Brian J. Ford
The preceding chapters have offered us challenging insights into the development of the study of diseases and their impact on human health. This final chapter adopts a contemplative stance and considers the future. For fifty years, microbiology has dwindled to become a 'Cinderella' science. Young biologists have been discouraged from entering the discipline, since it has been tacitly assumed that the major infections were known and relatively little work remained to be accomplished. Virologists, when retired, found they were not replaced (Ford 2000a; Slade, personal communication 2001).
Much microbiology became subsumed into molecular biology, and the topic generally became regarded as unfashionable and passé. The levels of immunisation among the young fell to dangerously low totals, and when the BCG vaccine was proving difficult to source in Britain, wholesale vaccination of the teenage population was relegated to a matter of low priority. This is at variance with the realities of the subject, since the new millennium, arbitrary as the demarcation might be, may well herald an entirely new era of infection. We are encountering new diseases that may have implications for human health (such as BSE); recently identified pathogens (including Helicobacter pylori and Campylobacter); new types of well-known pathogens (for example, E. coli O157 H7); and a range of new means of transmission. From cling-film wrapped sandwiches, that offer a secure medium for cryophilic organisms like Listeria, to international transportation, which can bring people into contact with new diseases and can offer pathogens a unique channel through which to propagate an epidemic (in addition to global dissemination of the consequences), the new problems are largely undivined and widely ignored. This final chapter reviews a selection of the new problems, emphasising the grounds for the belief that a radically changed proactive stance to novel infection risks will be a necessary concomitant to a secure and civilised lifestyle in the future. Microorganisms are great opportunists, and the channels for transmission that are available in the modern world add greatly to the problems that will be encountered in the West.