The child's symptoms begin with mild fever, headache, muscle pains, followed by vomiting and diarrhea, then bleeding from the mouth, nose and gums. Death follows in the form of organ failure from low blood pressure.
這個患兒的症狀首先是 低燒、頭痛和肌肉痛， 之後出現嘔吐和腹瀉， 後來口、鼻和牙齦開始出血， 最終由於低血壓引起器官衰竭，導致死亡
Sounds familiar? If you're thinking this is Ebola, actually, in this case, it's not. It's an extreme form of dengue fever, a mosquito-born disease which also does not have an effective therapy or a vaccine, and kills 22,000 people each year. That is actually twice the number of people that have been killed by Ebola in the nearly four decades that we've known about it. As for measles, so much in the news recently, the death toll is actually tenfold higher. Yet for the last year, it has been Ebola that has stolen all of the headlines and the fear.
是不是聽起來很熟悉？ 如果你覺得這會不會是埃博拉， 實際上，就本例來說並不是。 本例是登革熱的極端形式，這是一種通過蚊子傳播的疾病，它也沒有有效的治療方法或疫苗，並且每年殺死 2.2 萬人。 其實，這一數字相當於 埃博拉病毒，在自我們知道它以來的 近 40 年裡，所殺死的人數的兩倍 而近期新聞中頻繁提到的麻疹 死亡人數實際上是登革熱的十倍之多。 然而在去年， 佔據所有頭條，引起所有恐慌的 卻是埃博拉。
Clearly, there is something deeply rooted about it, something which scares us and fascinates us more than other diseases. But what is it, exactly? Well, it's hard to acquire Ebola, but if you do, the risk of a horrible death is high. Why? Because right now, we don't have any effective therapy or vaccine available.
顯然，有某種東西深深地根植其中， 這種東西讓我們如此害怕， 成為了揮之不去的陰影，沒有其它疾病能做到這一點。 而它到底是什麼呢？ 其實，得上埃博拉是很不容易的， 但如果真的患病， 以可怕的死狀離去，是極有可能的。 為什麼？ 因為現在我們沒有任何有效的治療方法或疫苗可用。
And so, that's the clue. We may have it someday. So we rightfully fear Ebola, because it doesn't kill as many people as other diseases. In fact, it's much less transmissible than viruses such as flu or measles. We fear Ebola because of the fact that it kills us and we can't treat it. We fear the certain inevitability that comes with Ebola. Ebola has this inevitability that seems to defy modern medical science.
所以，這就是原因。 可能我們終將研製出來。 所以我們害怕埃博拉，是合情合理的， 因為它殺死的人沒有其它疾病那麼多， 實際上，它的傳染性比 流感和麻疹之類的病毒，低多了。 我們害怕埃博拉是因為這一事實： 它能殺死我們，我們卻無能為力。 我們害怕伴隨埃博拉而來的某種不可避免性。 埃博拉的這種不可避免性 似乎是在挑戰現代醫學。
But wait a second, why is that? We've known about Ebola since 1976. We've known what it's capable of. We've had ample opportunity to study it in the 24
outbreaks that have occurred. And in fact, we've actually had vaccine candidates available now for more than a decade. Why is that those vaccines are just going into clinical trials now?
等一下，為什麼會這樣？ 從 1976 年起我們就知道埃博拉了， 我們知道它有多厲害， 我們也有足夠的機會來研究它， 因為一共出現了 24 起爆發的病例。 而實際上， 現在我們手上已經有了候選疫苗， 在十多年前就有了。 那為什麼這些疫苗到現在才進行臨床實驗？
This goes to the fundamental problem we have with vaccine development for infectious diseases. It goes something like this: The people most at risk for these diseases are also the ones least able to pay for vaccines. This leaves little in the way of market incentives for manufacturers to develop vaccines, unless there are large numbers of people who are at risk in wealthy countries. It's simply too commercially risky.
這就遇到了研製感染性疾病的疫苗時 面臨的根本問題。 大致情況是這樣： 患上這些疾病風險最高的人 也是最無力支付疫苗的一群人。 這就導致幾乎沒有市場動力 來推動生產商研製疫苗， 除非在富國有大量人群面臨風險。 簡單來說，商業風險過高。
As for Ebola, there is absolutely no market at all, so the only reason we have two vaccines in late-stage clinical trials now, is actually because of a somewhat misguided fear. Ebola was relatively ignored until September 11 and the anthrax attacks, when all of a sudden, people perceived Ebola as, potentially, a bioterrorism weapon.
至於埃博拉，則完全沒有市場， 所以，如今我們能有兩種疫苗進入後期臨床實驗， 唯一的原因是，有點被誤導的恐懼。相對來說，埃博拉一直以來被忽視了，直到 911 和炭疽襲擊，突然之間，人們意識到 埃博拉是一種潛在的，具有生物恐怖襲擊性的武器。
Why is it that the Ebola vaccine wasn't fully developed at this point? Well, partially, because it was really difficult -- or thought to be difficult -- to weaponize the virus, but mainly because of the financial risk in developing it. And this is really the point. The sad reality is, we develop vaccines not based upon the risk the pathogen poses to people, but on how economically risky it is to develop these vaccines. Vaccine development is expensive and complicated. It can cost hundreds of millions of dollars to take even a well-known antigen and turn it into a viable vaccine.
為什麼這時埃博拉疫苗還沒有完全研製出來？ 部分是因為非常困難--或者說覺得很困難--來使病毒武器化。 但主要原因是研製疫苗的財務風險。 這一點是問題真正所在。 現實的可悲之處在於， 我們研製一種疫苗， 並非是考慮病原體對人類的風險有多大， 而是考慮研製疫苗的經濟風險有多大。 研製疫苗既昂貴又複雜， 要花費高達數億美元 才能選出一種，甚至是已經熟知的抗原， 將它轉化為可用的疫苗。
Fortunately for diseases like Ebola, there are things we can do to remove some of these barriers. The first is to recognize when there's a complete market failure. In that case, if we want vaccines, we have to provide incentives or some type of subsidy. We also need to do a better job at being able to figure out which are the diseases that most threaten us. By creating capabilities within countries, we then create the ability for those countries to create epidemiological and laboratory networks which are capable of collecting and categorizing these pathogens. The data from that then can be used to understand the geographic and genetic diversity, which then can be used to help us understand how these are being changed immunologically, and what type of reactions they promote.
幸運的是，對於像埃博拉這樣的疾病， 我們還是可以做一些事情 來打破這些壁壘的。 首先，要承認市場已經完全不起作用的現狀， 在這種情況下，如果我們想得到疫苗， 就必須提供獎勵措施，或某種形式的補貼。 我們也需要更加努力， 來找出對我們威脅最大的疾病有哪些。 首先確立這些國家內部的研發力量，在此基礎上 我們幫助這些國家建起 創立流行病學和實驗室網絡的能力，有了這些，我們就有能力採集這些病原體，並進行分類。由此而來的數據 可用於瞭解其地理分佈和遺傳多樣性， 有助於幫助我們瞭解 這些免疫學上的變化是如何產生的 以及促進了哪種類型的反應。
So these are the things that can be done, but to do this, if we want to deal with a complete market failure, we have to change the way we view and prevent infectious diseases. We have to stop waiting until we see evidence of a disease becoming a global threat before we consider it as one. So, for Ebola, the paranoid fear of an infectious disease, followed by a few cases transported to wealthy countries, led the global community to come together, and with the work of dedicated vaccine companies, we now have these: Two Ebola vaccines in efficacy trials in the Ebola countries –
所以說，這些事情是可以做的， 但要做到這些， 如果我們想要在市場無力的情況下解決問題， 就必須改變我們看待、預防傳染性疾病的方法。 我們不能在看到疾病成為全球性威脅的證據之前， 總是袖手旁觀。 當我們認為它是的時候，就應該行動起來 所以，對於埃博拉來說， 對傳染性疾病的極度恐慌， 出現於幾例傳染者轉移至富裕國家之後。 這種恐慌促使全球各國攜起手來， 加上專門的疫苗公司的努力， 我們才有了現在的結果： 兩種埃博拉疫苗正在發病國家進行療效試驗，
and a pipeline of vaccines that are following behind.
後續還會有疫苗不斷地生產出來。
Every year, we spend billions of dollars, keeping a fleet of nuclear submarines permanently patrolling the oceans to protect us from a threat that almost certainly will never happen. And yet, we spend virtually nothing to prevent something as tangible and evolutionarily certain as epidemic infectious diseases. And make no mistake about it -- it's not a question of "if," but "when."
每年我們花費數十億美元， 以維持核潛艇艦隊， 在海洋中持續巡邏， 而這支艦隊所預防的威脅， 幾乎可以肯定絕不會出現。 然而，我們又實際上幾乎沒有花費多少錢 來預防流行性傳染病這樣的問題， 這個問題切實存在，並且一定是不斷進化的。
These bugs are going to continue to evolve and they're going to threaten the world. And vaccines are our best defense. So if we want to be able to prevent epidemics like Ebola, we need to take on the risk of investing in vaccine development and in stockpile creation. And we need to view this, then, as the ultimate deterrent -- something we make sure is available, but at the same time, praying we never have to use it.
對此不應當犯錯--這不是“如果”的問題，而是“什麼時候”的問題。這些病毒還會不斷進化，還會威脅整個世界，而疫苗是我們的最佳防禦手段。所以如果我們想要預防譬如埃博拉的蔓延， 我們就必須承擔風險， 向疫苗研製與物資儲備投入資金。 而且我們應當，把它看作最終防線-- 我們確保有效的良方， 而與此同時， 祈禱永遠不要用到它。
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