Our struggle against deadly microbes is endless. Scourges that have plagued human beings since the ancients still threaten to unleash themselves; new maladies are brewing that have yet to make their appearance in the headlines; and lethal germs employed as weapons of warfare and terrorism have again emerged as a worldwide menace. Regardless of their mode of attack or co-habitation, microbes exist solely to multiply, thrive, and find new hosts. The most egalitarian of living organisms, they cross all national boundaries and every social class, attacking without prejudice.
Across the 20th century, the relationship between human beings and microbes changed with scientific advances in our understanding and amelioration of infectious diseases. With the advent of miraculous antibiotics and preventive vaccines, it looked to many as if the ultimate victory against deadly germs was imminent. Accompanying such delusions of victory has been an underestimation of the highly unpredictable power of infection. As we see with each return of an epidemic, be it naturally induced or man-made, germs still have the power to incite panic and action — that is, until the crisis subsides and they are all too soon forgotten. Underpinning these trends is a failure to embrace the unsettling fact that in the 21st century, the global village is host to a burgeoning community of dangerous and contagious emerging and re-emerging infections. These pathogens demand far more respect and action than mere attempts at isolation or foolhardy efforts to build a wall around our nation.
Public health is a purchasable commodity but it is an investment that works best when purchased in advance rather than paid out as each crisis arises. We must accept that contagion cannot be confined to national boundaries. It is a global problem that affects us all and only the global community can make inroads in safeguarding our health. But we must always remember: we never really conquer germs. At best, all we can hope is to wrestle them to a draw.
Howard Markel, M.D., Ph.D. is the George E. Wantz Professor of the History of Medicine and Professor of Pediatrics and Communicable Diseases at the University of Michigan, where he directs the Center for the History of Medicine. He is the author of several books, including the award-winning Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892 [Johns Hopkins University Press] and, most recently, the critically acclaimed When Germs Travel: Six Major Epidemics and the Fears They Have Unleashed, which first appeared in 2004 from Pantheon Books/Alfred A. Knopf and was recently published in paperback by Vintage Books/Random House.