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June 7, 1995

Health at Home Means Watching the Global Village

JAMA. 1995;273(21):1648-1649. doi:10.1001/jama.1995.03520450016007

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THE SLOGAN of the environmental movement, "Think globally, act locally," could be appropriated by physicians and others concerned about immigrants who carry infections endemic in their native lands as part of their personal baggage.

Given the unprecedented reach of microbes through immigration and other factors such as travel and importation of foreign goods, physicians are discovering that they sometimes need to consider relatively exotic possibilities when diagnosing their patients' illnesses.

Recent eruptions of deadly infections, such as Zaire's Ebola virus outbreak in May and last September's pneumonic plague epidemic in India, underscore the globalization of infections in a world shrunk by air travel. And while the real and potential risks posed by the influx of immigrants from areas where infections like tuberculosis (TB) and Chagas disease are endemic seem less cataclysmic than the possibility of a "hot zone" epidemic sweeping the planet, the former pose risks substantial enough to prompt

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