Krause Richard M
Laboratory of Human Bacterial Pathogenesis, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Building 16, Room 202, 16 Center Drive, MSC 6705, Bethesda, MD 20892, USA.
Clin Lab Med. 2002 Dec;22(4):835-48. doi: 10.1016/s0272-2712(02)00027-6.
Microbes will evolve and the epidemics they cause will continue to occur in the future as they have in the past. Microbes emerge from the evolutionary stream as a result of genetic events and selective pressures that favor new over old. It is nature's way. Microbes and vectors swim in the evolutionary stream, and they swim much faster than humans. Bacteria reproduce every 30 minutes and, for them, a millennium is compressed into a fortnight. They are "fleet afoot," and the pace of research must keep up with them or they will overtake. Microbes were here on Earth 2 billion years before humans arrived, learning every trick of the trade for survival, and they are likely to be here 2 billion years after we depart. Current research on the rise and decline of epidemics is broadly based and includes evolutionary and population genetics of host-microbe relationships. Within this context, the 19th century pandemic of scarlet fever has been described. The possibility is raised that the GAS, which currently cause STSS, possess some of the virulence factors that caused pandemic scarlet fever. Furthermore, the GAS isolated during the recent outbreaks of ARF in certain locales in the United States have the virulence properties of the GAS frequently isolated in the first half of the 20th century. Finally, it is suggested that the strategy to confront emerging infectious diseases should be the study of infectious diseases from all points of view. They remain the greatest threats to our society.
微生物将会进化，它们所引发的流行病在未来仍会像过去一样继续出现。由于有利于新物种而非旧物种的基因事件和选择压力，微生物从进化的长河中脱颖而出。这是自然的方式。微生物和病媒在进化的长河中游动，而且它们游动的速度比人类快得多。细菌每30分钟繁殖一次，对它们来说，一千年被压缩成了两周。它们“行动敏捷”，研究的步伐必须跟上它们，否则它们就会超越我们。在人类出现之前20亿年，微生物就已在地球上存在，它们学会了生存的每一项技能，而且在我们离开后，它们可能还会在地球上存在20亿年。当前关于流行病兴衰的研究基础广泛，包括宿主-微生物关系的进化遗传学和群体遗传学。在此背景下，有人描述了19世纪的猩红热大流行。有人提出，目前导致中毒性休克综合征的A组链球菌拥有一些曾引发大流行性猩红热的毒力因子。此外，在美国某些地区近期急性风湿热疫情期间分离出的A组链球菌具有20世纪上半叶经常分离出的A组链球菌的毒力特性。最后，有人建议应对新发传染病的策略应该是从各个角度研究传染病。它们仍然是我们社会面临的最大威胁。
