And while short-term risk for epidemics after geophysical disasters may be low (9), long-term effects of ecologic change on disease emergence, aptly shown in the exaggerated size of viruses (e.g., HIV), are huge. Rockman's meticulously drawn mutants, alluding to genetic engineering or environmental pollution, also articulate dilemmas inherent in disease control: because of microbes' evolutionary potential, our very drugs or pesticides, may contribute to selection of mutations, adaptations, and migrations that enable pathogens to proliferate and nonpathogens to become virulent. Manifest or not, the destiny of humans, animals, and the natural environment is inextricably interlinked. Influenza in Refugees on the Thailand–Myanmar Border, May–October 2009 We describe the epidemiology of influenza virus infections in refugees in a camp in rural Southeast Asia during May–October 2009, the first 6 months after identification of pandemic (H1N1) 2009 in Thailand. Influenza A viruses were detected in 20% of patients who had influenza-like illness and in 23% of those who had clinical pneumonia. Seasonal influenza A (H1N1) was the predominant virus circulating during weeks 26–33 (June 25–August 29) and was subsequently replaced by the pandemic strain. A review of passive surveillance for acute respiratory infection did not show an increase in acute respiratory tract infection incidence associated with the arrival of pandemic (H1N1) 2009 in the camp. We describe the epidemiology of infl uenza virus infections in refugees in a camp in rural Southeast Asia during May-October 2009, the fi rst 6 months after identifi cation of pandemic (H1N1) 2009 in Thailand. Infl uenza A viruses were detected in 20% of patients who had infl uenza-like illness and in 23% of those who had clinical pneumonia. Seasonal infl uenza A (H1N1) was the predominant virus circulating during weeks 26-33 (June 25-August 29) and was subsequently replaced by the pandemic strain. A review of passive surveillance for acute respiratory infection did not show an increase in acute respiratory tract infection incidence associated with the arrival of pandemic (H1N1) 2009 in the camp. P andemic (H1N1) 2009 emerged in April 2009 and subsequently spread around the globe. The World Health Organization issued a pandemic declaration on June 11, 2009 (1,2). By October 25, 2009 , >440,000 laboratory-confi rmed cases, including >5,700 deaths, had been reported to WHO (3) . The fi rst case of pandemic (H1N1) 2009 infection was diagnosed in Thailand on April 28, 2009 , and subsequently the virus was detected in all provinces. The Thailand Ministry of Public Health reported 27,639 confi rmed cases and 170 deaths as of October 10, 2009 (4) . Myanmar (Burma) reported its fi rst confi rmed case of pandemic (H1N1) 2009 infection during the week beginning July 5, 2009 , and by the end of October 2009 had reported <100 confi rmed cases with no deaths (5) . Although most infections caused by this new virus have been mild, severe disease has been reported, particularly in young adults (6) .