In 2003, the Boston University Medical Center (BUMC) was awarded a $128 million grant from the National Institutes of Health (NIH) to build one of two national maximum-containment laboratory facilities for pathogen research. The National Emerging Infectious Diseases Laboratories (NEIDL) are meant to support the National Institute of Allergy and Infectious Diseases' biodefense research agenda, conducting research to develop new approaches to treating, preventing, and diagnosing a variety of bacterial and viral diseases. The facility includes a biosafety level 4 (BSL-4) containment laboratory housed in a 192,000 square foot building. Although the NEIDL BSL-4 laboratory accounts for only 13 percent of the building's total space, it has been the source of virtually all of the community concern surrounding this project. The location of the facility on Albany Street in Boston's South End, which is an environmental justice community, has been controversial, and there have been numerous public meetings over the plans for the facility as well as three legal actions challenging the project. Continuing Assistance to the National Institutes of Health on Preparation of Additional Risk Assessments for the Boston University NEIDL, Phase 3, the fifth in a series of reports about the proposed facility, provides further technical input on the scope and design of any additional studies that may be needed to assess the risks associated with the siting and operation of the NEIDL. This report presents comments and questions on a "90 percent", or penultimate, draft of the revised risk assessment. According to the report, the "90 percent" draft of the risk assessment is a substantial improvement over past documents reviewed. Additionally, the report makes recommendations to improve the version that is ultimately prepared for public comment.

In October 1999, the Forum on Emerging Infections of the Institute of Medicine convened a two-day workshop titled "International Aspects of Emerging Infections." Key representatives from the international community explored the forces that drive emerging infectious diseases to prominence. Representatives from the Americas, Africa, Asia and the Pacific, and Europe made formal presentations and engaged in panel discussions. Emerging Infectious Diseases from the Global to the Local Perspective includes summaries of the formal presentations and suggests an agenda for future action. The topics addressed cover a wide range of issues, including trends in the incidence of infectious diseases around the world, descriptions of the wide variety of factors that contribute to the emergence and reemergence of these diseases, efforts to coordinate surveillance activities and responses within and across borders, and the resource, research, and international needs that remain to be addressed.

During July 10-13, 2011, 68 participants from 32 countries gathered in Istanbul, Turkey for a workshop organized by the United States National Research Council on Anticipating Biosecurity Challenges of the Global Expansion of High-containment Biological Laboratories. The United States Department of State's Biosecurity Engagement Program sponsored the workshop, which was held in partnership with the Turkish Academy of Sciences. The international workshop examined biosafety and biosecurity issues related to the design, construction, maintenance, and operation of high-containment biological laboratories- equivalent to United States Centers for Disease Control and Prevention biological safety level 3 or 4 labs. Although these laboratories are needed to characterize highly dangerous human and animal pathogens, assist in disease surveillance, and produce vaccines, they are complex systems with inherent risks. Biosecurity Challenges of the Global Expansion of High-Containment Biological Laboratories summarizes the workshop discussion, which included the following topics: Technological options to meet diagnostic, research, and other goals; Laboratory construction and commissioning; Operational maintenance to provide sustainable capabilities, safety, and security; and Measures for encouraging a culture of responsible conduct. Workshop attendees described the history and current challenges they face in their individual laboratories. Speakers recounted steps they were taking to improve safety and security, from running training programs to implementing a variety of personnel reliability measures. Many also spoke about physical security, access controls, and monitoring pathogen inventories. Workshop participants also identified tensions in the field and suggested possible areas for action.

Infectious diseases remain a leading cause of prolonged illness, premature mortality, and soaring health costs. In the United States in 1995, infectious diseases were the third leading cause of death, right behind heart disease and cancer. Mortality is mounting over time, owing to HIV/AIDS, pneumonia, and septicemia, with drug resistance playing an ever-increasing role in each of these disease categories. This book, a report from a Forum on Emerging Infections workshop, focuses on product areas where returns from the market might be perceived as being too small or too complicated by other factors to compete in industrial portfolios with other demands for investment. Vaccines are quintessential examples of such products. The lessons learned fall into four areas, including what makes intersectoral collaboration a reality, the notion of a product life cycle, the implications of divergent sectoral mandates and concepts of risk, and the roles of advocacy and public education. The summary contains an examination of the Children's Vaccine Initiative and other models, an industry perspective on the emerging infections agenda, and legal and regulatory issues.

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 dieseases 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.

Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response System: A Program Review describes the capacity, quality, and effectiveness of the international and domestic facilities and programs that are a part of a DoD system to monitor and address emerging infectious diseases globally. The committee concludes that the goals of the system are in U.S. military, U.S. civilian, and global public health interests and that substantial progress has been made toward achieving system goals.

The Forum on Emerging Infections was created in 1996 in response to a request from the Centers for Disease Control and Prevention and the National Institutes of Health. The goal of the forum is to provide structured opportunities for representatives from academia, industry, professional and interest groups, and government to examine and discuss scientific and policy issues that relate to research, prevention, detection, and management of emerging infectious diseases. A critical part of this mission has been the convening of a series of workshops. Public Health Systems and Emerging Infections summarizes the fourth in a series of five workshops. With a focus on our knowledge and understanding of the role of private and public health sectors in emerging infectious disease surveillance and response, the participants explored the effects of privatization of public health laboratories and the modernization of public health care. The issues discussed included epidemiological investigation, surveillance, communication, coordination, resource allocations, and economic support.