Gertrude Belle Elion was a twentieth-century scientist in the US who researched the structure of viral DNA to help develop anti-viral medications. For her work on drug development, Elion was a co-recipient of the 1988 Nobel Prize in Physiology or Medicine, even though she lacked a PhD or MD. In the 1970s, Elion helped to develop acyclovir, an early anti-viral medication, alongside a team of other researchers. Acyclovir was one of the first selective medications to effectively treat herpes simplex virus types 1 and 2, or HSV-1 and HSV-2. Those are common viruses that can be transmitted via close contact or sexual intercourse, and cause sores on the mouth and genitals. The medications that Elion helped develop were also some of the first to specifically inhibit the replication of viral DNA. By creating medications like acyclovir based on her knowledge of chemistry and biology, rather than through trial and error, Elion helped create a new model for drug development, in addition to making an effective treatment for herpes, which afflicts billions of people globally, and can cause life-threatening illness in infants.

George Herbert Hitchings researched and developed medications that targeted specific parts of DNA replication processes to treat cancers and various illnesses in the US during the twentieth century. By studying DNA analogs, or manmade substances that resemble the structure of naturally occurring DNA components and are capable of inhibiting DNA replication, Hitchings promoted a novel approach to pharmaceutical research and drug development, known as rational drug design. Using that novel approach, Hitchings and his research team created acyclovir, one of the first medications to effectively treat herpes, a condition that can be sexually transmitted but can also be passed from mother to child, causing life-threatening illness in infants. Hitchings also contributed to the development of cancer treatments, immunosuppressant medications, anti-viral medications, and anti-malarial medications. Hitchings’s research on DNA analogs established rational drug design as a method to create new pharmaceutical drugs, some of which treat sexually transmitted illnesses.

In 2001, David Kimberlin and colleagues published “Natural History of Neonatal Herpes Simplex Virus Infections in Acyclovir Era,” hereafter, “Natural History of Herpes,” in the journal Pediatrics. In the article, the researchers explore the natural history of herpes, which entails asking how herpes simplex virus, or HSV, progresses in infants when treated with acyclovir, one of the first antiviral medications that effectively treated HSV in adults. HSV can cause painful lesions on the mouth or genitals. When infants contract HSV, it can cause life-threatening illness, including skin lesions, blindness, developmental delays, and often death. At the time of publication, researchers and physicians had evidence that acyclovir could effectively treat neonatal HSV, but physicians still struggled to address the condition quickly enough to improve treatment outcomes. “Natural History of Herpes” presents an updated picture, as of 2001, of how HSV progresses to provide physicians with quicker ways to identify the condition in neonates, who frequently contract the disease from their mothers in utero or during labor and delivery.

Gonorrhea is a sexually transmitted disease, or STD, caused by the bacterium Neisseria gonorrhoeae. Common symptoms of the disease include painful urination and genital discharge. There are records of historical discussions of gonorrhea in ancient civilizations and during the Middle Ages, but scientists did not begin investigating the scientific causes and treatments of the STD until the sixteenth century. In the 1700s, physicians attributed gonorrhea to the same cause as another STD, syphilis. Later, in the 1800s, researchers discovered the two diseases were not the same and identified the bacteria N. gonorrhoeae that causes gonorrhea. By the 1900s, researchers began using antibiotics to target the bacteria, but many drugs eventually developed antibiotic resistance. In 2020, the World Health Organization, or WHO, estimated that 82.4 million individuals contracted gonorrhea globally, and as of 2024, researchers continue to experiment with various antibiotic drugs to provide adequate treatment for the disease.

Acyclovir is an antiviral medication that scientists developed in the twentieth century to treat herpes, a disease caused by the viruses herpes simplex virus-1 and herpes simplex virus-2, or HSV-1 and HSV-2. The viruses cause painful lesions to develop on the mouth and genitals. Herpes is a very common condition and acyclovir was one of the first medications to effectively heal and reduce the duration of lesions caused by HSV-1 and HSV-2. Scientists at Wellcome Research Laboratories in Research Triangle Park, North Carolina, developed acyclovir with the specific aim of inhibiting the replication process of HSV-1 and HSV-2 in a host’s cell, which was a novel approach to drug development at the time. Physicians have since used acyclovir to treat other diseases caused by herpesviruses. Scientists have developed new drugs for the treatment of genital herpes based on acyclovir’s mechanism of action and, as of 2024, physicians still prescribe acyclovir to treat oral and genital herpes, providing relief to the millions of people living with herpes globally.

In July 2011, Makoto Ohnishi and colleagues published the article “Is Neisseria gonorrhoeae Initiating a Future Era of Untreatable Gonorrhea?: Detailed Characterization of the First Strain with High-Level Resistance to Ceftriaxone,” hereafter, “Untreatable Gonorrhea,” in the journal Antimicrobial Agents and Chemotherapy. Gonorrhea is a sexually transmitted disease, or STD, caused by the bacterium Neisseria gonorrhoeae. In 2009, Ohnishi and a few of his co-authors found the first ceftriaxone-resistant strain of gonorrhea, called H041. That strain demonstrated resistance to ceftriaxone, one of the last remaining and effective first-line antibiotic treatment drugs for N. gonorrhoeae. In “Untreatable Gonorrhea,” Ohnishi and Colleagues confirm that the H041 strain is resistant to ceftriaxone and analyze the bacterium’s mechanism of resistance. “Untreatable Gonorrhea” was one of the first publications to characterize the H041strain and highlights a need for global public health interventions to prevent the rapid spread of gonorrhea.

Philippe Ricord was a nineteenth-century physician and surgeon in France who studied syphilis and demonstrated that it is different from gonorrhea. As of 2024, researchers recognize that syphilis and gonorrhea are both sexually transmitted infections, or STIs. However, the bacterium Treponema pallidum causes syphilis, leading to symptoms such as sores and fever, whereas the bacterium Neisseria gonorrhoeae causes gonorrhea and leads to different symptoms such as discharge from the urethra. Before Ricord, researchers thought syphilis and gonorrhea were the same disease. Ricord, through observation and experimentation, distinguished syphilis from gonorrhea and arranged the stages of syphilis into primary, secondary, and tertiary, each associated with different symptoms and levels of severity. By distinguishing syphilis from other STDs and accurately categorizing its stages, Ricord helped researchers better understand how to treat syphilis, a disease that can be transmitted from mother to child, causing life-threatening illness in infants.