Emerging infectious diseases in the United States, 1993

Three outbreaks of disease in the United States in 1993 caused by Escherichia coli O157:H7, Cryptosporidium organisms, and a previously unrecognized hantavirus clearly illustrate the increasing challenges posed by emerging infectious diseases. The largest US outbreak of E. coli O157:H7 infection reported occurred as a result of contaminated hamburgers served at a fast-food restaurant chain. The largest recorded waterborne disease outbreak in US history was due to contamination of a municipal water supply with cryptosporidia. In the southwestern United States, hantavirus was first recognized as the cause of a pulmonary syndrome with a mortality rate exceeding 50%. The detection of and response to these outbreaks document the need for a strong partnership between the clinical and public health sectors to prevent and control diseases. Health care reform in the United States provides an opportunity to address critical needs, such as improved surveillance and diagnosis, to ensure timely detection of and rapid response to newly emerging infectious diseases.