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Archive for the ‘Graphs’ Category

Coccidioidomycosis in the United States

Although largely limited to the western and southwestern states, Coccidioidomycosis is more commonly reported than legionellosis. More Americans die from Coccidioidomycosis than from the other two regional mycoses, Blastomycosis and Histoplasmosis. [1,2]


While Coccidioidomycosis is best known as a disease of California (“Valley Fever”) , highest incidence is reported from Arizona.  These data are even more striking when adjusted for relative population size (cases per 100,000 population).



  1. Berger S. Infectious Diseases of the United States, 2019. 1,422 pages , 513 graphs , 18,048 references.  Gideon e-books,
  2. Gideon e-Gideon multi-graph tool,

India: Diphtheria, Pertussis and Tetanus

Although global incidences of Diphtheria, Pertussis and Tetanus declined dramatically during the second half of the twentieth century, relatively high rates for these diseases continue to be reported from India.  India accounted for 17.7% of the total World’s population in 2018, but reported 46% of global Tetanus, 53% of global Diphtheria (and only 10.2% of global Pertussis) that year.  Similarly, 68% of the population of Southeast Asia (SEA) live in India, while that country accounted for 85% of Diphtheria, 75% of Pertussis and 90% of tetanus for SEA in 2018. [1-4]   Trends for these data are charted in the following three graphs. [5]


  1. Berger S. Infectious Diseases of India, 2019. 620 pages , 109 graphs , 6,807 references. Gideon e-books,
  2. Berger S. Diphtheria: Global Status, 2019. 389 pages , 451 graphs , 699 references. Gideon e-books,
  3. Berger S. Tetanus: Global Status, 2019. 561 pages , 816 graphs , 390 references. Gideon e-books,
  4. Berger S. Pertussis: Global Status, 2019. 417 pages , 514 graphs , 1,028 references. Gideon e-books,
  5. Gideon e-Gideon multi-graph tool,

Venereal Diseases in Europe

As of 2017, the reported incidence of syphilis in the European Union is higher that that of HIV infection.   In the following chart, I’ve contrasted trends of venereal diseases for the region. [1]  Data are derived from GIDEON and the Gideon e-book series. [2]  Note that gonorrhea is most common, followed by syphilis, HIV / AIDS and lymphogranuloma venereum (LGV).  In fact, if current trends continue, LGV infection may become more common than AIDS in the near future.  As depicted in the second chart,  reported cases of chlamydial infection are higher than the combined total for all other venereal diseases, and continue to be rise at an alarming rate.

1. Gideon e-Gideon multi-graph tool,

2. Berger S. Infectious Diseases of the World, 2019. 1,750 pages , 456 graphs , 42,302 references. Gideon e-book series,

Diphtheria in Thailand

Although two fatal cases of diphtheria were recently reported in Thailand [1], rates of this disease have declined dramatically since the 1970’s.  In fact, Thailand can serve as an icon for the effectiveness of vaccination.  In the following graph, I’ve contrasted rates of diphtheria, pertussis and tetanus with WHO estimates of DPT vaccine uptake.  The second graph depicts the effect of DPT vaccination on diphtheria mortality in this country. [2,3]


  2. Berger S. Infectious Diseases of Thailand, 2019. 506 pages , 169 graphs , 2,339 references. Gideon e-books,
  3. Gideon e-Gideon multi-graph tool,

Note featured on ProMED

Measles: Correlation of Vaccine Uptake with Disease Rates

The following is a country-by-country analysis of measles reporting trends vs. vaccine uptake.  For purposes of consistency, incidence data and population statistics used to calculate rates per 100,000 will be limited to those published by the World Health Organization (WHO).  Resultant graphs were generated by Gideon and abstracted from the Gideon e-book series [1,2]  True estimates of vaccination update statistics are those published by WHO, in most cases available only since 1980.  Data published by the countries themselves were not used, to avoid possible bias or inconsistency when comparing data among countries. Historical disease data which precede 1980 have also been appended to graphs to further appreciate the impact of vaccination.

The reader will note that in virtually all cases, the presumed impact of vaccine uptake on disease incidence occurs when vaccine uptake exceeds 80%, and again when rates increase beyond 90%.   As such, the few countries which have not achieved 80% uptake, or have consistently reported >90% uptake since 1980 are excluded.  Graphs are not included for countries for which data are not reported, or reported only sporadically.

Individual graphs for 135 countries are presented below in alphabetical order.  In 127 (94%) of these, a clear relationship seems to exist between increasing vaccine uptake and decreasing rates of measles.  In eight cases, temporary “spikes” in disease incidence were reported during years of high vaccine uptake: Japan, Jordan, Republic of Korea, Seychelles, Solomon Islands, South Africa, Sri Lanka and Syria.

I have not attempted to perform a statistical analysis of this phenomenon, and cannot say with certainty that a confounding (third) factor does not exist.  Nevertheless, these graphs appear to indicate a favorable effect of vaccination on measles incidence.

Measles Vaccine Uptake vs. Disease rates (per 100,000)


  1. Gideon e-Gideon multi-graph tool,
  2. Berger S. Measles: Global Status, 2019. 548 pages , 538 graphs , 5,779 references. Gideon e-books,

Streptococcus suis Infection in Thailand

Currently, Streptococcus suis infection is more commonly reported in Thailand than a number of more familiar zoonoses acquired from pigs – Trichinosis, Hepatitis E, Brucellosis and Japanese encephalitis. [1,2]   See graph below


  1. Berger S. Infectious Diseases of Thailand, 2019. 506 pages , 169 graphs , 2,339 references.  Gideon e-books,
  2. Gideon e-Gideon multi-graph tool,

Tick-Borne Diseases of Norway

Tick-borne encephalitis (TBE) is one of eight zoonoses carried by ticks in Norway (the others are Anaplasmosis, Babesiosis, Louping ill, Lyme borreliosis, Relapsing fever, Rickettsial spotted fever and Tularemia).  As displayed in the following graphs, rates of human TBE are considerably lower than those of other tick-borne diseases in Norway, and below TBE rates reported by neighboring countries. [1-3]




  1. Berger S. Infectious Diseases of Norway, 2019. 387 pages , 138 graphs , 858 references. Gideon e-books,
  2. Berger S. Tick-borne Encephalitis: Global Status, 2019. 89 pages , 49 graphs , 787 references
  3. Gideon e-Gideon multi-graph tool,

Note featured on ProMED


Venereal Diseases in Australia, the U.K. and the U.S.

As noted in a recent ProMED post, the incidence of gonorrhea, syphilis and genital chlamydial infection are increasing in the United States, United Kingdom and Australia.   I’ve compared recent trends for these diseases in the following graphs, based on data from Gideon [1]  Note that highest rates for all three conditions are consistently reported by the United States.



  1. Gideon e-Gideon multi-graph tool,

Note features on ProMED

Tularemia in Liechtenstein

A recent post in ProMED reported that a hare infected with tularemia had been identified in Liechtenstein.  Although Liechtenstein  reported no cases of human tularemia during January 1, 2003 to November 6, 2018, the neighboring territory of Switzerland has experienced a remarkable increase in disease incidence.  In fact, current rates of human infection in Switzerland are reminiscent of those reported in the United States during the 1930’s. [1-3]


  1. Berger S. Tularemia: Global Status, 2018. 74 pages , 45 graphs , 688 references. Gideon e-books,
  2. Berger S. Infectious Diseases of Liechtenstein. 236 pages , 24 graphs , 10 references. Gideon e-books,
  3. Gideon e-Gideon multi-graph tool,


Rabies in Costa Rica

Recently, a biologist in Costa Rica acquired rabies while working in a cave.  For over five decades, Costa Rica has reported the lowest rates of rabies in Central America (El Salvador reports the highest rates), both in terms of cases and cases per 100,000 population. [1,2]   Costa Rica also reports the lowest incidence of animal rabies for the region.

In the above graph, data for Costa Rica appear as a row of red dots at the lower margin (arrow).


  1. Berger S. Rabies: Global Status, 2018. 475 pages , 557 graphs , 2,570 references
  2. Berger S. Infectious Diseases of Costa Rica, 2018. 334 pages , 120 graphs , 373 references
  3. Gideon e-Gideon multi-graph tool,

Note featured on ProMED