古老的“瘟疫”一词再次成为头条新闻。美国国家公共电台（NPR）的俄罗斯事务记者查尔斯·梅恩斯本周报道了目前我们所了解的情况：一名在俄罗斯实验室研究鼠疫的研究人员于上周因不明原因引发的肺炎去世。
The ancient word "plague" is back in the headlines. NPR's Russia correspondent Charles Maynes reported this week on what we know about a Russian researcher working in a lab studying the plague who died from pneumonia of an unknown origin last week.
梅恩斯报道称，这名员工是一名28岁的女性，在距离莫斯科约2500英里的西伯利亚一家实验室工作。俄罗斯消费者健康监管机构的一项调查得出结论，她体内的任何病原体都与她从事的传染病研究无关。
Maynes reports that the employee was a 28-year-old woman who worked in a lab in Siberia, some 2,500 miles from Moscow. An investigation by Russia's consumer health watchdog concluded that no pathogens in her body were connected to her work with infectious disease.
但当地媒体对肺鼠疫的传播提出了担忧，而NPR尚未对此进行独立证实。
But local media have raised concerns about the spread of pneumonic plague, which NPR has not independently confirmed.
肺鼠疫是西伯利亚该实验室所研究的疾病之一。这种病可通过空气传播，且可能致命。
It's one of the diseases studied at the lab in Siberia. It's airborne and can be fatal.
尽管俄罗斯方面指出已有200名“接触者”被隔离，并否认该地区存在鼠疫病例，但疑问依然存在。周三，世界卫生组织总干事谭德塞在一次新闻发布会上表示，俄罗斯的这些保证——至少——并不完整：“我们尚未掌握此次事件的全貌，也无法进行全面的风险评估。”
While noting that 200 "contacts" were in quarantine, Russia has denied that there are cases of plague in the area. But questions loom.
与此同时，以下是我们目前所了解的关于细菌性疾病鼠疫——以及被称为肺鼠疫的变异类型——的相关信息。鼠疫的不同类型鼠疫有多种类型，具体取决于细菌侵袭人体的哪个部位。当跳蚤叮咬人类时，患者通常会患上所谓的腺鼠疫。在这种情况下，典型的症状是出现一个或多个肿胀且疼痛的淋巴结，即所谓的“腺痈”（buboes）。
In a press conference Wednesday, the head of the World Health Organization, Tedros Adhanom Ghebreyesus said these Russian assurances were — at the very least — incomplete: "We don't yet have the full picture of this event and we're not able to conduct a full risk assessment. In the meantime, here's what we do know about the bacterial disease of plague — and the variant known as pneumonic plague. Plague variations The plague comes in several versions, depending on which body part the bacteria invade. When a flea bites a person, the individual typically develops what's called bubonic plague.
（“腺鼠疫”一词源自希腊语“boubon”，意为腹股沟，因为有些患者的腹股沟部位会出现淋巴结肿胀。）医生可以通过采集患者的血液或淋巴结样本，并送往实验室检测来诊断这种疾病。
In this case, the telltale sign is one or more swollen and painful lymph nodes, known as buboes. (The word "bubonic" comes from the Greek boubon which means groin, because some people have swollen lymph nodes in their groin.) Doctors can diagnose the disease by taking a sample from the person's blood or lymph nodes and then submitting the sample to a lab for testing.
但当细菌传播到肺部时，就可能引发所谓的肺型鼠疫。美国疾病控制与预防中心表示，在这种情况下，通常没有鼠疫的典型症状。
But when the bacteria spread to the lungs, this can cause what's called pneumonic plague. In this case, there's often no telltale sign of the plague, according to the Centers for Disease Control and Prevention.
埃默里大学的医学昆虫学家阿德莱德·米亚林贾拉表示，这种类型要危险得多。“它通过飞沫传播，几乎和新冠病毒一样，因此很容易在人与人之间传播。”
This version is much more dangerous, says medical entomologist Adelaide Miarinjara at Emory University. "It transmits pretty easily between people because it spreads through droplets, almost like COVID spreads."
她补充说，与鼠疫的其他类型相比，肺型鼠疫可能导致更快的死亡，因为病情进展更迅速。“关键在于早期诊断。如果人们没有意识到这种可能性，或者不寻求治疗，就可能死亡。”治疗需要使用抗生素，通常通过静脉输液给药。
And people can die more quickly with pneumonic plague than other forms, she adds, because the disease progresses more rapidly. "The key here is early diagnosis. If people aren't expecting it or don't seek treatment, they can die."
2017年，马达加斯加曾爆发大规模肺型鼠疫疫情，当时该国一名来自农村地区的人将疾病带到了沿海城市托马西纳。米亚林贾拉当时就在马达加斯加，她表示，这座城市近一个世纪以来从未出现过鼠疫病例。“当时有一人在公共交通工具上传染了这种疾病。”
Treatment involves antibiotics, often administered by IV infusion. In 2017, Madagascar suffered a large outbreak of pneumonic plague when a person from a rural part of the country brought the disease to the coastal city of Toamasina. That city hadn't seen a case of the plague in nearly a century, says Miarinjara, who was in Madagascar at the time.
该国记录了超过2400例疑似病例，其中包括近1900例肺型鼠疫病例。一项研究估计，在这场疫情中，约25%的确诊病例患者死亡。
"A person transmitted the disease on public transportation," she says. The country recorded more than 2,400 suspected cases, including nearly 1,900 cases of pneumonic plague.
隔离的历史 至于关于这名被隔离的实验室工作人员在俄罗斯的“接触者”的报道——这反映了人类对鼠疫等疾病长期以来的应对方式。
One study estimated that about 25% of people with confirmed cases died in this outbreak.
将病人隔离或进行检疫的想法至少可以追溯到3000年前。《圣经》中的《利未记》提到了如何隔离麻风病人。
The history of quarantine As for the reports of Russian "contacts" of the lab worker under quarantine — that reflects a long-standing response to sicknesses like the plague. The idea of isolating, or quarantining, sick people dates back at least 3,000 years.
而“quarantine”（隔离）一词本身则起源于黑死病时期。当时，如今属于克罗地亚的城邦杜布罗夫尼克实施了可能是历史上首次由政府强制执行的隔离措施。
The Book of Leviticus in the Bible mentions how to isolate people with leprosy. The word "quarantine" itself arose during the Black Death, when the city-state of Dubrovnik, now part of the country of Croatia, enacted what is likely the first state-imposed isolation.
当时，杜布罗夫尼克是亚得里亚海沿岸一座富有的商业城市。城市领导人希望将腺鼠疫隔绝在外。因此，他们开始强制游客在城外一座偏远的岛屿上等待40天，之后才能上岸。
At the time, Dubrovnik was a wealthy merchant city along the coast of the Adriatic Sea. City leaders wanted to keep the bubonic plague out. So they began to force visitors to wait for 40 days on a remote island outside the city before coming ashore.
他们将这种等待称为“quarantino”，这个词源自意大利语中表示“40”的词汇。“最初的隔离措施基本上是靠临时应变的，”杜布罗夫尼克拉扎雷托隔离中心教育项目主管伊瓦娜·马里纳维奇在2021年接受美国国家公共电台（NPR）采访时说。拉扎雷托是历史上首批专门用于隔离的建筑。
They called the wait quarantino from the Italian word for "40." "The first quarantine was pretty much improvised," Ivana Marinavić, the head of educational programs at the Lazarettos of Dubrovnik told NPR in 2021 The Lazarettos were the first buildings ever constructed for the sole purpose of quarantining. If you broke the quarantine during the plague, the consequences were severe.
如果在鼠疫期间违反隔离规定，后果将非常严重。“会受到酷刑，或者被割掉鼻子或耳朵，”马里纳维奇告诉NPR。
"Torture, or cutting your nose or your ears off," Marinavić told NPR. For stories about life in our changing world, to NPR's Global Health newsletter.
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pneumonic plague