The Evolution of Infectious Disease

To prove his hypothesis, Ewald shows how the effectiveness of vaccines and anti-bacterial drugs can eventually be overcome or evolutionarily bypassed by pathogens such as malaria, tuberculosis, cholera, and E. coli. He supports this with a preponderance of historical evidence indicating the mechanisms of predator, vector-borne, waterborne, and attendant-borne transmission of disease. Each of these has shown the efficacy of removing or blocking the method of transmission as the best way of preventing spread of the disease, as opposed to more conventional medical attempts to effect change within, or to kill, the pathogen itself. The final proof comes in his discussion of the effects that war has had on the degree of virulence of pathogens such as influenza.

All this is merely a preamble to his examination of the historica

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of warning against conceit in the battle against diphtheria and tuberculosis. These sit-and-wait diseases have been suppressed, not eradicated, and only need a disease such as AIDS to re-establish themselves as killers of millions of people each year (66). Ewald's extensive assessment of cholera and its transmission by way of contaminated water sources provides a fascinating historical perspective which has significance in the face of continuing problems with this disease in urban centers where water supplies remain unpurified and vaccination has waned. In essence, Ewald has shown that this pathogen has survived intact through thousands of years and that humans have only been able to suppress its spread by understanding the true nature of this water-borne parasite. The emphasis is on changing the social structures of people rather than any futile attempts to alter the organism. The chapter on attendant-borne transmission of pathogens presents a chilling picture for any and all who have spent or will eventually spend time in hospitals or nursing-care institutions. Ewald contends that hospital pathogens are apparently more virulent because of the frequency of passage from attendant to patient to attendant, and so on, by the
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Approximate Word count = 2233
Approximate Pages = 9 (250 words per page)

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