Epilogue• 291Polio’s recent history, however, raises alarm bells about the efficacy of
eradicating infectious diseases. The World Health Organization itself keeps
pushing back the target date for eliminating this dreaded disease of the
young, despite polio’s confinement in 2001 to 10 countries, a sharp drop from
125 in 1988. (The last case in the United States occurred in 1979 .) A far more
alarmist word comes from the head of the successful campaign against small-
pox, Dr. D. A. Henderson. In October 2002 , he shocked the medical world
by asserting that elimination of polio would never succeed. Rogue polio, he
argued, could always be possible, either by chance or by design. As proof, he
gave three examples: ( 1 ) individuals with impaired immunity can per-
manently harbor and transmit the polio virus; ( 2 ) a weakened polio virus
used as a vaccine in the Dominican Republic mysteriously mutated, trigger-
ing a polio outbreak in 2001 ;( 3 ) in 2002 , researchers at a New York lab-
oratory synthesized a virile polio specimen from mail-order materials. The
only way to fight polio (and presumably other infectious diseases), Hender-
son concluded, was a return to routine vaccination.^59
Known and unknown diseases recognize no boundaries. The Centers for
Disease Control and Prevention in Atlanta, Georgia, has an entire depart-
ment devoted to a project entitled “Unexplained Illness and Deaths Surveil-
lance.” Hospital-acquired diseases, or nosocomials, infect an estimated two
million patients in the United States each year, killing about ninety thou-
sand. At the beginning of this millennium, drug-resistant infections alone
accounted for more than fourteen thousand of these deaths.^60
Scientists and pharmaceutical companies are hard-pressed to develop new
medicines fast enough to keep up with new pathogens or resistant strains. In
wealthier countries, antibiotics are overprescribed, causing the development
of drug resistance in microbes. In poorer countries, according to the World
Health Organization, sick persons take cheaper, weaker drugs and fail to
complete the treatment. We are reaping the bitter dual harvest of the im-
proper application of drug therapies and the cost-effective concentration of
the pharmaceutical companies on developing drugs for long-term use rather
than against potential epidemic threats.^61
The prospects and perils of the future cause us to grapple with a previously
unthinkable dilemma: should we completely eliminate all traces of microor-
ganisms that once caused such scourges as smallpox? Threats of bioterrorism
have given us pause. Keeping our laboratory cultures of smallpox, along with
other microbial pathogens, might prove essential for reconfiguring vaccines
against biologically engineered or accidentally mutated rogue microbes.