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Zika fever:
譯者: 易帆 余 審譯者: JieWei Li
our newest dread disease.
茲卡病毒:
What is it? Where'd it come from?
我們最新的可怕疾病。
What do we do about it?
它是什麼?從何而來?
Well for most adults, it's a relatively mild disease --
我們該怎麼應對?
a little fever, a little headache, joint pain, maybe a rash.
對多數成年人來說, 它只算是個輕微的小病──
In fact, most people who get it don't even know they've had it.
只會微微發燒、頭痛、 關節痛、可能會起紅疹。
But the more we find out about the Zika virus
實際上,很多得過的人 根本就不知道自己得過這個病。
the more terrifying it becomes.
但當我們越了解茲卡病毒,
For example, doctors have noticed an uptick
它就變得越恐怖。
of something called Guillain-Barré syndrome in recent outbreaks.
例如,最近醫生發現 在近幾次的疫情爆發中,
In Guillain-Barré, your immune system attacks your nerve cells
格林—巴利症候群患者 有急速增加的現象。
it can partially or even totally paralyze you.
一旦得了格林—巴利症, 你的免疫系統就會攻擊神經細胞,
Fortunately, that's quite rare, and most people recover.
它會使你部分或全身癱瘓。
But if you're pregnant when you're infected
還好,這樣的現象很罕見, 大多數人都能痊癒。
you're at risk of something terrible.
但如果妳懷孕時染上病毒,
Indeed, a child with a deformed head.
你會遭遇到很恐怖的風險。
Here's a normal baby.
沒錯,小孩子的頭部會畸形。
Here's that infant with what's called microcephaly.
這是正常的小孩。
a brain in a head that's too small.
這是患有小頭畸形的小孩,
And there's no known cure.
頭骨對腦來說太小了。
It was actually doctors in northeastern Brazil
目前還沒有治癒方法。
who first noticed, just a year ago, after a Zika outbreak,
其實這是由一群 在巴西東北部的醫生,
that there was a peak in the incidence of microcephaly.
在去年茲卡病毒爆發後首度發現的。
It took medical doctors another year
小頭畸形的案例突然攀升。
to be sure that it was caused by the Zika virus,
醫生們又用了一年
but they're now sure.
來確定是不是由 茲卡病毒所引起的症狀。
And if you're a "bring on the evidence" type,
但他們現在已經非常肯定了。
check out this publication.
如果你是「實事求是」那一型的人,
So where did it come from, and how did it get here?
可以來看看這篇公開的文章。
And it is here.
怎麼會這樣?到底怎麼傳到這裡的?
Like many of our viruses, it came out of Africa,
這裡的確有病例。
specifically the Zika forest in Uganda.
像其他許多病毒一樣, 茲卡病毒是從非洲傳出來的,
Researchers at the nearby Yellow Fever Research Institute
準確來說是烏干達的茲卡森林。
identified an unknown virus in a monkey in the Zika forest
研究員在黃熱病 調查機構的附近發現,
which is how it got its name.
確診出茲卡森林裡面的猴子 有這個未知病毒。
The first human cases of Zika fever
這就是茲卡病毒命名的由來。
surfaced a few years later in Uganda-Tanzania.
人類的第一件茲卡病例,
The virus then spread through West Africa
是那之後幾年 在烏干達坦尚尼亞間發現。
and east through equatorial Asia -- Pakistan, India, Malaysia, Indonesia.
之後這個病毒傳到西非,
But it was still mostly in monkeys and, of course, mosquitoes.
往東傳到亞洲的赤道國家,
In fact in the 60 years between the time it was first identified in 1947 and 2007
像巴基斯坦、印度、 馬來西亞、印尼等國。
there were only 13 reported cases of human Zika fever.
但這病毒仍大多存在猴子身上, 當然還有蚊子身上。
And then something extraordinary happened on the tiny Micronesian Yap islands.
其實在這 60 年間,也就是 1947 年第一次爆發到 2007 年,
There was an outbreak that affected fully 75 percent of the population.
人類染上茲卡病毒的 紀錄只有 13 例,
How did it get there? By air.
之後,在密克羅尼西亞的雅浦島上 發生了非常不尋常的事。
Today we have two billion commercial airline passengers.
有 75% 的人口都受到感染。
An infected passenger can board a plane, fly halfway around the world
病毒怎麼傳到那裡的?透過飛機。
before developing symptoms -- if they develop symptoms at all.
現在全球有 20 億商業飛行旅客。
Then when they land, the local mosquitoes begin to bite them and spread the fever.
一個受感染的乘客上了飛機, 就可以飛過大半個地球,
Zika fever then next surfaced in 2013 in French Polynesia.
在這之前,不會有任何症狀。
By December of that year, it was being transmitted locally by the mosquitoes.
一旦他們抵達目的地, 當地的蚊子就會咬他們並擴散病毒,
That led to an explosive outbreak in which almost 30,000 people were affected.
茲卡病毒接著於 2013 年 在法屬玻里尼西亞爆發。
From there it radiated around the Pacific.
當年12月病毒 就藉由蚊子傳到各地,
There were outbreaks in the Cook Islands, in New Caledonia,
造成疫情大規模爆發, 近三萬人遭到感染。
in Vanuatu, in the Solomon Islands
之後再擴散到整個太平洋地區。
and almost all the way around to the coast of South America and Easter Island.
傳出疫情的地區有 庫克群島、新喀里多尼亞、
And then, in early 2015,
萬那杜、所羅門群島,
there was an upsurge of cases of a dengue-like syndrome
幾乎整個南美沿岸和復活島都爆發了。
in the city of Natal in northeastern Brazil.
接著,在 2015 年年初,
The virus wasn't dengue, it was Zika, and it spread rapidly --
在巴西東北部的城市納塔爾,
Recife down the coast, a big metropolitan center, soon became the epicenter.
出現了大量疑似染上登革熱的病患。
Well people have speculated that it was 2014 World Cup soccer fans
那不是登革熱病毒,是茲卡, 而且傳播非常迅速。
that brought the virus into the country.
南岸的大都市勒西菲 也成了下一個疫情中心。
But others have speculated that perhaps it was Pacific Islanders
有人猜測是 2014 年的足球杯球迷
participating in championship canoe races
把病毒帶到巴西。
that were held in Rio that year that brought it in.
但有其他人推測 有可能是太平洋島居民
Well today, this is only a year later.
在里約舉辦的獨木舟競賽,
The virus is being locally transmitted by mosquitoes
在當年把病毒帶進來的。
virtually throughout South America, Central America, Mexico
現在,才事隔一年。
and the Caribbean Islands
病毒就在當地被蚊蟲傳播開來,
Until this year, the many thousands of cases
幾乎整個南美洲、中美洲、墨西哥、
that have been diagnosed in the US were contracted elsewhere.
加勒比海群島都被感染了。
But as of this summer, it's being transmitted locally in Miami.
直到今年,已有數千起病例
It's here.
在美國被確診出來, 但卻是在別處受到感染的。
So what do we do about it?
但今年夏天在邁阿密當地 已出現本土傳播病例,
Well, preventing infection
就在這裡。
is either about protecting people or about eliminating the mosquitoes.
所以我們該怎麼辦?
Let's focus on people first.
避免感染,
You can get vaccinated.
不是保護民眾就是消滅蚊蟲。
You can not travel to Zika areas.
我們先從人的面向來看。
Or you can cover up and apply insect repellent.
你可以注射疫苗。
Getting vaccinated is not an option, because there isn't a vaccine yet
不要去有茲卡疫情的地區。
and there probably won't be for a couple of years.
或是全身包起來噴防蚊液。
Staying home isn't a foolproof protection either
注射疫苗不在考量的範圍內, 因為根本就還沒有疫苗。
because we now know that it can be sexually transmitted.
且接下來幾年也許都不會有。
Covering up and applying insect repellent does work ...
一直待在家裡也不是個方法。
until you forget.
因為我們現在知道 它也可以透過性交傳染。
(Laughter)
包得緊緊地跟噴防蚊液是有用的,
So that leaves the mosquitoes, and here's how we control them now:
除非你忘了。
spraying insecticides.
(笑聲)
The protective gear is necessary because these are toxic chemicals
那就從蚊子下手吧, 我們控制的方法就是:
that kill people as well as bugs.
噴灑殺蟲劑。
Although it does take quite a lot more to kill a person than to kill a bug.
防護員一定要穿防護衣, 因為那是有毒的化學物質,
These are pictures from Brazil and Nicaragua.
它不只殺蟲,也可以殺人。
But it looks the same in Miami, Florida.
只是殺人的劑量比殺蟲來的高很多。
And we of course can spray insecticides from planes.
這是在巴西和尼加拉瓜的照片。
Last summer, mosquito control officials in Dorchester County, South Carolina,
但看起來和佛羅里達的邁阿密一樣。
authorized spraying of Naled, an insecticide,
當然我們也可以用飛機噴灑殺蟲劑。
early one morning, as recommended by the manufacturer.
去年夏天,
Later that day, a beekeeper told reporters
南卡州多徹斯特郡的蚊蟲控制人員,
that her bee yard looked like it had been nuked.
被授權准許噴灑一種 叫乃力松的殺蟲劑。
Oops.
製造商建議要在早上噴藥。
Bees are the good guys.
當天傍晚,有養蜂人跟記者說,
The citizens of Florida protested, but spraying continued.
她的養蜂場看起來 像被轟炸過一樣。
Unfortunately, so did the increase in the number of Zika fever cases.
哇……
That's because insecticides aren't very effective.
蜜蜂是好的昆蟲。
So are there any approaches that are perhaps more effective than spraying
佛羅里達居民發起抗議, 當局卻依然故我。
but with less downsides than toxic chemicals?
不幸的是,茲卡病例仍在增加。
I'm a huge fan of biological controls,
那是因為殺蟲劑不夠有效。
and I share that view with Rachel Carson, author of "Silent Spring,"
那有什麼方法 是比噴灑殺蟲劑還有效,
the book that is credited with starting the environmental movement.
但副作用比有毒的化學藥劑小?
In this book she tells the story, as an example,
我非常推崇生物控制這個方式。
of how a very nasty insect pest of livestock
我向瑞秋卡森分享我的想法, 她是《寂靜春天》的作者。
was eliminated in the last century.
這本書促使了環境保護運動的抬頭。
No one knows that extraordinary story today.
她在書中以故事為例,
So Jack Block and I, when we were writing an editorial
說明了一種非常討人厭的牲畜害蟲
about the mosquito problem today, retold that story.
是如何在上世紀滅絕的。
And in capsule form, it's that pupae -- that's the immature form of the insect --
現在沒人知道這個驚人的故事。
were irradiated until they were sterile, grown to adulthood
所以當時我和傑克布拉克就一起
and then released from planes all over the Southwest,
藉由重述這個故事的方式, 寫了篇有關蚊子問題的社論,
the Southeast and down into Mexico and into Central America
簡而言之,
literally by the hundreds of millions from little airplanes,
在昆蟲尚未成蟲仍是蛹的時後,
eventually eliminating that terrible insect pest
就用放射線照射, 使他們無繁殖能力,
for most of the Western Hemisphere.
牠們長大成蟲後, 用飛機將牠們釋放到西南部、
Our real purpose in writing this editorial
東南部、往下到墨西哥跟中美洲,
was to introduce readers to how we can do that today --
直接從小飛機放飛幾億隻的蚊子,
not with radiation but with our knowledge of genetics.
最後將這糟糕的害蟲
Let me explain.
從西半球消失。
This is the bad guy: Aedes aegypti.
我們寫這篇社論的用意,
It's the most common insect vector of diseases,
是要告訴讀者 我們現在可以怎麼做──
not just Zika but dengue, Chikungunya, West Nile virus
不是靠放射線的方式, 而是靠我們對遺傳學的知識。
and that ancient plague, yellow fever.
讓我解釋一下。
It's an urban mosquito,
這個壞蛋 : 白線斑蚊。
and it's the female that does the dirty work.
這個昆蟲是最常見的疾病帶原者,
She bites to get a blood meal to feed her offspring.
不只是茲卡,還有登革熱、 屈公熱、西尼羅病毒
Males don't bite; they don't even have the mouth parts to bite.
和那個古老的瘟疫黃熱病。
A little British company called Oxitec genetically modified that mosquito
牠是一種都市型蚊子,
so that when it mates with a wild female, its eggs don't develop to adulthood.
而且只有母蚊子會咬人。
Let me show you.
她咬人是為了吸血來餵食後代。
This is the normal reproductive cycle.
公蚊子不會叮人, 牠們甚至沒有叮人的器官。
Oxitec designed the mosquito so that when the male mates with the wild female
一間名為 Oxitec 的英國生技小公司 修改了蚊子的基因,
the eggs don't develop.
讓公蚊和野生母蚊子生下的卵 無法順利成長至成年。
Sounds impossible?
我秀給大家看。
Well let me show you just diagrammatically how they do it.
這是正常的傳宗接代週期,
Now this represents the nucleus of a mosquito cell,
Oxitec 則是讓公蚊子和 野生母蚊子交配後
and that tangle in the middle represents its genome,
產下的卵無法成長。
the sum total of its genes.
聽起來很不可思議?
Scientists added a single gene
讓我用圖解的方式告訴各位 他們是怎麼辦到的。
that codes for a protein represented by this orange ball
這個代表蚊子細胞裡的細胞核,
that feeds back on itself to keep cranking out more of that protein.
中間一坨一坨的代表牠的基因組,
The extra copies, however, go and gum up the mosquitoes' genes,
也就是所有的基因。
killing the organism.
科學家插入了一個基因,
To keep it alive in the laboratory they use a compound called tetracycline.
圖中橘色球代表被編碼過的蛋白質,
Tetracycline shuts off that gene and allows normal development.
這蛋白質會被回植到細胞裡,
They added another little wrinkle so that they could study what happens.
然後開始持續大量 增生出同樣的蛋白質。
And that is they added a gene that makes the insect glow under UV light
然而,多餘的蛋白質 會把蚊子的基因黏合在一起,
so that when they released it they could follow exactly how far it went
並摧毀有機體。
how long it lived and all of the kinds of data
為了讓公蚊在實驗室存活, 他們使用了一種合成物稱作四環素。
for a good scientific study.
四環素會關掉那個基因, 並且讓公蚊正常成長。
Now this is the pupal stage, and at this stage
他們也運用了一個小技巧, 來研究公蚊的變化。
the females are larger than the males.
他們插入了另一個基因, 讓昆蟲在紫外線燈底下成長,
That allows them to sort them into the males and the females
在將來釋放公蚊後, 好跟蹤牠們飛了多遠、
and they allow only the males to grow to adulthood.
活了多久,
And let me remind you that males don't bite.
還有將來方便各種研究的資料。
From there it's pretty simple.
這是蛹的階段,而在這個階段,
They take beakers full of male mosquitoes,
雌性會比雄性來得大。
load them into milk cartons, and drive around the city,
所以他們能將雄性和雌性區分開來,
releasing them guided by GPS.
而且他們只讓公蚊長大至成蚊。
Here's the mayor of a city releasing the first batch
我再次提醒各位,公蚊不會咬人。
of what they call the "friendly Aedes."
這樣就單純多了。
Now I wish I could tell you this is an American city, but it's not.
他們把裝滿蚊子的燒杯
It's Piracicaba, Brazil.
裝進牛奶箱子,然後開車繞市區,
The amazing thing is that in just a year
並且根據衛星定位將牠們釋放。
it brought down the cases of dengue by 91 percent.
這位市長釋放了第一批蚊子,
That's better than any insecticide spraying can do.
他們稱這些蚊子為 「友善的埃及伊蚊」。
So why aren't we using this remarkable biological control in the US?
跟各位說,我希望 這是在美國的城市,但並不是。
That's because it's a GMO: a genetically modified organism.
這是在巴西的皮拉西卡巴。
Notice the subtitle here says if the FDA would let them
最驚奇的是,僅僅才一年的時間,
they could do the same thing here, when Zika arrives.
登革熱的案例下降了 91% 。
And of course it has arrived.
比噴灑任何殺蟲劑 所得到的成果好太多了。
So now I have to tell you the short form
所以我們為何不在美國 使用這個卓越的生物防治方法呢?
of the long, torturous story of GM regulation in the US
那是因為牠是GMO: 基因改造生物。
In the US, there are three agencies that regulate genetically modified organisms:
注意看一下副標題寫的, 如果美國食藥管理局同意,
the FDA, the Food and Drug Administration,
當茲卡病毒爆發時, 他們可以在這裡做同樣的事。
the EPA, the Environmental Protection Agency,
當然茲卡的確來了。
and the USDA, US Department of Agriculture.
所以現在我用簡短的方式, 來向各位說明
Took these folks two years to decide that it would be the FDA
這個在美國 又臭又長的基因改造規範。
that would regulate the genetically modified mosquito.
在美國,有三個機構 在管理基因改造的生物:
And they would do it as a new animal drug, if that makes any sense.
FDA ,食品藥物管理局,
Took them another five years going back and forth and back and forth
EPA,國家環境保護局,
to convince the FDA that this would not harm people,
以及 USDA,美國農業部。
and it would not harm the environment.
這些單位花了兩年的時間 才決定由食品藥物管理局
They finally gave them, this summer, permission to run a little test
來規範管理基因改造蚊子,
in the Florida Keys,
如果有效,他們會將它 看成是一種新的動物藥品,
where they had been invited years earlier when they Keys had an outbreak of dengue.
然後又花了五年的時間來來回回,
Would that it were that easy.
說服食品藥物管理局 這不會對人類有害,
When the local residents heard
也不會對環境有害。
that there would be genetically modified mosquitoes tested in their community
在今年夏天,他們終於同意
some of them began to organize protests.
在佛羅里達群島做一個小小的測試,
They even organized a petition on the internet with this cuddly logo,
在幾年前登革熱爆發的時候, 他們就被邀請這麼做了。
which eventually accumulated some 160,000 signatures
要是這麼簡單就好了。
And they demanded a referendum
當地的居民一聽到,
which will be conducted in just a couple of weeks
會有基因改造的蚊子被釋放到 他們的社區試驗時,
about whether the trials would be permitted at all.
部分居民就開始組織抗議行動。
Well it's Miami that really needs these better ways of controlling insects.
他們甚至在網上發送 有這個可愛標誌的請願書,
And there the attitudes are changing.
最終獲得了 16 萬人的簽名聯署。
In fact, very recently a bipartisan group of more than 60 legislators
他們要求公投,
wrote to HHS Secretary Sylvia Burwell
並且會在幾個禮拜內就舉行,
asking that she, at the Federal level, expedite access for Florida
決定這個試驗是否應該被批准。
to this new technology.
但其實邁阿密才是真正需要 這個方法來控制蚊蟲的地方。
So the bottom line is this:
那邊的態度正在改變。
biological control of harmful insects
事實上,最近一個包含 60 多個立法委員的兩黨組織
can be both more effective and very much more environmentally friendly
寫信給美國公衛部部長 希爾維雅布爾維爾,
than using insecticides, which are toxic chemicals.
要求她在聯邦高層 加速完成佛羅里達
That was true in Rachel Carson's time; it's true today.
對這項科技的請求。
What's different is that we have enormously more information
所以結論是:
about genetics than we had then,
利用生物控制來控制害蟲,
and therefore more ability to use that information
遠比使用有毒的化學藥物殺蟲劑
to affect these biological controls.
來得有效,且對環境也比較友善。
And I hope that what I've done is aroused your curiosity enough
這在瑞秋卡森的時代是正確的, 在我們的時代也是。
to start your own inquiry -- not into just GM mosquitoes
不一樣的是,我們比當時的人
but to the other genetically modified organisms that are so controversial today.
擁有更多基因學方面的知識,
I think if you do that, and you dig down through all of the misinformation,
因此我們擁有更多的能力 來運用那這些資訊,
and the marketing
來影響控制這些生物。
on the part of the organic food industry and the Greenpeaces
我希望我有引起各位的好奇心,
and find the science, the accurate science,
讓各位開始進行研究── 不只是基因改造蚊子,
you'll be surprised and pleased.
還有其它當今仍備受爭議的 基因改造生物。
Thank you.
我想如果你開始研究, 並往下挖掘所有的誤導資訊,
(Applause)
以及有機食品產業和