The Lancet  
Apr 14, 2012  Volume 379  Number 9824  p1365 – 1460 e48
http://www.thelancet.com/journals/lancet/issue/current

Viewpoint
Balance between clinical and environmental responses to infectious diseases
Justin V Remais, Joseph NS Eisenberg

Preview
A child enters a village clinic in China, presenting with symptoms of lead poisoning. She is treated and the area around her house is investigated to find the source of the poisoning—an environmental response designed to prevent re-exposure. A child enters the same clinic, presenting with symptoms of acute schistosomiasis. He is treated and sent home, only to be reinfected in his contaminated community. This contrasting response to chemical and infectious environmental hazards is not an isolated example; rather, it is a reflection of the largely clinical orientation of many efforts to control infectious diseases worldwide,1 despite the potential for environmental interventions to sustainably and cost effectively limit re-exposure to environmental pathogens.