al ▁Pr adesh , ▁P un j ab , ▁H ary ana ▁and ▁the ▁north ▁eastern ▁states ▁of ▁India . ▁In ▁T amil ▁N adu , ▁four ▁en demic ▁areas ▁were ▁identified ▁in ▁the ▁survey — ( Mad ur ai , ▁Ram nad , ▁Raj ap al ay am , ▁and ▁S iv ag anga ). ▁The ▁common ▁factor ▁found ▁in ▁these ▁areas ▁was ▁the ▁practice ▁of ▁bath ing ▁in ▁common ▁p onds . ▁ ▁Trans mission ▁and ▁dis sem ination ▁▁ ▁Dem ellow ' s ▁theory ▁of ▁in fection ▁ ▁Kar un ar ath na e ' s ▁auto in oc ulation ▁theory ▁ ▁Ha emat ogen ous ▁spread ▁– ▁to ▁distant ▁sites ▁L ym ph atic ▁spread ▁– ▁causing ▁l ym ph aden itis ▁( rare ) ▁ ▁Dem ellow ▁post ulated ▁that ▁while ▁bath ing ▁in ▁common ▁p onds , ▁the ▁nas al ▁m uc osa ▁came ▁into ▁contact ▁with ▁inf ect ious ▁material . ▁Kar un ar ath na e ▁proposed ▁that ▁the ▁satellite ▁les ions ▁in ▁skin ▁and ▁conj unct ival ▁m uc osa ▁arose ▁as ▁a ▁result ▁of ▁auto in oc ulation . ▁ ▁Because ▁of ▁its ▁relationship ▁to ▁fish ▁path og ens , ▁Rh inos por id ium ▁is ▁pres umed ▁to ▁have ▁evol ved ▁from ▁aqu atic ▁path og ens ▁similar ▁to ▁the ▁other ▁Mes om yc et oz oe a ▁and ▁evol ved ▁to ▁inf ect ▁m amm al ▁and ▁bird ▁hosts . ▁ ▁If ▁this ▁happened ▁once ▁or ▁more ▁than ▁once ▁is ▁unknown