A few decades ago, emerging infectious diseases were not the subject of interest they are today. What put them on the map, in part, was the AIDS epidemic, a disease that seemingly came out of nowhere and grabbed the international spotlight overnight. But a 1992 report from the Institute of Medicine that highlighted the from threat new diseases also played a significant role, write David Morens and Anthony Fauci of the NIAID this week in mBio. The IOM report spurred institutional progress and research advances, they write, and today we see a very different lansdscape in emerging infections, one marked by significant improvements but also a greater understanding of the scope of the problem.
The IOM report heightened public awareness of the issue, but it also spurred action in the public sector, prompting both the CDC and NIAID to release research and response plans. CDC launched the journal Emerging Infectious Diseases (EID), an example that was soon followed by numerous other journals that deal with emerging infections. But public awareness and new journals only get you so far. In the actual struggle to prevent and control emerging infectious diseases, what appears to have mattered most in the past 20 years is… drumroll, please? New technology. (Surprised? No, me neither.)
Advances in the past 20 years have refined what, exactly, an emerging infectious disease is and opened the organisms up to study in some profound new ways. Genomic techniques, for instance, have facilitated discovery of such pathogens as hantavirus and Kaposi's sarcoma-associated herpesvirus, and enabled unparalleled explorations of the diversity and evolution of emerging pathogens, providing an understanding of virulence and drug resistance that would otherwise be impossible. Genomics and proteomics have also moved along progress in surveillance, diagnosis, and vaccine and therapy design.
And thanks to new techniques we now know that sometimes an infection doesn’t look like an infection: many chronic diseases, including cervical and gastric cancers and hemolytic-uremic syndrome, among other conditions, have an infectious basis that was only discovered in recent years.
All this adds up to some remarkable progress, write Morens and Fauci, in understanding and controlling emerging disease threats, and there is a growing optimism in the outlook for controlling these diseases. Now, thanks to progress in antiviral therapies, HIV infection is no longer the death sentence it once was. Measles may well be eradicated and polio is under control. To be sure, infectious diseases still kill 15 million people every year, and new diseases will continue to emerge unexpectedly, but considering the progress of the past 20 years, Morens and Fauci see reason for optimism in the coming decades. Let’s hope they’re right.