Why is meningitis so dangerous? - Melvin Sanicas

譯者: Regina Chu 審譯者: Marssi Draw

In 1987, tens of thousands of people

1987 年，成千上萬人 聚集在沙烏地阿拉伯

gathered in Saudi Arabia for the annual Hajj pilgrimage.

參加一年一度的朝覲

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

原本是個慶祝的活動 最後變成一場健康災難

just a few days after the pilgrimage,

朝覲後僅數天 超過二千個腦膜炎病例

more than 2,000 cases of meningitis broke out

在沙烏地阿拉伯及世界各地爆發

spreading across Saudi Arabia and the rest of the world.

The outbreak was so fierce

此場爆發之兇猛

that it was believed to have sparked a wave of deadly meningitis epidemics

以致於大家認為引發了 一波致命腦膜炎流行病

that ultimately infected tens of thousands of people worldwide.

疫情最終擴及全世界 感染成千上萬的人

Meningitis is the inflammation of the meninges,

腦膜炎就是腦膜發炎 腦膜由三層組織構成

three tissue layers responsible for protecting the brain and spinal cord.

主要功能為保護腦部及脊髓

What makes meningitis so dangerous compared to other diseases

腦膜炎與其他疾病相較 之所以如此危險

is the sheer speed with which it invades a person’s body.

完全在於其侵入人體的速度

In the worst cases, it causes death within a day.

在最糟的情況下 只要一天就會造成死亡

Fortunately, that’s rare for patients who receive early medical treatment.

幸運的是

病患如能即早治療 這種情況極為罕見

The disease primarily comes in three forms:

這種疾病主要有三種類型

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

黴菌、病毒及細菌

最後一種是目前最致命 也是我們要專注的焦點

and what we’ll focus on.

People usually contract bacterial meningitis by breathing in

人們會得到細菌性腦膜炎

通常是因為吸入了患者 打噴嚏或咳嗽時噴出的小飛沫

tiny particles of mucus and saliva that spray into the air

when an infected person sneezes or coughs.

It can also be transmitted through kissing,

也可經由親吻、共享香菸 共用牙刷或餐具而傳染

or sharing cigarettes, toothbrushes or utensils.

Some people can be infected and carry the disease

某些人受感染後成為帶原者 本身不會出現症狀或生病

without showing symptoms or getting sick,

使此疾病更加快速傳染給別人

which helps the disease spread quickly to others.

Once the bacteria enter the nose, mouth, and throat,

這種細菌一旦進入鼻腔、口腔及喉嚨

they cross the surrounding membranes and enter the bloodstream.

就會穿過附近的黏膜進入血液

From there, bacteria have rapid access to the body’s tissues

細菌從那裡開始快速進入身體組織

--including a membrane called the blood-brain barrier.

包括一種稱為血腦障壁的隔膜

This is made of a tight mesh of cells which separate blood vessels from the brain,

這種隔膜由緊密的細胞網構成

將血管與腦部分開

and block everything except for a specific set of particles,

並阻擋一切物質進出

只讓特定粒子 如水分子及某些氣體通過

including water molecules and some gases.

But in ways that scientists are still trying to understand,

但是科學家仍在試著找出 腦膜炎細菌如何騙過這層障壁

meningitis bacteria can trick the barrier into letting them through.

讓它們通過

Inside the brain, the bacteria swiftly infect the meninges.

在大腦內部，細菌很快感染腦膜

This triggers inflammation as the body’s immune response kicks into overdrive,

這會引發炎症

因為身體的免疫反應開始超負荷

bringing on fever and intense headaches.

導致發燒及劇烈頭痛

As swelling in the meninges worsens, the neck begins to stiffen.

隨著腦膜腫脹惡化

頸部開始變硬

Swelling in the brain disrupts its normal function--

腦部腫脹會打亂其正常功能

causing symptoms like hearing loss and extreme light sensitivity.

引發如喪失聽力 及對光極端敏感等症狀

隨著顱腔的壓力增加 也可能使病患困惑

As pressure increases in the cranium, it may also make the person confused--

這是此病的特徵之一

one of the hallmarks of the disease.

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

數小時內

快速增殖的細菌開始釋放毒素

leading to septicemia, also known as blood poisoning.

導致敗血症，又稱血中毒

This breaks down blood vessels,

它會使血管爆裂，血液滲出

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

在皮下形成一開始 看起來像紅疹的東西

and evolves into big discoloured blots beneath the skin.

然後演變成大塊瘀斑

At the same time, these toxins burn through oxygen in the blood,

與此同時

這些毒素會燒盡血中的氧氣

reducing the amount that gets to major organs like the lungs and kidneys.

減低輸送到重要器官如肺和腎臟的量

That increases the chance of organ shut down

這會增加器官衰竭的機會

--and alongside spreading septicemia, threatens death.

並傳播敗血症，威脅生命

That all sounds scary, but doctors are so good at treating meningitis

這些聽起來超可怕

但是醫師非常擅長治療腦膜炎

that a visit to the hospital can drastically reduce an adult’s risk of dying from it.

只要去一趟醫院

就能大幅減低成人死於此病的風險

The longer it’s left untreated, though,

然而，等待治療的時間愈長

the more likely it will lead to lasting damage.

就愈有可能造成永久傷害

If declining oxygen levels cause cell death in extreme parts of the body

如果缺氧導致身體末端的細胞死亡

--like fingers, toes, arms and legs-- the risk of amputation goes up.

例如手指、腳趾、手臂及小腿

需要截肢的風險就增高

And if bacterial toxins accumulate in the brain and trigger cell death,

如果細菌的毒素累積在腦部 並引起細胞死亡

腦膜炎也可能造成 腦部長期傷害及記憶喪失

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

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

所以快速治療至關重要 預防更不可或缺

That's why most countries have vaccines that defend against the disease

這也就是為什麼 大部分國家都會施打疫苗

以防疫此疾病最致命的形式

in its deadliest forms.

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

疫苗通常施打在風險最高的人身上

例如幼童、免疫力低下的人

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

或曾經參與過大型聚會的人

where an outbreak of meningitis could potentially happen.

因為腦膜炎可能會在此爆發

In addition to those gatherings,

除了這些聚會外

meningitis is most common in a region called the meningitis belt

腦膜炎在所謂 「腦膜炎流行帶」最為常見

that stretches across Africa, though cases do happen all over the world.

這個流行帶橫跨非洲 儘管全世界都有病例

If you’re concerned that you or someone you know may have meningitis,

如果你擔心自己或認識的人 可能得到腦膜炎

get to the doctor as soon as possible;

盡快就醫！

quick action could save your life.

快速行動可以救你一命