Plagues part of the human condition

November - December, 2008  |  Volume 7, Issue 6

The Plague of Athens in 430 B.C., which led to the decline of the Golden Age of Greece, is one of 10 historically notable outbreaks described in an article in The Lancet Infectious Diseases by authors from the National Institute of Allergy and Infectious Diseases.

The phenomenon of widespread, socially disruptive disease outbreaks has a long history prior to HIV/AIDS, severe acute respiratory syndrome, avian influenza and other emerging diseases of the modern era.

"There appear to be common determinants of disease emergence that transcend time, place and human progress," says NIAD Director Dr. Anthony S. Fauci, one of the study authors.

Other factors underlying many instances of emergent diseases are poverty, lack of political will and changes in climate, ecosystems and land use, the authors contend. "A better understanding of these determinants is essential for our preparedness for the next emerging or re-emerging disease that will inevitably confront us," says Fauci.

"The art of predicting disease emergence is not well developed," says Dr. David Morens, another NIAID co-author. "We know, however, that the mixture of determinants is becoming ever more complex, and out of this increased complexity comes increased opportunity for diseases to reach epidemic proportions quickly."

One consequence of the increased mobility in the modern age can be seen in the 2003 outbreak of the novel illness SARS, which rapidly spread from Hong Kong to Toronto and elsewhere as infected passengers traveled by air.

To better understand and predict disease emergence, Morens and his coauthors stress the need for research aimed at broadly understanding infectious diseases as well as specifically understanding how disease-causing microorganisms make the jump from animals to humans.

"Emerging infections: A perpetual challenge." DM Morens, GK Folkers and AS Fauci. Lancet Infect Dis 2008; 8: 710-19.

To view Adobe PDF files, download current, free accessible plug-ins from Adobe's website.