Why we have virus outbreaks & how we can prevent them | Nathan Wolfe

譯者: Yu-Ju Chiang 審譯者: Ai-Ying (Erin) Chiang

When most people think about the beginnings

大部分人一想到愛滋的起源

of AIDS, they're gonna think back to the 1980s.

就想到 1980 年代。

And certainly, this was the decade in which we discovered AIDS

的確，當時我們發現了愛滋病

and the virus that causes it, HIV.

還有它的病原，HIV

But in fact this virus crossed over into humans many decades before,

不過，這個病毒實際上卻在幾十年前就已經滲入人類社會

from chimpanzees, where the virus originated, into humans who hunt these apes.

從病毒的源頭宿主黑猩猩，感染獵殺猩猩的人類們

This photo was taken before the Great Depression

這張照片是在經濟大蕭條之前拍攝的

in Brazzaville, Congo.

地點在剛果首都布拉薩

At this time, there were thousands of individuals,

我們認為，當時已有上千個當地居民

we think, that were infected with HIV.

感染了HIV

So I have a couple of really important questions for you.

那麼讓我問各位幾個很重要的問題

If this virus was in thousands

如果當時已有上千名

of individuals at this point,

居民感染了病毒

why was it the case that it took us until 1984

為什麼我們一直要到 1984 年

to be able to discover this virus?

才發現這個病毒?

OK now, more importantly,

更重要的問題是

had we been there in the '40s and '50s, '60s,

我們在 40′ 50′ 和60年代是否去過那裡

had we seen this disease, had we understood

是否已經看過這個疾病，是否完全了解

exactly what was going on with it, how might that have changed and completely

愛滋病的機制？如果是的話，是否會完全改變

transformed the nature of the way this pandemic moved?

且轉化這個傳染病的自然感染途徑?

In fact, this is not unique to HIV. The vast majority of

其實，不只是 HIV ，絕大多數的

viruses come from animals.

病毒都是從動物身上發現的

And you can kind of think of this as a pyramid of this bubbling up of viruses

大家應該可以想像層出不窮的病毒，就像這個金字塔

from animals into human populations.

從動物宿主傳染到人類族群

But only at the very top of this pyramid do these things become completely human.

但是唯有金字塔頂端的病毒才會完全轉化成人類病毒

Nevertheless, we spend the vast majority

然而，我們卻將絕大部份的精力

of our energy focused on this level of the pyramid,

專注在金字塔頂層

trying to tackle things that are already completely adapted to human beings,

想辦法對付這些已經完全適應人類

that are going to be very very difficult to address --

而且非常難處理的病毒

as we've seen in the case of HIV.

HIV 就是很好的例證

So during the last 15 years,

因此，過去 15 年來

I've been working to actually study the earlier interface here --

我都在研究底層的病毒

what I've labeled "viral chatter," which was a term coined

這裡標出的「viral chatter」是個新創的名詞

by my mentor Don Burke.

由我的教授 Don Burke 所創

This is the idea that we can study the sort of

這個觀念就是，我們可以研究

pinging of these viruses into human populations,

追溯病毒入侵人類族群的足跡、

the movement of these agents over into humans;

病毒感染蔓延到人類的途徑

and by capturing this moment,

藉著捕捉這些蛛絲馬跡

we might be able to move to a situation where we can catch them early.

我們或許可以早一步發現它們

OK, so this is a picture, and I'm going to show you

好的，這是其中一張照片，我會給大家看看

some pictures now from the field.

一些實地勘查的照片

This is a picture of a central African hunter.

照片中的人是一名中非獵人

It's actually a fairly common picture.

這其實是一張很普通的照片

One of the things I want you to note from it

我希望大家注意看照片中

is blood -- that you see a tremendous amount of blood contact.

動物的血，你可以看到獵人與獵物有大量的血液接觸

This was absolutely key for us. This is a

這對我們非常重要。這是一種

very intimate form of connection.

非常直接的接觸

So if we're going to study viral chatter, we need to

因此，要研究病毒的蛛絲馬跡，我們必須

get to these populations who have intensive contact with wild animals.

深入那些跟野生動物有密集接觸的居民

And so we've been studying people like this individual.

因此，我們的研究樣本都是像照片中的獵人

We collect blood from them, other specimens.

收集他們的血液還有其他檢體

We look at the diseases, which are in the animals as well as the humans.

在裡面找同時出現在動物跟人體中的疾病

And ideally, this is going to allow us to catch these things

希望這樣做可以讓我們抓到病毒

early on, as they're moving over into human populations.

在它們在人類族群中蔓延前及早發現

And the basic objective of this work is not to just

研究工作的基本目標不只是

go out once and look at these individuals,

去勘查一次，拜訪這些居民

but to establish thousands of individuals

而是在這些人類族群中，

in these populations that we would monitor

對上千個當地居民

continuously on a regular basis.

建立持續且規律的監控

When they were sick, we would collect specimens from them.

當他們生病了，我們就會收集檢體

We would actually enlist them --

我們甚至招募他們

which we've done now -- to collect specimens from animals.

收集動物的檢體，現在已經這樣做了

We give them these little pieces of filter paper.

我們發給他們這種小張的濾紙

When they sample from animals,

當他們從動物身上取下樣本時

they collect the blood on the filter paper

會把動物血液收集在濾紙上

and this allows us to identify yet-unknown viruses from exactly the right animals --

如此可以幫助我們在正確的動物樣本

the ones that are actually being hunted.

也就是獵物上鑑定出一些目前未知的病毒

(Video) Narrator: Deep in a remote region of Cameroon,

影片解說 : 在喀麥隆偏遠地帶的深處

two hunters stalk their prey.

兩個獵人正在追蹤他們的獵物

Their names are Patrice and Patee.

他們是派崔斯和帕帝

They're searching for bush meat;

他們正在找尋野生獸肉

forest animals they can kill to feed their families.

也就是可以殺來餵飽家人的叢林野生動物

Patrice and Patee set out most days to go out hunting

派崔斯和帕帝大部分的時間都

in the forest around their homes.

在家附近的叢林中打獵

They have a series of traps, of snares that they've set up

他們設下一連串的陷阱及機關

to catch wild pigs, snakes, monkeys,

為的是想抓些野豬、蛇、猴子

rodents -- anything they can, really.

老鼠，任何能抓到的都好

Patrice and Patee have been out for hours but found nothing.

派崔斯和帕帝已經在外好幾個小時卻一無所獲

The animals are simply gone.

動物們好像都不見了

We stop for a drink of water.

我們停下來喝口水

Then there is a rustle in the brush.

然後樹叢裡傳出一陣窸窣聲

A group of hunters approach,

一群獵人向我們走來

their packs loaded with wild game.

他們背著豐碩的成果

There's at least three viruses

在這種猴子身上至少可以找到

that you know about, which are in this particular monkey.

三種已知的病毒

Nathan Wolfe: This species, yeah. And there's many many more pathogens

就在這一種猴子身上，沒錯，而且還有非常多病原體

that are present in these animals.

都存在這些動物體內

These individuals are at specific risk,

這些人感染的風險特別高

particularly if there's blood contact, they're at risk for transmission

特別是有血液接觸的人，很有可能被傳染

and possibly infection with novel viruses.

且可能感染到一些新病毒

Narrator: As the hunters display their kills, something surprising happens.

當獵人們展示他們的成果，令我們驚訝的是

They show us filter paper they've used to collect the animals' blood.

他們拿出收集了動物血液的濾紙

The blood will be tested for zoonotic viruses,

這些血液會用來檢測寄生的病毒

part of a program Dr. Wolfe has spent years setting up.

這是渥夫博士花了好幾年準備的研究計畫

NW: So this is from this animal right here,

所以這張是從這隻動物身上採集的

Greater Spot-Nosed Guenon.

大白鼻長尾猴

Every person who has one of those filter papers has at least,

每個身上帶著這些濾紙的人至少、

at a minimum, been through our basic health education

最少都受過我們基本的健康教育

about the risks associated with these activities,

教導他們這些活動的相關風險

which presumably, from our perspective,

我們認為應該能

gives them the ability to decrease their own risk,

為他們降低感染的風險

and then obviously the risk to their families,

當然還能降低家人感染的風險

the village, the country, and the world.

降低傳染村莊、國家、世界的風險

NW: OK, before I continue, I think it's important to take just a moment

好的，在我繼續進行前，我想很重要的是花點時間

to talk about bush meat. Bush meat is the hunting of wild game.

討論野生獸肉，也就是野味

OK? And you can consider all sorts of different bush meat.

好嗎？大家可以把各種野味都列入考慮

I'm going to be talking about this.

我想討論這個議題

When your children and grandchildren

當你的子孫

sort of pose questions to you about this period of time,

問起這段時期

one of the things they're gonna ask you,

他們會問你的一個問題就是

is how it was they we allowed some of our closest living relatives,

我們怎麼能讓一些我們的近親物種

some of the most valuable and endangered species

那些地球上最珍貴又稀有的生物滅絕

on our planet, to go extinct because we

難道是因為

weren't able to address some of the issues

我們沒有能力處理在世界某些地方

of poverty in these parts of the world.

發生的貧困問題

But in fact that's not the only question they're going to ask you about this.

事實上他們會問的不僅如此

They're also going to ask you the question

他們也會問你

that when we knew that this was the way that HIV entered

我們既然知道這是 HIV 侵入

into the human population,

人類族群的方式

and that other diseases had the potential to enter like this,

而其他疾病也可能循同樣方式入侵

why did we let these behaviors continue?

為什麼還繼續放任這種行為 ？

Why did we not find some other solution to this?

為什麼不找其他解決方法 ？

They're going to say, in regions of profound

他們會說，在世界某些

instability throughout the world,

極度動盪不安的地區

where you have intense poverty, where populations are growing

有嚴重的貧困問題且人口繼續增加

and you don't have sustainable resources like this,

如果沒有像打獵這樣穩定的生計來源

this is going to lead to food insecurity.

就沒有穩定的食物來源

But they're also going to ask you probably a different question.

不過，他們也可能會問不同的問題

It's one that I think we all need to ask ourselves,

這也是我們需要捫心自問的

which is, why we thought the responsibility rested with this individual here.

為什麼我們認為是這個人該負起責任

Now this is the individual -- you can see just right up over his right shoulder --

現在你看到的這個人，你可以注意看他右肩膀上

this is the individual that hunted the monkey

就是這個人獵到

from the last picture that I showed you.

上一張照片中的猴子

OK, take a look at his shirt.

現在看看他的上衣

You know, take a look at his face.

再看看他的臉

Bush meat is one of the central crises,

捕捉野味目前是

which is occurring in our population right now,

地球上的人類

in humanity, on this planet.

目前在人道上最關鍵的危機

But it can't be the fault of somebody like this.

但這不是一個人需要承擔的錯誤

OK? And solving it cannot be his responsibility alone.

是吧 ？解決這個問題也不是他一個人的責任

There's no easy solutions,

這沒有簡單的解決辦法

but what I'm saying to you is that we neglect this problem

不過，我想和大家說，要是我們輕忽這個問題

at our own peril.

後果自負

So, in 1998, along with my mentors

所以在 1998 年我跟著我的教授

Don Burke and Colonel Mpoudi-Ngole,

Don Burke 和 Colonel Mpoudi-Ngole

we went to actually start this work

開始著手工作

in Central Africa, to work with hunters

走入中非，與當地的獵人們

in this part of the world.

一起合作

And my job -- at that time I was a post-doctoral fellow,

我的任務是...當時我還是個博士後研究員，

and I was really tasked with setting this up.

為了準備工作忙的不可開交

So I said to myself, "OK, great --

所以我跟自己說 : 好，太棒了

we're gonna collect all kinds of specimens. We're gonna go to all these

我們要收集各種檢體，我們要到各個

different locations. It's going to be wonderful."

不同的地區，一定很好玩

You know, I looked at the map; I picked out 17 sites;

就這樣，我看著地圖，挑出 17 個地點

I figured, no problem.

我想一定沒問題

(Laughter)

（笑聲）

Needless to say, I was drastically wrong.

不用說，我真是大錯特錯

This is challenging work to do.

這是一項極具挑戰的工作

Fortunately, I had and continue to have

很幸運地，在我的工作團隊中，

an absolutely wonderful team of colleagues and collaborators in my own team,

我一直都能與一群很棒的同事及中間人合作

and that's the only way that this work can really occur.

這也是研究計畫可以順利誕生的原因

We have a whole range of challenges about this work.

在過程中我們遇到各種不同的挑戰

One of them is just obtaining trust

其中之一就是得到

from individuals that we work with in the field.

與我們合作的居民的信任

The person you see on the right hand side is Paul DeLong-Minutu.

大家看到右手邊的人是 Paul DeLong-Minutu

He's one of the best communicators that I've really ever dealt with.

他是我遇過最厲害的交涉者之一

When I arrived I didn't speak a word of French,

我剛到當地時一個法文單字都不會

and I still seemed to understand what it was he was saying.

但是我似乎可以理解他在說什麼

Paul worked for years

Paul 有好幾年的工作經驗

on the Cameroonian national radio and television,

在喀麥隆的國家廣播及電視

and he spoke about health issues. He was a health correspondent.

他談論健康議題，擔任衛生醫療記者

So we figured we'd hire this person -- when we got there he could

所以我們想如果雇用這個人，當我們到達當地

be a great communicator.

他會個很好的交涉人

When we would get to these rural villages, though, what we found out

不過到了鄉下村子裡，我們才發現

is that no one had television,

沒有人有電視

so they wouldn't recognize his face.

所以居民根本認不出他

But -- when he began to speak

但是他一說話

they would actually recognize his voice from the radio.

居民卻從廣播中認出他的聲音

And this was somebody who had incredible

因此這個人非常適合

potential to spread aspects of our message,

替我們散佈所要傳達的觀念

whether it be with regards to wildlife conservation

不管是有關野生動物保育

or health prevention.

或是疾病預防方面

Often we run into obstacles. This is us coming back from

我們常遇到困難。這時我們正從

one of these very rural sites,

非常偏僻的地方要趕著回去

with specimens from 200 individuals

帶著 200 位居民的檢體

that we needed to get back to the lab within 48 hours.

要在 48 小時之內回到實驗室

I like to show this shot -- this is

我想讓大家看這張照片

Ubald Tamoufe, who's the lead

他是 Ubald Tamoufe，是喀麥隆地區的

investigator in our Cameroon site.

領隊研究員

Ubald laughs at me when I show this photo

我讓 Ubald 看這張照片時他還取笑我

because of course you can't see his face.

當然你們看不到他的臉

But the reason I like to show the shot

我展示這張照片的原因是

is because you can see that he's about to solve this problem.

大家可以看到他正要解決我們的問題

(Laughter)

(笑聲)

Which -- which he did, which he did.

而且還成功了。

Just a few quick before and after shots.

快速的看幾張前後期的照片

This was our laboratory before.

這是我們實驗室之前的樣子

This is what it looks like now.

這是它現在的樣子

Early on, in order to ship our specimens,

早期，為了要運送檢體

we had to have dry ice. To get dry ice we had to go

必須要用到乾冰，要拿到乾冰我們必須要

to the breweries -- beg, borrow, steal to get these folks to give it to us.

到釀酒廠，向他們討、去借、或偷才有

Now we have our own liquid nitrogen.

現在我們有自己的液態氮

I like to call our laboratory the coldest place in Central Africa -- it might be.

我喜歡叫我們實驗室「中非最冷的地方」，應該算名符其實

And here's a shot of me, this is the before shot of me.

這張是我的照片，研究前期的照片

(Laughter)

(笑聲)

No comment.

不予置評

So what happened? So during the 10 years that we've been doing

中間發生了什麼事？在我們進行研究的 10 年中

this work, we actually surprised ourselves.

連我們自己都感到驚訝

We made a number of discoveries.

我們有好幾項新發現

And what we've found is that if you look in the right place,

我們發現，只要研究切入點正確

you can actually monitor the flow

其實可以觀察到

of these viruses into human populations.

這些病毒滲透到人類族群的趨勢

That gave us a tremendous amount of hope.

這帶給我們很大的希望

What we've found is a whole range of new viruses in these individuals,

我們從居民身上找到各種不同的新病毒

including new viruses in the same group

包過一些和 HIV 同類的新病毒

as HIV -- so, brand new retroviruses.

全新的反轉錄病毒

And let's face it, any new retrovirus in the

讓我們面對現實，無論是何種反轉錄病毒

human population -- it's something we should be aware of.

進入人類族群，就是我們應該要注意

It's something we should be following. It's not something

要追蹤的大事。

that we should be surprised by.

我們不應該因此措手不及。

Needless to say in the past

不需多說，以前

these viruses entering into these rural communities

這些病毒要是進入農村社區

might very well have gone extinct.

就幾乎等於滅絕。

That's no longer the case. Logging roads provide access to urban areas.

現在不可同日而語，木棧道提供進入都市的管道

And critically, what happens in central Africa

嚴格來說，在中非爆發的問題

doesn't stay in Central Africa.

最後也會影響全世界

So, once we discovered that it was really possible

所以一發現

that we could actually do this monitoring,

加以監控的可行性很高

we decided to move this from research, to

我們決定將研究進一步推到

really attempt to phase up to a global monitoring effort.

真正嘗試逐步進行全球監控的工作

Through generous support and partnership

憑藉著慷慨的支持和

scientifically with Google.org and the Skoll Foundation,

與 Google.org 及史科爾基金會在科學上的合作

we were able to start the Global Viral Forecasting Initiative

我們創立了全球病毒預報先遣行動

and begin work in four different sites

開始在非洲和亞洲

in Africa and Asia.

四個不同地方進行

Needless to say, different populations from different parts of the world

不用說，世界不同地區的不同族群

have different sorts of contact.

接觸病毒的方式不同

So it's not just hunters in Central Africa.

所以不只是中非的獵人

It's also working in live animal markets --

活體動物市集中也有蔓延的危險

these wet markets -- which is exactly the place where

這些潮溼的市場，也正是 SARS

SARS emerged in Asia.

在亞洲爆發的地方

But really, this is just the beginning from our perspective.

不過這對我們來說其實只是開端

Our objective right now, in addition to

我們現在的目標，

deploying to these sites and getting everything moving,

除了在這些地方部署，讓一切上軌道

is to identify new partners

還有找到新的夥伴

because we feel like this effort needs to be extended

因為我們覺得這樣的活動需要多方同時進行

to probably 20 or more sites throughout the world -- to viral hotspots --

大約需到達 20 個以上遍佈世界各地、病毒猖獗的地方

because really the idea here is to cast an incredibly wide net

因為我們提出的想法是撒下天羅地網

so that we can catch these things, ideally,

希望能捕捉到病毒

before they make it to blood banks,

防堵它們滲入血庫

sexual networks, airplanes. And that's really our objective.

入侵性行為網絡、航空。這就是我們的目標

There was a time not very long ago

不久之前

when the discovery of unknown organisms

我們還對發現未知的有機生物

was something that held incredible awe for us.

抱持著非常敬畏的態度

It had potential to really change the way that we saw ourselves,

這很有可能改變我們看待自己的方式

and thought about ourselves.

和對自己的想法

Many people, I think, on our planet right now

我認為現在地球上很多人

despair, and they think

感到絕望，他們認為

we've reached a point where we've discovered most of the things.

我們已經發現絕大多數事物

I'm going tell you right now: please don't despair.

我在這裡告訴大家，請不要覺得絕望

If an intelligent extra-terrestrial

如果具高等智慧的外星人

was taxed with writing the encyclopedia of life on our planet,

要編一部地球生命的百科全書

27 out of 30 of these volumes

30 本裡有 27 本

would be devoted to bacteria and virus,

將會是有關細菌和病毒

with just a few of the volumes left

最後剩下的幾本

for plants, fungus and animals,

才是寫植物、真菌和動物的

humans being a footnote;

人類只算得上是小小的註解

interesting footnote but a footnote nonetheless.

一個內容有趣但簡短的註解

This is honestly the most exciting period

現在真的是研究地球上未知生命型態

ever for the study of unknown life forms on our planet.

最令人興奮的一段時期

The dominant things that exist here

重點是

we know almost nothing about.

我們幾乎一無所知

And yet finally, we have the tools, which will allow us to actually explore that world

不過，我們終於有了工具，可供探索那個世界

and understand them.

進而增進了解

Thank you very much.

非常感謝

(Applause)

(掌聲)