:n.[内科]流行性感冒(简写flu);家畜流行性感冒;
We arrived at the hospital; it was crowded. 我们到达医院的时候,那儿很拥挤
All health staff were dressed in NASA-like bio-safety suits. 所有医护人员都穿上像美国太空总署的生物安全服
bio-safety:生物安全;
We all had face masks in our pockets. 我们全部在衣袋里都有面罩
I, being a hypochondriac , didn't breathe for two hours. 我犹如一个疑病症患者,两小时都不能呼吸
hypochondriac:n.忧郁症患者;adj.忧郁症的;
But we could see what was happening. 可是我们目睹这是甚么一回事
Immediately, we started reaching out to pediatricians from six hospitals in the city and in Buenos Aires Province. 我们立即开始联络位于城市及 布宜诺斯艾利斯省一共六间医院的儿科医生
pediatricians:n.儿科医师;[儿科]儿科医生(pediatrician的复数);
Our main goal was to find out how this new virus behaved in contact with our children,in the shortest time possible. 我们的主要目的是在最短到时间内找出 这种新病毒在接触小孩时有甚么表现
behaved:v.表现;表现得体;有礼貌;(behave的过去分词和过去式)
A marathon work. 是一场马拉松式的工作
In less than three months, we could see what effect this new H1N1 virus had on the 251 children hospitalized by this virus. 在三个月内 我们见到新型H1N1病毒 在251个因该病毒而留医的小朋友身上产生甚么影响
We could see which children got more seriously ill: children under four, especially those less than one year old; patients with neurological diseases; and young children with chronic pulmonary diseases. 我们见到哪些小孩会病得较重: 四岁以下,尤其少于一岁的小朋友; 有神经疾病的患者; 与及患上慢性肺部疾病的小朋友
especially:adv.尤其;特别;格外;十分; chronic:adj.慢性的;长期的;习惯性的; pulmonary:adj.肺的;有肺的;肺状的;
Identifying these at-risk groups was important to include them as priority groups in the recommendations for getting the influenza vaccine, not only here in Argentina, but also in other countries which the pandemic not yet reached. 识别这些高危人士很重要 可以将他们囊括在 建议优先取得流感疫苗的一群里 不单只在阿根廷 在其它流感大流行尚未出现的国家都一样
Identifying:n.识别,标识;标识关系;v.识别;(identify的现在分词) at-risk:adj.处于危险中的; priority:n.优先;优先权;[数]优先次序;优先考虑的事; recommendations:n.推荐;推荐信;推荐规范(recommendation的复数形式);
A year later, when a vaccine against the pandemic H1N1 virus became available, we wanted to see what happened. 一年后 对抗流感大流行H1N1病毒的疫苗面世 我们想见到会发生甚么事
After a huge vaccination campaign aimed at protecting at-risk groups, these hospitals, with 93 percent of the at-risk groups vaccinated, had not hospitalized a single patient for the pandemic H1N1 virus. 在一个以保障高危一族为主 的大型疫苗接种活动后 那些医院有9成3的高危人士接种疫苗 之后他们再没有需要 留医H1N1流感的单一患者
vaccination:n.接种疫苗;种痘;
(Applause) （拍掌）
In 2009: 251. 2009年:251宗
In 2010: zero. 2010年:0宗
Vaccination is an act of individual responsibility, but it has a huge collective impact. 接种疫苗是个人责任的表现 却带来庞大的集体影响
individual:n.个人;有个性的人;adj.单独的;个别的; collective:adj.集体的;共同的;集合的;集体主义的;n.集团;集合体;集合名词;
If I get vaccinated, not only am I protecting myself, but I am also protecting others. 假如我一经接种,我不单只保障自己 更保障了其他人
Sol had whooping cough. 索尔罹患百日咳
Sol was very young, and she hadn't yet received her first vaccine against whooping cough. 索尔还很年幼 她不能够注射首支疫苗来对抗百日咳
I still wonder what would have happened if everyone around Sol had been vaccinated. 我仍然在想如果每一个在索尔身边的人都已经接种了疫苗 会有一个怎么样的结果
(Applause)