respiratory infections 2002 First detection of Staphylococcus aureus bacteria completely resistant to vancomycin 2002 Outbreak of multidrug‐resistant Salmonella Newport in the United States 2002 Norovirus infection on cruise ships entering U.S. ports 2003 Global outbreak of severe acute respiratory syndrome (SARS) caused by a previously unknown coronavirus 2003 Identification of a new, hypervirulent strain of Clostridium difficile as the cause of hospital outbreaks of gastrointestinal illness in the United States and Canada 2003 Cases of monkeypox in the United States linked to exotic pets imported from Central Africa 2003 Re‐emergence of avian influenza A (H5N1) in Southeast Asia, and outbreaks in Africa 2005 Marburg hemorrhagic fever outbreak in Angola 2005 Identification in Sweden of a new virus, human bocavirus, among children hospitalized with acute respiratory infections 2006 Rift Valley fever outbreak in Kenya 2007 Ebola hemorrhagic fever outbreak in the Democratic Republic of the Congo 2007 Outbreak of Nipah virus encephalitis in Bangladesh 2007 First detection in Italy of mosquito‐borne transmission of chikungunya fever, previously detected only in parts of Africa and South and Southeast Asia 2007 Discovery in Thailand of a new human species of Bartonella, an insect‐borne bacteria that multiples inside red blood cells causing fever, fatigue, muscle pain, headache, and rash 2007 Hemorrhagic fever outbreak in Uganda caused by a new stain of Ebola: Bundibugyo Ebola virus 2007 Outbreak of Marburg hemorrhagic fever in Uganda 2008 Ebola‐like outbreak in Zambia due to a previously unknown virus: Lujo hemorrhagic fever virus 2008 Isolation in Australia of a new virus (transplant‐associated arenavirus related to lymphocytic choriomeningitis virus) after three recipients of liver or kidney transplants from a single donor developed febrile illness and died 2008 Increasing outbreaks and international spread of carbapenem‐resistant Enterobacteriaceae, and first detection of New Delhi metallo‐beta‐lactamase (NDM‐1), a genetic element that can confer such resistance 2009–10 Locally transmitted dengue in Florida, representing the first cases acquired in the continental United States outside the Texas–Mexico border since 1945 2009–10 Influenza pandemic caused by a new influenza strain, influenza A (H1N1) 2010 Outbreaks of cholera in Haiti 2011 Outbreak of Shiga toxin‐producing Escherichia coli O104:H4 (STEC O104:H4) infections in Germany 2011 Identification by an international team of researchers of a strain of gonorrhea (H041) resistant to all available antibiotics 2 | CDC ID Framework plan to guide national efforts to prevent and control emerging infectious threats (1). Since then, new microbes or new forms of old ones have been discovered nearly every year, and infectious disease outbreaks triggering international responses have been reported on nearly every continent (Box 1). We have recent real‐life examples of disease threats such as severe acute respiratory syndrome (SARS) and H5N1 and H1N1 influenza that emerged from animal reservoirs and clearly underscore the need and value of a “One Health” approach to disease prevention linking human, animal, and environmental health efforts. October 2011 | 3 While our changing, globalized world has provided increased opportunities for emergence and spread of infectious diseases, it has also brought significant advances for their control. Scientifically, we have a greater understanding of how microbes emerge, persist, develop resistance, and cause disease, including detailed knowledge of the molecular mechanisms that generate the endless flow of mutations and adaptations that make microbes difficult or impossible to “conquer.” In addition, new linkages between chronic diseases and infectious agents (Box 2) have been recognized, with some chronic diseases now prevented by vaccines or treated with antimicrobial drugs. Other advancements include increased opportunities for public health application of new technologies and innovations (e.g., molecular tools for diagnostics and epidemiology); health information technology (IT) tools—including electronic health records—for disease surveillance and health communications; and new vaccines and innovative approaches for preventing zoonotic and vectorborne diseases. The ID Framework takes into account many of the scientific, demographic, technological, and economic developments currently modifying efforts to protect public health, challenging us to re‐think our processes and strategies and take advantage of new ways to prevent disease and improve health. Notable trends include an increased emphasis on disease prevention as a basic, cost‐saving component of U.S. healthcare; greater individual awareness of public health issues; an aging, more susceptible population; increased public‐ and private‐sector involvement in global health efforts; and greater recognition that the U.S. public health system is a critical part of national bioterrorism preparedness and response. Today’s difficult economic environment has affected individuals, businesses, industries, and governments throughout the world. Budgetary and other constraints have, in turn, had a major impact on public health, requiring difficult decisions at the national, state, and local levels. Ensuring that these