On first setting foot on the moon, Neil Armstrong famously proclaimedthat he had taken "One small step for man, one giant leap formankind." With minor adjustments, he could have been referringto one of the most important distinctions between limited outbreaksof infectious diseases and the occurrence of devastating pandemics:one small step to man, one giant leap to mankind. Recent events,such as the reports of cases of avian influenza and monkeypoxin humans and the outbreak of severe acute respiratory syndrome(SARS), bring this distinction into sharp focus.
From the Departments of Medicine (M.S.K., D.S.S.), Microbiology (M.S.K.), and Pathology and Laboratory Medicine (D.S.S.), Boston University School of Medicine, Boston.
This article was published at www.nejm.org on February 25, 2004.
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