Sporadic mild illness (Calderon et al. 1991) and, more conclusively, numerous outbreaks of severe disease including E. coli 0157 H7 (Bruce et al. 2003; Keene et al. 1994; Yoder et al. 2008) have been linked to other bathers at IWs.
The emergence of ribotype 027, which has been shown to express in vitro, more toxin, and production of increased spores has been linked to numerous outbreaks involving more severe C. difficile disease and a greater chance of relapse compared to other known ribotypes [ 10, 12, 21, 22, 26].
In contrast, BoHV-5 infection and disease appear to be more frequent in Argentina and Brazil, where numerous outbreaks were described in the last decades [ 7- 11].
Although sporadic cases of meningo-encephalitis by BoHV-5 have been reported in Australia [ 3, 18], Italy [ 19] and Hungary [ 20], BoHV-5 infection and disease are more frequent in Argentina and Brazil; where numerous outbreaks have been described in the last decades [ 16, 21- 24].
Countywide, in the first four months of 1988, 339 cases of giardiasis were reported, down from 500 in the same period a year earlier when day care center outbreaks were more numerous than they have been this year.
The emerging NAP1 strain of C. difficile has been associated with numerous outbreaks and appears to be more virulent than other endemic and epidemic C. difficile strains (3 – 9 ).
These data suggest that the current schedule of acellular pertussis vaccine doses is insufficient to prevent outbreaks of pertussis and the possibility of earlier or more numerous booster doses of acellular pertussis vaccine either as part of routine immunization or for outbreak control should be entertained [ 29].
Outbreaks were more common in late winter and in spring, and more numerous in certain regions, which did not strictly correspond to the known horse population density.
In Xinjiang, Uighur grievances have triggered numerous outbreaks of violence.
The last outbreak of CSF occurred in Britain in 1986, but numerous outbreaks were confirmed in Germany, the Netherlands, Spain and Italy in 1998.
