2007年VOA标准英语-As Global Migration of Tuberculosis Crosses Bor

By Melinda Smith
Washington, D.C.
21 March 2007
 
watch Tuberculosis¹ US report

Beginning around 1995, the United States experienced a steady decline in the rate of tuberculosis. But in the last three years, health experts have noticed something disturbing -- the rate of decline has been cut in half. That means more people are turning up with TB.  Where are these new cases coming from?  VOA's Melinda Smith reports on how the global migration² of a once-curable disease has motivated scientists to go back to the laboratory.

Fifty-two-year-old Jesse Eubanks waits for someone to come who is very important to him.

"I feel like I'm being locked up in jail,” he jests.

 
Jesse Eubanks
Jesse Eubanks is partially³ joking. But he is clearly frustrated⁴ with having to wait at home for the arrival three days a week of Baltimore city health employee Linda Ellison.

As she watches, Jesse swallows a handful of pills.  In the four months she has been visiting, she says he has made a remarkable⁵ transition. "[He] wasn't doing well, very weak and all, but I can see a very good progress now, very good."

Jesse is one of 34 tuberculosis patients reported last year in Baltimore, Maryland.   Because his TB is confirmed, he must participate in the city's Directly Observed Therapy program. 

By delivering the medicine in person, the health care worker makes sure treatment is carried out.

DOTS, as it is often called, was pioneered in Baltimore 30 years ago when tuberculosis was out of control.  In a 15-year period, Directly Observed Therapy led to a 70 percent reduction in Baltimore's TB rate, and four of the city's five tuberculosis clinics were shut down. The World Health Organization endorses⁶ Directly Observed Therapy.

 
Dr. Richard Chaisson
But Dr. Richard Chaisson of Johns Hopkins University's Center for Tuberculosis Research says many countries do not participate in DOTS because the program is so labor-intensive.  He thinks that is a mistake. "It's actually cheaper to hire extra people and go out and treat people effectively because you have fewer failed treatments, fewer relapses, and fewer cases of drug resistant⁷ tuberculosis."

Tina Ward⁸, a tuberculosis patient, has months to go before her medical care is finished.  Standard TB treatment takes six to nine months.  Advanced cases that are multi-drug resistant -- and are treatable - can take 18 to 24 months of care. 

When patients do not take their medicine on schedule or do not get it on a regular basis, the bacteria becomes even more difficult to stamp out. 

 
Dr. Kenneth Castro
Dr. Kenneth Castro, the Director of TB Prevention at the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia says slacking off from regular dosing is dangerous:

"You either interrupt treatment because you feel better, think you no longer need the drugs, that gives rise to mutations that normally occur.  And then the population of bacteria that takes over are these drug-resistant bacteria," explains the doctor.

Meanwhile, Jesse Eubanks lives a few kilometers away from a man who just might be able to help him. 

His name is Jacques Grosset, a professor at the Johns Hopkins University School of Medicine.   Dr. Grosset is passionate⁹ about the benefits of a drug called Moxifloxacin.  He says research on mice and preliminary clinical trials with humans have shown the drug may cut treatment time from six months to four, and perhaps even shorter in the future. "It's a big revolution!  It means we are permitted to think 'new'!" says Dr. Grosset.

Since 2005, TB among the white population in the United States has continued to decline. But it remains¹⁰ steady within the African-American community, and shows the greatest increase among immigrants.  At least half of all new cases of tuberculosis in the United States are among the foreign-born.  Most come across the border from Mexico or from Vietnam and the Philippines. 

Without proper medical care in the early stages of TB, health experts say, there are few options left once the disease becomes drug resistant.

Even Dr. Jacques Grosset fears that his 'miracle' drug, Moxifloxacin, has limitations. "Moxifloxacin is now one of the key drugs to treat multi-drug resistant [TB], but moxifloxacin alone is not able to cure.  You have to have the combination of drugs.  We need plenty of new drugs."

Every expert we talked with agreed: the development of those new drugs cannot happen without a financial commitment by pharmaceutical¹¹ companies and governments willing to pay for their purchase.  Dr. Kenneth Castro adds, "The reality with tuberculosis is: you pay now or pay later -- and pay lots more later -- both in terms of monetary¹² investment and human lives that it's going to cost."

1 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

2 migration   

n.迁移，移居，（鸟类等的）迁徙

参考例句：

• Swallows begin their migration south in autumn.燕子在秋季开始向南方迁移。
• He described the vernal migration of birds in detail.他详细地描述了鸟的春季移居。

3 partially   

adv.部分地，从某些方面讲

参考例句：

• The door was partially concealed by the drapes.门有一部分被门帘遮住了。
• The police managed to restore calm and the curfew was partially lifted.警方设法恢复了平静，宵禁部分解除。

4 frustrated   

adj.挫败的，失意的，泄气的v.使不成功( frustrate的过去式和过去分词 )；挫败；使受挫折；令人沮丧

参考例句：

• It's very easy to get frustrated in this job. 这个工作很容易令人懊恼。
• The bad weather frustrated all our hopes of going out. 恶劣的天气破坏了我们出行的愿望。 来自《简明英汉词典》

5 remarkable   

adj.显著的，异常的，非凡的，值得注意的

参考例句：

• She has made remarkable headway in her writing skills.她在写作技巧方面有了长足进步。
• These cars are remarkable for the quietness of their engines.这些汽车因发动机没有噪音而不同凡响。

6 endorses   

v.赞同( endorse的第三人称单数 )；在（尤指支票的）背面签字；在（文件的）背面写评论；在广告上说本人使用并赞同某产品

参考例句：

• There isn't one country in the Middle East that now endorses the Eisenhower Doctrine. 但至今没有一个中东国家认可它。 来自辞典例句
• Whether any of this truly endorses Dr Patel's hypothesis is moot. 这些视频能否真正证明帕特的假设成立还是个未知数。 来自互联网

7 resistant   

adj.(to)抵抗的，有抵抗力的

参考例句：

• Many pests are resistant to the insecticide.许多害虫对这种杀虫剂有抵抗力。
• They imposed their government by force on the resistant population.他们以武力把自己的统治强加在持反抗态度的人民头上。

8 ward   

n.守卫，监护，病房，行政区，由监护人或法院保护的人（尤指儿童）；vt.守护，躲开

参考例句：

• The hospital has a medical ward and a surgical ward.这家医院有内科病房和外科病房。
• During the evening picnic,I'll carry a torch to ward off the bugs.傍晚野餐时，我要点根火把，抵挡蚊虫。

9 passionate   

adj.热情的，热烈的，激昂的，易动情的，易怒的，性情暴躁的

参考例句：

• He is said to be the most passionate man.据说他是最有激情的人。
• He is very passionate about the project.他对那个项目非常热心。

10 remains   

n.剩余物，残留物；遗体，遗迹

参考例句：

• He ate the remains of food hungrily.他狼吞虎咽地吃剩余的食物。
• The remains of the meal were fed to the dog.残羹剩饭喂狗了。

11 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

12 monetary   

adj.货币的，钱的；通货的；金融的；财政的

参考例句：

• The monetary system of some countries used to be based on gold.过去有些国家的货币制度是金本位制的。
• Education in the wilderness is not a matter of monetary means.荒凉地区的教育不是钱财问题。