Published 21 August 2008, doi:10.1136/bmj.a1365
Cite this as: BMJ 2008;337:a1365

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Several horsemen of the apocalypse

The first 150 words of the full text of this article appear below.

The eradication of smallpox was meant to be the harbinger of future triumphs over infectious diseases. But it’s looking more and more like a one-off. Polio was meant to have followed smallpox by 2000, but this deadline has been shifted forward several times.

Similarly, tuberculosis refuses to go away. As a recent Lancet review reminds us, a third of the world is infected with Mycobacterium tuberculosis, and two million people die from tuberculosis every year, even though the BCG vaccine has been available for more than 75 years. For reasons unknown, this vaccine doesn’t seem to "work" in much of the world. The causative organism always keeps a few jumps ahead of our attempts to stamp it out. The emergence of extensively drug resistant tuberculosis on the heels of multidrug resistant tuberculosis is scary for the whole world, with South Africa currently on the front line of the battle . . . [Full text of this article]

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