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June 19, 1996

Infectious Diseases

Author Affiliations

Cornell University Medical College, New York, NY; Merck & Co, White House Station, NJ

JAMA. 1996;275(23):1816-1817. doi:10.1001/jama.1996.03530470044026

Mortality due to infectious diseases appears to be increasing.1 Factors that are thought to be important include microbial evolution, population growth, particularly in urban megacities in the less developed world, climate change, environmental habitat disruption, and large-scale movements of persons across international borders.2 Recognition of the continued importance of microbial threats to health and of the need to understand the complex factors that underlie the emergence and reemergence of infectious diseases has led to the establishment of new national and global surveillance systems.3

The dynamic and unpredictable nature of infectious diseases was highlighted by an unanticipated outbreak of Ebola virus hemorrhagic fever in Kikwit, Zaire.4 From January to June 1995, 315 persons developed the disease and 244 died, a case fatality rate of 77%. Only 4 previous outbreaks of Ebola virus infection in humans have been recognized, and the most recent was 15 years ago in