Child health and life expectancy improved together in many societies i
n the 20th century. As the incidence of diseases with major extrinsic
causes declined, the heritability of disease as a whole increased. Acc
ordingly, the genetic (intrinsic) causes of disease have become import
ant. The genome project is an international venture out of which will
come new knowledge about the biological basis of health and disease, a
nd technologies to apply that knowledge in medicine and other discipli
nes. Phenylketonuria (PKU) at one time was seen only as a rare inborn
error of metabolism causing severe mental retardation. Yet, the gene f
requency is about 1% in Caucasian and Oriental populations, higher sti
ll in some populations with particular histories that have enhanced ge
ne frequency. These genetic facts make PKU a paradigm in human genetic
s. This genetic disease, for which it was thought there was nothing to
be done, has yielded to inquiries at clinical, metabolic, protein (en
zyme) and DNA (PAH gene) levels. Results have shown that, early diagno
sis (by population screening) and treatment (by low phenylalanine diet
) largely prevents mental retardation. DNA analysis reveals particular
associations between PKU mutations, RFLP haplotypes and populations;
these associations are relevant for counselling. PKU illustrates well
how medical science, molecular biology and gene mapping can improve kn
owledge and contribute to child health.