Hospitalizations After the Persian Gulf War

To the Editor: In “Reemergence of Plasmodium vivax malaria in the Republic of Korea” (1), the term eradication was, in my judgment, inappropriately used. In 1981, Yekutiel proposed that eradication is “The purposeful reduction of specific disease prevalence to the point of continued absence of transmission within a specified area by means of a time limited campaign” (2). In 1984, Hinman proposed an important addition that eradication must have followed a “deliberate effort” (3). At the Dahlem Workshop in 1997 (4), a more comprehensive definition was proposed. This definition states that eradication is “Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed” (4). At the same conference, two other terms were also defined. Elimination of disease: “Reduction to zero of the incidence of a specified disease in a defined geographic area as a result of deliberate efforts; continued intervention measures are required.” Elimination of infection: “Reduction to zero of the incidence of infection caused by a specific agent in a defined geographic area as a result of deliberate efforts; continued measures to prevent reestablishment of transmission are required.” These definitions promote unanimity in using the term eradication and avoid misconceptions over accomplishments.