【經濟學人】 The Economist 看北美流感 H1N1 Swine Flu

面對北美流感(之前俗稱豬流感, H1N1 Swine Flu),台灣的政治人物已經落到用隔空喊話的地步,卻說不出一個真能安撫人心的道理出來;陸委會可以為了江陳會以及莫名其妙的 ECFA 花大錢拍電視廣告、占用黃金時段來進行逆向的宣導、企圖營造三人成虎的事實,但是面對北美流感時,整體醫療政策與食品政策的組織與動員就是裝傻、裝呆、沉默、踢皮球、之後猛邀請記者開文不對題的會議或記者會、與資訊來源隔空喊話、或乾脆行文下令叫提出警告的學者閉嘴(這真的有好笑了)。

與其這樣,不如來看看【經濟學人】最新一期關於北美流感的文章,看看國外怎麼看待這件事情,中譯文來自中國大陸經濟學人中文團隊:
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An unwelcome Mexican wave
不受歡迎的墨西哥潮
Apr 27th 2009 | NEW YORK
From Economist.com
A mysterious new virus is spreading from Mexico. Could it spark a global pandemic?
神秘新病毒從墨西哥蔓延開來:這會引發一場全球性流感疫情嗎?

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.
本週末墨西哥城的各足球場和大教堂空無一人,這在世人的記憶中還是第一次。但是對於生活在這座佈局雜亂的大都市中的2000萬墨西哥人而言,這並不 是普通的時刻。墨西哥當局下令關閉了所有學校,禁止大型的公共集會以及其他減少人與人接觸的指令,以此來控制突發地全球性病毒災難:截止4月27日星期 一,豬流感病毒已經奪走100條生命。隨著威脅傳到北美其他地區甚至更遠,美國疾病控制中心以及世界衛生組織的官員宣佈處於公共衛生緊急狀態。

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.
罪魁禍首是一種被稱之為A/H1N1的非尋常新型病毒,該病毒是變異為能從豬身上傳染給人類的一種豬流感病毒。墨西哥官方在3月底就開始注意到,感 染肺炎以及其他呼吸道疾病的病人數量異常之多。初步調研後的結論表示,這些病症並非季節性流感所致,而是因為一種由豬、鳥、人類病毒組成的全新雜交病毒 鏈。

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.
在看似感染這種病毒(至少從症狀來看)的人數急劇增加之後,墨西哥提升了預警級別。超過1500名墨西哥人受到可能是這種新病毒所致症狀的折磨。但 是,還不能確定是否大多數病例都是由A/H1N1病毒所致,還是感染了普通的流感病毒。在世界衛生組織專家們的幫助下,墨西哥當地實驗室正緊張地對基因樣 本進行檢測,以確認實際感染豬流感病毒的人數。

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.
儘管墨西哥在控制病毒方面的努力,加利福尼亞、德克薩斯、堪薩斯、奧爾良以及紐約這5個美國州也已經確認有A/H1N1病毒溫和感染的疫情。幾年前被致命性SARS病毒暴發肆虐的加拿大也確認出現了豬流感疫情。在英國,以色列以及新西蘭,豬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).
作為回應,許多國家都越來越警惕,同時增加抗病毒藥物的存量。儘管世界衛生組織保證,熟食豬肉不會傳染豬流感,但還是有一些國家吵嚷著要禁止進口北 美地區的豬肉。中國和俄羅斯開始隔離出現疑似症狀的遊客。亞洲的各大機場已經將發熱感應設備打開,以此來檢測發熱的到來旅客(這些設備在受到早前的禽流感 以及SARS恐嚇之後就已安裝)。世界衛生組織將一項會議安排從週二提前到週一,會上將確定是否將其流行病威脅預警調高一個等級,從3調至4(總共有6個 等級)。

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從本質上而言是否是一種危險的傳染病,目前還言之過早。在墨西哥的所有病例都妥善檢查之後,官方才能得知這些出現流感症狀的病人患有的 是否真的是這種新型病毒還是僅僅只是一些較老型的、不是那麼好擔憂的流感病毒。而且如果沒有這些診斷資訊,也根本不可能決定這種新型病毒的毒性及致死率 等。有關當局很可能在未來的幾天就這些疑問做出定斷,但是在此之前,這個可在全球範圍傳播擴散的病毒應該引起多大的擔憂呢?

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.
真可謂喜憂參半。年輕健康的人似乎成為了這種新病毒的易感人群,而不像普通的流感病毒那樣,通常是年老體衰的人感染。因為大多數人都沒有經常和豬接 觸,所以世界上的許多人都對此病毒缺乏免疫力。這兩個因素合起來則很有可能引起一場大規模的病毒感染,而如果真是這樣的話,那麼將會擴散的非常迅速。現在 還沒有預防A/H1N1病毒傳播的疫苗,就算有關當局從現在開始開發一種疫苗也將耗去好幾個月的時間才能進行該疫苗的生產,而到了那個時侯,病毒早就已經 發生變異了。

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.
豬流感病毒好的一面是,至少目前來講,像特敏福這種常規的抗病毒藥物治療對其有效。世界衛生組織擁有5百萬左右的抗病毒藥物存量,計畫供疫情最嚴重 的國家使用。美國也有5千萬的藥物儲備,同時美國有關當局已經批准在國內下發其中的四分之一。其他的國家也同樣有自己的抗病毒藥物儲備,隨時可用。

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.
同樣令人欣慰的一點是,墨西哥之外的所有確診病例似乎都還病性溫和。墨西哥的多數疑似死亡病例看似都是由於病人拖到病情非常嚴重採取就診所致。這意味著,就算這種病毒在全球範圍內氾濫,那也不會具有致命性:因為提前治療很可能會擊退該病毒。而這也是值得興奮的最重要原因,雖然具體如何,現在還未能知 曉。

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.
在應對流行性疾病方面,與幾年前相比,世界各國如今準備更加充分。這還得多虧了香港、多倫多以及其他早前病毒爆發的中心地區所得到的苦痛教訓,現在 許多國家都有緊急情況規定,而且也更加警惕。世界衛生組織各成員國也同意了一系列合理的關於流行病準備措施完善度、基因樣品共用以及其他全球應對的合作措 施的國際規約。因此,就目前而言,這項新的流行病應對體系似乎運轉良好:但是這是否好到能夠應對A/H1N1?還需要一些時日來發現。