Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 2, Number 4—October 1996
Perspective

Guarding Against the Most Dangerous Emerging Pathogens: Insights from Evolutionary Biology

Paul W. EwaldComments to Author 
Author affiliation: Department of Biology, Amherst College, Amherst, Massachusetts, USA

Main Article

Table 2

First-level checklist for identifying the most dangerous emerging pathogens. If the answer to any of the questions is yes, the potential for continuous transmission between humans should be assessed. If this potential is high, the pathogen should be considered particularly dangerous.

Does it have a tendency for waterborne transmission?
Is it vector-borne with the ability to use humans as part of the life cycle?
If it is directly transmitted, is it durable in the external environment?
Is it attendant-borne?
Is it needle-borne?*
If it is sexually transmitted, is it mutation-prone with a tropism for critical cell types or does it have invasive or oncogenic tendencies?

*The hypothesized importance of needleborne transmission has not yet been tested; it has been included in this listing on the basis of the harmfulness of needleborne pathogens and the hypothetical assocations between needleborne transmission and virulence (17).

Main Article

References
  1. Morse  SM. Emerging viruses: defining the rules for viral traffic. Perspect Biol Med. 1991;34:387409.PubMedGoogle Scholar
  2. Morse  SM. Examining the origins of emerging viruses, In: Morse SM, editor. Emerging viruses. New York: Oxford, 1993;10-28.
  3. Morse  SM. Factors in the emergence of infectious disease. Emerg Infect Dis. 1995;1:715. DOIPubMedGoogle Scholar
  4. Satcher  D. Emerging infections: getting ahead of the curve. Emerg Infect Dis. 1995;1:16. DOIPubMedGoogle Scholar
  5. Henderson  DA. Surveillance systems and intergovernmental cooperation. In: Morse SM, editor. Emerging viruses. New York: Oxford, 1993;283-9.
  6. Holland  J. Replication error, quasispecies populations, and extreme evolution rates of RNA viruses. In: Morse SM, editor. Emerging viruses. New York, Oxford, 1993;203-18.
  7. Krause  RM. Foreword. In: Morse SM, editor. Emerging viruses. New York: Oxford, 1993;xvii-xix.
  8. McNeill  WH. Patterns of disease emergence in history. In: Morse SM, editor. Emerging viruses. New York: Oxford, 1993;29-36.
  9. Smith  T. Parasitism and disease. Princeton: Princeton University Press, 1934.
  10. Dubos  R. Man adapting. New Haven, Conn: Yale University Press, 1965.
  11. Burnet  FM, White  DO. Natural history of infectious disease, 4th ed. Cambridge: Cambridge University Press, 1972.
  12. Thomas  L. Notes of a biology-watcher: Germs. N Engl J Med. 1972;247:5535.
  13. Levin  S, Pimentel  D. Selection of intermediate rates of increase in parasite-host systems. Am Nat. 1981;117:30815. DOIGoogle Scholar
  14. Levin  BR, Allison  AC, Bremermann  HJ, Cavalli-Sforza  LL, Clarke  BC. B\Frentzel-Beyme R, et al. Evolution of parasites and hosts. Group report, In: Anderson RM, May RM, editors. Population Biology of Infectious Diseases. Berlin: Springer-Verlag 1982;213-43.
  15. Anderson  RM, May  RM. Coevolution of hosts and parasites. Parasitology. 1982;85:41126. DOIPubMedGoogle Scholar
  16. Ewald  PW. Host-parasite relations, vectors, and the evolution of disease severity. Annu Rev Ecol Syst. 1983;14:46585. DOIGoogle Scholar
  17. Ewald  PW. Evolution of Infectious Disease. New York: Oxford University Press, 1994.
  18. Morens  DM, Marchette  NJ, Chu  MC, Halstead  SB. Growth of dengue type-2 virus isolates in human peripheral blood leukocytes correlates with severe and mild dengue disease. Am J Trop Med Hyg. 1991;45:64451.PubMedGoogle Scholar
  19. Gulig  PA, Doyle  TJ. The Salmonella typhimurium virulence plasmid increases the growth rate of salmonellae in mice. Infect Immun. 1993;61:50411.PubMedGoogle Scholar
  20. Ewald  PW. Transmission modes and the evolution of virulence, with special reference to cholera, influenza and AIDS. Hum Nat. 1991;2:130. DOIGoogle Scholar
  21. Åsjö  B, Morfeldt-Månson  L, Albert  J, Biberfeld  G, Karlsson  A, Lidman  K, Replicative capacity of human immunodeficiency virus from patients with varying severity of HIV infection. Lancet. 1986;334:6602.
  22. ChengMayer  C, Seto  D, Tateno  M, Levy  JA. Biologic features of HIV-1 that correlate with virulence in the host. Science. 1988;240:802. DOIPubMedGoogle Scholar
  23. Albert  J, Böttiger  B, Biberfeld  G, Fenyö  EM. Replicative and cytopathic characteristics of HIV-2 and severity of infection. Lancet. 1989;333:8523. DOIGoogle Scholar
  24. Fenyö  EM, Albert  J, Åsjö  B. Replicative capacity, cytopathic effects and cell tropism of HIV. AIDS. 1989;3:S512.PubMedGoogle Scholar
  25. Levy  JA. Human immunodeficiency viruses and the pathogenesis of AIDS. JAMA. 1989;261:29973006. DOIPubMedGoogle Scholar
  26. Tersmette  M, Gruters  RA, de Wolf  F, de Goede  REY, Lange  JMA, Schellekens  PTA, . Evidence for a role of virulent human immunodeficiency virus (HIV) variants in the pathogenesis of acquired immunodeficiency syndrome: Studies on sequential HIV isolates. J Virol. 1989;63:211825.PubMedGoogle Scholar
  27. Tersmette  M, Lange  JMA, de Goede  REY, de Wolf  F, Eefink Shaattenkerk  JKM, Schellekens  PTA, Association beteween biological properties of human immunodeficiency virus variants and risk for AIDS and AIDS mortality. Lancet. 1989;333:9835. DOIGoogle Scholar
  28. Ma  X, Sakai  K, Sinangil  F, Golub  E, Volsky  DJ. Interaction of a noncytopathic human immunodeficiency virus type 1 (HIV-1) with target cells: Efficient virus entry followed by delayed expression of its RNA and protein. Virology. 1990;176:18494. DOIPubMedGoogle Scholar
  29. Schneweis  KE, Kleim  J-P, Bailly  E, Niese  D, Wagner  N, Brackmann  HH. Graded cytopathogenicity of the human immunodeficiency virus (HIV) in the course of HIV infection. Med Microbiol Immunol (Berl). 1990;179:193203.
  30. Gruters  RA, Terpstra  FG, DeGoede  REY, Mulder  JW, DeWolf  F, Schellekens  PTA, Immunological and virological markers in individuals progressing from seroconversion to AIDS. AIDS. 1991;5:83744. DOIPubMedGoogle Scholar
  31. Schellekens  PTA, Tersmette  M, Roos  MTL, Keet  RP, Dewolf  F, Coutinho  RA, . Biphasic rate of CD4+ cell count decline during progression to AIDS correlates with HIV-1 phenotype. AIDS. 1992;6:6659.PubMedGoogle Scholar
  32. Hirsch  I, Salaun  D, Brichacek  B, Chermann  JR. HIV-1 cytopathogenicity-genetic difference between direct cytotoxic and fusogenic effect. Virology. 1992;186:64754. DOIPubMedGoogle Scholar
  33. Koot  M, Keet  IPM, Vos  AHV, DeGoede  REY, Roos  MTL, Coutinho , RA, . Prognostic value of HIV-1 syncytium-inducing phenotype for rate of CD4+ cell depletion and progression to AIDS. Ann Intern Med. 1993;118:6818.PubMedGoogle Scholar
  34. Connor  RI, Mohri  H, Cao  YZ, Ho  DD. Increased viral burden and cytopathicity correlate temporally with CD4+ T lymphocyte decline and clinical progression in human immunodeficiency virus type 1- infected individuals. J Virol. 1993;67:17727.PubMedGoogle Scholar
  35. Connor  RI, Ho  DD. Human immunodeficiency virus type 1 variants with increased replicative capacity develop during the asymptomatic stage before disease progression. J Virol. 1994;68:44008.PubMedGoogle Scholar
  36. Fisher  SG. Epidemiology: a tool for the study of human papillomavirus-related carcinogenesis. Intervirology. 1994;37:21525.PubMedGoogle Scholar
  37. Puel  J, Lheritier  D, Guyader  M, Izopet  J, Briant  L, Tricoire  J, Viral load and mother-to-infant HIV transmission. Lancet. 1992;340:859. DOIPubMedGoogle Scholar
  38. Weiser  B, Nachman  S, Tropper  P, Viscosi  KH, Grimson  R, Baxter  G, . Quantitation of human immunodeficiency virus type 1 during pregnancy: relationship of viral titer to mother-to-child transmission and stability of viral load. Proc Natl Acad Sci U S A. 1994;91:803741. DOIPubMedGoogle Scholar
  39. Kaye  JN, Cason  J, Pakarian  F, Jewers  R, Kell  B, Bible  J, . Viral load as a determinant for transmission of human papillomavirus type 16 from mother to child. J Med Virol. 1994;44:41521. DOIPubMedGoogle Scholar
  40. Adjorloto-Johnson  G, De Cock  KM, Ekpini  E, Vetter  KM, Sibailly  T, Brattegaard  K, Prospective comparison of mother-to-child transmission of HIV-1 and HIV-2 in Abidjan, Ivory Coast. JAMA. 1994;272:4626. DOIPubMedGoogle Scholar
  41. Ewald  PW. Cultural vectors, virulence, and the emergence of evolutionary epidemiology. Oxford Surveys in Evolutionary Biology. 1988;5:21545.
  42. Ewald  PW. Waterborne transmission and the evolution of virulence among gastrointestinal bacteria. Epidemiol Infect. 1991;106:83119. DOIPubMedGoogle Scholar
  43. Weniger  BG, Tansuphaswadikul  S, Young  NL, Pau  CP, Lohsomboon  P, Yindeeyoungyeon  W, Differences in immune function among patients infected with distinct Thailand HIV-1 strains, In: Proceedings of the Tenth International Conference on AIDS. Yokohama, Japan, 7-12 August 1994; Abstract O12C.
  44. Kitayaporn  D, Tansuphaswadikul  S, Lohsomboon  P, Pannachet  K, Kaewkungwal  J, Limpakarnjanarat  K, Survival of AIDS patients in the emerging epidemic in Bangkok, Thailand. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;11:7782.PubMedGoogle Scholar
  45. Learmont  J, Tindall  B, Evans  L, Cunningham  A, Cunningham  P, Wells  J, Long-term symptomless HIV-1 infection in recipients of blood products from a single donor. Lancet. 1992;340:8637. DOIPubMedGoogle Scholar
  46. Cao  YZ, Qin  LM, Zhang  LQ, Safrit  J, Ho  DD. Virologic and immunologic characterization of long-term survivors of human immunodeficiency virus type 1 infection. N Engl J Med. 1995;332:2018. DOIPubMedGoogle Scholar
  47. Kirchhoff  F, Greenough  TC, Brettler  DB, Sullivan  JL, Desrosiers  RC. Brief report: absence of intact nef sequences in a long-term survivor with nonprogressive HIV-1 infection. N Engl J Med. 1995;332:22832. DOIPubMedGoogle Scholar
  48. Ewald  PW. Evolution of mutation rate and virulence among human retroviruses. Phil Trans Roy Soc Lond. Ser B Biol Sci. 1995;346:33343.
  49. Mitscherlich  E, Marth  EH. Microbial Survival in the Environment. Berlin, Germany: Springer-Verlag, 1984.
  50. Meegan  JM. Rift Valley fever in Egypt: an overview of the epizootics in 1977 and 1978. Contributions to Epidemiology and Biostatistics. 1981;3:10013.
  51. House  JA, Turell  MJ, Mebus  CA. Rift valley fever: present status and risk to the western hemisphere. Ann N Y Acad Sci. 1992;653:23342. DOIPubMedGoogle Scholar
  52. Levine  PH, Manns  A, Jaffe  ES, Colclough  G, Cavallaro  A, Reddy  G, The effect of ethnic differences on the pattern of HTLV-I-associated T-cell leukemia/lymphoma (HATL) in the United States. Int J Cancer. 1994;56:17781. DOIPubMedGoogle Scholar
  53. Franco  EF, Villa  LL, Ruiz  A, Costa  MC. Transmission of cervical human papillomavirus infection by sexual activity: differences between low and high oncogenic risk types. J Infect Dis. 1995;172:75663.PubMedGoogle Scholar
  54. Weissman  JB, Murton  KI, Lewis  JN, Friedemann  CHT, Gangarosa  EJ. Impact in the U.S. of the Shiga dysentery pandemic of Central America and Mexico: A review of surveillance data through 1972. J Infect Dis. 1974;129:21823.PubMedGoogle Scholar
  55. Dixon  RE. Effect of infections on hospital care. Ann Intern Med. 1978;89:74953.PubMedGoogle Scholar
  56. Haley  RW, Culver  DH, White  JW, Morgan  WM, Emori  TG. The nationwide nosocomial infection rate: A new need for vital statistics. Am J Epidemiol. 1985;121:15967.PubMedGoogle Scholar
  57. Raju  TNK, Kobler  C. Improving handwashing habits in the newborn nurseries. Am J Med Sci. 1991;302:3558. DOIPubMedGoogle Scholar
  58. Pittet  D, Wenzel  RP. Nosocomial bloodstream infections. Arch Intern Med. 1995;155:117784. DOIPubMedGoogle Scholar
  59. Belnap  D, O'Donnell  JJ. Epidemic gastroenteritis due to Escherichia coli 0:111. J Pediatr. 1955;47:17893. DOIPubMedGoogle Scholar
  60. Rountree  P, Freeman  BM. Infections caused by a particular phage type of Staphylococcus aureus. Med J Aust. 1955;2:15761.
  61. Jessen  O, Rosendal  K, Bülow  P, Faber  V, Eriksen  KR. Changing staphylococci and staphylococcal infections: A ten-year study of bacteria and cases of bacteremia. N Engl J Med. 1969;281:62735.PubMedGoogle Scholar
  62. Locksley  RM, Cohen  ML, Quinn  TC, Tompkins  LS, Coyle  MB, Kirihara  JM, . Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission, and evolution of nosocomial infection. Ann Intern Med. 1982;97:31724.PubMedGoogle Scholar
  63. Rello  J, Torres  A, Ricart  M, Valles  J, Gonzalez  J, Artiga  A, . Ventilator-associated pneumonia by Staphylococcus aureus. Am J Respir Crit Care Med. 1994;150:15459.PubMedGoogle Scholar
  64. Holzman  R, Florman  A, Lyman  M. Gentamicin resistant and sensitive strains of S. aureus. Factors affecting colonization and virulence for infants in a special care nursery. Am J Epidemiol. 1980;112:35261.PubMedGoogle Scholar
  65. Gezon  HM, Rogers  KD, Thompson  DJ, Hatch  TF. Some controversial aspects in the epidemiology of hospital nursery staphylococcal infections. Am J Public Health. 1960;50:47384. DOIGoogle Scholar
  66. Gezon  HM, Schaberg  MJ, Klein  JO. Concurrent epidemics of Staphylococcus aureus and group A streptococcus disease in a newborn nursery-control with penicillin G and hexachlorophene bathing. Pediatrics. 1973;51:38390.PubMedGoogle Scholar
  67. Craven  DE, Reed  C, Kollisch  N, DeMaria  A, Lichtenberg  D, Shen  K, . A large outbreak of infections caused by a strain of Staphylococcus aureus resistant to oxacillin and aminoglycosides. Am J Med. 1981;71:538. DOIPubMedGoogle Scholar
  68. Huebner  J, Pier  GB, Maslow  JN, Muller  E, Shiro  H, Parent  M, . Endemic nosocomial transmission of Staphylococcus epidermidis bacteremia isolates in a neonatal intensive care unit over 10 years. J Infect Dis. 1994;169:52631.PubMedGoogle Scholar
  69. Donnenberg  MS, Kaper  JB. Enteropathogenic Escherichia coli. Infect Immun. 1992;60:395361.PubMedGoogle Scholar
  70. Donnenberg  MS, Tacket  CO, James  SP, Losonsky  G, Nataro  JP, Wasserman  SS, . Role of the eaeA gene in experimental enteropathogenic Escherichia coli infection. J Clin Invest. 1993;92:14127. DOIPubMedGoogle Scholar
  71. Franke  J, Franke  S, Schmidt  H, Schwarzkopf  A, Wieler  LH, Baljer  G, . Nucleotide sequence analysis of enteropathogenic Escherichia coli (EPEC) adherence factor probe and development of PCR for rapid detection of EPEC harboring virulence plasmids. J Clin Microbiol. 1994;32:24603.PubMedGoogle Scholar
  72. Schmidt  H, Plaschke  B, Franke  S, Russman  H, Schwarzkopf  A, Heesemann  J, Differentiation in virulence patterns of Escherichia coli possessing eae genes. Med Microbiol Immunol (Berl). 1994;183:2331. DOIGoogle Scholar
  73. Spitz  J, Yuhan  R, Koutsouris  A, Blatt  C, Alverdy  J, Gecht  G. Enteropathogenic Escherichia coli adherence to intestinal epithelial monolayers diminishes barrier function. Am J Physiol. 1995;268:G3749.PubMedGoogle Scholar
  74. Rogers  KB, Koegler  SJ. Inter-hospital cross-infection of epidemic infantile gastro-enteritis associated with type strains of Bacterium coli. J Hyg (Lond). 1951;49:15261. DOIPubMedGoogle Scholar
  75. Marcy  SM. Microorganisms responsible for neonatal diarrhea, in Remington JS, Klein JO, editors. Infectious diseases of the fetus and newborn infant. Philadelphia: WB Saunders, 1976:892-978.
  76. Saroglou  G, Cromer  M, Bisno  AL. Methicillin-resistant Staphylococcus aureus:interstate spread of nosocomial infections with emergence of gentamicin-methicillin resistant strains. Infect Control. 1980;1:819.PubMedGoogle Scholar
  77. Pavillard  R, Harvey  K, Douglas  D, Hewstone  A, Andrew  J, Collopy  B, Epidemic of hospital-acquired infection due to methicillin-resistant Staphylococcus aureus in major Victorian hospitals. Med J Aust. 1982;1:4514.PubMedGoogle Scholar
  78. Lyon  BR, Iuorio  JL, May  JW, Skurray  RA. Molecular epidemiology of multiresistant Staphylococcus aureus in Australian hospitals. J Med Entomol. 1984;17:7989.
  79. Gooch  JJ, Britt  EM. Staphylococcus aureus colonization and infection in newborn nursery patients. Am J Dis Child. 1978;132:8936.PubMedGoogle Scholar
  80. Saravolatz  LD, Markowitz  N, Arking  L, Pohlod  D, Fisher  E. Methicillin-resistant Staphylococcus aureus. Ann Intern Med. 1982;96:116.PubMedGoogle Scholar
  81. Keating  JM. History of the yellow fever epidemic of 1878 in Memphis, Tennessee. Cincinnati, Ohio: Wrightson, 1879.
  82. Daschner  F. Infectious hazards in rooming-in systems. J Perinat Med. 1984;12:36.PubMedGoogle Scholar

Main Article

Page created: December 21, 2010
Page updated: December 21, 2010
Page reviewed: December 21, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external