It is easy, in light of the historical record, to believe that migration-caused health disasters are a thing of the past. There are, after all, few if any hermetically remote populations left on earth; and as we have seen, from Rome and China in the second century A.D. to the Pacific in the eighteenth and nineteenth centuries - as well as parts of South America in the twentieth century - virgin-soil conditions were the seedbeds of the great disease holocausts.

The problem, however, is much more complex. In addition to the fact that immigrants to many parts of the world suffer greatly increased incidences of coronary heart disease and various forms of cancer - as, for example, Japanese immigrants to the United States (Waterhouse et al. 1976; Robertson et al. 1977) - there is the ongoing tragedy of the acquired immune deficiency syndrome (AIDS), which should be sufficient to quell undue optimism. It is far from impossible, as Joshua Lederberg (1988) has noted, that the AIDS viruses will continue to mutate, perhaps even, in his words, "learning the tricks of airborne transmission," and, as he says, "it is hard to imagine a worse threat to humanity than an airborne variant of AIDS."

Of course, that may not - indeed, probably will not - happen. But it may. Even if it does not, the great ease of human mobility and migration, along with the ability of our worst diseases to sustain themselves, ensures that - with or without virgin-soil populations in the traditional sense - we have not seen the last mobility-caused infectious catastrophe.

David E. Stannard

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