We found that recommendations to double dose for N. ceranae, other one dose treatments do result in rebound.  Like with many pests and diseases, a series of treatments at recommended levels works far better.
 
Fumagillin is both cyto- and genotoxic.   In humans, it's the drug of last resort.  We do need an alternative, but in the interim, a more conservative approach to the use of the drug in bees in warranted - doubling doses is not the answer.
 
<There is a recent report that Fumigillin may initially reduce the spore
count in an infected hive, the rebound effect after medication concludes
will find infection as much as 100% higher than before treatment.>

 



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