Abstract
Over the past 20 years, the continental United States has experienced unprecedented local transmission of infectious diseases which were previously only known to be travel-associated. Confirmed infections have included malaria, dengue, chikungunya, zika, and leishmaniasis. Scientific projection models predict an increasing risk of such infections in the future, particularly in southern states along the Gulf Coast. Outbreaks may reflect changes in climate conditions, infrastructural capacity, and patterns of human behavior.