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The Soriano Award Lecture. Emerging infections of the nervous system
1Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287.
Abstract:
The epidemic of acquired immunodeficiency disease [AIDS] has focused interest on the origins of "new" infectious agents. Great plagues are well known from the distant past, but a number of novel diseases affecting the nervous system infections have emerged in recent years. The causes of such new disorders are diverse: whereas rapid mutations of microbes allow the evolution of truly novel agents, the appearance of new diseases is more often due to changes in human or vector populations or changes in societal mores that result in dissemination of preexistent microbes. Examples of recently emerging infections that involve the nervous system include the enterovirus 70 epidemics with poliomyelitis-like disease, the appearance of California virus encephalitis in the midwestern United States, the rapid spread of Lyme disease with its many neurological complications in the eastern United States, and the outbreak of bovine spongiform encephalopathy in the United Kingdom, in addition to the devastating epidemic of human immunodeficiency virus (HIV), which will cause nervous system disease in over half of those infected. As the world population increases and modern transportation brings us closer into a "global village" more new agents will emerge and more will be sustained. Knowledge of the molecular biology and ecology of the agents and awareness of how our actions can alter their behavior are our best defense.
Insights
New infectious diseases, including those affecting the nervous system, are emerging due to microbial evolution and societal changes. Understanding pathogen ecology and human behavior is key to preventing future epidemics like acquired immunodeficiency disease (AIDS).
Area of Science:
- Epidemiology
- Infectious Diseases
- Neuroscience
Background:
- The emergence of novel infectious diseases, exemplified by acquired immunodeficiency disease (AIDS), necessitates understanding the origins of new pathogens.
- Historically, major plagues are known, but recent years have seen an increase in novel neurological infections.
Observation:
- New diseases arise from diverse causes, including rapid microbial mutation, shifts in human or vector populations, and changes in societal behaviors facilitating pathogen spread.
- Recent examples of emerging neurological infections include enterovirus 70 causing poliomyelitis-like illness, California virus encephalitis, Lyme disease with neurological complications, bovine spongiform encephalopathy, and human immunodeficiency virus (HIV).
Findings:
- Human immunodeficiency virus (HIV) infection is projected to cause nervous system disease in over half of infected individuals.
- The increasing global population and interconnectedness through modern transportation contribute to the emergence and sustained presence of new infectious agents.
Implications:
- Enhanced knowledge of the molecular biology and ecology of infectious agents is crucial for effective defense.
- Awareness of how human actions influence the behavior and spread of pathogens is essential for mitigating future outbreaks and protecting public health.