Evolutionary Control of Infectious Disease: Prospects for

Evolutionary theory may contribute to practical solutions for control of disease by identifying inter-ventions 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 trans-mission. Preliminary studies show such correspondences: toxigenicity is negatively associated with access to uncontaminated water in Brazil; and in Chile, where the potential for waterborne transmis-sion 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 un-contaminated water and vector-proofing of houses cause evolutionary reductions in virulence. Key words: infectious diseases- control- pathogens- waterborne transmissio