The outbreak of cholera in Hamburg in 1892 and the epidemics of yellow fever in the Americas led to the decision to establish the International Sanitary Bureau with permanent headquarters in Washington. To a very large extent, we are still following the bureau's recommendations, only the list of pestilential diseases is shorter by one.
Cholera is far from disappearing.
There were approximately 400,000 cases in the Americas in 1991. This number fell to 18,000 in 1997, but recent reports indicate that as a result of flooding caused by El Ni o, the number of cases in Peru has increased dramatically this year. Over the past 5 years, emerging diseases have caused intense concern and activity. The growth in international travel is a major factor. Statistics from the World Tourism Organization show that some 1 million persons per day traveled from their homes by air in 1995.