title: Evolutionary control of infectious disease: prospects for vectorborne and waterborne pathogens.
abstract: Evolutionary theory may contribute to practical solutions for control of disease by identifying interventions that may cause pathogens to evolve to reduced virulence. Theory predicts, for example, that pathogens transmitted by water or arthropod vectors should evolve to relatively high levels of virulence because such pathogens can gain the evolutionary benefits of relatively high levels of host exploitation while paying little price from host illness. The entrance of Vibrio cholerae into South America in 1991 has generated a natural experiment that allows testing of this idea by determining whether geographic and temporal variations in toxigenicity correspond to variation in the potential for waterborne transmission. Preliminary studies show such correspondences: toxigenicity is negatively associated with access to uncontaminated water in Brazil; and in Chile, where the potential for waterborne transmission is particularly low, toxigenicity of strains declined between 1991 and 1998. In theory vector-proofing of houses should be similarly associated with benignity of vectorborne pathogens, such as the agents of dengue, malaria, and Chagas' disease. These preliminary studies draw attention to the need for definitive prospective experiments to determine whether interventions such as provisioning of uncontaminated water and vector-proofing of houses cause evolutionary reductions in virulence.
authors.affiliation: Department of Biology, Amherst College, MA 01002-5000, USA.
authors.forename: P W
authors.initials: PW
authors.lastname: Ewald
authors.forename: J B
authors.initials: JB
authors.lastname: Sussman
authors.forename: M T
authors.initials: MT
authors.lastname: Distler
authors.forename: C
authors.initials: C
authors.lastname: Libel
authors.forename: W P
authors.initials: WP
authors.lastname: Chammas
authors.forename: V J
authors.initials: VJ
authors.lastname: Dirita
authors.forename: C A
authors.initials: CA
authors.lastname: Salles
authors.forename: A C
authors.initials: AC
authors.lastname: Vicente
authors.forename: I
authors.initials: I
authors.lastname: Heitmann
authors.forename: F
authors.initials: F
authors.lastname: Cabello
mesh_terms: D000818:Animals; D005075:Biological Evolution; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000635:transmission; D004199:Disease Vectors; D006801:Humans; D010963:Plasmodium falciparum / Q000472:pathogenicity; D014349:Trypanosoma cruzi / Q000472:pathogenicity; D014734:Vibrio cholerae / Q000472:pathogenicity; D014774:Virulence; D014871:Water Microbiology