HFRS Outbreak Case Group Mapping

Source: Kulagin, Fedorova & Ketiladze (1962).
Outbreak period: 18 Oct – 29 Nov 1961. Total cases: 113.

PDF page references use paper page numbers (= PDF viewer page − 4).


Group A — Precise point exposure, included

PDF source (group identity): Paper p. 6 (PDF p. 10), paragraph 2: > “…a group of persons who remained in the department for 3–4 hours only > on the 24th of October. Out of 24 persons in this group, 18 became ill.”

PDF source (individual incubation data): Paper p. 8 (PDF p. 12), paragraph 2: > “The duration of the incubation period in their group was as follows: > 3 of 17 days, 1 of 19 days, 2 of 21 days, 8 of 22 days, 1 of 23 days, > 2 of 25 days, and 1 of 27 days (an average of 21.5 days).”

Case_no n E_L E_R Onset k T_lower T_upper Interval
A-1 3 Oct 24 Oct 24 Nov 10 17 16 18 2 days
A-2 1 Oct 24 Oct 24 Nov 12 19 18 20 2 days
A-3 2 Oct 24 Oct 24 Nov 14 21 20 22 2 days
A-4 8 Oct 24 Oct 24 Nov 15 22 21 23 2 days
A-5 1 Oct 24 Oct 24 Nov 16 23 22 24 2 days
A-6 2 Oct 24 Oct 24 Nov 18 25 24 26 2 days
A-7 1 Oct 24 Oct 24 Nov 20 27 26 28 2 days

IC likelihood: ✅ Fully applicable. Formula: T_lower = k − 1, T_upper = k + 1 (within-day calendar uncertainty only). All T_lower ≥ 16 > 0; interval width is a constant 2 days across all cases. This is the tightest possible window consistent with calendar-day recording.

Current status: ✅ INCLUDED (v3b, v4)


Group B — Fixed building staff (permanent workers in main building)

PDF source (overview): Paper p. 5 (PDF p. 9), paragraphs 3–4: > “During October… out of 63 permanent personnel, 5 had had hemorrhagic fever > previously and apparently were immune, consequently 58 men were at risk, > of these 52 became ill (89.6%).”

Exposure window left bound (E_L = Oct 7): Paper p. 4 (PDF p. 8), last paragraph: > “the rodents, on 7 Oct, were transferred over to permanent accommodations > for animals (rooms #2 and 12)”

Exposure window right bound (E_R ≈ Oct 25): Animal removal announced Nov 2 (paper p. 9); earliest B-1 onset was Oct 18, suggesting effective exposure ended ~Oct 25.

B-1 — Zone 1 (rooms adjacent to animal rooms #2 and #12)

PDF source: Paper p. 5 (PDF p. 9), paragraph 3: > “out of 23 persons working in the 1st section (rooms #3, 9, 10, 12, and 13), > 20 had become ill”

Group n Cases AR E_L E_R Onset range
B-1 23 20 87% Oct 7 Oct 25 Oct 18 – unknown

IC likelihood: ⚠️ Applicable in principle; informativeness is onset-dependent. Formula: T_lower = O_day − Oct 25 − 1, T_upper = O_day − Oct 7 + 1 (window width = 18 days, fixed by E window).

Onset example T_lower T_upper Width Info type
Oct 18 (earliest) −8 → clamped to ~0 12 ~12 Upper bound only
Oct 28 2 22 20 Interval (weak)
Nov 10 15 35 20 Interval (moderate)
Nov 20 25 45 20 Interval (broader)

Early-onset cases (onset ≤ Oct 25, i.e., within the exposure window) yield T_lower ≤ 0 — effectively only an upper bound. Later-onset cases provide genuine two-sided intervals of ~20-day width.

Current status: ❌ NOT INCLUDED — individual onset dates unavailable


B-2 — Zone 2 (farther from animal rooms)

PDF source: Paper p. 5 (PDF p. 9), paragraph 3: > “only 10 of the 33 workers in the 2nd section became ill”

Group n Cases AR E_L E_R
B-2 33 10 30% Oct 7 Oct 25

IC likelihood: ⚠️ Same formula as B-1; onsets likely later (Zone 2 lagged Zone 1 per paper p. 5), so a larger fraction may have T_lower > 0. Window width = 20 days if individual onset data were obtained.

Current status: ❌ NOT INCLUDED — individual onset dates unavailable


B-3 — Immune (prior infection 1–3 years earlier)

PDF source: Paper p. 5 (PDF p. 9), paragraph 3: > “out of 63 permanent personnel, 5 had had hemorrhagic fever previously > and apparently were immune”

Conclusion 4, paper p. 10 (PDF p. 14): > “5 workers of those working constantly in the infected area had this > disease previously (1–3 years ago) and didn’t become ill.”

Group n Cases Notes
B-3 5 0 Prior immunity

IC likelihood: N/A — no cases; not relevant to incubation estimation.

Current status: N/A (no cases)


Group C — Other-building personnel (non-main-building staff)

PDF source: Paper p. 5 (PDF p. 9), paragraph 4: > “out of 34 workers from other buildings, 14 visited the department’s > premises frequently, and 11 of them (78.5%) became ill with hemorrhagic > fever. The remaining 20 workers visited the department from 1-3 times > during this period and 6 of them (30%) became ill.”

C-1 — Frequent visitors

Group n Cases AR E_L E_R Onset range
C-1 14 11 78.5% Oct 7 Nov 1 Oct 25 – Nov 1

IC likelihood: ⚠️ Applicable in principle, but structurally weak. Formula: T_lower = O_day − Nov 1 − 1, T_upper = O_day − Oct 7 + 1

Since E_R = Nov 1 and the reported onset range is also Oct 25 – Nov 1, T_lower = O_day − Nov 1 − 1 ≤ −1 for all known onsets → T_lower ≤ 0 for every case in this group. All C-1 cases provide only an upper bound on incubation (P(T < T_upper)), carrying minimal information about the lower tail of the distribution.

Onset example T_lower T_upper Info type
Oct 25 −8 → ~0 19 Upper bound only
Nov 1 −1 → ~0 26 Upper bound only

Current status: ❌ NOT INCLUDED — individual onset dates unavailable; additionally, all cases yield T_lower ≤ 0 (upper bounds only)


C-2 — Occasional visitors (1–3 visits)

Group n Cases AR E_L E_R
C-2 20 6 30% Oct 7 Nov 1

IC likelihood: ❌ Doubly limited. (1) Same upper-bound-only problem as C-1 (onset ≤ E_R for most cases). (2) “1–3 visits” means E is not a continuous window but a set of discrete unknown visit dates — the shared [Oct 7, Nov 1] window overestimates E_R per person; true individual E_L/E_R require knowing specific visit dates.

Current status: ❌ NOT INCLUDED — individual onset + visit dates unavailable; IC formula is further confounded by multiple unknown visit dates


Group D — External incidental visitors

PDF source (D-1 and D-2): Paper p. 6 (PDF p. 10), paragraph 1: > “Out of 94 persons who visited the department by chance, 44 became ill. > Out of 13 persons who visited the department often, 10 became ill, and > out of 81 persons who visited the department from 1-3 times, 34 became ill.”

D-1 — Frequent external visitors

Group n Cases AR E_R
D-1 13 10 76.9% Nov 1

IC likelihood: ❌ E_L unknown per person; E_R ≈ Nov 1 but individual visit patterns not reported. Cannot compute meaningful T_lower/T_upper without knowing when each person first visited.

Current status: ❌ NOT INCLUDED — individual visit dates unavailable; E_L undefined per person


D-2 — Occasional external visitors (1–3 visits)

Group n Cases AR E_R
D-2 81 34 42% Nov 1

IC likelihood: ❌ Same problems as D-1, compounded by larger n with diverse unknown visit patterns. Some of these individuals may overlap with the “precisely known” 6–14 cases referenced in the paper text, but they cannot be identified without the original records.

Current status: ❌ NOT INCLUDED — individual visit dates unavailable


D-3 — Single-day visitors on Oct 24 (parent population of Group A)

PDF source: Paper p. 6 (PDF p. 10), paragraph 2: > “a group of persons who remained in the department for 3-4 hours only > on the 24th of October. Out of 24 persons in this group, 18 became ill.”

Group n Cases AR E_L E_R k range
D-3 24 18 75% Oct 24 Oct 24 17–27 days

IC likelihood: ✅ Fully applicable — E_L = E_R = Oct 24, same structure as Group A. Group A IS these 18 cases; the 6 non-cases contribute nothing to incubation estimation.

Current status: ✅ INCLUDED via Group A (D-3 cases = Group A cases)


D-4 — Very brief visitors (≤5 minutes)

PDF source: Paper p. 6 (PDF p. 10), paragraph 1: > “cases have been established of single momentary (not more than 5 minutes) > visits to the department after which the disease followed”

Group Cases Notes
D-4 unknown Count not reported

IC likelihood: ⚠️ Single-visit structure is ideal (E_L = E_R = visit day), but count of cases, visit dates, and onset dates are entirely unreported.

Current status: ❌ NOT INCLUDED — count and individual dates unknown


Group E — Direct animal handlers

PDF source: Paper p. 7 (PDF p. 11), paragraph 3: > “Out of 113 persons taken ill, only 5 had first hand and direct contact > with these particular rodents, and out of them 3 became ill. Of the 2 > who didn’t become ill, one was a zoologist who, for many years, worked > with wild rodents in localities with natural foci of infection, and the > other had hemorrhagic fever in 1960.”

Group n Cases AR E_L E_R Notes
E-1 5 3 60% Sep 24 Oct 7 2 non-cases: presumed immune

Rodents arrived Sep 24 (expedition return); transferred to animal rooms Oct 7. E_L = Sep 24 (quarantine contact begins), E_R = Oct 7 (rodents moved).

IC likelihood: ⚠️ Applicable in principle with a 13-day exposure window. Formula: T_lower = O_day − Oct 7 − 1, T_upper = O_day − Sep 24 + 1

Onset example T_lower T_upper Width Info type
Oct 25 (plausible early) 17 32 15 Interval (moderate)
Nov 5 28 43 15 Interval (moderate)
Nov 15 38 53 15 Interval (broader)

All plausible onset dates yield T_lower > 0. The 15-day interval width is wider than Group A but narrower than Groups B/C. With 3 cases, the contribution would be small but methodologically legitimate.

Current status: ❌ NOT INCLUDED — individual onset dates unreported


Group F — Close contacts of cases (human-to-human transmission check)

PDF source: Paper p. 9 (PDF p. 13), paragraph 4: > “Epidemiological investigation showed that there was no hemorrhagic fever > among those who had contact with patients of the disease. This ruled out > the contagiosity of the infection.”

Group Cases Conclusion
F-1 0 Human-to-human transmission fully excluded

IC likelihood: N/A — no cases.

Current status: N/A (no cases)


Aggregate precision summary (from paper text)

Paper p. 8 (PDF p. 12), paragraph 2: > “with accurately established dates for the incubation period of 24 men, > the shortest duration was 14 days and the longest 32 days > (an average of 20.4 days)”

Conclusion 3, paper p. 10 (PDF p. 14): > “In 32 cases it was possible to establish accurately the duration of the > incubation period, which consisted on the average of 20.4 days with a > variation of 14-32 days.”

Note: text body says 24 men; Conclusion 3 says 32 cases — inconsistency within the original paper. Group A accounts for 18 of these “precisely known” cases. The remaining 6–14 are other single-visit persons whose individual onset data are not in the current dataset.


IC Likelihood Status and Current Inclusion

Summary table

Group n cases IC applicable? T_lower formula T_upper formula Interval width T_lower > 0? Info quality Currently included? Blocking factor
A 18 ✅ Yes k − 1 k + 1 2 days (fixed) Always (min 16) High ✅ Yes (v3b, v4)
Other precise (~6–14) ~6–14 ✅ Yes k − 1 k + 1 2 days Yes High ❌ No Individual onset dates not in dataset
B-1 20 ⚠️ Partial O − Oct 25 − 1 O − Oct 7 + 1 20 days Only if onset > Oct 25 Low–moderate ❌ No Individual onset dates unavailable
B-2 10 ⚠️ Partial O − Oct 25 − 1 O − Oct 7 + 1 20 days Likely for most Low–moderate ❌ No Individual onset dates unavailable
B-3 0 N/A N/A N/A No cases
C-1 11 ⚠️ Structurally weak O − Nov 1 − 1 O − Oct 7 + 1 26 days Never (onset ≤ E_R) Low (upper bound only) ❌ No T_lower ≤ 0 for all cases; onset dates unavailable
C-2 6 ❌ Confounded Unknown per person Unknown per person Unknown Very low ❌ No Multiple unknown visit dates; onset unavailable
D-1 10 ❌ Infeasible Undefined Undefined None ❌ No E_L undefined per person
D-2 34 ❌ Infeasible Undefined Undefined None ❌ No E_L undefined per person
D-3 18 ✅ Yes k − 1 k + 1 2 days Always High ✅ Yes (= Group A)
D-4 unknown ⚠️ In principle O − visit − 1 O − visit + 1 2 days Yes High ❌ No Count and dates unknown
E-1 3 ⚠️ Moderate O − Oct 7 − 1 O − Sep 24 + 1 15 days Always (onset >> Oct 7) Moderate ❌ No Individual onset dates unreported
F-1 0 N/A N/A N/A No cases

Priority for future inclusion (if individual data become available)

  1. Other precise single-visit cases (~6–14): same model as Group A, highest information density — direct drop-in to v4 with no code changes.

  2. Group E-1 (n=3): 15-day window, all T_lower > 0, moderate information. Small but legitimate contribution; exposure dates well-defined.

  3. Group B-1 late-onset cases: 20-day window; only those with onset after Oct 25 contribute two-sided intervals. Worth stratifying.

  4. Group B-2: similar to B-1 but weaker signal due to lower attack rate and likely later onsets with wider windows.

  5. Groups C-1, C-2, D-1, D-2: not recommended — upper-bound-only contribution or undefined individual exposure windows.