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Infectious disease may pose grave threats to the community, requiring public health interventions that impose some limits on basic rights. Just how severe and certain the threat must be before limits may be imposed has been the source of controversy for more than 100 years. These conflicts have been shaped by changing conceptions of the appropriate relationship between the individual and the state. In the 1980s there emerged a dictum, spawned by the encounter with AIDS, that there was no tension between public health and civil liberties, that abrogations of civil liberties inevitably hindered the protection of public health. In 2003, this looks more like a vain hope than a careful observation.