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Archive for the ‘Graphs’ Category

Tularemia Deaths in the United States

Rates of fatal tularemia in the United States have changed little since the 1960’s, and are similar to those reported for plague. [1]  See graph:


  1. Berger SA. Infectious Diseases of the United States, 2017. 1,220 pages, 496 graphs, 14,855 references. Gideon e-books

Infectious Diseases of the United States

Japanese Encephalitis in India

The idea that most cases of “acute encephalitis” in Uttar Pradesh are caused by diseases other than Japanese encephalitis is borne out by reporting statistics.  In the following chart, note the precipitous decline in “Japanese encephalitis” incidence which followed introduction of reporting for “Acute encephalitis” in 2008 (upper graph).  This phenomenon is even more striking for India as a whole (lower graph). [1,2]



  1. Berger S. Japanese Encephalitis: Global Status. 83 pages, 63 graphs, 1,034 references. Gideon e-books,
  2. Berger S. Infectious Diseases of India. 533 pages, 89 graphs, 5,763 references. Gideon e-books.

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Botulism in The United States

Rates of food-borne botulism in the United Sates have declined somewhat since the 1990’s, while those of infant botulism continue to increase. [1]  See graph


  1. Berger S. Botulism: Global Status, 99 pages, 90 graphs, 877 references, Gideon e-books

Botulism: Global Status

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Cyclosporiasis in The United States

The following background information on Cyclosporiasis in the United States is abstracted from Gideon and the Gideon e-book series [1]   (Primary references are available on request)

Cyclosporiasis is the least common reportable protozoan infection in the United States.  In 2008, the reported disease rate among 10 states was 2.25 per 100,000 population.

The true incidence of food-borne cyclosporiasis in the United States has been estimated at 11,407 to 19,808 cases per year (15 hospitalizations), accounting for 0.1% of all food-borne illness. Approximately 42% of cases are imported.

1,110 individual cases of cyclosporiasis were reported during 1997 to 2008.  849 (76.5%) of the cases occurred in seven states, including 498 (44.9% of total) in Florida.  51.7% of cases with known travel history were autochthonous. {p 21471951}

No fatal cases were reported during 1998 to 2006.

Nine food-borne outbreaks (325 cases) of cyclosporiasis were reported during 1998 to 2002; 0 in 2007; 3 (66 total cases) in 2008; 1 (8 cases) in 2009; 0 in 2010.  Eleven   outbreaks (3,533 cases) related to imported food were reported during 1996 to 2014.

Reported disease rates have increased somewhat since 2012.  See graph:


Chronology of reported outbreaks:

  1. Outbreak (20 cases) among health-care workers at a hospital in Chicago, Illinois. Related to contaminated water
  1. Outbreak at a country club in New York State
  1. Outbreak in Florida associated with consumption of contaminated fresh raspberries.
  1. Multiple outbreaks (1,465 cases, 978 confirmed) in at least 15 states including New York (307), Florida (220), Massachusetts (170), New Jersey (103), South Carolina (38). Vehicles included raspberries and other fruit. The raspberries were imported from Guatemala and were thought to have been contaminated by water used in pesticide sprays.
  1. Outbreak (56 cases) at a hotel in Texas.
  1. Outbreaks (25 event-associated case clusters encompassing 370 cases) reported from eight states (California, Florida, Maryland, Nebraska, Nevada, Rhode Island, New York and Texas) and Canada (Ontario).
  1. Outbreaks (26 clusters encompassing 228 cases) reported from Virginia, Washington DC and Baltimore. Fresh basil and basil-pesto sauce implicated as the source. An additional 20 possible clusters (75 cases) were under investigation at the time.
  1. Outbreaks (over 1,700 cases during a five-month period) associated with raspberries, mesculun lettuce and basil. Fresh raspberries, imported from Guatemala were implicated in 19 of 21 outbreaks/ 70 sporadic cases confirmed in the United States and Canada during this period.
  1. Outbreak (57 cases) at a wedding in Massachusetts was associated with contaminated berries.
  1. Outbreaks (62 cases in 2outbreaks) in Missouri were associated with fresh basil, grown in either the United States of Mexico.
  1. Outbreak (54 cases) at a wedding in Philadelphia, Pennsylvania was ascribed to imported (Guatemalan) raspberries in a wedding cake. This was the fifth year that outbreaks associated with Guatemalan raspberries had occurred in North America during the spring months.
  1. Outbreak (96 cases) at a residential facility in Pennsylvania was associated with contaminated raw snow peas imported from Guatemala
  1. Outbreak (90 cases) in Illinois and Texas was caused by contaminated basil and spring mix salad.
  1. Outbreak (70 cases) in Florida
  1. Outbreak (100 cases) in Georgia among persons who had visited an aquarium
  1.  Outbreak (643 cases) involving multiple locations was related to contaminated bagged salad imported from Mexico.
  1. Outbreak (202 cases, including 49 in Texas) involved multiple locations.
  1. 2015. Outbreak (72 cases) in Texas
  1.  Outbreak (495 cases) in 30 states was related to ingestion of contaminated cilantro imported from Mexico.
  1.  Outbreak (72 cases) in Texas.


  1. Berger SA. Cyclosporiasis: Global Status, 2017. Gideon e-books.

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Arboviruses in Queensland

As of 2017, Ross River disease and Barmah Forest disease continue to infect a considerable number of people in Queensland, Australia. In fact, rates of these two mosquito-borne viral infections in this state have changed little during the past 25 years. [1]   See graph:


  1. Berger SA. Infectious Diseases of Australia, 2017.  491 pages, 165 graphs, 2,982 references.  Gideon e-books,

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Tetanus in Italy

Although the incidence of tetanus in Europe has been decreasing for many years, disease rates in Italy have changed little during the past two decades.  In fact, Italy currently accounts for most cases reported in the region. [1]  See graph:


  1. Berger S, 2017. Tetanus: Global Status. 528 pages, 812 graphs, 349 references. Gideon e-books,

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Schistosomiasis in The Philippines

The following is abstracted from reference [1] and the Gideon web application .  Primary references are available on request.

Schistosomiasis was first reported in the Philippines in 1906, and as of 1921, an estimated 25,000 to 30,000 people were infested.  During 1944 to 1945, 1,700 cases were reported among American and Australian military personnel serving in the Philippines.

An estimated 300,000 Filipinos were infested as of 1948.  By 1970, the disease was known  to be epidemic to 24 provinces.; and as of 1975, 5 million persons were considered at risk and approximately 1 million infected.  By 2002, an estimated 800,000 were infested and 6.7 million at risk; and as of 2010, an estimated 560,000 were infested.

Reported incidence and mortality data are summarized in the following graph:

In recent years, cases have been reported from Mindoro Oriental and Sorsogon in Southern Luzon; the provinces of North, East and Western Samar; LeyteBohol in Eastern Visayas; all of Mindanao with the exception of Misamis Oriental, Davao Oriental and Maguindanao.

Schistosomiasis is most common among males, and individuals ages > 19 years.  

Notable outbreaks were reported in Davao del Sur in 2000 (222 cases as of October – most in Digos- Igpit, Colorado, and Matti barangays); and in Palo, Leyte in 2011 (99 cases)

Infestation by Schistoma japonicum is common among dogs, field water buffaloes (Carabao) and rats on Leyte.  The local snail reservoir is Oncomelania hupensis quadrasi 


  1. Berger S. Infectious Diseases of the Philippines, 2017. 342 pages, 93 graphs, 1,035 references. Gideon Informatics

Tick-borne Encephalitis in the Baltic Region

Rates of Tick-borne encephalitis reported by Estonia, Latvia and Lithuania have been strikingly similar for the past two decades.  See graph [1] :

This phenomenon seems to have begun only after dissolution of the former Soviet Union, and could reflect similar ecology, weather or other regional factors.


Graphs on Graphs

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Hepatitis E in the United Kingdom

A recent posting in ProMED discussed the threat of Hepatitis E related to pork products imported into the United Kingdom from France, Germany and the Netherlands.  Indeed, all countries concerned have been reporting increasing rates for this disease in recent years – see graph [1]  :


  1. GIDEON Graphs Tool

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Travel-Related African Trypanosomiasis

During January 1970 to May 2017, 138 case reports of travel-related trypanosomiasis were published in the medical literature.  In 49 cases (36%) the patients were identified as Europeans, and in 49 (37%) the disease was acquired in Tanzania.  A chronology of these events follows below [1].

African Trypanosomiasis – A Chronology of Travel-Related Cases

Year               Patient From                              Infected In                         Cases (#)

1970  Switzerland multiple **  1
1970  United States multiple  2
1975  Sweden Gambia  1
1977  Switzerland multiple  1
1981  United States Tanzania  1
1986  United States Zambia  1
1990 *  Switzerland Rwanda   2
1991  United States multiple   1
1991  New Zealand multiple   1
1992  France Angola   1
1994*  France Rwanda   2
2004*  United Kingdom Ghana   1
1995*  Netherlands Zimbabwe   1
1995*  Netherlands Cameroon   1
1996  Mexico Kenya   1
1996  Italy D. R. Congo   1
1997  Brazil Angola   1
1997  France Rwanda   1
1998  Australia Tanzania   1
1999  United States Tanzania   3
1999  France Gabon   1
2000  South Africa Malawi   1
2000  United States Tanzania   1
2000  United Kingdom Tanzania   1
2000  United Kingdom Zambia   1
2000  France Guinea   2
2000  Germany N.A.   1
2000  Australia Tanzania   1
2001  Italy Tanzania   2
2001  Brazil  Angola   1
2001  Netherlands Tanzania   3
2001  United Kingdom Zambia   1
2001  United States Tanzania   4
2001  Norway Tanzania   1
2001  Germany Cameroon   1
2001  United Kingdom Tanzania   1
2001  United States Sudan   1
2001  United States Angola   1
2001  Belgium Tanzania   2
2001  Sweden Tanzania   1
2001  South Africa Tanzania   3
2002  United Kingdom Tanzania   1
2002  India Tanzania   1
2002  United States Tanzania   1
2002  Canada D. R. Congo   1
2002  France Gabon   1
2003  United Kingdom Tanzania   2
2004  South Africa Malawi   2
2004  United Kingdom Tanzania   2
2004  Netherlands Angola   1
2004  Italy Gabon   1
2004  Italy C.A.R.   1
2004  United States Tanzania   2
2005  United States Tanzania   1
2005  South Africa Malawi   2
2005  South Africa Zimbabwe   1
2005  Italy multiple   2
2006*  Netherlands Tanzania   1
2006  Italy D. R. Congo   1
2006  United States Tanzania   1
2006  South Africa Uganda   1
2007*  France multiple   2
2007  Canada Malawi   1
2007  South Africa Malawi   5
2007  United Kingdom Malawi   1
2007  Australia Malawi   2
2008  United Kingdom Tanzania   1
2008  United Kingdom Zambia   1
2008  Spain Eq. Guinea   1
2008  Netherlands Tanzania   1
2008  United States Tanzania   1
2008  South Africa Tanzania   1
2008  Canada  D. R. Congo   1
2008  South Africa Malawi   2
2008  Australia Uganda   1
2009*  France Gabon   1
2009*  Netherlands Angola   1
2009*  United Kingdom Tanzania   1
2009  Portugal Angola   1
2009  South Africa multiple   3
2009  United States Zimbabwe   1
2009  Israel Tanzania   1
2009  Germany Tanzania   1
2009  United States Tanzania   1
2009  Netherlands Tanzania   1
2009  Poland Uganda   1
2010  South Africa Zambia   1
2010  United States Cameroon   1
2010  United Kingdom Zimbabwe   1
2010  United Kingdom multiple   1
2010  Portugal Angola   1
2010  United States Zambia   1
2010  South Africa D. R. Congo   2
2010  South Africa Malawi   1
2012*  France Gabon   1
2012  Belgium Kenya   2
2012  Germany Kenya   1
2012  Sweden Tanzania   1
2012  United States Zimbabwe   1
2014*  Germany Cameroon   1
2015  Canada Zambia   1
2016*  Spain  Eq. Guinea   1
2016*  China Gabon   1
2016  United States multiple   1
2016  United States Uganda   1
2017  Netherlands Tanzania   1


*      year of publication

**     exposure in multiple / countries


Trypanosomiasis due to T. brucei gambiense entered Tanzania from Zaire in approximately 1902; T.b. rhodesiense from Mozambique in 1910.  As of 2004, transmission was reported in Kigoma (Kibondo and Kasulu districts), Tabora (Kigoma, Sikonge and Urambo districts), and Rukwa (Mpanda district).  Highest prevalence occurs in Arusha and Kigoma.   An estimated 1.5 million persons lived in endemic zones during the 1980’s.   For several decades, disease rates in Tanzania have paralleled those reported for Africa as a whole  (see graph) [2]



Prevalence surveys have demonstrated that 15.8% of cattle (Bos indicus) from traditional pastoral Maasai and managed Boran regions are infested; 0.7% in Monduli District, northern Tanzania.  The parasite has also been identified in 10.1% of domestic pigs in Mbulu, Arumeru and Dodoma; and in 0.010% of tsetse flies (Glossina swynnertoni and G. pallidipes) in Serengeti National Park.


  1. Berger SA. Gideon Guide to Cross Border Infections, 2017. 217 pages, 128 tables, 3,936 references Gideon e-books
  2. GIDEON – (user generated graphs tool)

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