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  • Only one human disease in history has been fully stamped out; smallpox, with the World

    歷史上只有一種人類疾病完全被根除:天花

  • Health Organization declaring it eradicated way back in 1980.

    世界衛生組織宣稱天花在 1980 年被根除。

  • But, we might be close to eradicating a second disease; polio.

    但是,我們可能幾乎要根除第二種疾病:小兒麻痺

  • Yes, the disease that brings up imagery of wheelchairs and iron lungs may soon be on

    沒錯,這個疾病帶出了輪椅和鐵肺的照片,可能很快

  • its way out, but as of 2019, we're not there yet.

    就會消失,但到了 2019,我們還沒到那一步

  • Polio, also known as poliomyelitis, is an infectious disease caused by the aptly-named

    小兒麻痺,又叫脊髓灰質炎,是一種傳染性疾病

  • poliovirus, which comes in three strains, and is spread mostly by consuming contaminated water.

    由脊髓灰質炎病毒所造成,總共有三種類型,主要透過受汙染的飲用水散播

  • And by contaminated we mean, well

    受汙染的意思就是,嗯......

  • So, the kid poops it out, the virus gets in the water around there, usually in the sewage.

    就是,小孩大便完,病毒就進入附近的水中,通常是在汙水中

  • And then, sometime in the next day or two or three or a week or something, some other

    接著,隔天、或是兩三天,甚至是一個禮拜後的某個時候,其他小孩

  • kid will drink the sewage and it'll get in that kid and they'll cycle around like that.

    會喝下汙水,這樣會進入小孩體內,然後他們就像這樣循環下去

  • Hi, I'm Jay Wenger, I'm the Director of Polio at the Bill & Melinda Gates Foundation.

    嗨,我是 Jay Wenger,我是比爾與美琳達.蓋茲基金會小兒麻痺的主任

  • I started working on polio eradication in 2002, when I went to India, and I joined the

    我在 2002 年開始從事根除小兒麻痺,當時到了印度

  • Gates Foundation in 2011, and have been there ever since.

    我在 2011 年加入了蓋茲基金會,從那時就一直在那工作

  • Polio can be passed through the air with oral fluids, like from a cough or a sneeze, but

    小兒麻痺可以利用口腔液體在空氣傳播,像是咳嗽或是噴嚏

  • the cycle today usually begins with fecal oral transmission, mostly in areas with poor sanitation.

    但現今的循環通常是靠糞口路徑,主要在衛生條件差的地區

  • Once swallowed the virus heads straight to your intestines, finding places to replicate along the way.

    一旦吞下病毒,病毒會直接進入腸道,找到可以沿路複製的地方

  • Now, most of the time your body will take care of the invader with an immune response,

    目前,大多時候你的身體會對入侵者起免疫反應

  • giving you flu-like symptoms or no symptoms at all.

    帶來類流感的症狀或根本沒有任何症狀

  • There are two things that happen with a natural infection.

    自然感染會發生兩件事

  • Well, there are lots of things that happen, but the two main ones are, you develop humoral antibodies.

    有很多事情會發生,但主要的兩個是,你會發展出體液性抗體

  • And those are antibodies that float around your bloodstream.

    它們是漂浮在血液周圍的抗體。

  • And basically will, if the virus gets into your bloodstream, they'll attack it and you'll end up ejecting it.

    基本上,如果病毒進入血液,它們會攻擊病毒,最後把它趕出去

  • The second way is producing mucosal antibodies that are secreted in the gut to ensure it doesn't reproduce.

    第二種方法是產生在腸道中分泌的黏膜抗體,以確保其不會複製

  • But if those antibodies in the blood don't stop the infection, it could result in paralysis,

    但如果身體的那些抗體沒能阻止感染,就會導致癱瘓

  • which occurs in about one out of every 200 people who contract the poliovirus.

    感染脊髓灰質炎病毒的每 200 人中就會有 1 人癱瘓

  • That's because if the virus survives into your bloodstream, they can find a way into

    那是因為如果病毒在血液中存活,它們可以找到

  • your nervous system and eventually get into the anterior horn cells of your spinal cord.

    進入神經系統的方法,最後進入脊髓的角質細胞

  • Basically, they reproduce then they go into the cell and they reproduce

    基本上,它們會再生,然後它們進入細胞並在那裡繁殖

  • there, and they result in death of the actual anterior horn cell, and

    導致前面角質細胞的死亡

  • is that cell that the message from the brain transmits to the muscle.

    它是從大腦傳遞給肌肉訊息的細胞

  • And it causes an irreversible cell death.

    而且造成不可逆的細胞死亡

  • So, if these anterior horn cells die, it disrupts the transmission between the brain and the muscles,

    因此,如果這些前角細胞死亡,就會擾亂大腦和肌肉間的傳送

  • such as the muscles in the torso, limbs, and between our ribs.

    例如軀幹、四肢和肋骨之間的肌肉

  • And which part of the body becomes paralyzed will depend on which cells die.

    身體哪個部位癱瘓取決於哪些細胞死亡

  • But, for instance, if it attacks the nerves that ultimately go to the leg, say, the right

    但例如,如果它攻擊最終會進入腿部的神經,比方說右腳

  • leg, it can kill those nerves, and then, messages from the brain to the leg don't get there anymore.

    它可以殺死那些神經,然後,從大腦到腿部的訊息就不再傳到那裡。

  • And so, the leg will be paralyzed, you won't be able to move it.

    因此腿部會癱瘓,就沒辦法動了

  • That usually happens pretty quickly, usually within a day.

    這通常發生得很快,通常在一天內

  • But, if the virus gets to the nerves that influence your breathing muscles, that's especially

    但是,如果病毒到達影響呼吸肌肉的神經

  • bad, because you then can't breathe and your lungs don't work.

    那就更糟了,因為你不能呼吸,肺也不會運作

  • Weakened lungs could result in death, or in some cases, bringing in a machine to help

    肺部虛弱可能會導致死亡,或在某些情況下,會利用機器幫助

  • the patient breathe, like the iron lung

    患者呼吸,像是鐵肺

  • All of these effects of polio; weakened lungs, paralysis and death, are why so many people

    小兒麻痺的這些所有影響:虛弱的肺、癱瘓和死亡,就是為何這麼多人

  • are still focused on eradicating the disease.

    仍致力於根除這種疾病

  • Polio was a huge deal in the United States. It was actually the most feared infectious

    小兒麻痺在美國是個大麻煩,事實上是美國在

  • disease of like the 40s and 50s in the United States.

    40 和 50 年代最令人恐懼的傳染病

  • So, there was a huge push to develop a polio vaccine.

    因此,開發小兒麻痺疫苗有很大的推動力

  • And the first polio vaccine that got developed was developed by Salk, and that was based

    第一種小兒麻痺疫苗是由沙克所開發

  • on a killed poliovirus preparation.

    其為基於殺死小兒麻痺病毒的製劑

  • And so, that one was great, it was a breakthrough of its time.

    所以,那個很棒,這是當時的大突破

  • And if you inject killed poliovirus, what you get are the humoral antibodies.

    如果你注射殺死小兒麻痺病毒的疫苗,你注射的是體液性抗體

  • This boost of humoral antibodies in the blood helps lower the chance that the virus will

    血液中體液性抗體的增加有助於降低病毒

  • get to your spine, reducing the risk of polio-induced paralysis.

    進入脊柱的機會,降低小兒麻痺病毒引起的癱瘓風險

  • And so, the vaccine is good in that it prevents paralysis, and it has a little bit of an impact on the amount that you excrete.

    因此,疫苗很好,因為它可以預防麻痺,而且它對你分泌量有一點影響。

  • It reduces it a little bit, but not a lot.

    它會減少一點分泌量,但不多

  • So that, especially in tropical countries with rotten sanitation, the IPV is not actually

    因此,特別是在衛生條件惡劣的熱帶國家,IPV 其實

  • a good tool to get rid of the virus from a population.

    不是讓民眾擺脫病毒的好工具

  • That's because the IPV isn't as effective at boosting the mucosal antibodies, so the

    這是因為 IPV 在增加粘膜抗體方面的效果不佳

  • virus still reproduces in the gut, ensuring large numbers are still passed on through poop into water supplies.

    因此病毒仍會在腸道中在複製,確保大量病毒仍會透過糞便來進入供水系統

  • But a couple years later, Sabin came out with an oral vaccine.

    但過了幾年,沙賓開發出口服疫苗

  • This Sabin vaccine was developed using live, weakened strains of poliovirus and helped

    這種沙賓疫苗是由活性、弱化的小兒麻痺病毒所開發,不僅有助於

  • not only trigger humoral antibodies to protect from paralysis, but also mucosal antibodies,

    引發體液性抗體來防止癱瘓,還有助於黏膜液體

  • which greatly reduces the amount of poliovirus passed on through poop.

    明顯減少透過糞便傳播的小兒麻痺病毒數量

  • So, it was a huge difference and people found that soon that after using that in populations,

    所以說,這是一個很大的差異,大家很快就發現,接著大家就開始使用

  • giving every kid in the population the OPV, a couple times, you would actually drive the wild virus away.

    讓每個孩子使用 OPV 幾次,其實就可以把可怕的病毒趕走

  • This happened in Latin America and wild poliovirus was eventually eliminated from the

    這種情況發生在拉丁美洲,可怕的小兒麻痺病毒最終

  • entire Americas, and then in Europe and Eastern Asia which essentially became wild poliovirus free.

    從整個美洲消失,然後基本上從歐洲和東亞消失

  • But things sort of got slowed down a little bit in the 2000s, when we got down to like four countries.

    但是在 2000 年左右,行動有點緩和下來了,我們著手處理四個國家

  • And that was India, Pakistan, Afghanistan and Nigeria.

    有印度、巴基斯坦、阿富汗、奈及利亞

  • And we think that we are making progress toward finishing off polio in these last places.

    而且我們認為在根除小兒麻痺方面,我們在最後幾個地方取得了進展。

  • India had their last case in 2011, we're hoping Nigeria had their last case in 2016.

    印度最後一例是在 2011 年,我們希望奈及利亞的最後一例是在 2016 年

  • And we're down to only two countries right now, Afghanistan and Pakistan.

    而我們現在要處理兩個國家:阿富汗和巴基斯坦

  • If we get rid of the wild poliovirus there, it won't be anywhere else, there's nowhere else to be.

    如果我們能在那裡擺脫可怕的小兒麻痺病毒,其他地方也不會有了,任何地方都不會有

  • And so that will basically stop that as a cause of paralysis for kids everywhere.

    因此,這基本上是阻止各地兒童癱瘓的目標

Only one human disease in history has been fully stamped out; smallpox, with the World

歷史上只有一種人類疾病完全被根除:天花

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B2 中高級 中文 美國腔 病毒 抗體 癱瘓 細胞 脊髓 疫苗

我們是如何幾乎消滅小兒麻痺症的? (How Have We Almost Eradicated Polio?)

  • 83 6
    Jerry Liu 發佈於 2021 年 01 月 14 日
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