A case imported from India into the United States is the latest in a growing list of cross-border measles episodes. The following is a chronology of notable outbreaks reported during the past decade.

1998 – An outbreak (69 cases, 2 hospitalized, 0 fatal) in Tuvalu was ascribed to introduced cases among workers from Nauru.
1998 – An outbreak (33 cases) was linked to an infected visitor arriving to Alaska, United States from Japan.
1999 – An outbreak (75 confirmed cases) in Australia was traced to an index case from Indonesia.
2000 – Outbreaks (78 cases, total) in Canada were linked to travel in Mexico (6 cases), Bolivia (19 cases) and Belgium (25 cases).
2000 – An outbreak (992 cases, or 57% of all cases for the Americas region) in Haiti was thought to originated with imported cases from the Dominican Republic.
2000 to 2001 – An outbreak (1,062 cases, 0 fatal) was reported in Tanzania among refugees from Burundi.
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Time and Place:
Most outbreaks of leptospirosis are reported in coastal regions: Gujarat, Mumbai, Kerala, Chennai and the Andaman Islands.
- High rates have been reported from Valsad district (Gujurat) for several years.
- Outbreaks of ‘Andaman hemorrhagic fever’ were first reported in 1988, and identified as leptospirosis in 1993.
- Highest rates occur during October to November.

Prevalence surveys:
22.57% of FUO in Guwahti, Assam (2008 publication)
3.2% of febrile patients and 7.0% of febrile patients with jaundice in Delhi (1966). 32 cases were confirmed in the region during 2000 to 2001.
23.81% of patients hospitalized for febrile jaundice in Kolkata.

Seroprevalence surveys:
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With reference to a recent outbreak of KFD in Karanatka, India, an effective and safe vaccine has been available for over 15 years. 88,152 persons were immunized in trials during 1990 to 1992, with no report of adverse effects. The formalin-inactivated vaccine is prepared from tissue culture, and administered at a dose of 1.0 ml sc (0.5 ml below age 6), with a booster dose after 4 weeks.

The geographic distribution of this group of viruses is not restricted to Karanatka. For example, 22.4% of persons living in the Andaman and Nicobar Islands were found to be seropositive toward KFD in 2002; and closely related agents are reported in Saudi Arabia (Alkhurma virus) and China (Nanjianyin virus).

Update: Reported in ProMED

ProMED recently quoted GIDEON in a post about Malaria in India:

According to information available on the Global Infectious Disease and Epidemiology Network (GIDEON)

Two-thirds of all cases are reported from Gujarat, Karnatka, Madhya Pradesh, Orissa, Uttar Pradesh and Punjab.
- Orissa, Assam & Maharashtra account for 80 percent of all _plasmodium falciparum_ malaria.
- Malaria is reported nationwide, including Delhi and Bombay; but not in Hichal Pradesh, Jammu & Sikkim, isolated coastal areas around Western Ghats, Andaman and Nicobar Islands. Transmission begins with the onset of the Monsoon seasonb in mid-June.
- _P. vivax_ predominates until August, with _P. falciparum_ infection rising to a peak in September.
- There is no risk for malaria at altitudes above 2000 meters.

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