There are many aspects of coral disease that are poorly understood. The rel
ationship, if any, between human activities and the incidence of coral dise
ase is particularly important since it is frequently assumed that the numbe
r and prevalence of diseases are increasing, and are indicative of a genera
l decline in the marine environment. Certainly a good understanding of thes
e issues would assist in the conservation of coral reefs by identifying tar
gets for mitigating management programmes. In situ observations of coral di
sease and associated mortality were therefore compiled from more than 150 s
ources, and reviewed. Although there have been cases where disease has caus
ed major changes in the composition and structure of reefs, most notably in
the Caribbean, these are exceptions when compared to the number of locatio
ns at which disease has been observed. With the exception of white-band dis
ease, most frequently observed diseases do not appear to be specific in the
ir host requirements, affecting species in many different genera. The overw
helming majority of disease in the Caribbean (97% of locations) has been re
corded from coral reefs where human activities are expected to have medium
to high impacts. Regional scale patterns in the incidence of coral disease
may therefore be suitable bio-indicators of disturbance to coral reefs. Thi
s potential relationship should be investigated further with a view to usin
g patterns of disease to monitor specific sources of stress on reefs. (C) 2
000 Elsevier Science Ltd. All rights reserved.