Increasing population densities and lack of access to health care will contribute to an increase in world-wide disease outbreaks in the coming years, predicts Dr. John Higginbotham, epidemiologist and associate professor of community and rural medicine in the College of Community Health Sciences at The University of Alabama.

"Population density always has been a factor for spreading disease," he says. "The more contact you have, the more likely you are that it's going to happen. In today's world you can be in California in the morning and on the East Coast in the evening and spread anything you've encountered."

In fact, that's one of the things that worried epidemiologists during the early portions of the SARS epidemic — the possibility of an airborne contaminant spread on an airplane. First reported in Asia in February, severe acute respiratory syndrome spread to more than 25 countries in North America, South America, Europe and Asia over the next few months.

"We had not planned for SARS," Higginbotham says. "The World Health Organization had begun some preliminary work on possible outbreaks as part of preparing for biological terrorism and other such outbreaks, but they really kicked into high gear when SARS cropped up and did a good job of isolating and tracking it."

And as good a job as has been done, epidemiologists have no way of knowing what will come next. Higginbotham says a great deal of progress has been made in the ability to sequence and identify viruses and other disease-causing organisms since HIV was identified in the 1980s. West Nile virus is a good example of that speed, even as the virus itself has continued to move across the United States faster than anticipated.

"New disease-causing organisms come along all the time," he says. "But knowledge is power, even with epidemics. We may not know everything about a virus or bacteria, but we can still have preventive measures out, and that's good news for the future."

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