Infection Is Much Bigger Than We Thought, Bigger Than We Think, And Perhaps Bigger Than We Can Think

I am confident that I don't know "today's most important unreported story" because it hasn't been reported to me yet. But I'll take a stab at one of today's most important under-reported stories: Infection is much bigger than we thought, bigger than we think, and perhaps bigger than we can think. With apologies to J.B.S. Haldane, let me offer a less grandiose, but more tangible and testable (and ponderous) version: The infectious diseases that are already here but not yet generally recognized as infectious diseases will prove to be vastly more important than the infectious diseases that newly arise in the human population from some exotic source (such as the jungles of Africa) or genetic diseases that will be newly discovered by the human genome project. By "important" I mean both the amount of disease that can be accounted for and the amount that can be ameliorated, but I also mean how much of what we value as well as what we fear.

A judgment on this pronouncement can be assessed incrementally decade by decade over the next half-century. What are the diseases to keep an eye on? Heart disease and stroke; Alzheimer's, Parkinson's and other neurodegenerative diseases; impotence, polycystic ovary disease, cancers of the breast and ovaries, the penis and prostate; schizophrenia and the other major mental illnesses. The list goes on.

But is the scope really "bigger than we can think"? Who can say? We can speculate that the scope of infection may extend far beyond what many in the year 2000 would be willing to take seriously. If schizophrenia and manic depression are caused largely by infection, then perhaps the artistic breakthroughs in our society, the groundbreaking work of van Gogh, for example, can also be attributed to infection. How much of what we prize in society would not be here were it not for our constant companions? Rather than pass judgment now, I suggest that we return in 2010 to this offering and each of the other contributions to see how each is faring as the fuzziness of the present gives way to the acuity of hindsight.