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.

Support for this project was provided by the Centers for Disease Control and Prevention’s National Center for Infectious Diseases (Contract No. H75/CCH311468, TO#8), the U.S. Department of Defense (Contract No. DAMD17-01-2-0040), the U.S. Agency for International Development (Contract No. HRN-A-00-00-00012-00), the U.S. Department of Agriculture’s Food Safety and Inspection Service (Contract No. 590-0790-1-188), the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the National Institutes of Health’s Fogarty International Center, the Ellison Medical Foundation, the U.S. Food and Drug Administration, and the U.S. Joint Institute for Food Safety Research. The views presented in this report are those of the Institute of Medicine Committee on Emerging Microbial Threats to Health in the 21st Century and are not necessarily those of the funding agencies.

Library of Congress Cataloging-in-Publication Data

Microbial threats to health : emergence, detection, and response / Mark S. Smolinski, Margaret A. Hamburg, and Joshua Lederberg, editor(s) ; Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health.

p. ; cm.

Includes bibliographical references.

1. Communicable diseases—United States. 2. Public health—United States.

[DNLM: 1. Communicable Diseases, Emerging—epidemiology. 2. Communicable Diseases, Emerging—prevention & control. 3. Communicable Disease Control. WA 110 M626 2003] I. Smolinski, Mark S. II. Hamburg, Margaret A. III. Lederberg, Joshua. IV. Institute of Medicine (U.S.). Committe on Emerging Microbial Threats to Health in the 21st Century.

RA643.5.M53 2003

614.5′7—dc21

2003008754

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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 serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.