“…This could be due to our cultural background where men are more likely to report to the hospital; at the same time they are more likely to acquire infection due to more outdoor activities. This correlates with the studies of Singhal et al and Prajapati et al [10,34] Although the disease occurred throughout the year, there was an increase from May to September months. This is in concordance with other reports from India which have related increased transmission to rainfall and water contamination.…”