As in a classic situation, this outbreak in humans followed an outbreak in domestic dogs of the region.
Insecurity due to conflict further constrains the capacity of both national governments and external organizations to respond to outbreak situations.
This range can be assigned to high-risk areas in hospitals such as intensive care units or to outbreak situations [ 15, 18].
Superimposed on this poorly controlled VL-endemic situation are outbreaks that affect hundreds of thousands of people, as in Bihar in the early 1990s (3).
In such situations, early outbreak detection and investigation become crucial to ensure early and continuous reporting to authorities at the national level.
Despite this situation, influenza outbreaks during mass gatherings have rarely been described (8 – 10 ), and reports have not included results of detailed virologic testing.
The infrastructures needed differ in several aspects from traditional health information systems because they are to be used in situations when outbreaks threaten to overwhelm first-order information resources nationally and locally on hand for infectious disease control [2], [3].
Both reviews included worldwide MRSA data from endemic situations and outbreaks.
The methods used in this study were not designed to be sensitive to situations where outbreaks do not cluster spatially.
