gers were aged 65 and older, and 26 percent had risk factors other than age that placed them at risk for complications of influenza. Indeed 17 percent of the passengers and 19 percent of the crew members reported experiencing an acute respiratory illness during the cruise. The etiological agent was identified as influenza A/Sydney/5/97 (CDC, 1997c).


International trade in food and animal agriculture has increased markedly as an important aspect of globalization (see Figure 3-8). The United States and other countries now enjoy more goods from more countries than ever before. It is now possible to buy fresh produce at any time of the year, as well as a whole host of previously unattainable foods from areas around the world. Unfortunately, this wider array of product options brings with it the risk of cross-border transmission of infectious agents. Many species enter the United States each year as contaminants of commodities. Up to 70 percent of selected fruits and vegetables consumed in the United States come from developing countries during certain seasons (Osterholm, 1997). Agricultural produce, nursery stock, cut flowers, and timber can harbor insects, plant pathogens, slugs, and snails. Fish and shrimp pathogens and parasites have been introduced into the country through infected stock for

FIGURE 3-8 International agriculture trade, 1961–2000.

Reprinted with permission from Kimball, in Davis and Kimball, 2001.

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