The Microbe's View of Infection

The First International Conference on Emerging Infectious Diseases was held in Atlanta, Georgia, on 8 to 11 March 1998. It was organized by the Centers for Disease Control and Prevention with the sponsorship of the American Society for Microbiology.

Although the U.S. Surgeon General claimed in the mid-1970s that infectious diseases had been conquered, the ensuing years have brought us Legionnaires disease; the toxic shock syndrome; an awareness of Lyme disease; an outbreak of hantavirus infection; and, of course, HIV. The discovery that peptic ulcer and gastric cancer are manifestations of Helicobacter pylori infection has led to an increasing search for the infectious nature of other “noninfectious” diseases, such as atherosclerosis. And this is just in the United States. Worldwide, one can add dengue, cholera, diphtheria, and a score of other infectious diseases that seem to be new or have long been relegated to the realm of the clinical “zebras.”

Infectious diseases remain the leading cause of death and morbidity on our planet. Yet we have lived in populations large enough to sustain epidemic disease for less than 10 000 years. Of course, war, famine, poverty, and neglect, which are so prevalent in human populations, are always the harbinger of infection and disease. We also need to consider that our domestication of animals a scant 8000 years ago (a blink of the eye in evolutionary time) had a profound effect on the evolution of human disease. Measles is derived from canine distemper, mycobacteria came from ungulates, diphtheria came from water buffalo, and so on. Humans have always been confronted with “emerging infectious disease.”