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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

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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).

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