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Chapter 25 : Exterminating Pathogens
The name of Ali Maow Maalin deserves to be just as familiar to microbiology students as that of James Phipps, for it was Maalin, a 23-year-old Somalian cook, who in 1977 became the world’s last naturally acquired case of smallpox. Some time over the next few years, hopefully, another name, that of the last person on Earth to contract paralytic polio caused by wild poliovirus, will join the historic duo. Even today, the book from the 1997 conference, The Eradication of Infectious Diseases, stands as a major dossier on the realities of global and regional disease eradication efforts. Even the most formidable obstacles, such as the existence of an animal reservoir, can sometimes be overcome. The persistence of viable organisms in patients following recovery is one phenomenon that clearly can jeopardize wide-scale elimination. One of the principal lessons to emerge from previous programs of disease extermination is the importance of thoroughly understanding the natural history of particular pathogens. Then, suddenly, new outbreaks occurred in Brazil and elsewhere, leading to the discovery that the virus was carried not only by Aedes agypti, but also by mosquitoes living in the forest canopy. The World Health Organization's yaws campaign, one of its first initiatives in disease control, provides another lesson. The more radical step of exterminating pathogens entirely is bound to pose sharper dilemmas in relation to biodiversity as others become candidates for extinction.