I read the Wikipedia article on acute flaccid myelitis which contains a graph showing confirmed US cases peaking biennially in 2014, 2016 and 2018.

That got me wondering because I found that pattern to seem unusual compared to an annual one tied to seasons or a constant or increasing one. So I did a quick Google search on "biennial patterns in rates of infection" and turned up this paper: Regular biennial cycles in epidemics caused by parametric resonance which discusses, mathematically, the biennial patterns sometimes found in the incidence of measles.

What I'd like to know, in layman's terms, is the causes of biennial patterns such as these in terms of the way these infections spread among victims and develop within them.



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