According to the prevailing, traditional view parasites should develop reduced virulence towards their hosts, because more virulent pathogens are more likelyto drive the hosts, and thus themselves to extinction. Virulence is considered to be a primitive stage of a parasitive-host association. However the usefulness and validity of this view have been questioned. Recent studies suggest that parasites need not necessarily evolve towards reduced virulence. The points of view of Darwinian medicine in the direction of the evolution of virulence there may be many possible revolutionary trajectories, depending on the details of the parasite's life-history, the host's behavior and the transmissibility of the parasite. Theoretical and epidemiological evidences indicate that pathogens transmitted by arthropod vectors are significantly more lethal to humans than those transmitted by personal contac. Water borne enteric pathogens are less virulent after purification of water supplies. Recent experiments also support the emerging theory that parasitism can evolve to be either more or less virulent in a long-term host, depending on the way the parasite is transmitted to the host and on the environment in which they live.Atualmente considera-se que parasitas devem evoluir em direção à virulência reduzida, pois patógenos virulentos apresentam maiores probabilidades de levarem seus hospedeiros e eles próprios à extinção. A virulência é assim considerada estágio primitivo da associação parasita-hospedeiro. A validade dessas idéias tem sido questionada. Portanto, fez-se revisão dos estudos recentes que sugerem que parasitas não evoluem necessariamente em direção à reduzida virulência. Do ponto de vista da medicina darwinista, na evolução da virulência podem haver muitas trajetórias coevolutivas possíveis, que dependerão da história natural do parasita, do comportamento do hospedeiro e da via de transmissão.398402