This article examines whether the decline of Helicobacter pylori, a bacterium living in the human stomach since time immemorial, is good or bad for public health. Helicobacter pylori is one of humanity's oldest and closest companions, and yet it took scientists more than a century to recognize it. Just as scientists were learning the importance of H. pylori, however, they discovered that the bacteria are losing their foothold in the human digestive tract. Whereas nearly all adults in the developing world still carry the organism, its prevalence is much lower in developed countries such as the U.S. Epidemiologists believe that H. pylori has been disappearing from developed nations for the past 100 years thanks to improved hygiene, which blocks the transmission of the bacteria, and to the widespread use of antibiotics. The possibility that this bacterium may actually protect people against diseases of the esophagus has significant implications. For instance, current antibiotic treatments that eradicate H. pylori from the stomach may have to be reconsidered to ensure that the benefits are not outweighed by any potential harm. To fully understand H. pylori's effects on health, researchers must investigate the complex web of interactions between this remarkable microbe and its hosts. Ultimately, the study of H. pylori may help us understand other bacteria that colonize the human body, as well as the evolutionary processes that allow humans and bacteria to develop such intimate relations with one another. INSET: Overview/A Microbe's Effects.
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