Rates of pertussis in Colombia and neighboring countries have remained low since 1990, in parallel with increasing regional vaccine uptake [1-3] – see graph.

References:
1. Berger SA. Infectious Diseases of Colombia, 2012. 424 pages, 94 graphs, 1,483 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-colombia/
2. Berger SA. Pertussis: Global Status, 2012. 340 pages, 506 graphs, 401 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/pertussis-global-status/
3. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Recent warnings concerning a possible outbreak of yellow fever in Nigeria are well taken. During 1989 to 1993, this country accounted for 90.8% of total cases reported worldwide. See graph [1,2] :

References:
1. Berger SA. Yellow fever: Global Status, 2012. 141 pages, 124 graphs, 606 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/yellow-fever-global-status/
2. Berger SA. Infectious Diseeases of Nigeria, 2012. 425 pages, 61 graphs, 2,100 references. http://www.gideononline.com/ebooks/country/infectious-diseases-of-nigeria/

Malaria rates in Turkey are not dissimilar from those reported in the United States during the 1930′s and 1940′s. The risk for importation of malaria from Syria into Turkey is minimal, given recent disease trends in the two countries (see graph) [1-3]

References:
1. Berger SA. Infectious Diseases of Turkey, 2012. 435 pages, 99 graphs, 2407 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-turkey/
2. Berger SA. Malaria: Global Status, 2012. 398 pages, 537 graphs, 2128 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/malaria-global-status/
3. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Although French tourists might well be concerned regarding travel to some areas of the United States, American tourists in France are at higher risk for acquring Hantavirus infection – see graph [1-4]

In fact. there have been Europe accounted for 8 of the 13 published travel-related episodes of Hantavirus infection, and the Americas region for only 5 episodes:

Travel-related Hantavirus Infections from Europe:
1999 – A Belgian national acquired HFRS (nonfatal) while camping in France.
2002 – Hantavirus infection was reported among British military personnel in Slovenia.
2002 – An Italian traveler acquired HFRS (nonfatal) in Central Europe.
2003 – A Spanish trucker acquired HFRS (nonfatal) in Central Europe.
2005 – A Swedish traveler acquired HFRS (nonfatal) in Croatia.
2006 – A German traveler acquired HFRS (nonfatal) in Serbia.
2011 (publication year) – Two Czech nationals acquired hantavirus infection during a stay in a mountain hut in northern Slovakia.
2012 – A German tourist in Ireland was found to have Hantavirus infection.

Travel-related Hantavirus Infections from the Americas:
1998 (publication year) – A patient in Chile died of Hantavirus pulmonary syndrome acquired in Bolivia.
2001 – A French tourist acquired Hantavirus pulmonary syndrome (nonfatal) in Chile.
2002 – An imported case of Hantavirus pulmonary syndrome (Andes virus, nonfatal) from Chile was reported in the United States.
2006 – A patient in Canada died of Hantavirus pulmonary syndrome acquired in Bolivia.
2008 – An English tourist died in Chile of presumed Hantavirus infection acquired in Argentina.

References:
1. Berger SA. Infectious Diseases of France, 2012. 731 pages, 289 graphs, 2760 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-france/
2. Berger SA. Old-World Hantaviruses: Global Status, 2012. 64 pages, 49 graphs, 641 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/old-world-hantaviruses-global-status/
3/ Berger SA. Hantavirus Pulmonary Syndrome: Global Status, 2012. 30 pages, 16 graphs, 463 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hantavirus-pulmonary-syndrome-global-status/
4. Gideon Graph Tool, see tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

The following background data regarding cutaneous leishmaniasis in Israel are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Time and Place:
- Cutaneous leishmaniasis is endemic to the Jordan Valley, Dead Sea shore, central Negev, and Sinai border.
– Cutaneous leishmaniasis has been a reportable disease since 1956.
– Rates increased after the Six-day war of 1967, following acquisition of Judea and Samaria.
– Highest rates are encountered during June to October.
– Emerging foci have been identified in the areas of Nizzana (western Negev) and Yerucham. Nizzana accounts for 55% of cases among military personnel. (1996 to 2006)
– Fifteen cases of cutaneous leishmaniasis due to Leishmania major were reported from Sde Eliyahu (Beit She’an Valley) in 2007; 99 cases during 2008 to 2011.
- Increasing rates of leishmaniasis were reported in northern Israel during 1999 to 2003 (62.5 per 100,000 in Tiberias in 2003).
– Rates among military personnel were 0.11 per 100,000 in 2002, increasing to 196 per 100,000 in 2006
– 371 cases were reported from a university clinic in Jerusalem during 1988 to 1992.
– Four deaths were ascribed to cutaneous leishmaniasis during 1954 to 2003 – one in 1955 and three in 1958.

Rates of cutaneous leishmaniasis in the two countries which comprise historic palestine (Israel and Jordan) have been strikingly similar since 1991 – see graph [3] :

Agents:
- Most cases are due to Leishmania major, with sporadic infections by L. tropica.
- 33 cases of Leishmania tropica infection were documented in Tiberias and four nearby villages during 1996 to 2002.
- 161 cases of Leishmania tropica infection were reported in the Jerusalem district during 2004 to 2005, including 127 in Ma’ale Adumim.
- 72 cases of Leishmania major infection were reported from rural areas near Beit She’an during 2006 to 2008.

Reservoirs:
- The local reservoirs are Psammomys obesus (Jordan Valley, Arava and southern Israel) and Meriones crassus (western Negev).
- The hyrax (Procavia capensis) is a proven reservoir in northern Galilee, including areas of Leishmania tropica adjacent to the Sea of Galilee.
- Voles (Microtus guentheri) in Sde Eliyahu (Beit She’an region) are infected by Leishmania major.
- Sporadic infection has also been documented in gerbils (Gerbillus dasyurus).
- Leishmanial DNA has also been identified in Gerbillus dasyurus.

Prevalence surveys:
58% of rock hyraxes (Procavia capensis) in Ma’ale Adumim (PCR, 2010 publication) 14
19% of rock hyraxes (Procavia capensis, 2008 to 2010)
49% of Psammomys obesus, 43% of Meriones crassus, 33% of Paraechinus aethiopicus, 3% of Gerbillus dasyurus, 23% of Erinaceus concolor and 14% of Meriones tristami (2008 to 2011)
7.8% of golden jackals (Canis aureus) and 8% of red foxes Vulpes vulpes) (Leishmania tropica, 2010 publication)
18% of Phlebotomus papatasi sand flies and 16.5% of voles (Microtus guentheri in Sde Eliyahu (Beit She’an Valley, 2011 publication)

Vectors:
- The local vectors are Phlebotomus papatasi (for Leishmania major) and Ph. (Paraphlebotomus) sergenti(for Leishmania tropica).
- Ph. (Adlerius) arabicus is a proven vector of Leishmania tropica in the Northern Galilee.
- Ph. sergenti is implicated in transmission of L. tropica in the area of Tiberias; Ph. arabicus in the area of Karzim, Karkom and Amhun.
- Species found in the Judean Desert include Ph. (Paraphlebotomus) sergenti, Ph. papatasi, Ph. syriacus and Ph. Tobbi

Notable outbreaks:
1994 – An outbreak (32 cases) was reported in Yerucham.
2009 (publication year) – An outbreak of Leishmania tropica and Leishmania major infections was reported in Kfar Adumim (Jerusalem region).

Notes regarding the West Bank and Gaza – see graph:

– 28 cases of L. tropica infection were confirmed in Jericho during 1997 to 2002, accounting for 48.5% of cutaneous leishmaniasis.
– 466 cases of cutaneous leishmaniasis were reported in Jenin District during 2002 to 2009 (23 per 100,000 per year) – 93.6% due to Leishmania tropica 21 and 6.4% Leishmania major. Cases of cutaneous infection by Leishmania infantum were also identified.
– 26.3% of persons in the vicinity of Jericho are seropositive.
– The principal vectors in the West Bank (Jenin) region are Phlebotomus papatasi (for Leishmania major) and Ph. Sergenti (L. tropica).

References:
1. Berger SA. Infectious Diseases of Israel, 2012. 519 pages, 223 graphs, 1982 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-israel/
2. Berger SA. Cutaneous and Mucosal Leishmaniasis: Global Status, 2012. 106 pages, 92 graphs, 837 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/cutaneous-and-mucosal-leishmaniasis-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

The following review of Campylobacter infection in New Zealand is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] Primary references are available on request

Campylobacter infection is the most common reportable cause of bacterial diarrhea in New Zealand.. In fact, the incidence of campylobacteriosis exceeds that of any other reportable disease in New Zealand, accounting for 42.5% of all notified cases of infectious disease in 2010 (see graph [3] )

Rates of campylobacteriosis in New Zealand exceed those of the other major English-speaking countries (see graph 3] )

Time and Place:
– Highest rates are reported during late spring and early summer (November to January).
- Rates on South Island are correlated with lower socio-economic level, proportion of persons ages 25 to 44 and density of fresh food outlets.
- The Far North and much of the rural North Island report relatively low disease incidence during summer, with minimal inter-seasonal variation.
- A higher summer incidence and more seasonality variation is found in some North Island cities (Auckland, Hamilton, Napier) and some area of the South Island.
- The highest summer incidence and inter-seasonal variation is reported in Christchurch, Dunedin, much of the South Island, Wellington and Upper Hutt.

Graph Notes:
– Disease incidence varied from 1,915 cases in 1984, to 15,873 in 2006.
– Decreasing disease rates after 2007 were ascribed to disease control among poultry. – 17 fatal cases were reported during 1997 to 2011 – including 5 in 2002.
– 2,056 patients were hospitalized for Guillain-Barre syndrome (GBS, often associated with Campylobacteriosis) during 1988 to 2010.
- During this period, rates of GBS declined by a factor of 13%, following control of campylobacteriosis in poultry.
– During 1997 to 2011, between 10 outbreaks (1997) and 57 outbreaks (1999) have been registered per year.

Prevalence surveys:
6.8% of dairy calves (Campylobacter jejuni, Manawatu region, 2002)
44.8% of broiler chicken carcasses (2008 publication)
89% of domestic backyard chicken flocks in Canterbury (2011 publication)
0.34% of raw milk samples (2012 publication)
85% of surface water samples in Canterbury (2009 publication)

Seroprevalence surveys:
48% of ewes (Campylobacter fetus fetus, 2006 to 2009)

Notable outbreaks:
1987 (publication year) – An outbreak (19 cases) of campylobacteriosis in Christchurch was related to contamination of the water supply.
1990 – An outbreak (44 cases) of Campylobacter enteritis occurred at a camp near Christchurch.
1997 (publication year) – An outbreak (19 cases) was related to contamination of a town water supply.
1990 – An outbreak (99 cases) of Campylobacter enteritis occurred at a camp near Christchurch – drinking water was identified as the source.
2005 (publication year) – An outbreak (3 cases) in Christchurch was associated with consumption of pre-cooked sausages.
2006 – An outbreak (100,000 cases estimated) was associated with contaminated chicken.

References:
1. Berger SA. Infectious Diseases of New Zealand, 2012. 413 pages, 136 graphs, 1534 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-new-zealand/
2. Berger SA. Campylobacteriosis: Global Status, 2012. 96 pages, 95 graphs, 823 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/campylobacteriosis-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Following a steady decline that began ten years ago, the incidence of West Nile fever in both humans and animals has remained relatively low during the past two years. [1-3] See graph. It will be interesting to see whether these trends will continue through 2012.

References:
1. Berger SA. Infectious Diseases of the United States, 2012. 1089 pages, 467 graphs, 9760 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. West Nile fever: Global Status, 2012. 60 pages, 27 graphs, 880 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/west-nile-fever-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Since 1999, there has been a striking parallel among rates of reportable tick-borne diseases in the United States – see graph (Lyme disease expressed as cases per 100,000 for fit). [1,2]

References:
1. Berger SA. Infectious Diseases of the United States, 2012. 1089 pages, 467 graphs, 9760 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Although the incidence of sexually-transmitted disease in Australia has fluctuated widely during the past ninety years, syphilis rates have changed little – see graph. [1-3]

Note that rates of granuloma inguinale in Australia are among the highest in the world, similar to those encountered in the United States sixty years ago – see graph.

References:
1. Berger SA. Infectious Diseases of Australia, 2012. 519 pages, 161 graphs, 2950 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-australia/
2. Berger SA. Less-Common Venereal Diseases: Global Status, 2012. 68 pages, 65 graphs, 323 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/less-common-venereal-diseases-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

The following background data are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] Primary references available on request.

Time and Place:
Although sporadic cases of Hantavirus infection have been reported in Germany since 1983, the disease became officially reportable only in 2001.
- During 2005 to 2007, highest rates were reported in Baden-Wuerttemberg, Bavaria, North Rhine Westphalia, and Lower Saxony.
- During 2001 to 2006, rates in Baden Wurttemberg were 0.55 to 1.12 per 100,000, as compared to national rates of 0.17 to 0.54 per 100,000
- Recent cases have been described in Wurzburg, Thuringia, Octenwald and Rhon.
- Risk factors for infection include occupational exposure (construction workers), residence <100 m from forested areas, and exposure to mice.
- Yearly rates are affected by bank vole habitats (beech forest, seed plants), vole food supply (beechnut mast), climate factors (winter and spring temperatures), and human population density (Baden-Wurttemberg, 2001 to 2007).

Hantavirus Infection in Germany – Incidence and rates per 100,000 (see following graph)

40 cases were reported during 1977 to 1992; 1,320 during 2001 to 2006.
– 1,487 cases were reported during 2001 to 2006, including 670 in Baden Wurttemberg.
– 853 cases were reported during October 2011 to April 2012, including 580 (68%) in Baden-Wurttemberg.
- The annual disease rate in Reutlingen is estimated at 6.5 per 100,000 (1995 to 1999).

Seroprevalence surveys:
1.83% in southern and western regions, and 0.8% in the eastern region.
0.9% of persons in Mecklenburg-Vorpommern (1994 to 1998)
6.7% of persons in Lower Bavaria, following an outbreak (2009 publication)
2.1% of forest workers in Baden Wurttemberg – 9% in Reutlingen and Tubingen (2001 publication)
8.2% of male and 15.6% of female forestry workers in Brandenburg – most toward Tula virus or Dobrava-Belgrade virus (2011 publication)
10% of hunters in Styria and Burgenland (2003 publication)
9.6% of captive monkeys in Gottingen (2006)

Import-Export:
1988 – An American soldier acquired HFRS (nonfatal) in Germany.
2006 – A German traveler acquired HFRS (nonfatal) in Serbia.
2012 – A German tourist in Ireland was found to have Hantavirus infection.

Reservoirs:
- Puumala-like antigen is found in 12.2% of red bank voles (Myodes (Clethrionomys) glareolus) – the principal reservoir. Highest reservoir rates (22%) have been recorded in Ulm.
- Apodemus agrarius (striped field mouse) has been identified as a reservoir host of the Dobrava-Belgrade virus in three federal states.
- Tula virus has been identified in the Asian water vole (Arvicola amphibius), Microtus arvalis and M. agrestis.
- The muskrat (Ondatra zibethicus) has been implicated as a disease reservoir in northwestern Brandenburg and northeastern Saxony-Anhalt.

Infecting strains:
Puumala strain predominates, but antibody toward Hantaan strain is found in the south and east.
- Three cases of infection by Dobrava virus have been confirmed in a non-endemic focus in Northern Germany.
- The local reservoir is Apodemus agrarius.
- Infection by Tula virus has been confirmed in humans and rodents (Arvicola amphibius, Microtus arvalis and M. agrestis) in the northeast.
– A syndrome suggestive of American Hantavirus Respiratory Distress syndrome has been ascribed to local viral strains in Westfahlen.

Notable outbreaks:
1990 – An outbreak (16 cases, 0 fatal) of HFRS was reported among American soldiers in Germany.
2004 – An outbreak (38 cases) of Puumala virus infections in Lower Bavaria was associated with increased populations of bank voles (Myodes (Clethrionomys) glareolus).
2005 – An outbreak (89 cases) of Puumala virus infections was reported in Cologne, including 41 cases in the city center.
2007 – An outbreak (1,687 cases) of Puumala virus infection was reported, with most cases in rural areas in Baden-Wuerttemberg.
2010 – An outbreak (2,017 cases) was reported, including 736 cases in Baden-Wurttemberg during a 6-month period.

References:
1. Berger SA. Infectious Diseases of Germany, 2012. 510 pages, 147 graphs, 2,68 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-germany/
2. Berger SA. Old-World Hantaviruses: Global Status, 2012. 64 pages, 49 graphs, 641 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/old-world-hantaviruses-global-status/