An epidemic is an outbreak of a disease among members of a specific population that exceeds the extent of occurrence of the disease normally found in that population. Epidemics affect those members of the population who do not have an acquired or inherent immunity to the disease. Although most epidemics are caused by infectious organisms, the term can be applied to an outbreak of any chronic disease, such as lung cancer or heartdisease
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It depends upon what type of illness is spreading in the epidemic since they all would potentially be caused by different pathogens and, therefore, spread differently. It is the same way in an epidemic as in a local outbreak, just more people in a broader geographical area are involved to make it an epidemic.
Infectious organisms on/in people get in contact with other people and the infection is passed. Contact with others on an international basis is becoming more and more a regular part of daily life with widespread world and local travel for work and pleasure. Any passenger who arrives could be carrying disease-causing organisms that can be passed to others. Most bacteria and viruses are transmitted in public through coughs, sneezes and direct touching body to body/hand to hand or touching a surface someone with germs has touched.
Proper hygiene in public to protect yourself and others is essential. See the related questions for more detail about how diseases are spread and how to prevent that, plus how to wash your hands to remove germs.