The diseases that changed humanity forever - Dan Kwartler

譯者: Lilian Chiu 審譯者: C Leung

Since humanity's earliest days,

從人類最早出現以來，

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

我們就受到無數種 會造成疾病的病原體所困擾。

Invisible and persistent,

又看不見又反複出現，

these microorganisms and the illnesses they incur

這些微生物和它們所帶來的疾病，

have killed more humans than anything else in history.

在歷史上造成人類死亡的數目 比任何情況都還要多。

But which disease is deadliest varies across time and place.

但哪種疾病最致命， 則會因時因地而有所不同。

Because while the march of progress has made us safer

雖然科技進步讓我們能夠更安全，

from some infectious threats,

免受一些感染性的威脅，

human innovation often exposes us to surprising new maladies.

人類的創新卻經常讓我們 面臨出乎意料的新疾病。

Our tour of history’s deadliest diseases begins

我們探索史上最致命疾病的旅程，

when humans lived in small hunter-gatherer communities.

始於人類居住在 小型狩獵採集社區的時期。

The illnesses these pre-agricultural nomads encountered

這些農業時代之前的 遊牧民族遇到的疾病，

most likely came from the various animals they ate,

最有可能是來自他們所吃的各種動物，

and the soil and water they interacted with.

以及他們會接觸到的土壤和水。

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

沒有書面記載可以幫助 我們辨識出這些疾病，

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

但是，有些疾病在骨骼上 留下明顯的生長或損傷痕跡，

allowing bioarchaeologists to diagnose ancient remains.

讓生物考古學家可以診斷 古時留下的遺骸。

And researchers have found that bones from this era

研究人員已發現，該時代的 骨頭顯示當時存在結核病

suggest the presence of tuberculosis and treponemal infections.

及梅毒感染。

While these conditions are life-threatening,

雖然這些疾病都會造成死亡，

the deadliest diseases are invariably part of widespread epidemics,

但這些最致命的疾病向來 都是普遍流行病的一部分，

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

且沒有證據證明 在這個漫長的前農業時代

in this lengthy pre-agricultural period.

有任何大規模流行爆發。

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

然而，人類在大約 一萬兩千年前開始發展農業，

it brought a whole new crop of diseases.

這帶來了大量的新疾病。

Early farmers knew little about waste and water management,

早期的農民沒有太多關於 廢棄物及水源管理的知識，

setting the stage for diarrheal diseases like dysentery.

讓腹瀉疾病有發展的條件，比如痢疾。

Much worse, the proliferation of open fields and irrigation

更糟糕的是，開放式田地與灌溉的擴張

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

造成積水，

引來了蚊子，最終招致瘧疾，

one of history’s oldest and deadliest diseases.

就是史上最古老也最致命的疾病之一。

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

我們無法確切知道早期 有多少農民因瘧疾死亡，

or how many it left vulnerable to other lethal infections.

或有多少因此變得虛弱 而遭受其他致命感染。

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

但我們確實知道這種由蚊子 傳播的疾病仍，然在人類的

through humanity’s next major development: urbanization.

下一個重大發展時期 - 都市化下繼續散播。

In small communities,

在小型社區，

infectious diseases like measles and smallpox can only circulate so long

傳染病如麻疹和天花，

只能傳播一段時間就找不到宿主了。

before running out of hosts.

But in densely populated regions with high birth rates,

但在生育率高的人口密集地區，

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

快速演化的病毒，如流感，

可以不斷感染新的個體，

and morph into various strains.

並演化成各種變異株。

When large settlements became common,

當大型定居地變得普遍時，

medical science hadn't advanced enough to effectively treat

醫學還不夠先進

去有效治療或區別這些變種。

or even distinguish these variants.

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

醫學也沒有準備好對付史上 其中一種最致命的大流行疫情：

the Black Death.

黑死病。

From the 1330s to the 1350s,

從 1330 到 1350 的年代，

the bubonic plague swept Asia, Africa and Europe,

腺鼠疫橫掃亞洲、非洲，和歐洲，

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

令全球人口

從 4.75 億減少到約 3.5 億。

Like most Afro-Eurasian diseases,

和大多數亞歐非大陸的疾病一樣，

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

直到歐洲人在 1400 年代末期跨越 大西洋，這場瘟疫才傳了過去。

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

但在歐洲、亞洲及北非的瘟疫高峰期，

infection was almost guaranteed,

幾乎人人都會染疫，

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

而瘟疫的死亡率 介乎 30% 到 75% 之間。

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

然而，該疾病在人口中的分佈並不平均。

Many wealthy lords and landowners were able to stay safe

許多富有的領主和地主都能保持安全，

by hiding away in their spacious homes.

因為他們可以躲在寬敞的家中。

As medical knowledge became more robust,

隨著醫學知識越趨完整，

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

這種階級差異

開始反映出誰可以取得醫療照護。

And that divide became particularly apparent during the reign

在我們下一種致命疾病稱霸時，

of our next deadly disease.

此分裂現象變得特別明顯。

By the beginning of the 19th century,

到十九世紀初，結核病

tuberculosis was already one of the most common causes of death

已經是歐洲和美洲最常見的死因之一。

in Europe and the Americas.

But the Industrial Revolution led to working and living conditions

但工業革命造成了擁擠且通風不佳的

that were overcrowded and poorly ventilated,

工作和生活環境，

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

讓結核病演變成大流行疫情，

造成四分之一歐洲成年人口死亡。

The unhealthiest environments were largely populated by impoverished individuals

最不健康的環境中， 住的大部分是貧困的人，

who often went untreated,

他們通常沒接受治療，

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

而較富裕的患者卻能從醫生那裡 得到該時代最先進的照護。

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

二十世紀，疫苗在許多國家普及，

even eradicating the centuries-old viral threat of smallpox.

甚至消滅了有數百年 歷史的天花病毒威脅。

The advent of vaccination,

疫苗接種的出現，

alongside improvements in nutrition and hygiene,

再加上營養和衛生的改善，

have helped people live longer lives on average.

讓人類的平均壽命增加。

And today, medical advances in rapid testing and mRNA vaccines

如今，快速篩檢和 mRNA 疫苗 等等醫學上的進步，

can help us tackle new outbreaks in record time.

能幫助我們在創記錄的時間內 處理新的疾病爆發。

However, countless regions around the world

然而，世界各地有無數地區

remain unable to access vaccines,

仍然無法取得疫苗，

leaving them vulnerable to older threats.

讓他們難以抵禦之前的威脅。

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

每年仍有超過六十萬人死於瘧疾，

with 96% of deaths occurring in communities across Africa.

其中有 96% 的死亡 都發生在非洲各地的社區。

Tuberculosis continues to infect millions,

結核病還在繼續感染數百萬人，

almost half of whom live in Southeast Asia.

其中近半都居住在東南亞。

Addressing these ailments and those yet to emerge

若要處理這些和尚未出現的疾病，

will require scientists to develop new and more effective medicines.

會需要科學家開發出更有效的新藥物。

But something governments and health care systems can do today

但當今政府和醫療照護體系可以做的，

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

就是努力讓所有人都能取得 我們既有的治療方法。