The exact incidence of congenital<unk><unk>  is hard to estimate because in many parts of the developing world,<unk>  has been eliminated. However, very few cases are still reported in the U.S and they are believed to be imported cases. In addition,<unk>  infection and congenital<unk><unk>  are still a challenge in the developing world, with most cases occurring in Africa and Southeast Asia. In countries without<unk>  immunization, the incidence is estimated to range between 60-220 per 100,000 cases.
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