Infectious diseases vary by geographic region and population, and they change over time. Increasingly, humans are moving from one region to another, thereby becoming exposed to a variety of potential pathogens and also serving as part of the global dispersal process.1 Microbes picked up at one time and in one place may manifest in disease far away in time and place. Because many microbes have the capacity of persisting in the human host for months, years or even decades, the relevant time frame for study of exposures becomes a lifetime. Furthermore, microbes also move and change and reach humans via multiple channels.