Among the swine flu mysteries: Why only deaths in Mexico?
新闻概览
墨西哥已确认有7例猪流感死亡；美国确认有64例，无死亡病例
专家怀疑疾病会在墨西哥持续很久，感染更多的人
一些因素像营养不良、居住条件简陋会使墨西哥受害者更容易受到伤害
墨西哥已确认有7例猪流感死亡；美国确认有64例，无死亡病例
专家怀疑疾病会在墨西哥持续很久，感染更多的人
一些因素像营养不良、居住条件简陋会使墨西哥受害者更容易受到伤害
专家确认受害者是年轻人，他们应有高抵抗力
(CNN) -- It's a confounding question on the lips of disease detectives: Why have the only deaths from the swine flu outbreak happened in Mexico?
（CNN）——在我们挂在嘴边的疾病侦测中：为什么只有墨西哥会因爆发猪流感而死亡呢？这是一个令人相当困惑的问题。
Investigators also want to know why the disease has killed young adults, who should have the greatest resistance.
调查者同样很想知道为什么疾病会杀死年轻的成年人，他们应该有最强的抵抗力。
"They're good questions that we're asking, too," said Von Roebuck, spokesman for the U.S. Centers for Disease Control and Prevention. "We're still young in this investigation and we're still trying to understand exposure in this country as well as exposure in Mexico."
“这也是我们一直在问的问题，”，美国疾病控制与预防中心的发言人Von Roebuck说。“在这场调查中我们还很年轻，我们仍在试图明白我们国家和墨西哥暴露的猪流感问题。”
Mexico has reported 152 fatalities in flu-like cases in recent days, seven of which have been confirmed as swine flu. Another 19 patients have been confirmed as having swine flu but surviving. About 2,000 people have been hospitalized with symptoms.
最近墨西哥已报道有152例死于类似流感的病例，已有7例被确认为猪流感。另外有19个病人已被确认为患上猪流感但仍健在。有症状的约有2000人在医院查看。
By contrast, the United States has had 64 confirmed cases, five hospitalizations and no deaths.
相比之下，美国已经有64例确认的病例，5个住院治疗，无死亡病例。
"The difference in seriousness between the known U.S. cases and the Mexican cases is the question that everyone wants to answer," said Maryn McKenna, author of "Beating Back the Devil," a 2004 book on the history of the CDC, and the forthcoming "Superbug," about drug-resistant staph.
“这种不同在已知的美国病例和墨西哥病例中很严重，这个问题每个人都想知道答案，”， Maryn McKenna说，他是“赶走摩鬼” （是传染病防制中心2004载入历史的一本书）的作者，也是即将问世的“超级病毒”（关于抗药的葡萄状球菌）的作者。
There are no hard answers, but a consensus is emerging: The disease in Mexico has likely been around longer and infected more people than investigators can confirm.
没有什么难懂的答案，但是人们达成了一个共识：疾病在墨西哥比调查者可以确定的将会持续更长时间，并感染更多的人。
"Do we really know all of the cases that existed in Mexico or is this just the tip of the iceberg?" asked Louis Sullivan, a physician and former head of Health and Human Services under President George H.W. Bush.
“我们真得知道墨西哥所有存在的病例吗？或者这只是冰山一角？” Louis Sullivan问道，他是一个外科医生，并是前布什总统下健康和公共事业部的前领导。
McKenna said it's possible "there is much more flu in Mexico than we know because it hasn't been counted. That would mean that there are mild cases there as well, but that you have to get to a certain number of cases before, statistically, you start to see the very serious ones, and the U.S. hasn't had that many cases yet."
麦肯纳说“在墨西哥有比我们知道的还要多的流感，因为还没有计算过。这意味着那儿还有很多轻微的病例，但是在那之前你需要确定一定数量的病例，从统计上来讲，你开始看到非常严重的那种，美国目前还没有那么多的病例。”
It's a view shared on the streets of Mexico City, the hardest-hit area.
这种景象在最严重的疫区墨西哥城的街道也可以看到。
"My intuition is that as the medical community starts looking around and at what has happened they may find that swine flu was there and they just didn't catch it," said Ana Maria Salazar, a radio talk show host and political blogger who lives in Mexico City. "Nobody was looking for this. We were all looking for this in Asia."
“我的直觉是随着医疗团体开始进行调查并看看发生了什么，他们也许会发现猪流感就在那，他们就是抓不到，” Ana Maria Salazar说，她是一个收音机脱口秀节目主持人，还是一个政治论坛博客的博主，现住在墨西哥城，“没有人能够找到，我们过去一直在亚洲找。”
The new virus has genes from North American swine influenza, avian influenza, human influenza and a form of swine influenza normally found in Asia and Europe, said Nancy Cox, chief of the CDC's Influenza Division.
新病毒起源于北美的猪流行性感冒，家禽流行性感冒，人流行性感冒，猪流行性感冒的形成通常在亚洲和欧洲，传染病防治中心流感冒部门的领导南希·考克斯说到。
新病毒起源于北美的猪流行性感冒，家禽流行性感冒，人流行性感冒，猪流行性感冒的形成通常在亚洲和欧洲，传染病防治中心流感冒部门的领导南希·考克斯说到。
Influenza is basically an extreme upper respiratory infection, and, by itself, is rarely fatal. But it can lead to deadly complications, such as pneumonia. About 36,000 Americans die from flu complications every year.
流行性感冒基本上是一种极端地高级呼吸性感染病，就它自身来讲，是不会致命的。但是它会导致致命的并发症，如肺炎。每年约有36,000美国人死于流感并发症。
Swine flu is caused by a virus similar to the type of flu virus that, in various forms, infects people every year, but is a strain typically found only in pigs -- or in people who have direct contact with pigs.
猪流感是由一种病毒引起的，类似于流感病毒的那种类型，以各种形式每年都在感染人，但是以猪作为代表的一种种类——或者在与猪有直接接触的人的身上.
A couple of factors could be causing the greater death toll in Mexico, said Howard Markel, a physician and director of the Center for the History of Medicine at the University of Michigan.
在墨西哥，几个因素可能导致更多的死亡人数， Howard Markel说，他是一名医生并是密歇根大学的药史的中心负责人。
"They may have had cases for several months now and probably have a greater number of people who have the disease, probably tens of thousands," he said. "There may indeed be more cases in the United States. The snapshot we're seeing in the United States may be an incomplete snapshot."
“他们也许有病例好几个月了，也许有更多人有这种疾病，也许成千上万，”他说，“在美国也许会有更多病例。我们在美国看到的快照也许是一个不完整的快照。”
Also, he said, the people who have died in Mexico could have had what he called "another co-factor," such as taking medicine or having pre-existing infections that would make them more vulnerable. It's also possible, he said, that those who died had an underlying genetic predisposition or condition.
他说，在墨西哥死去的人可能有一种被叫做“另一种合成因素，”如吃药或之前存在的感染也许会使他们更脆弱。这也是可能的，他说，那些死去的人有一种潜在的遗传的易患病体质或状态。
Sullivan also pointed to possible "complicating factors," such as malnutrition, poor housing or crowded conditions.
苏里文同样指向可能的“复杂化的因素，”如营养不良，住的条件简陋或者拥挤的状况。
Markel noted that "flu was classically called a crowding disease in the 19th century."
Markel认为“流感在十九世纪被经典的称作密集疾病”
Disease investigators also are concerned by the fact that the outbreak has killed people in the prime of their lives, when they should have peak resistance.
疾病调查者也关注这次爆发已经夺去在生命全盛时期的人们这个事实，他们本应该有最强的抵抗力。
"It is certainly a red flag," Markel said.
“这的确是一个危险信号，”Markel说。
Health authorities have pointed out that this swine flu strain has never been seen. That may have a lot to do with the deaths, Markel said.
卫生当局指出这次猪流感种类从来没有见到过，对死者有很多事情可以做，Markel说到。
"It's a fairly novel strain," he said, "and the deaths could be from healthy people who have a healthy, robust immune system that overreacts."
“这是一种相当新的种类，”他说，“死者可能是健康的人，他们有反应过度的健康的、强壮的免疫系统.”
That could result in a "cytokine storm" in which the body secretes too many chemicals as it tries to kill offending microorganisms.
这可能会导致一个“细胞生长抑制素风暴”，在里面，身体会分秘很多化学元素，因为它试图杀死抵抗的微生物。
The hyper-response can lead to accumulation of fluid in the lungs and a condition called "acute respiratory distress syndrome."
这种高级反应会导致肺里的液体积聚，这种状态称为“急性呼吸窘迫综合症”。
Julio Frenk, former health minister of Mexico and now dean of the Harvard School of Public Health, holds an opposing view: The disease could be killing people who are not healthy because of their living conditions.
Julio Frenk，墨西哥前卫生部部长，现在是哈佛大学公共健康学院的系主任，有着相反的见解：疾病可能会夺去那些不健康的人的生命，因为他们的生活条件。
"There could also be some elements in the host," he said. "These are poor people. Maybe their immune response is not as efficient. So we're going to have to just keep trying to understand why this difference and whether that continues as the epidemic unfolds."
“这些人身上可能有一些成分”他说，“这些不幸的人，也许他们自身的免疫反应效率不是很高，所以我们将试图去理解为什么会有这种不同，随着流行病展开它会不会继续。”
He also noted that antiviral medications need to be taken within hours of the onset of symptoms, but people in Mexico may not have sought treatment immediately, if at all.
他指出抗病毒的药物需要在开始出现症状的数小时内服用，但是墨西哥的人们没有立即寻求治疗，从根本上来讲。
As the outbreak continues to unfold, so will the investigation.
随着猪流感爆发不断展开，调查也在不断进行。
"We're making every effort to truly understand this virus," said CDC's Roebuck. "But some of the reasons for what's happening we may never figure out."
“我们作出努力去真正明白这种病毒，”疾病防治中心的Roebuck说，“但是发生的许多原因我们也许永远也弄不明白。
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