Different historical periods have faced different challenges in infectious
disease control and public health, yet the fundamental elements are unchanging:
agent, host, environment, and the dynamic interplay among them. History is
easier to write in retrospect, but the outcome of any epidemic can be readily
predicted by analyzing that interplay. Mutations resulting in increased virulence
of an organism, entry into new populations or species, or the development
of drug resistance will all favor the spread of infection. Host immunity,
risk behavior, and health care service use will all impact host vulnerability
to infection. Poverty, unequal access to health care, and criminalization
of socially disapproved behaviors can increase the vulnerability to disease
of certain populations. With chilling predictability, the unprecedented spread
of the AIDS epidemic during the past several decades can be understood—and
further predicted—by an analysis of these several dimensions.
Selwyn PA. AIDS, Society. JAMA. 2004;292(2):276–277. doi:10.1001/jama.292.2.276
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