id author title date pages extension mime words sentences flesch summary cache txt cord-022452-gyuldf4a Ostroff, Stephen M. The Spread of Disease in the 20th Century and Lessons for the 21st Century 2009-11-16 .txt text/plain 2786 158 60 Although some have suggested that this outbreak was a natural event related to movement of the organism on sea-currents, a more likely explanation is that it was introduced in ballast released from a ship traveling from a cholera-endemic area. Investigations found that the human and avian outbreaks were linked and the causative agent was identified as West Nile virus, an arbovirus never previously seen in the western hemisphere (Asnis, Conetta, Texeira, Waldman, & Sampson, 2000) . Air travel from Hong Kong caused the spread of disease to locations in Mainland China and Taiwan. The outbreak resulted in severe disruptions to the global economy, to travel, and to commerce (World Health Organization, 2003b) . Avian disease due to H5N1 has now appeared in more than 50 countries in Asia, Europe, and Africa (World Health Organization, 2006a), either killing or requiring the destruction of hundreds of millions of birds. ./cache/cord-022452-gyuldf4a.txt ./txt/cord-022452-gyuldf4a.txt