Infectious diseases are a global hazard that puts every nation and every person at risk. The recent SARS outbreak is a prime example. Knowing neither geographic nor political borders, often arriving silently and lethally, microbial pathogens constitute a grave threat to the health of humans. Indeed, a majority of countries recently identified the spread of infectious disease as the greatest global problem they confront. Throughout history, humans have struggled to control both the causes and consequences of infectious diseases and we will continue to do so into the foreseeable future. Following up on a high-profile 1992 report from the Institute of Medicine, Microbial Threats to Health examines the current state of knowledge and policy pertaining to emerging and re-emerging infectious diseases from around the globe. It examines the spectrum of microbial threats, factors in disease emergence, and the ultimate capacity of the United States to meet the challenges posed by microbial threats to human health. From the impact of war or technology on disease emergence to the development of enhanced disease surveillance and vaccine strategies, Microbial Threats to Health contains valuable information for researchers, students, health care providers, policymakers, public health officials. and the interested public.

Microbial threats, including endemic and emerging infectious diseases and antimicrobial resistance, can cause not only substantial health consequences but also enormous disruption to economic activity worldwide. While scientific advances have undoubtedly strengthened our ability to respond to and mitigate the mortality of infectious disease threats, events over the past two decades have illustrated our continued vulnerability to economic consequences from these threats. To assess the current understanding of the interaction of infectious disease threats with economic activity and suggest potential new areas of research, the National Academies of Sciences, Engineering, and Medicine planned a 1.5-day public workshop on understanding the economics of microbial threats. This workshop built on prior work of the Forum on Microbial Threats and aimed to help transform current knowledge into immediate action. This publication summarizes the presentations and discussions from the workshop.

The National Academies of Sciences, Engineering, and Medicine in collaboration with the InterAcademy Partnership and the European Academies Science Advisory Committee held a workshop in November 2019 to bring together researchers and public health officials from different countries and across several relevant disciplines to explore what is known, and what critical knowledge gaps remain, regarding existing and possible future risks of harmful infectious agents emerging from thawing permafrost and melting ice in the Arctic region. The workshop examined case studies such as the specific case of Arctic region anthrax outbreaks, as a known, observed risk as well as other types of human and animal microbial health risks that have been discovered in snow, ice, or permafrost environments, or that could conceivably exist. The workshop primarily addressed two sources of emerging infectious diseases in the arctic: (1) new diseases likely to emerge in the Arctic as a result of climate change (such as vector-borne diseases) and (2) ancient and endemic diseases likely to emerge in the Arctic specifically as a result of permafrost thaw. Participants also considered key research that could advance knowledge including critical tools for improving observations, and surveillance to advance understanding of these risks, and to facilitate and implement effective early warning systems. Lessons learned from efforts to address emerging or re-emerging microbial threats elsewhere in the world were also discussed. This publication summarizes the presentation and discussion of the workshop.

Fungal diseases have contributed to death and disability in humans, triggered global wildlife extinctions and population declines, devastated agricultural crops, and altered forest ecosystem dynamics. Despite the extensive influence of fungi on health and economic well-being, the threats posed by emerging fungal pathogens to life on Earth are often underappreciated and poorly understood. On December 14 and 15, 2010, the IOM's Forum on Microbial Threats hosted a public workshop to explore the scientific and policy dimensions associated with the causes and consequences of emerging fungal diseases.

The emergence of HIV disease and AIDS, the reemergence of tuberculosis, and the increased opportunity for disease spread through international travel demonstrate the critical importance of global vigilance for infectious diseases. This volume highlights risk factors for the emergence of microbial threats to health, warns against complacency in public health, and promotes early prevention as a cost-effective and crucial strategy for maintaining public health in the United States and worldwide. The volume identifies infectious disease threats posed by bacteria and viruses, as well as protozoans, helminths, and fungi. Rich in information, it includes a historical perspective on infectious disease, with focuses on Lyme disease, peptic ulcer, malaria, dengue, and recent increases in tuberculosis. The panel discusses how "new" diseases arise and how "old" ones resurge and considers the roles of human demographics and behavior, technology and industry, economic development and land use, international travel and commerce, microbial adaptation and change, and breakdown of public health measures in changing patterns of infectious disease. Also included are discussions and recommendations on disease surveillance; vaccine, drug, and pesticide development; vector control; public education and behavioral change; research and training; and strengthening of the U.S. public health system. This volume will be of immediate interest to scientists specializing in all areas of infectious diseases and microbiology, healthy policy specialists, public health officials, physicians, and medical faculty and students, as well as anyone interested in how their health can be threatened by infectious diseases.

In the past half century, deadly disease outbreaks caused by novel viruses of animal origin - Nipah virus in Malaysia, Hendra virus in Australia, Hantavirus in the United States, Ebola virus in Africa, along with HIV (human immunodeficiency virus), several influenza subtypes, and the SARS (sudden acute respiratory syndrome) and MERS (Middle East respiratory syndrome) coronaviruses - have underscored the urgency of understanding factors influencing viral disease emergence and spread. Emerging Viral Diseases is the summary of a public workshop hosted in March 2014 to examine factors driving the appearance, establishment, and spread of emerging, re-emerging and novel viral diseases; the global health and economic impacts of recently emerging and novel viral diseases in humans; and the scientific and policy approaches to improving domestic and international capacity to detect and respond to global outbreaks of infectious disease. This report is a record of the presentations and discussion of the event.