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Emerging Infections: Microbial Threats to Health in the United States I Emerging Infections: Microbial Threats to Health in the United States http://www.nap.edu/catalog/2008.html i EMERGING INFECTIONS riginal paper book, not from the Microbial Threats to Health in the United States the authoritative version for attribution. ing-specific formatting, however, cannot be Joshua Lederberg, Robert E. Shope, Stanley C. Oaks, Jr., Editors Committee on Emerging Microbial Threats to Health Division of Health Sciences Policy Division of International Health INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1992 About PDFthis file: This new digital representation of original workthe has been recomposed XMLfrom files created from o the original typesetting files. breaks Page are true the line lengths, word to original; breaks, heading styles, and other typesett aspublication this inserted.Please versionoftypographicerrors have been accidentallyretained, and some print use the may Copyright © National Academy of Sciences. All rights reserved. Emerging Infections: Microbial Threats to Health in the United States http://www.nap.edu/catalog/2008.html ii NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sci- ences, the National Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist riginal paper book, not from the distinguished members of the appropriate professions in the examination of policy matters pertain- ing to the health of the public. In this, the Institute acts under both the Academy’s 1863 congres- sional charter responsibility to be an adviser to the federal government and its own initiative in the authoritative version for attribution. identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the ing-specific formatting, however, cannot be Institute of Medicine. Funding for this study was provided by the Centers for Disease Control, the Fogarty Interna- tional Center, Lederle-Praxis Laboratories, the Lucille P. Markey Charitable Trust, the National Institute of Allergy and Infectious Diseases of the National Institutes of Health, the Rockefeller Foundation, and the U.S. Army Medical Research and Development Command. Library of Congress Cataloging-in-Publication Data Emerging infections: Microbial threats to health in the United States / Joshua Lederberg, Robert E. Shope, and Stanley C. Oaks, Jr., editors. p. cm. Includes bibliographical references and index. ISBN 0-309-04741-2 1. Communicable diseases—United States. I. Lederberg, Joshua. II. Shope, Robert E. III. Oaks, S. C. RA643.5.E43 1992 614.4'273—dc20 92-26480 CIP First Printing, October 1992 Second Printing, November 1992 Third Printing, December 1993 Copyright 1992 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin. COVER: The background for the cover of this report is a photograph of batik designed and printed specifically for the Malaysian Society of Parasitology and Tropical Medicine. The print contains drawings of various parasites and insects; it is used with the kind permission of the Society. About PDFthis file: This new digital representation of original workthe has been recomposed XMLfrom files created from o the original typesetting files. breaks Page are true the line lengths, word to original; breaks, heading styles, and other typesett aspublication this inserted.Please versionoftypographicerrors have been accidentallyretained, and some print use the may Copyright © National Academy of Sciences. All rights reserved. Emerging Infections: Microbial Threats to Health in the United States http://www.nap.edu/catalog/2008.html iii COMMITTEE ON EMERGING MICROBIAL THREATS TO HEALTH JOSHUA LEDERBERG (Co-chair),* University Professor and Sackler Foundation Scholar, Rockefeller University, New York, New York ROBERT E. SHOPE (Co-chair), Professor of Epidemiology and Director, Yale riginal paper book, not from the Arbovirus Research Unit, Yale University School of Medicine, New Haven, Connecticut the authoritative version for attribution. BARRY R. BLOOM,* Weinstock Professor and Chairman, Department of ing-specific formatting, however, cannot be Microbiology and Immunology, and Investigator, Howard Hughes Medical Institute, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York ROBERT L. BUCHANAN, Research Leader, Microbial Food Safety Research Unit, Agricultural Research Service, Eastern Regional Research Center, U.S. Department of Agriculture, Philadelphia, Pennsylvania JOHN R. DAVID,† Richard Pearson Strong Professor and Chairman, Department of Tropical Public Health, Harvard School of Public Health, and Professor of Medicine, Harvard Medical School, Boston, Massachusetts CIRO A. DE QUADROS, Regional Advisor, Expanded Programme on Immunization, Pan American Health Organization, Washington, D.C. PATRICIA N. FULTZ, Associate Professor, Department of Microbiology, University of Alabama, Birmingham JOHN J. HOLLAND, Professor, Department of Biology and Institute for Molecular Biology, University of California, San Diego, La Jolla, California DEAN T. JAMISON, Professor, Department of Community Health Sciences and Department of Education, University of California, Los Angeles EDWIN D. KILBOURNE,§ Distinguished Service Professor, Department of Microbiology, Mount Sinai School of Medicine, New York, New York ADEL A. F. MAHMOUD,† John H. Hord Professor of Medicine and Chairman, Department of Medicine, Case Western Reserve University, University Hospitals of Cleveland, Cleveland, Ohio GERALD L. MANDELL, Professor of Medicine, Owen R. Cheatham Professor of Sciences, and Head, Division of Infectious Diseases, Department of Internal Medicine, University of Virginia, Charlottesville STEPHEN S. MORSE, Assistant Professor, Rockefeller University, New York, New York JUNE E. OSBORN,† Dean and Professor of Epidemiology, School of Public Health, and Professor of Pediatrics and Communicable Disease, Medical School, University of Michigan, Ann Arbor WILLIAM C. REEVES, Professor Emeritus of Epidemiology, School of Public Health, University of California, Berkeley About PDFthis file: This new digital representation of original workthe has been recomposed XMLfrom files created from o the original typesetting files. breaks Page are true the line lengths, word to original; breaks, heading styles, and other typesett aspublication this inserted.Please versionoftypographicerrors have been accidentallyretained, and some print use the may Copyright © National Academy of Sciences. All rights reserved. Emerging Infections: Microbial Threats to Health in the United States http://www.nap.edu/catalog/2008.html iv PHILIP K. RUSSELL, Professor of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland ALEXIS SHELOKOV, Director of Medical Affairs, the Salk Institute- Government Services Division, San Antonio, Texas P. FREDERICK SPARLING, Chairman, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill ANDREW SPIELMAN, Professor of Tropical Public Health, Department of Tropical Public Health, Harvard School of Public Health, Boston, riginal paper book, not from the Massachusetts the authoritative version for attribution. ing-specific formatting, however, cannot be PROJECT STAFF RUTH ELLEN BULGER, Director, Division of Health Sciences Policy POLLY F. HARRISON, Director, Division of International Health STANLEY C. OAKS, JR., Study Director ELIZABETH E. MEYER, Research Associate NANCY DIENER, Budget Analyst GREG W. PEARSON, Consultant Writer/Editor * Member, Institute of Medicine and National Academy of Sciences † Member, Institute of Medicine § Member, National Academy of Sciences About PDFthis file: This new digital representation of original workthe has been recomposed XMLfrom files created from o the original typesetting files. breaks Page are true the line lengths, word to original; breaks, heading styles, and other typesett aspublication this inserted.Please versionoftypographicerrors have been accidentallyretained, and some print use the may Copyright © National Academy of Sciences. All rights reserved. Emerging Infections: Microbial Threats to Health in the United States http://www.nap.edu/catalog/2008.html PREFACE v Preface riginal paper book, not from the As the human immunodeficiency virus (HIV) disease pandemic surely the authoritative version for attribution. should have taught us, in the context of infectious diseases, there is nowhere in ing-specific formatting, however, cannot be the world from which we are remote and no one from whom we are disconnected. Consequently, some infectious
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