A recent episode in Brescia is the latest of several outbreaks of viral gastroenteritis in Italy. The following background information is abstracted from GIDEON:

Primary references are available on request.

Prevalence surveys:
Adenoviruses account for 7% of pediatric hospitalizations in Rome for diarrhea, Rotavirus 18.2%, Astrovirus 1% (1987 to 1989)
Adenoviruses account for 17.6% of pediatric hospitalizations in Rome for diarrhea, Rotavirus 26.7%, non-polio Enteroviruses 8.5%, Coronaviruses 1.8%, Parvoviruses 0.9% (1985 publication)
Adenoviruses account for 6% of pediatric hospitalizations in Sicily for diarrhea, Rotavirus 25.1%, Astrovirus 7%, Norovirus 18.6% (2003)
Adenoviruses are found in 6.2% of pediatric patients with acute diarrhea (2005)
Noroviruses account for 10.4% of hospitalized pediatric gastroenteritis cases in northern Italy (2002)
Noroviruses were the most frequently involved viruses (23.7%) in sporadic acute diarrhea among hospitalized children and were more common in children >5 years (37%) than in children <5 years (10%). The frequency of Rotavirus, enteric Adenovirus and Astrovirus was 12.2%, 1.6% and 2.4%, respectively. (Brescia, 2007 publication)
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Historical:
Tick-borne relapsing fever was first described in the United States in 1915 (Colorado).
- The first case of louse-borne infection in the United States during the twentieth century was reported in 1976 – imported from Ethiopia.

Time and Place:
Peak incidence is reported during the summer, with 47% of cases from July to August.
- The disease is most common in Arizona, California, Colorado and Oregon.
- Sporadic cases are reported from Idaho, Kansas, Montana, Nebraska, New Mexico, Oklahoma, Texas, Utah, Washington and Wyoming.
- Most cases occur in the Cascade, Rocky Mountain, San Bernadino and Sierra Nevada ranges.
- 40% of cases occur in tourists to endemic areas (1977 to 2000).
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A recent outbreak in Dulovo belies the fact that measles rates in Bulgaria and surrounding countries have decreased considerably in recent decades. See graph:

We may assume that decreasing rates are the result of excellent vaccine coverage, which currently exceeds 90% for all countries in the region. See graph:
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ProMED quoted GIDEON in this post:

there were at least 10 human cases in the Volga delta between
1963 & 1968, and that human seropositivity rates of up to 8 percent
were found in European Russia & Western Siberia (see ProMED post West
Nile virus - former Soviet Union: background 20060908.2548)

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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Just as the kangaroo is largely limited to Australia, a number of mosquito-borne viral infections are found almost exclusively in this country. In the following graph, I’ve contrasted reporting rates for six of these diseases. Sporadic infection by six additional viruses are also encountered in Australia: Sindbis, Stratford, Edge Hill, Gan Gan, Kokobara and Trubanaman.

Update: Reported in ProMED

Time and Place:
Trichinosis was first documented in China in 1918.
- Disease prevalence in Beijing was estimated at 0.3% in 1918 and 0.16% in 1919.
- The principal foci of trichinosis are located in the southeast, center and northeast.
- As of 1999, 17 or the country’s provinces and autonomous regions report the disease.
- 4,033 cases (73 fatal) were reported during 1964 to 1979; 5,558 in 1983; 15,599 (141 fatal) during 1980 to 1989; 5,529 (26 fatal) during 1990 to 2002.
- 88.6% of clinical cases and 99.6% of fatal cases during 1964 to 2002 were reported from Yunnan, Guangxi and Tibet.

Prevalence 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

A recent outbreak of mumps in Macedonia highlights the fact that this country has reported highest rates in this region for much of the past three decades. In the following graph I have included the United States for comparison.

Update: Picked up by ProMED

A recent outbreak in Western Visayas belies the fact that measles rates in the Philippines have declined dramatically since the 1990′s, in parallel with increased vaccination usage.

From 1983 to 1997, the Philippines had reported one of the highest measles rates in this region.

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