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Migratory birds, the poultry trade, and the transport of free-range ducks have all been implicated in outbreaks across Southeast Asia [7], [29], [30].
Highly drug-resistant strains of Mycobacterium tuberculosis have been implicated in outbreaks and have been found throughout the world; a comprehensive understanding the magnitude of this threat requires an accurate assessment of the worldwide burden of resistance.
Unpasteurized juice has been implicated in outbreaks of Salmonella and emerging pathogens such as E. coli O157 H7 (Table 4.1).
During the spring of 2002, only three farms, which have never been implicated in outbreaks of cyclosporiasis, were allowed to export raspberries to the United States.
Introduction of infected hares from Italy already has been implicated in outbreaks of animal and human cases of tularemia in Dordogne (14 ).
Contaminated water sources have been implicated in outbreaks involving E. coli O157 H7 and Campylobacter together in Scotland (7 ) and in New York State (8, 9 ).
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More recently, M3 was implicated in outbreaks of severe disease in both the United States [7], [13], [16] and the United Kingdom [17].
However, certain vehicles may be more likely to be implicated in outbreak investigations than others.
The cause(s) remains unknown; however none of the occupational or environmental exposures that have been implicated in previous outbreaks of nephropathy have been established as sole risk factors in the current outbreaks.
Indeed, other norovirus outbreaks have previously been reported in the summer season (1, 3 ).The alternating trend of high and low incidence of outbreaks may be related to several factors, some of which may have been implicated in these outbreaks.
Outbreaks of S. pneumoniae have occurred in many settings (25 – 39 ), and individual serotypes have been implicated in localized outbreaks (27 – 29, 31, 39 ).
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