Fig. 3

Visceral leishmaniasis case count by year and month of fever onset in Kosra village in Sheikhpura district and Lal Bigha and Kashichak villages in Nawada district. These blocks are located south of the Ganges River and were not considered endemic for VL. Social links between villages may have facilitated low-level sustained transmission prior to recognition of the large outbreak in Kosra in 2017