The infectious disease-related challenges facing the health care system are growing instead of shrinking, a situation that's underscored by a new report from the Trust for America's Health and the Robert Wood Johnson Foundation.

The report, "Outbreaks: Protecting Americans from Infectious Disease 2013," points to some familiar areas of concern where outbreaks are still occurring, including bacterial infections acquired both in and out of health care facilities, HIV/AIDS and foodborne illnesses.

But also of note are resurgent and new forms of infections. The report highlights the increasing bacterial resistance to antibiotics, something that the federal government is taking steps to prevent, through the CDC targeting human prescription and consumption of antibiotics, and through the FDA working to limit their use in livestock.

The Middle East Respiratory Syndrome has infected 165 people and killed 71 of them. While the MERS has not reached U.S. soil, it is still a concern. "Because of the frequency of travel between the United States and the Middle East, it would not be surprising if in the year ahead we had a case of MERS," said Tom Inglesby, M.D., CEO and director of the UPMC Center for Health Security and a peer reviewer of the report, at a press briefing.

Also on the government's radar is the chikungunya virus, a mosquito-borne alphavirus that had been confirmed in patients who reside in St. Martin in the Caribbean. "It probably would be a matter of time before we find that in a southern state," Inglesby said, adding that the more established virus dengue also is being watched.

And of course there are the infections that are resurging because of the anti-vaccination movement, measles and whooping cough. "More than 2 million children under the age of 3 do not receive all recommended vaccinations, leaving them vulnerable for preventable diseases," the report notes.

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