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In recent weeks, reports of a mysterious respiratory illness have taken the U.S. by storm,
最近几周，有关一种神秘呼吸道疾病的报道席卷了整个美国，
one that's sickened at least 380 patients and turned fatal for seven.
这一疾病已经引发至少380人患病，且有7人已经不治身亡。
As health investigators from across the country begin to look into the issue, a common thread seems to be emerging: vaping.
随着全国各地的卫生调查人员开始追究这个问题，一条共同的线索——电子烟逐渐浮出了水面。
But medical studies are still in their preliminary stages,
问题是，（有关电子烟危害的）医学研究仍处于起步阶段，
and there remains a severe lack of information surrounding the health effects of vaping.
这方面的资料也处于严重匮乏阶段。
So what do we know so far?
那到目前为止，我们都知道些什么呢？
We reached out to Dr.Christiani, a pulmonologist and molecular epidemiologist
我们联系了肺病学家和分子流行病学家克里斯汀尼博士，
who reviewed and wrote an editorial about the most recent major medical reports on the vaping-related epidemic for the New England Journal of Medicine.
他就研究电子烟相关流行病的最新核心医学报告为《新英格兰医学杂志》写了一篇社论。
"The concerns about vaping are not new,
“人们对电子烟的担忧并不新鲜，
and there have been case reports for some years now of adverse health effects, presumably from the additives, things like flavorants.
到目前为止，外界对电子烟的不良健康影响，主要是推测性的，调味剂等添加剂的不良健康影响已经展开了多年的实例报道。
I think what's happened here is that it's a much larger scale."
在我看来，实际情况是，这样的例子远不止报道出来的那些。”
But before we dive into the theories of what's behind this vaping-related epidemic, let's break down how a vape works.
不过，在我们深入研究这场与电子烟相关的流行病背后的医学理论之前，我们不妨先来分析一下电子烟的工作原理。
Vapes, vape pens, e-cigarettes—whatever you want to call them—
蒸汽电子烟，蒸汽笔，电子烟——随便你怎么称呼——
are essentially just battery powered devices that heat a liquid into a vapor that can be inhaled.
它们本质上都是由电池供电，将液体加热成可以吸入的蒸汽的设备。
The vapor can contain flavoring and nicotine, but marijuana and hash oil are often used, too.
蒸汽中可能含有调味品和尼古丁，经常还会有大麻或大麻油。
Preliminary studies have also found vapes to contain heavy metals like nickel, tin, and lead,
初步研究还发现，电子烟中还含有镍、锡、铅、
benzene—which is a cancerous substance found in car exhaust—
苯——汽车尾气中发现的一种致癌物质——等重金属，
and ultrafine particles capable of traveling deep into the lung's tissues.
以及能够深入肺组织的超细颗粒。
Aldehydes—chemical compounds known to cause lung and heart disease—have also been found in vapes.
醛——已知会引发肺病和心脏病的一种化合物——也在电子烟中被发现了。
And then of course, there's nicotine.
当然，还有尼古丁。
A preliminary 2019 federal survey found that more than a quarter of U.S. high schoolers have vaped in the past 30 days.
2019年联邦初步调查发现，超过1/4的美国高中生在过去30天里都吸过电子烟。
Since nicotine is both addictive and harmful to brain development, the risk for this age group remains high.
尼古丁不仅具有成瘾性，还会损害大脑发育，因此这个年龄段吸食电子烟的风险是非常高的。
But now, with at least 380 confirmed cases of a mysterious respiratory illness in the U.S. , the public is looking for answers.
现在，鉴于美国已经有至少380例确诊的神秘呼吸道疾病病例，公众开始寻找答案了。
The first reported vaping-related death occurred in August 2019 in Illinois,
首例与电子烟有关的死亡报告出现于2019年8月，地点是伊利诺伊州，
and since then, six vaping-related deaths have been reported in California, Indiana, Kansas, Minnesota, and Oregon.
自那以来，加利福尼亚州、印第安纳州、堪萨斯州、明尼苏达州和俄勒冈州也相继报告了6例与电子烟相关的死亡案例。
What begins as coughing, chest pain, or shortness of breath can result in acute respiratory distress syndrome, or ARDS.
一开始可能只是咳嗽、胸痛或呼吸急促，最后则可能演变成急性呼吸窘迫综合征(ARDS)。
It's a highly dangerous—and oftentimes fatal—condition in which fluid accumulates in the lungs, preventing oxygen from circulating in the bloodstream.
这一症状是非常危险的，有时还会有生命危险，因为这时候肺部会出现积液，导致氧气无法在血液系统中循环。
But that's only one part of the story.
这还不算完。
"Unfortunately, the chemistry is complicated.
“不幸的是，电子烟的化学原理比较复杂。
The toxicology looks like it's lung injury, but the pattern is heterogeneous.
从毒理学检查角度来看，那些病例看起来都像是肺损伤，但损伤的模式是多种多样的。
Because it's a heterogenous group of disorders,
因为模式多种多样，
it does suggest that there may be more than one agent involved, because the response looks quite varied.
这就表明可能是不止一种因素作用的结果，因为表层的反应也有很多种。
But in all cases, it's much more accelerated than you'd expect in a chronic inhalation problem."
但不管是哪种情况，这类患者病情恶化的速度都比你根据其他慢性吸入疾病推测出来的速度快得多。”
And this acceleration may be a result of changes in the formulation of vaping agents.
这类恶化速度的加快可能是电子烟更换配方产生的结果。
"It's a much higher level of acuity suggesting that the source material has changed in the last year or so."
“灵敏度较高的测试手段表明，过去一年左右，电子烟的配方已经变了。”
A major suspect is vitamin E acetate, which is a thickening agent used to adjust THC levels.
有重大嫌疑的是维生素E醋酸酯——一种用来调整THC（四氢大麻酚）水平的增稠剂。
Health officials in New York State issued a report stating that they had found "very high levels" of Vitamin E
纽约州的卫生官员发布了一份报告，称他们在34名纽约州患者的取样中发现了“水平颇高的”维生素E含量，
in samples from 34 patients who have fallen ill in the state, many who reported buying marijuana for vaping purposes.
其中有许多人都报告说，他们购买大麻是为了吸电子烟。
"Vitamin E acetate is an oil.
“维生素E醋酸酯是一种油。
Some of the cases indeed, had what we call lipoid pneumonia, that can happen if someone were inhaling a vaseline type product.
事实上，有些病例患有我们所说的类脂性肺炎，如果他们吸入了凡士林类产品，是会出现这种情况。
But if you look carefully at the report, which was not a peer-reviewed report, they said 8 out of 34 reported using Vitamin E acetate in their mixture.
但如果你仔细看这份报告，这不是一份同行评审的报告，你会发现，他们说34人有8人报告说他们在自己的烟油混合物中使用了维生素E醋酸酯。
So, that's a minority, a substantial minority, and means that Vitamin E acetate has to be one of the many compounds investigated
这也就是说，他们只是那34个患者中的一小部分人，这也就意味着维生素E醋酸酯必须被纳入众多被研究的化合物的行列，
and it may well explain one or so of the outcomes, but it's not the whole picture.
对这种物质的研究或许能够很好地解释个别情况，但并不能解释所有患者的情况。
I think it's premature."
我认为现在下结论还为时过早。”
So yes, more research is needed.
所以，没错，我们还需要进一步的研究。
But how close are we to getting a diagnosis?
但问题是，我们距离确切诊断（电子烟的危害）还有多远呢？
"I think it's going to take some time.
“我认为还需要一些时间。
That's why I think it's prudent to advise people, as both physician and as public health specialists not to vape, because we don't know what it is.
这也是为什么我认为，谨慎的做法是，无论是作为医生，还是作为公共卫生专家，我都要建议大家不要吸食电子烟，因为我们并不是很了解它。
Even with a very large concerted effort, the number of potential culprits is large.
尽管很多人都在一起朝着这个方向努力，但可能犯错的人还是很多的。
Dissecting the chemistry of this may reveal compounds that haven't been adequately tested in humans or animals,
剖析其中的化学成分可能会揭示出一些在人类或动物身上没有得到充分测试的化合物的存在，
so we don't really even know the extent of the inhalation toxicity."
也就是说，我们甚至都不知道吸食毒性的大小。”
And this is because e-cigs remain largely unregulated in the U.S. , both in stores and out.
这是因为美国的电子烟很大程度上都还没有得到监管，无论是店内还是店外都没有。
In fact, FDA approval of the products is slated to begin in 2022, but in light of the recent fatalities, that may change.
事实上，FDA本打算2022年开始批准这类产品的，但照最近的死亡事件来看，形势恐怕有变。
While vaping is growing in popularity, with more than 40 million users worldwide,
尽管电子烟已经越来越受欢迎，放眼全球已经拥有超过4000万的用户，
it's worth mentioning that not every country is experiencing this epidemic.
但值得一提的是，并不是每个国家都陷入了这种流行病。
That might be because e-cigarettes aren't as strictly regulated in the U.S. like in other countries.
这可能是因为电子烟在美国还没有受到其他国家那样严格的监管。
In Australia, for example, e-cigs containing nicotine are banned altogether.
比如，在澳大利亚，含有尼古丁的电子烟就是完全禁止的。
And in countries like the U.K. and France, regulations are stricter.
而在英国和法国这样的国家，规定更为严格。
To remedy this situation, the FDA is currently working on a plan to remove flavored e-cigarettes from the market altogether.
为了挽救这一形势，FDA目前正在制定一项计划，意图将香型电子烟彻底清出市场。
"I just think we need accelerated research.
“我只是觉得我们有必要加快研究的步伐。
This is not the first time something dramatic has happened that requires a concerted response on the part of the science community,
这也不是第一次发生这种严重问题了，科学界，
the public health community, and actually manufacturers to the extent that they can be brought in to help figure this out."
公共卫生界甚至是制造商都需要团结起来，帮忙想办法解决这一问题。”
If you liked this episode, let us know down in the comments below.
如果你喜欢本期的视频，那就请在下面的评论中告诉我们吧。
And if you're curious about other medical conditions, check out Sick's latest video here.
如果你对其他疾病相关的内容感兴趣，请点击这里查看《Sick》栏目的最新视频。
Don't forget to subscribe and as always, thanks for watching, and we'll see you next time.
别忘了订阅我们的频道，还是那句老话，感谢大家的收看，我们下期节目再见。
