In 1987, tens of thousands of people gathered in Saudi Arabia for the annual Hajj pilgrimage. But what started out as a celebration led to a health crisis: just a few days after the pilgrimage, more than 2,000 cases of meningitis broke out spreading across Saudi Arabia and the rest of the world. The outbreak was so fierce that it was believed to have sparked a wave of deadly meningitis epidemics that ultimately infected tens of thousands of people worldwide.
1987 年,成千上萬人 聚集在沙烏地阿拉伯 參加一年一度的朝覲 原本是個慶祝的活動 最後變成一場健康災難 朝覲後僅數天 超過二千個腦膜炎病例 在沙烏地阿拉伯及世界各地爆發 此場爆發之兇猛 以致於大家認為引發了 一波致命腦膜炎流行病 疫情最終擴及全世界 感染成千上萬的人
Meningitis is the inflammation of the meninges, three tissue layers responsible for protecting the brain and spinal cord. What makes meningitis so dangerous compared to other diseases is the sheer speed with which it invades a person’s body. In the worst cases, it causes death within a day. Fortunately, that’s rare for patients who receive early medical treatment.
腦膜炎就是腦膜發炎 腦膜由三層組織構成 主要功能為保護腦部及脊髓 腦膜炎與其他疾病相較 之所以如此危險 完全在於其侵入人體的速度 在最糟的情況下 只要一天就會造成死亡 幸運的是
The disease primarily comes in three forms: fungal, viral, and bacterial-- the last being the most deadly by far, and what we’ll focus on. People usually contract bacterial meningitis by breathing in 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, or sharing cigarettes, toothbrushes or utensils. Some people can be infected and carry the disease without showing symptoms or getting sick, which helps the disease spread quickly to others.
病患如能即早治療 這種情況極為罕見 這種疾病主要有三種類型 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 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 也可經由親吻、共享香菸 共用牙刷或餐具而傳染 某些人受感染後成為帶原者 本身不會出現症狀或生病 使此疾病更加快速傳染給別人 這種細菌一旦進入鼻腔、口腔及喉嚨
Once the bacteria enter the nose, mouth, and throat, they cross the surrounding membranes and enter the bloodstream. From there, bacteria have rapid access to the body’s tissues --including a membrane called the blood-brain barrier. This is made of a tight mesh of cells which separate blood vessels from the brain, and block everything except for a specific set of particles, including water molecules and some gases. But in ways that scientists are still trying to understand, meningitis bacteria can trick the barrier into letting them through.
就會穿過附近的黏膜進入血液 細菌從那裡開始快速進入身體組織 包括一種稱為血腦障壁的隔膜 這種隔膜由緊密的細胞網構成 將血管與腦部分開 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 但是科學家仍在試著找出 腦膜炎細菌如何騙過這層障壁 讓它們通過
Inside the brain, the bacteria swiftly infect the meninges. This triggers inflammation as the body’s immune response kicks into overdrive, bringing on fever and intense headaches. As swelling in the meninges worsens, the neck begins to stiffen. Swelling in the brain disrupts its normal function-- causing symptoms like hearing loss and extreme light sensitivity. As pressure increases in the cranium, it may also make the person confused-- one of the hallmarks of the disease. A few hours in, the rapidly multiplying bacteria start to release toxins, leading to septicemia, also known as blood poisoning. This breaks down blood vessels, letting blood seep out and form what starts out looking like a rash, and evolves into big discoloured blots beneath the skin. At the same time, these toxins burn through oxygen in the blood, reducing the amount that gets to major organs like the lungs and kidneys. That increases the chance of organ shut down --and alongside spreading septicemia, threatens death. That all sounds scary, but doctors are so good at treating meningitis that a visit to the hospital can drastically reduce an adult’s risk of dying from it. The longer it’s left untreated, though, the more likely it will lead to lasting damage. If declining oxygen levels cause cell death in extreme parts of the body --like fingers, toes, arms and legs-- the risk of amputation goes up. And if bacterial toxins accumulate in the brain and trigger cell death, meningitis could also cause long-term brain damage and memory loss. So fast treatment, or better yet, prevention, is critical. That's why most countries have vaccines that defend against the disease in its deadliest forms. Those are usually given to the people who are most at risk--like young children, people with weak immune systems, or people who gather in large groups where an outbreak of meningitis could potentially happen.
在大腦內部,細菌很快感染腦膜 這會引發炎症 因為身體的免疫反應開始超負荷 導致發燒及劇烈頭痛 隨著腦膜腫脹惡化 頸部開始變硬 腦部腫脹會打亂其正常功能 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 這是此病的特徵之一 數小時內 快速增殖的細菌開始釋放毒素 導致敗血症,又稱血中毒 它會使血管爆裂,血液滲出 在皮下形成一開始 看起來像紅疹的東西 然後演變成大塊瘀斑 與此同時 這些毒素會燒盡血中的氧氣 減低輸送到重要器官如肺和腎臟的量 這會增加器官衰竭的機會 並傳播敗血症,威脅生命 這些聽起來超可怕 但是醫師非常擅長治療腦膜炎 只要去一趟醫院 就能大幅減低成人死於此病的風險 然而,等待治療的時間愈長 就愈有可能造成永久傷害 如果缺氧導致身體末端的細胞死亡 例如手指、腳趾、手臂及小腿 需要截肢的風險就增高 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 所以快速治療至關重要 預防更不可或缺 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 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 或曾經參與過大型聚會的人
In addition to those gatherings, meningitis is most common in a region called the meningitis belt that stretches across Africa, though cases do happen all over the world. If you’re concerned that you or someone you know may have meningitis, get to the doctor as soon as possible; quick action could save your life.
因為腦膜炎可能會在此爆發 除了這些聚會外 腦膜炎在所謂 「腦膜炎流行帶」最為常見 這個流行帶橫跨非洲 儘管全世界都有病例 如果你擔心自己或認識的人 可能得到腦膜炎 盡快就醫! 快速行動可以救你一命