Molecular Biology and Molecular Epidemiology of Salmonella Infections

Salmonelosis: Science in the service of public health The World Health Report of 2007 is entitled "A Safer Future-Global Public Health Security in the 21st Century". It shows how the world is at increasing risk of disease outbreaks, epidemics, industrial accidents, natural disasters and other health emergencies which can rapidly become threats to global public health security. Globalization, climate change and the increased movement of people, goods and services have increased the risk of spread of infectious diseases, and countries need to work together to identify risks and act to contain and control them. No single country, regardless of capability or wealth, can protect itself from outbreaks and other hazards without the cooperation of others. The report states that the prospect of a safer future is within reach - and that this is both a collective aspiration and a mutual responsibility. In the era of heightened concern about emerging diseases like avian influenza and foot and mouth disease, it would be prudent to remind ourselves that the salmoneloses represent a "democratic" set of human diseases which affect both developed and developing countries. As a public health challenge, typhoid fever and the non-typhoidal salmoneloses represent a significant risk to public health globally, especially in the developing world, where fragile health systems are struggling to meet demands from the population. Antibiotic resistance, veterinary drug use, poor vaccination coverage, increased migration, conflict situations, natural disasters and poor health infrastructure have compounded the difficulties in dealing with this important public health threat. Paradoxically, these public health realities occur concurrently with unprecedented advances in scientific knowledge and significant increases in the funding of research into health globally. As illustrated in this volume, so much has been learnt in the past decade about the basic biology of Salmonella enterica, including evolution of genomes, molecular epidemiology and gene expression. These advances have given us critical insights into evolutionary dynamics, antibiotic resistance patterns and pathogenetic mechanisms. However, and at the same time as pushing these frontiers of knowledge, it is also important that the knowledge gains are translated into tangible outcomes and interventions. How can the knowledge be translated into novel approaches to overcome antibiotic resistance, or mitigate evolutionary pressure which lead to its development? Or, furthermore, into less expensive and more rapid diagnostics? Or lead to the development of more rational and evidence-based public health policies and measures? Or towards obtaining the right balance between research that focuses on treatment and that which focuses on prevention? These are difficult challenges which require collective and creative thinking between the scientific and public health communities; where both communities can do well to heed the words of Bruce Alberts, former President of the US National Academy of Sciences, who said "Science cannot be focused solely on acquiring knowledge. It must also examine the ethical implications of the application of such knowledge in an international context in order to form legitimate public policy, and it must promote ways to ameliorate the miserable conditions in which the majority of the world's people live". Global public health security is the main health challenge of the 21st century and science must be used to provide such security to all peoples living on the planet. In the same context, the scientific community must enlarge its vision of scientific research problems, in order to make them more meaningful in an academic, scholarly, sense.