Bees generally have Nosema spores present in the gut and a stressor makes it worse. It only becomes a problem when the spore count gets above a critical level.
Yucel defined a low level as 0.1- 5 million spores per bee, medium infestation, 5-10 million spores per bee, and high infestation more than 10.1 million spores per bee.
There is some good background reading in his 2005 paper.
Also a huge amount of info on nosema on scientific beekeeping.com.
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