Second Opinion: 2001 Projections

Dec. 27 -- David Letterman has his top 10 lists. Here’s mine, a bit more serious though, for medical topics to watch in 2001, based on my reading of the medical and scientific trends:

1. Much more scientific attention will be focused on the role of microbes in a wide range of chronic illnesses, including heart disease and cancer.

2. A herpes virus called HHV-6 will become recognized far more widely as a major pathogen, particularly in its ability to trigger neurological diseases, including multiple sclerosis. 3. There will be an explosion of interest in the role that ancient infections play in illness. These infections have become part of our genetic structure, passed from on generation to generation. 4. AIDS/HIV science will continue to suffer major setbacks as current highly toxic treatments are gradually abandoned. More attention will be focused on ways to build up the body’s immune system. It will also become increasingly recognized that the cause of AIDS is much more complex than previously believed. 5. Advances in genetics will shed light on how toxic insults from the environment, including pesticides, can damage cells and set off a chain of events that will result in chronic illness. 6. Medicine will continue to team up with physics, mathematics and computer science to analyze the interaction of many body systems. Studying heart-brain or gut-brain interactions, for example, will provide medical researchers with new clues about the dynamics of how various forms of heart and bowel disease emerge. 7. The major disease of 2001 will be mad cow and its human counterpart, an apparent variant of Creutzfeld-Jacob disease, a deadly neurological disorder that leaves brains looking like swiss cheese. Nations worldwide, including the United States, will become involved in a major effort to stall the spread of mad cow. Some scientists will continue to argue that the cause of the disease is not a rogue protein called a prion, as usually claimed; rather that another form of infection or some form of environmental toxicity, possibly a pesticide, is involved. 8. The role of inflammation in setting off Alzheimer’s disease will gain strong ground, possibly implicating a microbial trigger that precedes plaque formation in the brain. 9. One of the most controversial medical subjects of 2001 will be vaccination. Research will begin to reveal that vaccines can have a strong impact on the body’s immune system, particularly in young children. In an era when scores of vaccines are in the pipeline and many parents are being led to believe that their children will require a dozen or more immunizations, scientific questions will be raised about the risk-benefit of some of these vaccines. 10. Many new prescription drugs have been fast-tracked through government safety scrutiny and some have been belatedly pulled from the market after reports of being associated with severe side effects and deaths. There is nothing to suggest that the new year will bring different results. The Food and Drug Administration has become more inept than ever before in its history.