MEDICINE: The Killers All Around

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-- The notorious flare-up in Gloucestershire, England, of what the press dubbed flesh-eating bacteria alerted people to the dangers of streptococcus-A infections. The common bacteria that cause strep throat generally produce no lasting harm if properly treated, but certain virulent strains can turn lethal. Strep-A infections claim thousands of lives each year in the U.S. and Europe alone.

-- Newspaper accounts publicized a startling flare-up of tuberculosis that was first detected last year at a high school in Westminster, California, a middle-class suburb of Los Angeles. The disease was apparently brought in by a 16-year-old Vietnamese immigrant who contracted it in her native country. Nearly 400 young people, or 30% of the school's students, have tested positive for the infection, and at least 12 have a variety of the TB bacterium that is resistant to standard antibiotic treatment. One student has lost part of her lung.

-- The New England Journal of Medicine reported that the children of Cincinnati suffered an epidemic of pertussis (whooping cough) last year. There were 352 cases (none fatal), compared with 542 cases in the 13 years from 1979 to 1992. The alarming part was that most of the children had been properly vaccinated, suggesting that an unusually hardy strain of the pertussis bacterium might be emerging. Another disturbing statistic: there were more than 6,500 cases nationwide, the largest number in more than 26 years.

-- In many parts of the U.S., especially the Northeast, people are already leery of strolling in wooded areas for fear of encountering ticks carrying Lyme disease, a potentially chronic, arthritis-like condition. Now the Journal of the American Medical Association has reported on another tick-borne disease, which struck 25 people in Wisconsin and Minnesota, killing two. It is caused by a new variety of the Ehrlichia bacterium, which was first detected in humans in 1954. Doctors are concerned because life-threatening Ehrlichia infections may be misdiagnosed as Lyme disease or even a bad cold.

A generation ago, no one had ever heard of Lyme or Legionnaires' disease, much less AIDS. Back in the 1970s, medical researchers were even boasting that humanity's victory against infectious disease was just a matter of time. The polio virus had been tamed by the Salk and Sabin vaccines; the smallpox virus was virtually gone; the parasite that causes malaria was in retreat; once deadly illnesses, including diphtheria, pertussis and tetanus, seemed like quaint reminders of a bygone era, like Model T Fords or silent movies.

The first widespread use of antibiotics in the years following World War II had transformed the most terrifying diseases known to humanity -- tuberculosis, syphilis, pneumonia, bacterial meningitis and even bubonic plague -- into mere inconveniences that if caught in time could be cured with pills or shots. Like many who went through medical school in the 1960s, Dr. Bernard Fields, a Harvard microbiologist, remembers being told, "Don't bother going into infectious diseases." It was a declining specialty, his mentors advised -- better to concentrate on real problems like cancer and heart disease.