Will We Lose the Battle Against Infectious Diseases?

by Tina Blue
December 20, 2000

          During the 1980s I spent a couple of years as a proofreader for a publishing company in Lawrence, Kansas, that specializes in printing scientific and technical journals. Of all the journals that I proofread, the one I found most fascinating was The Journal of Leprosy and Tropical Diseases.  I have always been interested in the spread of deadly diseases and in mankind's ongoing struggle to control them.

          One thing that alarmed me in my readings in this journal was that many of the articles were reports of increasing drug-resistance in the organisms responsible for such diseases as leprosy and leishmanniasis, both of which had long been controlled through drug therapies. It wasn't just that single-drug therapies were no longer working, so that physicians were having to resort to multivalent therapies, but also that cases of these diseases that did not respond to any drug or combination of drugs were becoming more common.

          We've seen a less-terrifying form of drug-resistance develop here in the United States. The excessive and indiscriminate prescribing of antibiotics has produced drug-resistant strains of streptococcus and staphylococcus bacteria. The possibility of contracting a drug-resistant staph infection has, in fact, become one of the great risks of hospitalization.

          Even childhood ear infections are becoming increasingly drug-resistant. When my children were infants and toddlers in the early 1980s, any ear infection was quickly cured with a single schedule of Amoxicillin. By the time I quit my daycare in 1999, most of the children I knew required two or three consecutive schedule of antibiotics to overcome an ear infection, and Amoxicillin was virtually never prescribed, since most ear infections no longer responded to it. Instead, the children would be started on Ampicillin, an "amplified" version of Amoxicillin, which had been developed to deal with those bacteria that had become resistant to Amoxicillin.

          But even Ampicillin failed to control many ear infections, so children would show up at the daycare with ever-more exotic and powerful antibiotics for me to administer during the day. I knew children who were being treated with one antibiotic or another for months at a time! (I can't help but wonder whether this was a responsible choice on the part of their pediatricians, but that issue would require an essay of its own.)

          We've been spoiled. Those of us who live in the advanced industrialized nations have, for the last several decades, enjoyed an entirely anomalous freedom from death by infectious disease. Our programs of vaccination against many diseases (e.g., mumps, measles, smallpox, whooping cough, polio, diphtheria, etc.) have enabled our children to survive at a rate unknown at any other time in mankind's history. We no longer have to produce six or ten children just to make sure that two or three will survive into adulthood. And those diseases that we and our children still get have become to a large degree treatable because of the discovery of microbicides, especially antibiotics.

          When I was in elementary school, my favorite stories and novels were those written by nineteenth-century authors. From reading such works, I got so used to the idea that most families lost several children that I considered it no less than a miracle that my five siblings and I were all still alive. I used to wonder which of us would succumb to which dread disease before adolescence, because I assumed that at least a couple of us would not make it out of childhood alive. I was too young to realize that vaccination and antibiotics had completely changed the odds.

          But the day may soon come when humanity looks back on this past century as a brief but glorious golden age. For a short while we have gained ascendancy over the myriad diseases that have plagued our species throughout our tenure on this planet.

          That ascendancy may be nearing its end.
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