Document 0532
 DOCN  M9480532
 TI    Dynamics of emergence.
 DT    9410
 AU    Krause RM; Fogarty International Center, National Institutes of Health,;
       Bethesda, MD 20892.
 SO    J Infect Dis. 1994 Aug;170(2):265-71. Unique Identifier : AIDSLINE
       MED/94308587
 AB    I have touched briefly here on the complex matrix of social, economic,
       political, and ecologic factors that have played a major role in the
       emergence of microbial diseases. But beyond these factors that
       contribute to the emergence of new infectious diseases, we must also
       recognize changes in microbial agents, human populations, insect
       vectors, and the ecologic relationships among them. Microbes and vectors
       swim in the evolutionary stream and they swim much faster than we do.
       Bacteria reproduce every 30 min; for them a millennium is compressed
       into a fortnight. Microbes were here, learning every trick for survival,
       2 billion years before humans arrived, and it is likely that they will
       be here 2 billion years after we depart. Furthermore, science cannot
       halt the future occurrence of new microbes, which emerge from the
       evolutionary stream as a consequence of genetic events and selective
       pressures that favor the new over the old. It is nature's way. For all
       of these reasons, old and new infections will occur in the future as
       they have in the past. Surveillance efforts, both in the United States
       and other regions of the world, will be needed to blunt the emergence of
       such infections and to forestall epidemics and pandemics. But
       surveillance alone cannot detect the unexpected emergence of future
       microbes or prepare the defense against them. That will require a
       broadly based research effort to devise new methods of diagnosis,
       treatment, and prevention. We must swim with the microbes and study
       their survival and adaptation to new habitats.(ABSTRACT TRUNCATED AT 250
       WORDS)
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY  Communicable
       Diseases/EPIDEMIOLOGY/*ETIOLOGY/TRANSMISSION  Cross
       Infection/EPIDEMIOLOGY/ETIOLOGY/TRANSMISSION  *Disease Outbreaks
       Epidemiology, Molecular/METHODS  Human  Models, Theoretical  Penicillin
       Resistance  Shock, Septic/EPIDEMIOLOGY/ETIOLOGY/TRANSMISSION
       Staphylococcal Infections/EPIDEMIOLOGY/*ETIOLOGY/TRANSMISSION
       Staphylococcus aureus/DRUG EFFECTS/*PHYSIOLOGY  Streptococcal
       Infections/EPIDEMIOLOGY/*ETIOLOGY/TRANSMISSION  *Streptococcus
       pyogenes/GENETICS/METABOLISM  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).