Abstract
Recent outbreaks of infectious diseases have clearly demonstrated that the concerns risen in the Institute of Medicine report, Emerging Infections, are more than theoretical.1 Whether due to diseases previously unknown to medical science, such as Hantavirus pulmonary syndrome or the Morbillivirus pneumonia of horses, or the return of known scourges like plague, cholera, and tuberculosis, infectious diseases are in a state of flux globally.2-6 The causes for this resurgence are many and complex and include overcrowded cities where population growth has outpaced supplies of clean water and adequate housing; increases in national and international travel; changes in food handling, shipping, and processing; and the concurrent deterioration of traditional public health activities such as surveillance and diagnostic laboratories needed to quickly recognize emerging problems.7 The net result is that national health has become an international challenge. Infectious diseases do not respect international boundaries; consequently, an outbreak of disease