People have illness and physicians diagnose and treat disease. Disease is an objective term which implies a malfunctioning of the body or part of the body. Disease is pathological and is diagnosed on the basis of recognizable signs and symptoms. Illness is the subjective experience of pain, discomfort or disorder. Although it is mostly safe to say that illness is the subjective experience of disease, it is possible to experience illness without having a disease and it is possible to have a disease and not feel ill.
Devastating pathogen-borne diseases and plagues, both viral and bacterial in nature, have affected humans since the beginning of human history. The true cause of these diseases was not understood at the time, and some people thought that diseases were a spiritual punishment. Over time, people came to realize that staying apart from afflicted persons, and disposing of the corpses and personal belongings of victims of illness, reduced their own chances of getting sick.
Epidemiologists study how diseases affect a population. An epidemic is a disease that occurs in an unusually high number of individuals in a population at the same time. A pandemic is a widespread, usually worldwide, epidemic. An endemic disease is a disease that is constantly present, usually at low incidence, in a population.
Emerging and Re-emerging Diseases
The distribution of a particular disease is dynamic. Therefore, changes in the environment, the pathogen, or the host population can dramatically impact the spread of a disease. According to the World Health Organization (WHO) an emerging disease (Figure) is one that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or geographic range. This definition also includes re-emerging diseases that were previously under control. Approximately 75 percent of recently emerging infectious diseases affecting humans are zoonotic diseases, zoonoses, diseases that primarily infect animals and are transmitted to humans; some are of viral origin and some are of bacterial origin. Brucellosis is an example of a prokaryotic zoonosis that is re-emerging in some regions, and necrotizing fasciitis (commonly known as flesh-eating bacteria) has been increasing in virulence for the last 80 years for unknown reasons.
Some of the present emerging diseases are not actually new, but are diseases that were catastrophic in the past (Figure). They devastated populations and became dormant for a while, just to come back, sometimes more virulent than before, as was the case with bubonic plague. Other diseases, like tuberculosis, were never eradicated but were under control in some regions of the world until coming back, mostly in urban centers with high concentrations of immunocompromised people. The WHO has identified certain diseases whose worldwide re-emergence should be monitored. Among these are two viral diseases (dengue fever and yellow fever), and three bacterial diseases (diphtheria, cholera, and bubonic plague). The war against infectious diseases has no foreseeable end.