Camp Butler was plagued pneumonia, cholera, smallpox, dysentery, malaria] and other diseases spurred by close contact, poor nutrition, and inadequate clothing and housing.

Rapid spread of plague pneumonia, which is often fatal if not treated with appropriate antibiotics within 24 hours of symptoms, could be prevented by immediate use of surgical masks.

Says Allan Barnes, a research biologist who directs the plague laboratory at the federal Centers for Disease Control (CDC) in Fort Collins, Colo.: "We still worry about a plague pneumonia epidemic, even though the last time that happened in this country was 1924."

In the meantime, we should adapt public health lessons learned from preparedness for other respiratory illnesses that can spread from person to person, like smallpox, plague pneumonia, SARS and human influenza, as we plan for avian influenza as a possible cause for a future global influenza crisis like that of 1918.