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The main reason the real rates for these rare-infection diseases is lower is because we're only analyzing the stats on the people we actually know got the disease, and for these rare diseases that means people who either died (so the local authorities checked), or got sick enough to go see a doctor *and* got their infection analyzed. If you just felt meh, or didn't present symptoms, or your doctor waved you off, then you won't be in the stats.

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