Publications (16)45.16 Total impact
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Article: Ausbildungsprogramme für angewandte Epidemiologie in Deutschland und Europa
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ABSTRACT: Ausbrüche von Infektionskrankheiten, wie z. B. SARS und Influenza, können weitgreifende Folgen für die Gesellschaft haben. Daher kommt der Ausbildung von Nachwuchswissenschaftlern bei der Kontrolle von Infektionskrankheiten eine große Bedeutung zu. Die deutsche Postgraduiertenausbildung für angewandte Epidemiologie (PAE) am Robert Koch-Institut (RKI) und das European Programme for Intervention Epidemiology Training (EPIET) bemühen sich, dieser Herausforderung zu begegnen. Seit Bestehen konnten 27 Personen die PAE und 12 Personen deutscher Herkunft das EPIET-Programm beginnen. Von 36 Absolventen waren 17 unmittelbar nach dem Abschluss des Trainings am RKI in regionalen oder lokalen Gesundheitsbehörden in Deutschland tätig gewesen. Seit 2006 konnte die Anzahl der jährlich ausgebildeten Nachwuchswissenschaftler der PAE von 3 auf 6 erhöht werden, die des EPIET von 9 auf 19. Zudem sind 5 Landesstellen als Ausbildungsstätten in die PAE aufgenommen worden. Die Zusammenarbeit zwischen EPIET und PAE ist innerhalb der letzten Jahre verstärkt und diversifiziert worden. Absolventen dieser Ausbildungsprogramme werden mittelund langfristig eine Schlüsselrolle im Schutz gegen Infektionskrankheiten in Deutschland und Europa spielen. Outbreaks of infectious diseases such as SARS and influenza can have a profound impact on society. Therefore, training epidemiologists in infectious diseases control is of crucial importance. The German Postgraduate training in Applied Epidemiology (PAE) at the Robert Koch Institute (RKI) and the European Programme for Intervention Epidemiology Training (EPIET) are striving to meet these challenges. Currently, 27 and 12 persons of German origin have joined PAE and EPIET, respectively. A total of 17 out of the 36 alumni started working at the RKI, regional or local German health authorities after completing their training. Since 2006, the number of yearly admitted fellows increased from 3 to 6 in PAE, and 9 to 19 in EPIET and 5 state health departments have been added as training sites. The collaboration between EPIET and PAE has been strengthened and diversified in recent years. Alumni of these programs will play a key role in the control of infectious diseases in Germany and Europe.Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 04/2012; 52(2):203-207. · 0.66 Impact Factor -
Article: A large outbreak of influenza B-associated benign acute childhood myositis in Germany, 2007/2008.
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ABSTRACT: Benign acute childhood myositis (BACM) is a rare syndrome associated with various viral infections. Bilateral calve pain may lead to inability to walk. During winter 2007/2008, we investigated a nationwide outbreak of influenza-associated BACM (IA-BACM) to identify etiologic (sub)type, describe the course of disease, and explore how well the syndrome is known among physicians. We performed retrospective and prospective case finding in all German federal states. Physicians returned patient-based questionnaires containing information about sex, age, disease progression, patient-management, and number of BACM cases treated previously. We compared IA-BACM cases with influenza cases from the German virologic sentinel surveillance system for influenza. We investigated 219 children with IA-BACM. They coincided with the curve of influenza B of the German virologic sentinel surveillance system for influenza. Median age was 7 years, 74% (160/216) of cases were male, median time between the onset of fever and onset of BACM-symptoms was 3 days lasting for a median of 4 days. Almost half of the affected children had presented at hospitals. One case with beginning renal impairment occurred, but the patient recovered completely. Most reporting physicians had not seen BACM-patients previously. Multivariable analysis showed IA-BACM's strong association with influenza B, male sex, and age between 6 and 9 years. Influenza B caused a large BACM outbreak in Germany. Onset of BACM symptoms followed shortly after the onset of influenza symptoms. The course of this disease was almost exclusively mild and self-limiting. Diagnosis of this rare but distinct clinical entity by the alert physician can spare the patient potentially unneeded invasive testing and hospital admission.The Pediatric Infectious Disease Journal 08/2011; 30(8):e142-6. · 3.58 Impact Factor -
Article: Characteristics and risk factors for symptomatic Giardia lamblia infections in Germany.
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ABSTRACT: In developed countries, giardiasis is considered a travel related disease. However, routine surveillance data from Germany indicate that >50% of infections were acquired indigenously. We studied the epidemiological characteristics of symptomatic Giardia infections acquired in Germany and abroad, and verified the proportion of cases acquired in Germany in order to investigate risk factors for sporadic autochthonous Giardia infections. We identified Giardia cases notified by 41 local health authorities between February 2007 and January 2008 and interviewed them on their clinical symptoms, underlying morbidities, travel abroad and potential risk factors for the disease. We conducted a case-control-study including laboratory-confirmed (microscopy or antigen-test) autochthonous Giardia cases with clinical manifestations (diarrhoea, cramps, bloating) and randomly selected controls from the local population registry matched by county of residence and age-group (0-5, 6-19, > or =20 years). Secondary cases, controls with diarrhoea and persons who had travelled outside Germany in the three weeks prior to disease onset (exposure period) were excluded. We calculated adjusted odds ratios (aOR) with 95% confidence intervals (CI) using conditional logistic regression. Of 273 interviewed cases, 131 (48%) had not travelled abroad during the defined exposure period. Of these 131, 85 (65%) were male, 68 (54%) were living in communities with >100,000 inhabitants and 107 (83%) were aged 20 years or older. We included 120 cases and 240 controls in the case-control study. Cases were more likely to be male (aOR 2.5 CI 1.4-4.4), immunocompromised (aOR 15.3 CI 1.8-127) and daily consumers of green salad (aOR 2.9 CI 1.2-7.2). Contact with animals (pets/farm animals) and exposure to surface water (swimming/water sports) were not associated with symptomatic disease. A substantial proportion of Giardia lamblia cases in Germany are indigenously acquired. Symptomatic cases are significantly more likely to be immunocompromised than control persons from the general population. Physicians should consider Giardia infections among patients with no recent history of travel abroad, particularly if they have immune deficiencies. Green salads may be an important vehicle of infection. Information campaigns highlighting this food-borne risk should emphasise the risk to persons with immune deficiencies.BMC Public Health 01/2010; 10:41. · 2.00 Impact Factor -
Article: [Intervention epidemiology training programs in Germany and Europe. An investment in our future].
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ABSTRACT: Outbreaks of infectious diseases such as SARS and influenza can have a profound impact on society. Therefore, training epidemiologists in infectious diseases control is of crucial importance. The German Postgraduate training in Applied Epidemiology (PAE) at the Robert Koch Institute (RKI) and the European Programme for Intervention Epidemiology Training (EPIET) are striving to meet these challenges. Currently, 27 and 12 persons of German origin have joined PAE and EPIET, respectively. A total of 17 out of the 36 alumni started working at the RKI, regional or local German health authorities after completing their training. Since 2006, the number of yearly admitted fellows increased from 3 to 6 in PAE, and 9 to 19 in EPIET and 5 state health departments have been added as training sites. The collaboration between EPIET and PAE has been strengthened and diversified in recent years. Alumni of these programs will play a key role in the control of infectious diseases in Germany and Europe.Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 03/2009; 52(2):203-7. · 0.66 Impact Factor -
Article: Underreporting of human alveolar echinococcosis, Germany.
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ABSTRACT: We estimated the total number of human alveolar echinococcosis cases in Germany from 2003 through 2005 using the multiple source capture-recapture method. We found a 3-fold higher incidence of the disease than that shown by national surveillance data. We propose a revision of the reporting system to increase case ascertainment.Emerging Infectious Diseases 07/2008; 14(6):935-7. · 6.79 Impact Factor -
Article: Changing epidemiology of human brucellosis, Germany, 1962-2005.
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ABSTRACT: Trends in the epidemiology of human brucellosis in Germany were investigated by analyzing national surveillance data (1962-2005) complemented by a questionnaire-based survey (1995-2000). After a steady decrease in brucellosis incidence from 1962 to the 1980s, a persistent number of cases has been reported in recent years, with the highest incidence in Turkish immigrants (0.3/100,000 Turks vs. 0.01/100,000 in the German population; incidence rate ratio 29). Among cases with reported exposure risks, 59% were related to the consumption of unpasteurized cheese from brucellosis-endemic countries. The mean diagnostic delay was 2.5 months. Case fatality rates increased from 0.4% (1978-1981) to a maximum of 6.5% (1998-2001). The epidemiology of brucellosis in Germany has evolved from an endemic occupational disease among the German population into a travel-associated foodborne zoonosis, primarily affecting Turkish immigrants. Prolonged diagnostic delays and high case fatality call for targeted public health measures.Emerging infectious diseases 01/2008; 13(12):1895-900. · 6.17 Impact Factor -
Article: Leptospirosis in Germany, 1962-2003.
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ABSTRACT: Epidemiologic trends of human leptospirosis in Germany were investigated by analyzing national surveillance data from 1962 to 2003 and by conducting a questionnaire-based survey from 1997 to 2000. After a steady decrease of leptospirosis incidence from 1962 to 1997, surveillance data indicate an increase in disease incidence to 0.06 per 100,000 (1998-2003). Of 102 laboratory-confirmed cases in humans from 1997 to 2000, 30% were related to occupational exposures. Recreational exposures were reported in 30% (including traveling abroad in 16%), whereas residential exposure accounted for 37% of the cases. Direct contact with animals, mostly rats and dogs, was observed in 31% of the cases. We conclude that recent changes in transmission patterns of leptospirosis, partially caused by an expanding rat population and the resurgence of canine leptospirosis, may facilitate the spread of the disease in temperate countries like Germany. Preventive measures should be adapted to the changing epidemiology of leptospirosis.Emerging infectious diseases 08/2005; 11(7):1048-54. · 6.17 Impact Factor -
Article: Salmonella agona outbreak from contaminated aniseed, Germany.
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ABSTRACT: A nationwide outbreak of Salmonella Agona caused by aniseed-containing herbal tea occurred from October 2002 through July 2003 among infants in Germany. Consumers should adhere strictly to brewing instructions, although in exceptional cases this precaution may not be protective, particularly when preparing tea for vulnerable age groups.Emerging infectious diseases 08/2005; 11(7):1124-7. · 6.17 Impact Factor -
Article: Outbreak of wound botulism in injecting drug users in Germany, October-December 2005.
Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 02/2005; 10(12):E051215.4. · 6.15 Impact Factor -
Article: A nationwide outbreak of Salmonella Bovismorbificans PT24, Germany, December 2004-March 2005.
Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 02/2005; 10(3):E050324.1. · 6.15 Impact Factor -
Article: Zoonotische Infektionen beim Menschen
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ABSTRACT: Zoonosen sind Infektionskrankheiten, die auf natürlichem Weg vom Tier (Vertebraten) auf den Menschen übertragen werden können. Die Bedeutung der Zoonosen liegt in der Häufigkeit der Erkrankungsfälle, der hohen Letalität einzelner Zoonosen und der Möglichkeit von bisher auf das Tierreservoir beschränkten Erregern, die Artengrenze zum Menschen zu überwinden. Veränderte Bedingungen der Lebensmittelproduktion (inklusive Massentierhaltung) und der Ernährung sowie demographische, klimatische und ökologische Faktoren fördern die Verbreitung von Zoonoseerregern. Im Rahmen des seit 1. Januar 2001 geltenden Infektionsschutzgesetzes unterliegt Zoonoses are infectious diseases that can be transmitted from vertebrate animals to humans. Their significance lies in the large number of cases that occur, the high case fatality ratio of certain zoonoses, and the potential for some pathogens as yet restricted to animal hosts to cross the species barrier and infect humans. Changing habits in food production (for example, intensive animal husbandry) and food consumption as well as demographic, climatic, and ecological factors contribute to the spread of zoonotic pathogens. Several zoonoses are notifiable in Germany according to the Protection Against Infection Act enacted 1 January 2001. The European Commission issued a new directive on the monitoring of zoonoses and zoonotic agents on 17 November 2003. There is ongoing need to develop further measures to prevent and control zoonotic diseases on a national as well as international basis.Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 06/2004; · 0.66 Impact Factor -
Article: Sorbitol-fermenting enterohaemorrhagic Escherichia coli O157:H− causes another outbreak of haemolytic uraemic syndrome in children
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ABSTRACT: An outbreak of haemolytic uraemic syndrome (HUS) among children caused by infection with sorbitol-fermenting enterohaemorrhagic Escherichia coli O157:H- (SF EHEC O157:H-) occurred in Germany in 2002. This pathogen has caused several outbreaks so far, yet its reservoir and routes of transmission remain unknown. SF EHEC O157:H- is easily missed as most laboratory protocols target the more common sorbitol non-fermenting strains. We performed active case-finding, extensive exploratory interviews and a case-control study. Clinical and environmental samples were screened for SF EHEC O157:H- and the isolates were subtyped by pulsed-field gel electrophoresis. We identified 38 case-patients in 11 federal states. Four case-patients died during the acute phase (case-fatality ratio 11%). The case-control study could not identify a single vehicle or source. Further studies are necessary to identify the pathogen's reservoir(s). Stool samples of patients with HUS should be tested with an adequate microbiological set-up to quickly identify SF EHEC O157:H-. -
Article: Description of the early stage of pandemic (H1N1) 2009 in Germany, 27 April-16 June 2009
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ABSTRACT: We report characteristics of the early stage of the pandemic (H1N1) 2009 in Germany. Until 16 June 2009, 198 confirmed cases were notified. Almost half of the cases (47%) were imported, mostly from Mexico and the United States. About two third of indigenous cases were outbreak-related (with two large school-associated outbreaks, n=74). According to our results Germany is still in the early stage of the pandemic with limited domestic transmission. -
Article: Leptospirosis in Germany, 1962–2003
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ABSTRACT: Epidemiologic trends of human leptospirosis in Germany were investigated by analyzing national surveillance data from 1962 to 2003 and by conducting a questionnaire-based survey from 1997 to 2000. After a steady decrease of leptospirosis incidence from 1962 to 1997, surveillance data indicate an increase in disease incidence to 0.06 per 100,000 (1998-2003). Of 102 laboratory-confirmed cases in humans from 1997 to 2000, 30% were related to occupational exposures. Recreational exposures were reported in 30% (including traveling abroad in 16%), whereas residential exposure accounted for 37% of the cases. Direct contact with animals, mostly rats and dogs, was observed in 31% of the cases. We conclude that recent changes in transmission patterns of leptospirosis, partially caused by an expanding rat population and the resurgence of canine leptospirosis, may facilitate the spread of the disease in temperate countries like Germany. Preventive measures should be adapted to the changing epidemiology of leptospirosis. -
Article: Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005
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ABSTRACT: In June 2005 Coxiella burnetii-infected sheep, grazing and lambing on a meadow bordering a residential area, caused a large Q fever outbreak (331 cases) in Germany. Our outbreak investigation provided attack rates (AR) by distance between residence and meadow, sex and age groups. The AR of people living within 50 m of the meadow was 11·8%. It decreased the further the residence was from the meadow, falling to 1·3% at 350–400 m distance (RR 8·7, 95% CI 4·5–17·1). The AR was higher in men (RR 1·4, 95% CI 1·1–1·8). In the 25–64 years age group, the AR was 2·3 times higher compared to other age groups (95% CI 1·7–3·0). The distance-related AR showed a relationship between risk of infection and living close to the meadow. Ongoing urbanization will probably lead to further Q fever outbreaks, hence prevention activities undertaken by animal and public health practitioners should be aligned and strengthened. -
Article: Outbreak of wound botulism in injecting drug users
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ABSTRACT: Between October and December 2005, 16 cases of wound botulism were notified to the health authorities of North Rhine-Westphalia, Germany. All patients were injecting drug users (IDU) and the epidemiological investigations suggested contaminated injection drugs as the most probable source of infection. Clostridium botulinum was cultivated from clinical samples of six patients and molecular typing revealed that the different isolates were clonally identical. Two samples of heroin, one of them provided by a patient, were examined but C. botulinum could not be isolated. This outbreak demonstrates that IDU are at risk for acquiring wound botulism by injecting contaminated drugs. A greater awareness of this disease is needed by physicians and a close cooperation between public health authorities, street workers, operators of sheltered injecting facilities, and medical centres focusing on IDU is essential to prevent and manage outbreaks in IDU in a timely manner.
Top co-authors
Top Journals
Institutions
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2004–2012
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Robert Koch Institut
- Abteilung für Infektionsepidemiologie
Berlin, Land Berlin, Germany
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2011
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Institut für Arbeit und Gesundheit
Dresden, Saxony, Germany
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