Notwitstanding a recent outbreak in Utah, infant botulism has accounted for an growing percentage of total cases in recent years. [1,2] In the following graph, I’ve summarized trends for botulism in the United States. Note that total case numbers have been increasing since 1995, despite a decrease in the incidence of food-borne botulism.

(See the Graph tool tutorial at www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Botulism: Global Status, 2011. 80 pages, 86 graphs, 510 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/botulism-global-status/

Notwithstanding a recent outbreak in Georgia, Cyclospora is the least common intestinal protozoan reported in the United States. [1] In the following chart, I have summarized the incidence of cyclosporiasis, giardiasis, amebiasis and cryptosporidiosis. As indicated at the black arrow, ongoing trends for amebiasis (no longer reported as of 1994 = 2,983 cases) were “continued” by reports of cryptosporidiosis (2,972 cases in 1995).

(outline of Gideon Graph module – see http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps)

Reference:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/

Note published in ProMED

Although Listeria monocytogenes is a relatively uncommon cause of food-borne infection in the United States, this species is associated with a disproportionate mortality rate. In recent years, Salmonella and Listeria have been associated with more cases of fatal bacterial food related disease than any other agent, despite the the relative rarity of listeriosis as a disease. [1,2] In fact, case-fatality rates of the most common agent, Salmonella, have not paralleled increases in disease incidence. See graphs 1 and 2.

(See the Graph tool tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states
2. Berger SA. Listeriosis: Global Status, 2011. 93 pp, 103 graphs, 487 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/listeriosis-global-status/

Note disussed in Promed

Although national reporting was discontinued as of 1994, endemic typhus was once the most common rickettsial infection in the United States. [1,2] (see graph).

19,663 cases of endemic typhus were reported during 1944 to 1953; 812 during 1954 to 1963; 315 during 1964 to 1973; 588 during 1974 to 1983; and only 447 during 1984 to 1993. Disease rates peaked during the 1930′s and 1940′s. In fact, 787 military personnel acquiring the disease 15 fatal) during World War II – 497 of these infected in the United States. [1,2]

(See the Graph tool tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Endemic Typhus Group: Global Status, 2011. 50 pp, 34 graphs, 185 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/endemic-typhus-group-global-status/

Reported in ProMED

The following background data are abstracted from Gideon www.GideonOnline.com and from references 1-2.

Time and Place:
Tick-borne relapsing fever was first described in the United States in 1915 (Colorado).
– 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 involve tourists to endemic areas (1977 to 2000).
– Tick-borne relapsing fever is reportable in Arizona, California, Colorado, Idaho, New Mexico, Nevada, Texas, Utah and Washington.
– 450 cases (300 confirmed and 150 probable) were reported by 11 western states during 1977 to January 2000. Only one fatal case was reported during this period – a neonate born to an infected mother.
– 285 cases were reported by California, Colorado, Idaho, Texas and Washington during 1985 to 1996.

The first case of louse-borne infection in the United States during the twentieth century was reported in 1976 – imported from Ethiopia.

Additional geographic notes:
– Washington and Oregon reported 30 cases during 1965 to 1978.
– Colorado reported 2 cases during 1945 to 1976; 3 in 1977.
– Washington reported 24 cases during 1991 to 1994.
– Oregon reported 73 cases during 1964 to 1989; Washington 27; Arizona 74; Texas 25; Idaho 13; New Mexico 15; Oklahoma 2.
– California reported 251 cases during 1921 (state’s first case) to 1941; 173 during 1964 to 1989; 95 during 1978 to 1998 (including 3 to 18 cases yearly during 1985 to 2002). five cases were reported in the Lake Tahoe region in 2005, 3 during the summer of 2006.
– Texas reported 13 cases during 1990 to the first half of 1994.

An American tourist acquired relapsing fever in Israel (1988 publication).

Infecting species:
– Borrelia hermsii (vector Ornithodoros hermsi) and B. coriaceae in the western region
– B. turicatae (vector O. turicatae) in the southwest. There is also evidence for the existence of Borrelia turicatae in Florida. – B. parkeri (vector O. parkeri) in the west
– B. mazzottii (vector O. talaje) in the south.
– B. miyamotoi has been identified in ixodid ticks (Ixodes pacificus) in California (2006 publication)
– B. coriaceae has been identified in Ornithodoros coriaceus, a common parasite of livestock in the western United States.

Prevalence surveys:
1.9% of I. scapularis adults and 0.8% of nymphs in the northeastern United States (Borrelia miyamotoi, 2009 publication)

Notes regarding transmission:
– Ornithodoros hermsi is nocturnal and feeds within 20 to 90 minutes – thus, patients rarely recall the tick bite.
– B. hermsii is maintained in small sylvatic rodents, notably chipmunks (Tamias spp.) and pine squirrels (Tamiascuirus spp.) above 1,000 meters’ elevation.
– Antibodies to Borrelia hermsii are present in 5.4% of big brown bats (Eptesicus fuscus). (Georgia, 2007 publication)
- Borrelia turicatae has been detected in dogs in Texas. (2007 publication)

Notable outbreaks:
All of the following outbreaks were associated with tick (Ornithodoros spp.) infestations of rodent nests in cabins.
1968 – An outbreak was reported in Spokane County, Washington.
1973 – Outbreaks (62 clinical cases, 16 confirmed) were reported in Grand Canyon National Park, Arizona.
1989 – An outbreak (6 cases) was reported in San Bernardino County, California.
1990 to 1991 – Outbreaks (24 cases, 14 confirmed) were reported in Grand Canyon National Park, Arizona. No outbreaks were reported in this area during 1992 to 1999.
1995 – An outbreak (23 family members) was reported among campers in Colorado.
2002 – An outbreak (5 cases) of Borrelia hermsii infection was associated with a cabin in western Montana. Infected ticks (Ornithodoros hermsi) were identified at the time.
2002 – An outbreak was associated with a family gathering in New Mexico.

References:
1. Berger SA. Relapsing fever: Global Status,, 2011. 63 pp, 68 graphs, 174 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/relapsing-fever-global-status/
2. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/

Notwithstanding an ongoing outbreak in northern Bohemia, the Czech Republic has managed to reduce mumps to levels comparable to those of the United States. In the following graph, I have contrasted rates per 100,000 population for these two countries:

Graph generation system outlined in [1])

Note that a precipitous decline in mumps in the Czech Republic followed the introuction of widespread MMR vaccination in 1987. [2,3]

1. Gideon Graphs module tutorial Gideon Graphs
2. Berger SA. Infectious Diseases of the Czech Republic, 2011. 424 pp, 139 graphs, 1192 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-czech-republic/
3. Berger SA. Mumps: Global Status, 2011. 157 pp, 187 graphs, 390 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/mumps-global-status/

Reproduced by ProMED

Rates of hepatitis B in Tajikistan and surrounding countries have declined considerably since the 1990′s, and are similar to those reported in the United States. Interestingly, this trend began a decade before the introduction of universal Hepatitis B vaccination in the region. [1,2]

References:
1. Berger SA. Infectious Diseases of Tajikistan, 2011. 340 pp, 80 graphs, 87 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-tajikistan/2. Berger SA. Hepatitis B: Global Status, 2011. 327 pp, 405 graphs, 1517 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-b-global-status/

Cited in ProMED
c
Featured in ProMED

An ongoing chronology of cross-border rabies cases reported during 1970 to July 2011 includes 59 cases of human infection, from 20 countries; and 29 importations of rabid animals (27 dogs, 1 horse and 1 cat) from 14 countries. Gideon www.GideonOnline.com The most common countries for human exposure were India and the Philippines (8 cases each), followed by Mexico (6) and Morocco (4). Seven rabid animals originated in Morocco. The case detailed in ProMED is the third to originate in Haiti (the two previous patients also died in the United States), and the thirteenth case of imported rabies in the U.S. since 1983. [1,2]

References:
1. Berger SA. Rabies: Global Status, 2011. 366 pp, 546 graphs, 1056 references. Gideon e-book series, http://www.gideononline.com/ebooks/disease/rabies-global-status/2. Berger SA. Infectious Diseases of the United States, 2011. 1030 pages, 464 graphs, 8237 references, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/

Although the incidence of Lyme disease the United States has been steadily increasing since 1993, case numbers for Pennsylvania, New York and Connecticut (the three states with highest disease rates) have not changed substatially. [1,2] See graph

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon E-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Lyme Disease: Global Status, 2011. 68 pages, 61 graphs, 496 references. Gideon E-books, http://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

Update: Posted in ProMED

Regarding a recent outbreak in Jujuy, recent rates of ornithoisis in Argentina are strikingly similar to those reported in the United States during the 1950′s. [1-3]

References:
1. Berger SA. Infectious Diseases of Argentina, 2010. 410 pp. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-argentina/
2. Berger SA. Infectious Diseases of the United States, 2010. 996 pp. http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
3. Berger SA. Ornithosis: Global Status, 2010. 36 pp. Gideon e-book series. http://www.gideononline.com/ebooks/disease/ornithosis-global-status/