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Dealing With the Little Things : Humans can't let up in war against disease-causing microbes

February 11, 1996

In this age of polio vaccines and penicillin, many Americans have been raised with the expectation that a cure is as close as the doctor's office. But new data indicate we aren't as safe as we thought. The findings also indicate that, biologically speaking, humankind is just another link in the ecological food chain.

More than a quarter-century ago, U.S. Surgeon General William Stewart declared that medical researchers could finally "close the books on infectious diseases." Today, scientists are struggling to unlock the secrets of emerging threats such as the acquired immunodeficiency virus (AIDS), Ebola hemorrhagic fever, the hantavirus and Lyme disease. At the same time, medicine is facing renewed and dire challenges from other microscopic predators including the more familiar E-coli bacterium, streptococcus pneumonia, rabies and tuberculosis.

Yes, we are all better off as a result of scientific miracles. The development of antibiotics, for example, has played a major role in improved health. So have aggressive government-funded disease prevention and treatment programs. Together these efforts have helped to push life expectancy in the United States from about 50 years at beginning of the century to 73 today. Nonetheless, an editorial published in a recent issue of the Journal of the American Medical Assn. provided a somber but ultimately more realistic assessment of man vs. microbe when it declared, "We have never been more vulnerable."

Indeed, a Center for Disease Control study, reported in JAMA, showed a 58% increase in the nation's mortality rate due to infectious diseases between 1980 and 1992. Many of the deaths were directly attributable to the AIDS virus--which has taken more than 285,000 American lives and is the leading cause of death of persons 25 to 44. But there also were "surprising" increases in deadly respiratory ailments among the elderly and a 83% jump in fatal blood infections.

So what is one to make of this new microbial offensive? First, we must realize we are engaged in a centuries-old battle for supremacy. Diseases change. Keeping up requires a commitment to basic research in areas such as microbiology, infectious diseases and genetics. It requires better management of antibiotics, which, if overused, foster the appearance of drug-resistant strains. It demands that our government continue to closely monitor diseases across the globe. And lastly it obligates us to continue to make significant investments in public health. Meanwhile, we are going to have to get used to the fact that we are in a long-term contest in which today's general sense of security could prove to be transient.

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