The Pacific Northwest is closely connected with East Asia and the Pacific Rim through trade, transport, travel, and immigration. Integration of Pacific Rim economies is increasing as U.S. companies develop new markets in Asia and locate manufacturing facilities abroad, and as Asian companies operate in U.S. markets. Washington generates more revenue from trade with Asia than does any other state, and the ports of Seattle and Tacoma together handle the second largest volume of container shipping in the United States. Also, the region's population has changed in the past two decades. Since the end of the Vietnam conflict we have received tens of thousands of immigrants from Southeast Asia and smaller numbers from elsewhere in Asia, Africa, and Latin America.
Routes of transmission are important in the risk of new infection.
Thus, this article addresses the risk of disease emergence through the importation and circulation of new disease carried in by human hosts, inadvertent importation of vectors, and effects of regional economic and social development. First, we review diseases that have already emerged or re-emerged in the Northwest. Then we consider the potential risk from those still far from our borders. A known or previously identified pathogen or syndrome that is increasing in incidence, expanding into new geographic areas, affecting new population groups, or threatening to increase in the near future . The Northwest is experiencing rapid urban growth, especially in the Puget Sound region.