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This finding mirrors the secondary bacterial infections characteristic of infected and immunosuppressed European harbor seals during PDV epidemics (1 ).
During local epidemics, 1 or 2 of these species accounted for most isolates from pneumonia patients (5 – 13 ).
Neisseria meningitidis serogroup A (NmA) has been responsible for most localized epidemics or epidemic waves, and other meningococcal serogroups occasionally caused epidemics (1, 2 ).
In the past 20 years, dengue virus (DENV) and chikungunya virus (CHIKV) have caused large and geographically wide ranging epidemics (1, 2 ).
Misperceptions of risk can lead to inappropriate reactions during epidemics (1, 2 ), such as stigmatization of those who are perceived as possible sources of infection (3 ).
Subsequently, this virus (QH05, clade 2.2) disseminated from Asia to Europe and Africa, which has led to great concern and energetic debates about the role of migratory birds in influenza epidemics (1 – 5 ).
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However, there are other independent risk factors, which show a significant variability among studies performed in different countries and even among different RSV seasons within the same country with alternation of minor and major epidemics [ 1, 3, 4, 21].
However, neuroinvasive disease is now more frequent and the case fatality rates range from 4.2 to 18.6 % in more recent epidemics [ 1, 4, 5].
Serotypes 8, 11 19 and 37 are held responsible for EKC and it is known that especially serotypes 8 and 19 cause epidemics [ 1, 2].
Mathematical models have become an important tool in analyzing the causes, dynamics, and spread of epidemics [1].
In Southeast Asia, India, Pakistan, Sri Lanka, Myanmar, Thailand, Indonesia, the Philippines, Cambodia, Vietnam, Hong Kong, and Malaysia have documented the epidemics [1, 5, 12, 13].
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