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Volume 15, Number 11—November 2009

Population Mobility, Globalization, and Antimicrobial Drug Resistance

Douglas W. MacPhersonComments to Author , Brian D. Gushulak, William B. Baine, Shukal Bala, Paul O. Gubbins, Paul Holtom, and Marisel Segarra-Newnham
Author affiliations: Migration Health Consultants Inc., Cheltenham, Ontario, Canada (D.W. MacPherson); McMaster University, Hamilton, Ontario, Canada (D.W. MacPherson); Migration Health Consultants Inc., Singapore (B.D. Gushulak); Agency for Healthcare Research and Quality, Rockville, Maryland, USA (W.B. Baine); Food and Drug Administration, Rockville (S. Bala); University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (P.O. Gubbins); Keck School of Medicine, Los Angeles, California, USA (P. Holtom); Veterans Affairs Medical Center, West Palm Beach, Florida, USA (M. Segarra-Newnham)

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Global estimates of annual migrant populations

Administrative category Population estimates and year Reference
Refugees 16 million in 2007 (18)
Asylum seekers or refugee claimants 650,000 in 2007 (18)
Internally displaced persons 51 million in 2007, includes those displaced by natural disasters and conflict (18)
Temporary (recreational or business travel) movement 924 million in 2008 (19)
Regular immigrants Annual flow of 2.4 million, reported in 2005 (from a stock of 200 million immigrants worldwide) (20)
International students 2.1 million in 2003 (21)
Migrant workers 81–86 million in 2005 (22)
Trafficked (across international borders) persons Estimated 800,000 in 2006 (23)
Domestic arrivals, by air Estimated 900 million in 2007 (24)

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  1. Centers for Disease Control and Prevention. 150th anniversary of John Snow and the pump handle. MMWR Morb Mortal Wkly Rep. 2004;53:783.
  2. Thompson  T, Sobsey  M, Bartram  J. Providing clean water, keeping water clean: an integrated approach. Int J Environ Health Res. 2003;13(Suppl 1):S8994. DOIPubMed
  3. World Health Organization. Immunization service delivery and accelerated disease control. New vaccines and technologies [cited 2009 Jun 8]. Available from
  4. Institute of Medicine. Emerging infections: microbial threats to health in the United States. In: Joshua Lederberg, Robert E. Shope, and Stanley C. Oaks, Jr., editors. Washington: The National Academies Press; 1992.
  5. World Health Organization. World health report 2007: a safer future. Global public health security in the 21st century [cited 2009 Jun 8]. Available from
  6. Tenover  FC. Mechanisms of antimicrobial resistance in bacteria. Am J Infect Control. 2006;34(Suppl 1):S3–10; discussion S64–73.
  7. Andini  N, Nash  KA. Intrinsic macrolide resistance in Mycobacterium tuberculosis complex is inducible. Antimicrob Agents Chemother. 2006;50:25602. DOIPubMed
  8. Gagneux  S, Burgos  MV, DeRiemer  K, Encisco  A, Munoz  S, Hopewell  PC, Impact of bacterial genetics on the transmission of isonizid-resistant Mycobacterium tuberculosis. PloS Pathology. 2006; 2:e61. Epub 2006 Jun 16.
  9. Kuritzkes  DR. Report from the XV International HIV Drug Resistance Workshop. AIDS Clin Care. 2006;18:834.PubMed
  10. Monto  AS, McKimm-Breschkin  JL, Macken  C, Hampson  AW, Hay  A, Klimov  A, Detection of influenza viruses resistant to neuraminidase inhibitors in global surveillance during the first 3 years of their use. Antimicrob Agents Chemother. 2006;50:2395402. DOIPubMed
  11. Schunk  M, Kumma  WP, Miranda  IB, Osman  ME, Roewer  S, Alano  A, High prevalence of drug-resistance mutations in Plasmodium falciparum and Plasmodium vivax in southern Ethiopia. Malar J. 2006;5:54. DOIPubMed
  12. Xiao  JC, Xie  LF, Fang  SL, Gao  MY, Zhu  Y, Song  LY, Symbiosis of Mycoplasma hominis in Trichomonas vaginalis may link metronidazole resistance in vitro. Parasitol Res. 2006;100:12330. DOIPubMed
  13. Katiyar  S, Pfaller  M, Edlind  T. Candida albicans and Candida glabrata clinical isolates exhibiting reduced echinocandin susceptibility. Antimicrob Agents Chemother. 2006;50:28924. DOIPubMed
  14. Mentel  M, Spirek  M, Jorck-Ramberg  D, Piskur  J. Transfer of genetic material between pathogenic and food-borne yeasts. Appl Environ Microbiol. 2006;72:51225. DOIPubMed
  15. MacDougall  C, Powell  JP, Johnson  CK, Edmond  MB, Polk  RE. Hospital and community fluoroquinolone use and resistance in Staphylococcus aureus and Escherichia coli in 17 US hospitals. Clin Infect Dis. 2005;41:43540. DOIPubMed
  16. Chee-Sanford  JC, Mackie  RI, Koike  S, Krapac  IG, Lin  YF, Yannarell  AC, Fate and transport of antibiotic residues and antibiotic resistance genes following land application of manure waste. J Environ Qual. 2009;38:1086108. DOIPubMed
  17. Nagulapally  SR, Ahmad  A, Henry  A, Marchin  GL, Zurek  L, Bhandari  A. Occurrence of ciprofloxacin-, trimethoprim–sulfamethoxazole-, and vancomycin-resistant bacteria in a municipal wastewater treatment plant. Water Environ Res. 2009;81:8290. DOIPubMed
  18. United Nations High Commission for Refugees. 2007 global trends: refugees, asylum-seekers, returnees, internally displaced and stateless persons. Statistics, 17 June 2008 [cited 2009 Jun 8]. Available from
  19. United Nations World Tourism Organization. UNWTO world tourism barometer [cited 2009 Jun 8]. Available from
  20. United Nations. International migration 2006. New York: The Nations [cited 2009 Jun 8]. Available from
  21. Böhm  A, Folari  M, Hewett  A, Jones  S, Kemp  N, Meares  D, Vision 2020—forecasting international student mobility, a UK perspective, 2004 [cited 2009 Jun 8]. Available from
  22. International Labour Organization. Towards a fair deal for migrant workers in the global economy. International Labour Conference, 92nd Session, 2004. Report VI [cited 2009 Jun 8]. Available from
  23. US Department of State. Trafficking in persons report, June 4, 2008 [cited 2009 Jun 8]. Available from
  24. International Air Transportation Association. Fact sheet: IATA–International Air Transport Association [cited 2009 Jun 8]. Available from
  25. Chan  CW, Lynch  E, Spathis  R, Hombhanje  FW, Kaneko  A, Garruto  RM, Flashback to the 1960s: utility of archived sera to explore the origin and evolution of Plasmodium falciparum chloroquine resistance in the Pacific. Acta Trop. 2006;99:1522. DOIPubMed
  26. Klein  S, Bosman  A. Completeness of malaria notification in the Netherlands 1995–2003 assessed by capture-recapture method. Euro Surveill. 2005;10:2446.PubMed
  27. Skarbinski  J, Eliades  MJ, Causer  LM, Barber  AM, Mali  S, Nguyen-Dinh  P, Malaria surveillance—United States, 2004. MMWR Surveill Summ. 2006;55(SS04):2337.PubMed
  28. MacPherson  DW, Gushulak  BD. Balancing prevention and screening among international migrants with tuberculosis: population mobility as the major epidemiological influence in low-incidence nations. Public Health. 2006;120:71223. DOIPubMed
  29. Centers for Disease Control and Prevention. Trends in tuberculosis—United States, 2005. MMWR Morb Mortal Wkly Rep. 2006;55:305–8 [cited 2009 Jun 8]. Available from
  30. Public Health Agency of Canada. Drug-resistant tuberculosis among the foreign-born in Canada [cited 2009 Jun 8]. Available from
  31. Falzon  D, Desenclos  JC. World TB Day: European countries report over 400,000 tuberculosis cases in 2004. Euro Surveill. 2006;11 [cited 2009 Jun 8]. Available from
  32. World Health Organization. Anti-tuberculosis drug resistance in the world. Report No. 3 [cited 2009 Jun 8]. Available from
  33. World Health Organization. Addressing the threat of tuberculosis caused by extensively drug-resistant Mycobacterium tuberculosis. Wkly Epidemiol Rec. 2006;81:386–90 [cited 2009 Jun 8]. Available from
  34. Committee on Homeland Security. The 2007 XDR TB incident—a breakdown at the intersection of Homeland Security and Public Health. September 2007 [cited 2009 Jun 8]. Available from
  35. Reinert  RR, Jacobs  MR, Appelbaum  PC, Bajaksouzian  S, Cordeiro  S, van der Linden  M, Relationship between the original multiply resistant South African isolates of Streptococcus pneumoniae from 1977 to 1978 and contemporary international resistant clones. J Clin Microbiol. 2005;43:603541. DOIPubMed
  36. Sutrisna  A, Soebjakto  O, Wignall  FS, Kaul  S, Limnios  EA, Ray  S, Increasing resistance to ciprofloxacin and other antibiotics in Neisseria gonorrhoeae from East Java and Papua, Indonesia, in 2004—implications for treatment. Int J STD AIDS. 2006;17:8102. DOIPubMed
  37. Centers for Disease Control and Prevention. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae among men who have sex with men—United States, 2003, and revised recommendations for gonorrhea treatment, 2004. MMWR Morb Mortal Wkly Rep. 2004;53:3358.PubMed
  38. Maurer  LH, Sneider  TJ. Gonococcal urethritis in males in Vietnam: three penicillin regimens and one tetracycline regimen. JAMA. 1969;207:9468. DOIPubMed
  39. Researchers report HIV and STD statistics from Vietnam. AIDS Wkly. 2000;20:212.
  40. Centers for Disease Control and Prevention. Decreased susceptibility of Neisseria gonorrhoeae to fluoroquinolones—Ohio and Hawaii, 1992–1994. MMWR Morb Mortal Wkly Rep. 1994;43:3257.PubMed

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Page created: December 09, 2010
Page updated: December 09, 2010
Page reviewed: December 09, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.