The diseases that changed humanity forever - Dan Kwartler

翻译人员: Benjamin Zhao 校对人员: kate shi

Since humanity's earliest days,

从人类早期开始

we’ve been plagued by countless disease-causing pathogens.

我们就一直被各种致病的病原体所困扰。

Invisible and persistent,

这些无形且持久的微生物及其导致的疾病

these microorganisms and the illnesses they incur

have killed more humans than anything else in history.

已经是剥夺人类性命之物的王中之王。

But which disease is deadliest varies across time and place.

然而，最致命的疾病会随着 时间和地点的改变而变化。

Because while the march of progress has made us safer

虽然人类不断的进步 会让我们免受一些传染病的威胁，

from some infectious threats,

human innovation often exposes us to surprising new maladies.

但人类的创新往往让我们面临新的疾病。

Our tour of history’s deadliest diseases begins

历史上最致命疾病始于

when humans lived in small hunter-gatherer communities.

人类活在小型狩猎采集社区的时期。

The illnesses these pre-agricultural nomads encountered

这些早期游牧民族 最常遇到的疾病可能来自

most likely came from the various animals they ate,

他们所食用的各种动物

and the soil and water they interacted with.

以及他们接触的土壤和水源。

There are no written records to help us identify these diseases,

虽然没有书面记录可以 帮助我们弄清楚这些疾病，

however, some illnesses leave distinct growths or lesions on the skeleton,

但有些疾病会在骨骼上 留下独特的生长物或病变，

allowing bioarchaeologists to diagnose ancient remains.

能够让生物考古学家 对古代的遗骸进行诊断。

And researchers have found that bones from this era

研究人员发现 这个时期的骨骼显示出

suggest the presence of tuberculosis and treponemal infections.

存在肺结核和梅毒感染。

While these conditions are life-threatening,

虽然这些疾病威胁生命

the deadliest diseases are invariably part of widespread epidemics,

但最致命的疾病无一例外 都是广泛流行的大疫情。

and there’s no evidence of any large-scale outbreaks

没有证据表明在这段 漫长的农前时期出现了大规模疫情。

in this lengthy pre-agricultural period.

However, when humans started developing agriculture around 12,000 years ago,

然而，当人类在大约一万两千年前 开始发展农业时，

it brought a whole new crop of diseases.

农业带来了一整套新的疾病。

Early farmers knew little about waste and water management,

早期的农民对 废物和水资源的管理知之甚少，

setting the stage for diarrheal diseases like dysentery.

为像痢疾这样的腹泻性疾病铺平道路。

Much worse, the proliferation of open fields and irrigation

更糟糕的是 开阔的田地和灌溉造成了滞水，

created standing pools of water which brought mosquitoes and in turn malaria—

带来了蚊子，从而带来了疟疾--

one of history’s oldest and deadliest diseases.

历史上最古老也是最致命的疾病之一。

We don’t know exactly how many early farmers malaria killed,

我们不知道究竟 有多少早期的农民因疟疾丧生

or how many it left vulnerable to other lethal infections.

或者有多少人因此变得 易受其他致命感染的侵袭。

But we do know this mosquito-borne illness continued to spread

但我们确实知道，这种由蚊子传播的疾病

through humanity’s next major development: urbanization.

继续在城市化， 这一人类下一个重大发展进程中传播。

In small communities,

在小社区中，

infectious diseases like measles and smallpox can only circulate so long

像麻疹和天花这样的传染病 只能在宿主群体中传播一段时间。

before running out of hosts.

But in densely populated regions with high birth rates,

但在人口密集且出生率高的地区，

fast-evolving viruses like the flu can continually infect new individuals

像流感这样快速演变的病毒 可以不断感染新的个体

and morph into various strains.

并演化成各种毒株。

When large settlements became common,

当大型定居点变得普遍时

medical science hadn't advanced enough to effectively treat

医学科学还没有进步到足以有效治疗，

or even distinguish these variants.

甚至区分这些病毒变种，

Nor was it prepared to deal with one of the deadliest pandemics of all time:

也没有准备好应对 有史以来最致命的大流行病之一

the Black Death.

黑死病。

From the 1330s to the 1350s,

从 13 世纪的 30 年代到 50 年代 鼠疫席卷了亚洲，非洲和欧洲

the bubonic plague swept Asia, Africa and Europe,

reducing the global population from 475 million to roughly 350 million.

全球人口从 4.75 亿减少到大约 3.5 亿

Like most Afro-Eurasian diseases,

和大多数非洲-欧亚疾病一样

the plague didn’t cross the Atlantic until Europeans did in the late 1400s.

鼠疫直到 14 世纪末 欧洲人穿越大西洋后才进入美洲，

But at the height of the plague in Europe, Asia, and North Africa,

但在欧洲、亚洲和北非鼠疫的高峰期

infection was almost guaranteed,

感染几乎是必然的，

and the plague’s fatality rate ranged from 30 to 75%.

而鼠疫的死亡率 在 30% 到 75% 之间。

However, the illness wasn't equally distributed among the population.

然而，疾病在人口中的分布并不平均，

Many wealthy lords and landowners were able to stay safe

许多富有的领主和地主通过躲在

by hiding away in their spacious homes.

宽敞的家中保持安全。

As medical knowledge became more robust,

随着医学知识变得越来越扎实，

this kind of class disparity began reflecting who had access to medical care.

这种阶级差异开始 折射出谁可以得到医疗服务。

And that divide became particularly apparent during the reign

在我们下一个致命疾病的统治期间

of our next deadly disease.

这种差距变得尤为明显。

By the beginning of the 19th century,

到 19 世纪初，

tuberculosis was already one of the most common causes of death

肺结核已经是 欧洲和美洲最常见的死亡原因之一。

in Europe and the Americas.

But the Industrial Revolution led to working and living conditions

但工业革命导致工作和生活条件

that were overcrowded and poorly ventilated,

拥挤且通风很差，

turning TB into an epidemic that killed a quarter of Europe’s adult population.

使得肺结核成为一种疫情 杀死了欧洲成年人口的四分之一。

The unhealthiest environments were largely populated by impoverished individuals

贫困的人口大多 居住在最不健康的环境。

who often went untreated,

他们通常未受治疗

while doctors provided wealthier victims with the era’s most cutting-edge care.

而医生为富有的病患 提供了那个时代最先进的护理。

Throughout the 20th century, vaccines became common in many countries,

在 20 世纪，疫苗在许多国家逐渐普及

even eradicating the centuries-old viral threat of smallpox.

甚至根除了肆虐了 几个世纪的病毒——天花

The advent of vaccination,

疫苗的出现，

alongside improvements in nutrition and hygiene,

加上营养和卫生的改善，

have helped people live longer lives on average.

帮助人们的延长了平均寿命。

And today, medical advances in rapid testing and mRNA vaccines

如今，快速检测和 mRNA 疫苗 方面的医学进步

can help us tackle new outbreaks in record time.

可以帮助我们在 创纪录的时间内应对新的疫情。

However, countless regions around the world

然而，世界上仍有无数地区无法获得疫苗，

remain unable to access vaccines,

leaving them vulnerable to older threats.

使他们容易受到之前病毒的威胁。

Malaria still takes the lives of over 600,000 people every year,

每年仍有超过 60 万人死于疟疾，

with 96% of deaths occurring in communities across Africa.

其中 96% 的死亡发生在非洲各地。

Tuberculosis continues to infect millions,

结核病继续感染数百万人，

almost half of whom live in Southeast Asia.

其中近一半受感染的人生活在东南亚。

Addressing these ailments and those yet to emerge

为解决这些疾病 以及那些还未出现的疾病

will require scientists to develop new and more effective medicines.

将需要科学家研发 更新且更有效的药物。

But something governments and health care systems can do today

但政府和医疗系统 今天可以做的是努力是让

is working to make the treatments we have already accessible to all.

所有人都能用上 当下我们已有的治疗方案。