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6– 8 The editorial suggests that serotypes 1 and 5 might be selected by use of PCV7; however, increases in disease caused by these serotypes has not been seen in countries that have introduced PCV7 and substantial outbreaks of each have been observed in the absence of vaccination.
The cost of avian influenza virus outbreaks in poultry is substantial; outbreaks of influenza A(H5N1) virus during 2004 2009 caused US $30 billion in damage (29 ), and the frequency of highly pathogenic avian influenza outbreaks in poultry appears to be increasing (11 ).
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The substantial outbreak of cryptococcosis due to C. gattii in the south-west of Canada and the north-west of the US has focused attention on the importance of C. gattii as a primary and emerging pathogen [6].
Although GeoSentinel would not be likely to receive reports from outbreaks of dengue that are restricted to regions of a country not frequented by travelers, most substantial outbreaks do eventually spread widely (27 ).
The prevalence of A. cantonensis in wild rats and snails in Shenzhen poses substantial risk for future outbreaks of human eosinophilic meningitis.
While the evidence of the importance of acquired resistance among HIV-infected persons is elusive, the risk of primary disease after infection with drug-resistant strains is substantial, as demonstrated by the outbreaks of MDR-TB among hospitalised HIV-infected patients and healthcare workers in Europe and the USA [ 238].
Outbreaks of Ebola virus can cause substantial morbidity and mortality in affected regions.
Recent outbreaks of RVF have resulted in substantial human illness and livestock losses in Kenya (9, 10, 12 ).
When syndromic surveillance was sufficiently sensitive to detect a substantial proportion of outbreaks, it generated frequent false alarms.
One-sentence summary for table of contents: When syndromic surveillance detected a substantial proportion of outbreaks before clinical case finding, false-positive results occurred.
In late February 2015, however, HPAI virus subtype H5, emerged in US midwestern states, leading to a substantial number of outbreaks in commercial poultry farms in the region.
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