Name: 【Ted-Ed】為何腦膜炎如此危險? (Why is meningitis so dangerous? - Melvin Sanicas)
Uploaded: 2018-11-20T01:37:17.000Z
Duration: 4 min 54 s

In 1987, tens of thousands of people gathered in Saudi Arabia for the annual Hajj pilgrimage.

1987 年，數以萬計的人們聚集在沙烏地阿拉伯參加一年一度的 Hajj 朝聖活動

But what started out as a celebration led to a health crisis:

但是伴隨著這次慶典而來的是一場健康危機

just a few days after the pilgrimage, more than 2,000 cases of meningitis

就在朝聖活動幾天之後，超過 2000 起的腦膜炎案例發生

broke out spreading across Saudi Arabia and the rest of the world.

這場疫情蔓延擴散沙烏地阿拉伯和世界各地

The outbreak was so fierce that it was believed to have sparked a wave of deadly meningitis

疫情爆發來得如此兇猛以至於大多數人相信會有一波腦膜炎

epidemics that ultimately infected tens of thousands of people worldwide.

大流行，最終會感染全世界數以萬計的人們

Meningitis is the inflammation of the meninges, three tissue layers responsible

腦膜炎指得就是腦膜發炎，腦膜是一個三層的組織

for protecting the brain and spinal cord. What makes meningitis so dangerous compared

功能是保護大腦和脊椎。讓腦膜炎

to other diseases is the sheer speed with which it invades a person's body.

相較於其他疾病來說更加危險的是它能夠入侵人體的速度

In the worst cases, it causes death  within a day. Fortunately, that's rare

最糟的情況下，一天就能夠致命。幸好，這對

for patients who receive early medical treatment.

大部分能夠在早期接受治療的病患就不是如此

The disease primarily  comes in three forms:

腦膜炎傳染途徑主要有以下三種：

fungal, viral, and bacterial-- the last being the most deadly by far,

真菌、病毒和細菌感染 -- 最後一種是至今最致命的

People usually contract bacterial meningitis by breathing in tiny particles

人們通常藉由吸入病患打噴嚏或咳嗽排在空氣當中的口沫以及黏液上的微小粒子

of mucus and saliva that spray into the air when an infected person sneezes or coughs.

It can also be transmitted through kissing, or sharing

cigarettes, toothbrushes or utensils.  Some people can be infected and carry the

香菸、共用牙刷或者器皿等途徑傳染。某些人能夠在尚未顯現任何症狀或發病的時候

disease without showing symptoms or getting sick, which helps the disease

傳染給其他人，也因此幫助這種疾病

Once the bacteria enter  the nose, mouth, and

throat, they cross the surrounding  membranes and enter the bloodstream.

喉嚨，會跨越過周遭的細胞膜之後進入血管當中

From there, bacteria have rapid access to the body's tissues--including a membrane

至此，細菌就能夠迅速地通過身體的組織 -- 包括稱為血腦屏障的

called the blood-brain barrier. This is made of a tight mesh of cells which

細胞膜。血腦屏障是由一層緊密排列的細胞

separate blood vessels from the brain, and block everything except for a specific

將血管和大腦區分開來，並且阻擋任何除了某些特定的粒子，像是水分子

set of particles, including water molecules and some gasses. But in ways

that scientists are still trying to understand, meningitis bacteria can trick

但科學家仍想方設法去了解到底為何引發腦膜炎的細菌能夠

Inside the brain, the bacteria swiftly infect the meninges.

This triggers inflammation as the body's immune response

這引發了身體的免疫系統過渡反應導致發炎現象

kicks into overdrive, bringing on fever and intense headaches. As swelling in the

產生發燒和劇烈頭痛症狀。腦膜不斷地

meninges worsens, the neck begins to stiffen. Swelling in the brain disrupts its

腫脹惡化，脖子開始變得僵直。腦中的腫脹擾亂了

normal function--causing symptoms like hearing loss and extreme

腦部正常功能－導致像是聽力受損以及對於光線嫉妒

light sensitivity. As pressure increases in the cranium, it may also make the

敏感的情形。當顱內壓力繼續累積，可能也會讓

person confused--one of the hallmarks of the disease.

人變得神智不清 — 也是腦膜炎其中一種最具代表性的症狀

A few hours in, the rapidly multiplying bacteria start to release toxins,

短短幾個小時時間，急速增加的細菌釋放的大量毒素

also known as blood poisoning. This breaks down blood vessels,

被人熟知為血毒症。讓血管崩解

letting blood seep out and form what  starts out looking like a rash, and

使血液滲出在皮膚表面形成像是起紅疹症狀，

evolves into big discoloured blots beneath the skin. At the same time, those toxins

演變成在皮膚下的大量血塊。於此同時，那些毒素

burn through oxygen in the blood, reducing the amount that gets to major organs like

耗光血液中的氧氣，減少進入像是肺和腎臟等主要器官

the lungs and kidneys. That increases the chance of organ shut down--and alongside

的氧氣量。導致這些器官衰竭的機率高升 — 伴隨著

敗血症的擴散，死亡的威脅一步步逼近

That all sounds scary, but doctors are so

這全都聽起來嚇人，但醫生們對於治療

good at treating meningitis that a visit to the hospital can drastically reduce an

腦膜炎都非常在行，一但前往醫院接受治療，成人致死率幾乎

adult's risk of dying from it. The longer  it's left untreated, though, the more

就降到接近零左右。拖越久不接受治療，導致長久損害的機率

likely it will lead to lasting damage. If declining oxygen levels cause cell

就越高。如果因為血氧濃度下降導致體內細胞

death in extreme parts of the body--like fingers, toes, arms and legs--the risk

大量死亡 —想是手指、腳趾、手臂和腿 —等的截肢風險

of amputation goes up. And if bacterial toxins accumulate in the brain and trigger

就增加。而若細菌毒素在腦中累積到一定的量而引發

cell death, meningitis could also cause long-term brain damage and memory loss.

細胞死亡，腦膜炎也就會對大腦造成長期傷害以及記憶受損

So fast treatment, or better yet,  prevention, is critical.

所以儘速治療，或最好能夠預防，是至關重要的

That's why most countries have vaccines that defend

這也是為什麼很多國皆會接種疫苗

against the disease in its deadliest forms.

Those are usually given to the people who are most at risk--like young children,

這些疫苗會給染病的高危險群施打 — 像是年幼的孩子們

people with weak immune systems, or people who gather in large groups where an

免疫系統虛弱的人們或者可能發生群聚感染的

outbreak of meningitis could potentially  happen.

meningitis is most common in a region called the meningitis belt that stretches

雖然全世界不時會有案例傳出，但腦膜炎最常見的地區稱為「腦膜炎好發帶」，範圍

across Africa, though cases do happen all over the world. If you're concerned that

橫跨非洲大陸。你若擔心你或者你所認識的人可能正感染腦膜炎的話，

you or someone you know may have  meningitis, get to the doctor as soon as

possible; quick action could save your life.