Origins of major human infectious diseases

Abstract

Many of the major human infectious diseases, including some now confined to humans and absent from animals, are 'new' ones that arose only after the origins of agriculture. Where did they come from? Why are they overwhelmingly of Old World origins? Here we show that answers to these questions are different for tropical and temperate diseases; for instance, in the relative importance of domestic animals and wild primates as sources. We identify five intermediate stages through which a pathogen exclusively infecting animals may become transformed into a pathogen exclusively infecting humans. We propose an initiative to resolve disputed origins of major diseases, and a global early warning system to monitor pathogens infecting individuals exposed to wild animals.

Figure 1. Illustration of the five stages through which pathogens of animals evolve to cause diseases confined to humans.

(See Box 1 for details.) The four agents depicted have reached different stages in the process, ranging from rabies (still acquired only from animals) to HIV-1 (now acquired only from humans).