流行病：如何预防流感大爆发（2020）

也就是下一次疾病流行的发生方式
（印度拉贾斯坦邦斋浦尔）
（阿努普里亚阿格加瓦尔 纪念医院的第二年住院医师）
（正在前往贫困人口的免费诊所）
We have a major proportion of the country who don't access health services properly.
我们国家有一大部分人口 无法获得适当的医疗服务
Other than proper doctors in our country,
在我们国家 除了合格的医生
people have a lot of trust in quacks
民众也非常信任庸医
or people who are not very well-qualified to give medicine.
或是不太有资格给人开药的人
（迪内什维杰医生 纪念医院胸腔内科医生）
This camp happens every month.
每月都会进行这样的活动
We will see at least four to five hundred patients.
我们至少会看四五百名病人
I go to a slum clinic on my weekends,
我周末时会去贫民窟的诊所
because we find the most serious manifestations of swine flu
因为我们发现 猪流感症状最严重的地方
in the most socio-economically poor areas.
就是在社会经济最贫困的区域
It's not that the flu attacks only the poor.
并不是说流感只攻击穷♥人♥
It attacks the rich in the same way.
流感也会攻击富裕的人
The poor are not able to fight against it.
只是穷♥人♥无法反抗
Because of overcrowding, poor hygiene, lack of resources, and malnutrition.
因为过度拥挤 卫生条件恶劣 缺乏资源和营养不良
There's no one to explain to them the severity of their disease.
没人向他们解释他们疾病的严重性
-You have a slight fever? -Yes.
-你有低烧？ -是的
-Have you used a thermometer? -No.
-用体温计测过吗？ -没有
Somehow, even if people develop symptoms of swine flu,
有些人哪怕是已经有了猪流感的症状
they tend to ignore it.
也往往会忽视
Some of them are daily wagers.
其中一些是拿日薪的
So, if they stop going for work, how will they support their family?
如果不去工作 谁来养家？
So, they go out and they end up spreading the disease even more.
所以他们去上班 结果还进一步散播了疾病
Of the higher-risk patients,
在高风险人群中
a very special group, yet neglected, is the group of pregnant females.
有一个非常特殊的人群被忽视了 那就是孕妇
You've had nausea for the last three, four days, correct?
你的恶心症状 持续三、四天了 对吗？
You might have heard about swine flu in Jaipur. There's an outbreak
你或许听说过斋浦尔的猪流感 目前有疫情
A pregnant woman is highly prone to this disease.
孕妇极易患上此病
I will prescribe a medicine for you,
我会为你开药
but make sure to get the test done in a day or two.
但你要确保在一两天内完成检查
I have a bad cough.
我咳得很厉害
-Anyone else coughing at home? -No.
-你家里有其他人咳嗽吗？ -没有
-No one at home has it? -No, and my cough is not going away.
-家里没人咳嗽？ -没人 但我的咳嗽一直不消退
-The cough is not going away? -No, it is getting worse.
-咳嗽不消退 -是的 还变严重了
（索尼 怀孕六个月）
I am thinking that, Soni,
我觉得 索尼
since you are not getting any relief, I think you should go to SMS Hospital.
既然你的病人没有任何缓解 我觉得你应该去辛格二世医院
-Which hospital? -SMS Hospital.
-哪家医院？ -辛格二世医院
The thing is you are pregnant, so we do not want to take any risks.
关键在于你怀孕了 我们不想冒任何风险
We want to rule out swine flu as a possibility.
我们想要排除猪流感的可能性
-Should we go tomorrow? -If you go today, it is best.
-可以明天去吗？ -最好今天就去
Okay, then.
那好吧
Is there reason to worry?
需要担心吗？
We just need to be sure.
我们只需要确保
I will arrange for the ambulance.
我来安排救护车
Go and show yourself there.
你就快去吧
They will run tests for all your issues. And they can prescribe treatment as well.
他们会检查你所有的问题 也可以为你安排治疗
In the past, I came across a pregnant lady
按我过去的经验 我曾经遇到过
and she got infected with swine flu.
感染猪流感的孕妇
Initially, they ignored.
他们一开始忽视了
By the time she came to us, she was very, very ill.
等她来找我们时已经病得很重了
And despite trying everything, we lost the patient.
尽管我们想尽一切办法 还是没能保住病人
So, it was very sad that,
所以这真是很悲惨
had they been a little more aware, two lives could have been saved.
如果他们能多注意一点 就能拯救两条性命了
（第三章 我们周围的警告）
Welcome everybody to the Ways and Means Subcommittee on Human Services.
欢迎各位来到公共事业 方式方法附属委员会
（美国俄勒冈州塞勒姆）
We're going to do a public hearing this morning on House Bill 3063.
我们今天上午将进行 3063法案的公众听证会
Senator Steiner Hayward is going to make a presentation on the bill.
斯坦纳海沃德参议员 将会对法案进行介绍
（伊丽莎白斯坦纳海沃德参议员 俄勒冈17参议院区）
Senator Steiner Hayward.
斯坦纳海沃德参议员
In essence, House Bill 3603 will require
大体上 3063法案将会要求
that children attending any school or licensed childcare facility
在任何学校或正规儿童保育机构 上学或托管的儿童
receive a course of immunizations that are listed in 3603A.
都必须接受3063A中所列出的 一系列免疫接种
It will remove non-medical exemptions
法案将取消非医学豁免
as a reason for not obtaining these immunizations.
作为不接受接种的理由
The intention is to protect children in licensed school settings
法案目的是为了保护正规学校
and licensed state care settings.
和正规保育机构中的儿童
Thank you, doctor.
谢谢你 医生
I'm a board-certified family physician.
我是持证家庭医生
I firmly believe that I have a responsibility as a legislator
我坚信 我作为立法者有责任
to promote good science,
推广优良科学
to promote what's in the best interest of the vast majority of Oregonians.
促进符合大多数俄勒冈人 最大利益的事情
I mean, this is a public health emergency. It truly is.
这可是公共卫生紧急事件 真的是
We're gonna go to public hearing,
我们将进行公众听证
and we're gonna give everybody two minutes to state your position on the bill
我们将给每个人两分钟事件 来表明你对法案的态度
and what you want us to know, people who have signed up for and against.
以及你想让我们知道的事情 包括支持和反对的人
I'm here to oppose House Bill 3063.
我反对3063法案
I believe religious and philosophical exemptions to vaccination are imperative
我相信疫苗的宗教 和哲学豁免是必要的
since a medical exemption is nearly impossible to obtain.
因为医学豁免几乎是不可能获得的
（法案反对者）
Oregon has large groups of people inclined to vaccine hesitancy.
俄勒冈有一大群人倾向于疫苗犹豫
The idea that the government thinks
政♥府♥认为他们有权力
that they have any place to mandate toxic injections
强制向我们孩子的身体注射毒药
into our children's bodies is scary.
这一想法是可怕的
The first is that dichotomy between purity and impurity
首先是纯洁与不纯洁之间的二分法
and they see vaccines as this impure substance
他们将疫苗视为注入我们身体的
that we're putting into our bodies.
不纯物质
HB 3063 lays the groundwork for government overreach,
3063法案为政♥府♥过度干预奠定了基础
and the cost of that is our freedom.
而代价就是我们的自♥由♥
Oregonians tend to be pretty minimalist when it comes to the government.
在政♥府♥方面 俄勒冈人倾向于温和政♥治♥
So, vaccine hesitancy found fertile ground here in Oregon,
所以疫苗犹豫在俄勒冈很有生长空间
and for years, we've been seeing declining immunization rates.
多年来 免疫接种率都在下降
When I was a teenager, I received the exciting, new HPV vaccine Gardasil,
我在青少年时 接种了令人兴奋的 全新人类乳突病毒疫苗加卫苗
and I had facial paralysis for three months as a 17-year-old girl.
结果17岁的我面瘫了三个月
I have a family history of vaccine reactions to the MMR.
我有对麻腮风三联疫苗 产生不良反应的家族史
I lost the ability to walk and talk
我失去了行走和说话的能力
and it took me four months to regain those skills.
花了我四个月才重获这些技能
My son has microscopic colitis.
我儿子有显微镜结肠炎
He's had an endoscopy and colonoscopy at seven years old.
他七岁时接受了内窥镜和结肠镜检查
He did not have a solid stool till he was eight.
他八岁前大便都不成形
Correlation doesn't prove causation.
相关性不能证明因果关系
It's absolutely true that people can have adverse reactions after vaccines.
有些人在接种后会出现副作用 这是千真万确的
Some of them can be serious.
有一些可能会很严重
Relatively few of the very serious ones are actually associated with the vaccines.
而非常严重的副作用 实际很少和疫苗有关
Sixty years ago, autism was unknown, about one in 10,000.
六十年前 自闭症还不为人知 出现几率只有万分之一
Today, African-American males are diagnosed one in 48.
而现在 每四十八位非裔美国男性中 就有一位患上自闭症
Nobody becomes autistic.
没人会得上自闭症
They're autistic from birth,
自闭症都是天生的
but the symptoms of autism start to become clear
但是自闭症的症状会在12到24个月间
somewhere between 12 and 24 months,
变得很明显
and children get their first MMR vaccine at 12 months.
而儿童会在12个月时接种 第一针麻腮风三联疫苗
My doctor told me that getting the Tdap vaccine
我的医生告诉我 接种百白破疫苗疫苗
was the only way I could protect my unborn baby from pertussis.
是防止我未出生的孩子 患上百日咳的唯一办法
I had a hot, red, swollen arm for five or more weeks to show for it.
我红肿了五周多的手臂足以证明
These were the lasting effects
这是铝佐剂
that the adjuvant aluminum was having on my immune system.
对我的免疫系统来带的持续影响
The amount of aluminum you get from a whole series of immunizations
你在全系列接种过程中摄取的铝
is less than if you cook an acidic thing like tomato sauce in an aluminum pan.
比你用铝锅烹煮一次番茄酱 这样的酸性食物时摄取的还少
My mom and dad deserve the respect
我爸爸妈妈为我的利益
to make choices that are best for my life.
做选择的权利值得被尊重
Measles cases are skyrocketing.
麻疹病例已经暴增
And that's incredibly concerning.
这非常令人担忧
The disease itself is dangerous,
这种疾病本身就很危险
but it turns out that it also induces what's called immune amnesia,
结果这种疾病还能引起免疫失忆
which basically means your immune system forgets how to fight off anything else.
基本就是说你的免疫系统 忘记了如何跟其他东西对抗
Kids, in particular, who get measles
而孩子们 特别是得了麻疹的孩子
are at much higher risk of dying of all sorts of other things.
死于各种其他原因的风险要高很多
The idea that we're putting kids at risk this way
这种让孩子冒风险的想法
for something that's completely preventable...
特别还是这种完全可预防的疾病…
We should have had measles eradicated from the world by now.
我们现在应该已经把麻疹根除了才对
After my round of chemotherapy for a year, I was scared to go to school.
在接受了一年的化疗之后 我害怕回到学校