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The probability of a big outbreak is low.
But there was a big outbreak in the Midwest following a very dry summer.
Participants like Dr. Ross Brechner of the Maryland State Health Department said defining a big outbreak was difficult.
A WEEK after the discovery of Britain's first big outbreak of H5N1 avian flu, on a farm in Suffolk, turkeys are still in the news.
At one point we got a call saying there might be a big outbreak in a local school – we were brought in to test everybody.
Ms Sudue says although there may be cases from time to time, she was confident a big outbreak would not happen again.
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"It hasn't, and further big outbreaks are certain".
Vaccine uptake had fallen to 30% in 1975 after health fears, and there were big outbreaks through to the 1980s.
Health problems associated with poor water quality did not materialise in the way officials had feared, and there were no big outbreaks of cholera.
She pointed out that there had been no cases in over 300 days in areas of Sierra Leone that had seen big outbreaks of disease.
Over the past 40 years, the industrialization and centralization of our food system has greatly magnified the potential for big outbreaks.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com