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Our results showed substantial differences between the estimated generation time distributions for the different outbreaks.
Choose a three-year period and map the different outbreaks that have occurred in the world.
In 10 different outbreaks involving 130 adult patients there were 57 NLV positives.
Spruce budworm incidence maps for the period 1997 2003 in Minnesota were obtained and 12 different outbreaks identified.
The analysis, published today in the New England Journal of Medicine, revealed that there were actually two different lineages of the microbe, pointing to two different outbreaks spreading independently of one another.
After investigating several false leads, in particular Spanish cucumbers, the food inspectors were relieved to find a single source that linked all the different outbreaks, and even happier that it was outside of the European Union.
Through mid-August, 124 cases had been reported in 2018, including nine different "outbreaks"—that's three or more linked cases.
Outbreaks began May 2011 in the Tver region and this year at least 21 different outbreaks have been registered.
But officials say that although rats, cats and opossums can all carry fleas, different outbreaks have different causes.
"There's a need to connect all the dots between these different outbreaks," said Dr. Ajay Singh, a nephrologist at Harvard Medical School who is leading a study of the epidemic in India.
Figure 2 shows the estimated generation time distribution for the four different outbreaks; the parameter estimates are detailed in Table 1.
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