ON OCTOBER 2nd a British traveller, flying home to Glasgow from Afghanistan, began to feel ill. Within hours he was diagnosed with Crimean-Congo Haemorrhagic Fever, a virus nasty enough for him to be put onto a military transport aircraft for transfer to an isolation hospital in London. Less than 24 hours later he was dead.
10月2號，一名英國旅行者從阿富汗乘飛機返回故鄉格拉斯哥。在旅途中，他開始感到有些不適。幾個小時以後他被診斷出患有克裡米亞-剛果出血熱——這種疾病的病毒特別危險，足以讓他被送上一架軍用運輸機並轉移到倫敦的一家隔離醫院裡。他沒撐過24小時就病發身亡了。
This outbreak, on top of another death last month in Saudi Arabia from a previously unknown virus, a cousin of the Severe Acute Respiratory Syndrome (SARS), has set global health agencies on edge. Ten years ago the deaths of a couple of travellers from foreign parts might not have been news at all. But the fright of the SARS outbreak in 2003 has left alasting impression, and scientists and public-health officials now tend to see any putative disease threat through its lens.
上個月，在沙烏地阿拉伯有一種此前未知的病毒（嚴重緊急呼吸綜合症 （SARS）的類似病毒）導致一人死亡，再加上本次克裡米亞-剛果出血熱的爆發，這兩起事件讓全球各衛生機構緊張起來了。如果放在十年以前，從國外回來的幾個旅行者暴斃可能根本算不上什麼新聞。但對2003年 SARS 爆發的恐懼給人們留下了持久的印象，科學家和公共衛生官員如今往往對任何假定的疾病威脅都不敢輕忽。
It is refreshing, therefore, to take a wider look at the problem of infectious disease. Two recent books take very different approaches to the narrative of bacteria and viruses, prions and protists that humanity has known for centuries and the brand new bugs that, by opportunistic accident, hop between species and start a new evolutionary tussle. Mark Harrison, director of Oxford University’s Wellcome Unit for the History of Medicine, charts a chronological path through the history of such diseases. David Quammen, an American science journalist, picks up the story of contemporary blights, exploring how the next pandemic will be detected.
因此，如果能從更廣泛的角度來看待傳染病的問題，的確讓人耳目一新。最近有兩本新書面世，採取了截然不同的方法來敘述人類發現於幾個世紀以前的細菌、病毒、朊毒體和原生生物。兩本書中還提到了一些全新的微生物——它們具有「機會致病性」，活躍在各個物種之間，並在進化方面引發了一場新的爭論。馬克•哈裡森是牛津大學維爾康醫學史研究所負責人，他針對歷史上的此類疾病繪製了一張按時間順序排列的進程圖表。美國科學新聞記者大衛•奎門報導了當代疫病病源的情況，對人類會在什麼時候發現下一次大範圍流行病進行了研究。
「Quarantines have become tariffs by another name,」 Mr Harrison states at the beginning of 「Contagion」, which moves with scholarly deliberateness from 12th-century Europe through to the globalised early 20th century, to demonstrate how modern-day quarantines evolved. Commercewas already associated with infection during the Black Death, though it would be hundreds of years before rats were singled out as its carrier, and the first quarantines followed soon after. When the plague reappeared in Britain and onthe continent in the 1660s, European countries used tit-for-tat quarantines to keep out competitors, skim fees from merchants, reassure trading partners and punish those who quarantined them.
《疫病蔓延》一書用學術性的從容筆調從12世紀的歐洲一直寫到全球化的20世紀早期，展示了現代隔離檢疫的發展過程。哈裡森在書的開頭寫道：「隔離檢疫已經成了另一種名義上的關稅。」幾百年前，黑死病肆虐。儘管幾百年後人們才把老鼠確定為帶菌者，但當時的商業行為已經和疾病感染聯繫在了一起，而且其後不久就實施了人類歷史上首次隔離檢疫。17世紀60年代，當英國乃至整個歐洲大陸再次出現這場瘟疫的時候，歐洲國家採取了針鋒相對的隔離檢疫措施來阻攔競爭對手、從商人手中撈取錢財、消除貿易夥伴的疑慮並且懲治那些曾經對歐洲實施隔離檢疫的國家。
Mr Harrison follows the loosening of quarantines as the tides of free trade rose in the mid-19th century. A series of international conferences (and another bad bout of plague) finally gave birth to the first international health regulations in 1907 with the object of smoothing out commerce. On both sides of the Atlantic, quarantine was increasingly replaced by better intelligence and proactive measures.
哈裡森敘述道：19世紀中期，隨著自由貿易浪潮的興起，隔離檢疫措施有了一些鬆動。一系列國際會議（以及另一場瘟疫的猛烈侵襲）最終促使各國在1907年制定了首批國際衛生規程，旨在解決商業貿易難題。大西洋兩岸的國家逐漸採用更完善的疾病情報工作和主動防禦措施來代替隔離檢疫行為。
But current quarantine regulations are not immune to politicisation, and it is in making this point that Mr Harrison’s book is most illuminating, though this forms a small part of the overall narrative. In defending 「biosecurity」, governments have tended to react defensively to diseases like the H5N1 bird flu and mad-cow disease (or BSE), disrupting not just bilateral trade but international markets as well. For instance in the 2009 swine-flu pandemic, Russia, China and others banned pork imports from North America and Mexico despite protests by the World Trade Organisation and the European Union that there was no evidence the virus could travel in meat. Disease scares still provide an appealing cover for trade protectionism.
但現行的隔離檢疫規程仍然難免要受到政治化的影響。儘管哈裡森在通篇敘述中對此著墨不多，但正是對這一方面的論述讓本書極具啟發性。在保護「生物安全」的時候，各國政府對於 H5N1 禽流感和狂牛症（或稱 BSE）等疾病往往採取防禦性的反應，不僅中斷了雙邊貿易，還給國際市場帶來了負面影響。比如，2009年豬流感大範圍肆虐的時候，俄羅斯、中國等國家曾經禁止從北美和墨西哥進口豬肉——儘管當時世界衛生組織和歐盟抗議稱並沒有證據表明豬流感病毒可以通過食用肉類傳播。對疾病的恐慌仍然能夠為貿易保護主義提供有利的掩護。
Mr Quammen’s book, 「Spillover」, is ascientific narrative rather than an historical one, focusing on zoonotic infections, those that pass from animals to humans. This category makes up nearly two-thirds of all human infectious diseases, including rabies, Ebola and malaria. The three most recent outbreaks—of SARS, bird flu and swine flu—indicate that the next pandemic is likely to be zoonotic in origin.
奎曼的《溢出效應》與其說是採取了歷史性的敘述方式，不如說是從科學角度進行了描述。本書主要論述動物傳染病在人類身上引發的感染。在所有人類傳染疾病方面，這個範疇佔了將近三分之二，其中包括狂犬病、伊波拉病毒和瘧疾。歷史上最近三次的傳染病爆發（SARS、禽流感和豬流感）暗示下一場大範圍流行病可能也會起源於動物傳染病。
Mr Quammen analyses individual diseases, searching for patterns in their outbreaks. Most of the chapters focus on a single infection, and he ranges with ease over decades and continents, drawing upon years of interviews and field trips with scientists. Mr Quammen is alively writer and a good detective, tracing diseases from their first appearance back to their origins—in some cases, still unsettled.
奎曼分析了一些疾病個例，從它們的爆發情況中尋找規律。本書大部分章節主要描寫單一的某種疾病感染。憑藉多年的探訪經驗以及和科學家們一起做的實地考察，奎曼遊刃有餘地涉及了幾十年來各個大洲的感染情況。他是一位筆觸生動的作家，也像是一名神探，從疾病首次出現時追溯到它們的爆發源頭——某些疾病究竟起源於何處仍然懸而未決。
Familiar diseases are given a fresh gloss, while even the most devoted hypochondriac will find some new ones to worry about. (Ever heard of parrot fever?) One of the most surprising chapters is on HIV, about which much has already been written. Mr Quammen traces the various strains of HIV back to the beginning of the 20th century, when the virus is likely to have moved from a chimpanzee into a human. With judicious use of a fictional narrative he then draws the story forward, bringing in some startling new evidence for how HIV was able to spread so widely.
奎曼對人們熟知的疾病進行了全新的闡述，即使是最堅定的疑病者看了這本書之後也會產生另外的焦慮（聽說過鸚鵡熱嗎？）本書最讓人驚奇的章節之一是關於 HIV 的——針對這種病毒已經出版了很多相關資料。奎曼將幾種不同類型的 HIV 追溯到20世紀初：該病毒可能是在當時由黑猩猩傳染給人類的。然後，他審慎而明智地採用一種小說般的敘述方式將故事向前推進，針對 HIV 如何能夠如此廣泛傳播提出了一些驚人的新證據。
To his credit, Mr Quammen does not shy away from the lurid question of the 「next big one」 that will be on readers』 minds from the start. But he folds it into the story with due scientific rigour. Fro mone disease to the next he asks, 「Why hasn’t this gone big?」 In the case of SARS, for instance, the answer may be mostly sheer luck. Neither quarantines nor eradication programmes, nor even disease detectives, will be enough toguard mankind against the next outbreak. But wise precautions may limit collateral damage as humanity tries to stave off the next big one.
讀者從一開始關心的就是「下一場大瘟疫」將在什麼時候到來。值得讚揚的是，奎曼並沒有迴避這個聳人聽聞的問題。但他用一種恰當的科學嚴謹性把這個問題融入了敘述之中。每談到一種疾病，他都會問道：「為什麼這種疾病沒有大範圍流行？」比如拿 SARS 來舉例——答案可能通常被解讀為純粹的運氣。不管是進行隔離檢疫，還是實行病毒根除方案，抑或是派遣疾病調查員，都不足以幫助人類抵禦下一次流行病的爆發。但如今人類正在試圖延緩「下一場大瘟疫」的到來，此時採取理智的預防措施或許能減輕這場疫病的附帶損害。