The BPF clone of "H. influenzae" biogroup "aegyptius" is more difficult to evaluate. Cases of Brazilian Purpuric Fever have been predominant in the Sao Paulo state. Sao Paulo is one of the most developed states in Brazil, which makes it easier to receive reports of outbreaks of diseases like BPF. However, it is difficult to know whether BPF has affected other, more rural areas of Brazil. Scientists have not yet determined to what extent BPF has affected rural communities because of a lack of communication technology in these areas and a general lack of medical services.