A Ammon

European Centre for Disease Prevention and Control, Solna, Stockholm, Sweden

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Publications (92)279.6 Total impact

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    ABSTRACT: Shiga toxin (Stx)-producing Escherichia coli (STEC) of serogroup O174 are human pathogenic intimin gene (eae)-negative STEC. To facilitate diagnosis and subtyping, we genotypically and phenotypically characterized 25 STEC O174 isolates from humans with different clinical outcomes and from animals and the environment. fliC genotyping resulted in four different genotypes (fliCH2 : n = 5; fliCH8 : n = 8; fliCH21 : n = 11; fliCH46 : n = 1). Twenty-three strains were motile expressing the corresponding H antigen; two non-motile isolates possessed fliCH8 . The stx genotypes and non-stx virulence loci, including toxins, serine-proteases and adhesins correlated well with serotypes but showed no differences with respect to the isolates' origins. Multilocus sequence typing identified seven sequence types that correlated with serotypes. Core gene typing further specified the four serotypes, including a previously unknown O174:H46 combination, and revealed distant relationships of the different serotypes within serogroup O174 and in relation to other haemolytic uremic syndrome (HUS)-associated STEC. Only serotype O174:H21 was associated with HUS. Differences in virulence factors and in the adherence capacity of STEC O174 corroborated this separation into four distinct groups. Our study provides a basis for O174 subtyping, unravels considerable genotypic and phenotypic heterogeneity and sheds light to potential environmental and animal reservoirs.
    Environmental Microbiology 08/2013; · 6.24 Impact Factor
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    ABSTRACT: We present a summary of the main findings of the latest report of the European Food Safety Authority and European Centre for Disease Prevention and Control on zoonoses, zoonotic agents and food-borne outbreaks in the European Union (EU), based on data from 2009. Zoonoses are prevalent and widely distributed across several countries in the EU. The most important highlight of this report was the continuous decrease of human salmonellosis since 2005, probably due to effective control programmes in livestock.
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 01/2011; 16(13). · 5.49 Impact Factor
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    ABSTRACT: European Union (EU) and European Economic Area (EEA) countries reported surveillance data on 2009 pandemic influenza A(H1N1) cases to the European Centre for Disease Prevention and Control (ECDC) through the Early Warning and Response System (EWRS) during the early phase of the 2009 pandemic. We describe the main epidemiological findings and their implications in respect to the second wave of the 2009 influenza pandemic. Two reporting systems were in place (aggregate and case-based) from June to September 2009 to monitor the evolution of the pandemic. The notification rate was assessed through aggregate reports. Individual data were analysed retrospectively to describe the population affected. The reporting peak of the first wave of the 2009 pandemic influenza was reached in the first week of August. Transmission was travel-related in the early stage and community transmission within EU/EEA countries was reported from June 2009. Seventy eight per cent of affected individuals were less than 30 years old. The proportions of cases with complications and underlying conditions were 3% and 7%, respectively. The most frequent underlying medical conditions were chronic lung (37%) and cardio-vascular diseases (15%). Complication and hospitalisation were both associated with underlying conditions regardless of age. The information from the first wave of the pandemic produced a basis to determine risk groups and vaccination strategies before the start of the winter wave. Public health recommendations should be guided by early capture of profiles of affected populations through monitoring of infectious diseases.
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 12/2010; 15(49). · 5.49 Impact Factor
  • Andrea Ammon, Pia Makela
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    ABSTRACT: The European Community (EC) has been collecting for 15 years data on zoonoses and agents thereof that integrate the information from human cases and their occurrence in food and animals. The current data collection covers 11 zoonotic agents: Salmonella, Campylobacter, Listeria, verotoxigenic E. coli (VTEC), Yersinia spp., Brucella, Mycobacterium bovis, Trichinella and Echinoccoccus, as well as rabies and food-borne outbreaks. The European Food Safety Authority (EFSA) is assigned the tasks of examining the data collected and publishing the Community Summary Report. This Report is prepared in close collaboration with the European Centre for Disease Prevention and Control (ECDC) responsible for the surveillance of the communicable diseases in humans, and with EFSA's Zoonoses Collaboration Centre (ZCC, in the Technical University of Denmark). Member States report the data on animals, feed, food and food-borne outbreaks to EFSA's web-based reporting system and the data on the human cases are reported to ECDC's web-application for The European Surveillance System (TESSy). The flow and analysis of data are described as well as an outline of the future plans to improve the comparability of the data.
    International journal of food microbiology 05/2010; 139 Suppl 1:S43-7. · 3.01 Impact Factor
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    ABSTRACT: Surveillance and studies in a pandemic is a complex topic including four distinct components: (1) early detection and investigation; (2) comprehensive early assessment; (3) monitoring; and (4) rapid investigation of the effectiveness and impact of countermeasures, including monitoring the safety of pharmaceutical countermeasures. In the 2009 pandemic, the prime early detection and investigation took place in the Americas, but Europe needed to undertake the other three components while remaining vigilant to new phenomenon such as the emergence of antiviral resistance and important viral mutation. Laboratory-based surveillance was essential and also integral to epidemiological and clinical surveillance. Early assessment was especially vital because of the many important strategic parameters of the pandemic that could not be anticipated (the 'known unknowns'). Such assessment did not need to be undertaken in every country, and was done by the earliest affected European countries, particularly those with stronger surveillance. This was more successful than requiring countries to forward primary data for central analysis. However, it sometimes proved difficult to get even those analyses from European counties, and information from Southern hemisphere countries and North America proved equally valuable. These analyses informed which public health and clinical measures were most likely to be successful, and were summarized in a European risk assessment that was updated repeatedly. The estimate of the severity of the pandemic by the World Health Organization (WHO), and more detailed description by the European Centre for Disease Prevention and Control in the risk assessment along with revised planning assumptions were essential, as most national European plans envisaged triggering more disruptive interventions in the event of a severe pandemic. Setting up new surveillance systems in the midst of the pandemic and getting information from them was generally less successful. All European countries needed to perform monitoring (Component 3) for the proper management of their own healthcare systems and other services. The information that central authorities might like to have for monitoring was legion, and some countries found it difficult to limit this to what was essential for decisions and key communications. Monitoring should have been tested for feasibility in influenza seasons, but also needed to consider what surveillance systems will change or cease to deliver during a pandemic. International monitoring (reporting upwards to WHO and European authorities) had to be kept simple as many countries found it difficult to provide routine information to international bodies as well as undertaking internal processes. Investigation of the effectiveness of countermeasures (and the safety of pharmaceutical countermeasures) (Component 4) is another process that only needs to be undertaken in some countries. Safety monitoring proved especially important because of concerns over the safety of vaccines and antivirals. It is unlikely that it will become clear whether and which public health measures have been successful during the pandemic itself. Piloting of methods of estimating influenza vaccine effectiveness (part of Component 4) in Europe was underway in 2008. It was concluded that for future pandemics, authorities should plan how they will undertake Components 2-4, resourcing them realistically and devising new ways of sharing analyses.
    Public health 01/2010; 124(1):14-23. · 1.26 Impact Factor
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    Public Health. 01/2010; 124(5):300-300.
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    ABSTRACT: The recent detection of a novel influenza A(H1N1) virus has led to the first WHO declaration of a Public Health Event of International Concern under the International Health Regulations (IHR 2005). Here we review the early epidemiological findings of confirmed cases in Mexico, the US, Canada and EU/EFTA countries. Strengthened surveillance and continued, transparent communication across public health agencies globally will be necessary in coming months.
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 05/2009; 14(18):19204. · 5.49 Impact Factor
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    ABSTRACT: In developed countries, acute gastroenteritis (AGE) is a major source of morbidity. However, only a few studies have estimated its incidence and the associated medical burden. This population-based study determined the incidence of community-acquired AGE patients seeking medical care and the relative role of various pathogens. Stool samples from patients with AGE presenting to a general practitioner (GP), pediatrician, or specialist in internal medicine for that reason were screened for various bacterial and viral enteropathogens. A control group was established as well. Incidences were calculated by the number of positive patients divided by the general population. The study was performed in north-west Germany in 2004. The incidence of AGE patients requiring medical consultation was 4,020/100,000 inhabitants. Children (<5 years of age) were at the highest risk (13,810/100,000 inhabitants). Of the patients, 6.6% were tested positive for an enteropathogenic bacteria and 17.7% for a viral agent. The predominant pathogens were norovirus (626/100,000) and rotavirus (270/100,000). Salmonella was the most frequently detected bacteria (162/100,000). The results presented confirm AGE and, specifically, AGE of viral origin as a major public health burden in developed countries.
    European Journal of Clinical Microbiology 04/2009; 28(8):935-43. · 3.02 Impact Factor
  • Andrea Ammon, D Faensen
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    ABSTRACT: The basis for EU wide surveillance was Decision 2119/98/EC of the European Parliament and the Council in 1998. Since May 2005 it is the task of the European Centre for Disease Prevention and Control to coordinate and further develop this network. One key function of the ECDC is to standardise European surveillance and especially to harmonise the procedures of the surveillance networks that developed independently of each other. As a first step, the EU case definitions have been revised jointly with the Member States and the Commission. All surveillance networks are evaluated with a standard protocol before a decision is made at the ECDC on the continuation of the individual network activities. Simultaneously, the development of The European Surveillance System (TESSy) progressed. Since the beginning of 2008 data users have been trained and TESSy has been in use since April 2008. In the future the main focus must be the improvement of the quality and comparability of the data as such data are the essential prerequisite for decision making in public health.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 03/2009; 52(2):176-82. · 0.72 Impact Factor
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    ABSTRACT: The European Food Safety Authority and the European Centre for Disease Prevention and Control have just published their Community Zoonoses Report for 2007, analysing the occurrence of infectious diseases transmittable from animals to humans. Campylobacter infections still topped the list of zoonotic diseases in the European Union and the number of Salmonella infections in humans decreased for the fourth year in a row. Cases of listeriosis remained at the same level as in 2006, but due to the severity of the disease, more studies on transmission routes are warranted. The report highlights the importance of continued co-operation between veterinarians and public health specialists, both at the EU level and within Member States.
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 02/2009; 14(3). · 5.49 Impact Factor
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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-.
    Epidemiology and Infection 01/2009; · 2.87 Impact Factor
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    ABSTRACT: This issue of Eurosurveillance has two focuses: a special issue on capacity building and training for applied field epidemiology in Europe [1] and a focus on the European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE) by featuring two papers based on presentations made at ESCAIDE 2008. The authors of these papers were invited by the Eurosurveillance editors to submit an article for peer-review after the abstract selection had taken place, because of their overall quality and the focus on information for action. In their contribution from Thailand, Pawun et al. report on a field-investigation of a nosocomial outbreak of bullous impetigo in newborns, caused by Staphyloccoccus aureus, in a hospital in northern Thailand [2]. The results from this investigation lead to the implementation of immediate measures that stopped the outbreak. Moreover, the awareness raised of the problems identified during the investigation triggered the implementation of measures to prevent similar outbreaks in the future. The second paper by Girardi et al. reports on the diagnosis of latent tuberculosis infection, an issue of considerable debate [3]. The authors compare sensitivity and specificity of interferon-gamma assays for latent tuberculosis infection by assessing the association of test results with tuberculosis occupational exposure in 115 health care workers by using latent class analysis. They found that the estimated specificity of in vitro assays was higher than that of Tuberculin skin tests (TST) also among individuals who were not BCG-vaccinated and from their data the authors conclude that when applied in healthcare workers, in vitro assays may provide a significant increase of specificity for tuberculosis infection compared to TST, even among non- vaccinated individuals, at the cost of some sensitivity. The two papers presented serve as good examples for some of the unique features of ESCAIDE; the conference’s focus not only on applied science and epidemiology (including field investigations), but on the direct, concrete application of study results for public health action. ESCAIDE is supported by European Centre for Disease Control and Prevention (ECDC) and jointly organised by ECDC, the European Programme for Intervention Epidemiology Training (EPIET), the EPIET Alumni Network (EAN) and the Training Programs in Epidemiology and Public Health Intervention NETwork (TEPHINET EUROPE). Besides sharing scientific knowledge, ESCAIDE provides an excellent opportunity for experts with a wide range of various backgrounds who are involved in epidemiology and infectious disease control and prevention to strengthen and expand networks and share experiences. The first ESCAIDE took place in October 2007 in Stockholm and was followed by a conference in Berlin in October 2008. At the time of publication of this editorial, the third ESCAIDE in Stockholm has just come to its end. From start, ESCAIDE has been a success with constantly well over 600 visitors and an annual increase of submitted abstracts of around 10 percent. Even if the focus of the conference is Europe, its’ reach is global; in 2009, besides from Europe, participants came from Australia, Brazil, Canada, China, Hong Kong, New Zealand, Pakistan, the Philippines, Thailand, the Unites States and Vietnam. Pandemic H1N1 influenza has understandably been given some focus during the 2009 conference. However, as in previous years, many other topics were covered in the various sessions. Topics covered by plenary sessions ranged from ageing and infectious diseases to influenza vaccination and to new methods for analysing outbreaks. A new and special focus on this year’s ESCAIDE meeting was the viewpoint from the laboratory and its role in public health, with a plenary session on what genotyping has to offer epidemiologists. More specific information on the conference can be found on a dedicated website (www.escaide.eu/) [4]. Given that ESCAIDE is both a forum for exchanging scientific knowledge and good practice as well as for networking and personal professional development, the two focuses of this Eurosurveillance issue stand well side-by-side: ESCAIDE and capacity building and training for applied field epidemiology in Europe. Members of the ESCAIDE scientific committee are: Andrea Ammon, ECDC, Arnold Bosman, ECDC, Viviane Bremer, ECDC/EPIET, Johan Giesecke, ECDC (chair), Gérard Krause, ECDC Advisory Forum, Marion Koopmans, European Society for Clinical Virology , Davide Manissero, ECDC, Barbara Schimmer, EPIET Alumni Network, Ines Steffens, ECDC, Howard Needham, ECDC, Panayotis Tassios, European Society of Clinical Microbiology and Infectious Diseases. -------------------------------------------------------------------------------- References 1.Walke HT, Simone PM. Building capacity in field epidemiology: lessons learned from the experience in Europe. Euro Surveill. 2009;14(43):pii=19376. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19376 2.Pawun V, Jiraphongsa C, Puttamasute S, Putta R, Wongnai A, Jaima T, et al. An outbreak of hospital-acquired Staphylococcus aureus skin infection among newborns, Nan Province, Thailand, January 2008. Euro Surveill. 2009;14(43):pii=19372. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19372 3.Girardi E, Angeletti C, Puro V, Sorrentino R, Magnavita N, Vincenti D, et al. Estimating diagnostic accuracy of tests for latent tuberculosis infection without a gold standard among healthcare workers. Euro Surveill. 2009;14(43):pii=19373. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19373 4.ESCAIDE 2009 [Internet]. Stockholm: European Scientific Conference on Applied Infectious Disease Epidemiology. 2009. [cited 29 October 2009]. Available from: www.escaide.eu
    Eurosurveillance. 01/2009; 14(43).
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    Andrea Ammon, Daniel Faensen
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    ABSTRACT: Mit der im Jahr 1998 von EU-Parlament und Ministerrat getroffenen Entscheidung zur Etablierung eines EU-weiten Netzwerks zur Überwachung von Infektionskrankheiten wurde die Grundlage für die EUweite Surveillance geschaffen. Seit Mai 2005 hat das Europäische Zentrum für die Prävention und die Kontrolle von Krankheiten (ECDC) die Aufgabe, dieses Netzwerk zu koordinieren und weiterzuentwickeln. Eine der Hauptfunktionen des ECDC besteht darin, die europäische Infektionsüberwachung zu standardisieren und insbesondere die Verfahrensweisen der weitgehend voneinander unabhängigen Surveillance-Netzwerke zu vereinheitlichen. Als einer der ersten Schritte wurden in Zusammenarbeit mit den Mitgliedsstaaten die EU-Falldefinitionen für die Surveillance revidiert. Die Surveillance-Netzwerke werden derzeit nach einem standardisierten Protokoll evaluiert, bevor im ECDC eine Entscheidung über die Zukunft der einzelnen Netzwerkaktivitäten getroffen wird. Parallel wurde mit der Entwicklung eines einheitlichen Datenerfassungssystems (The European Surveillance System, TESSy) begonnen. Seit Beginn 2008 werden die Nutzer spezifisch geschult. TESSy ist seit April 2008 funktionsfähig. Zukünftig muss das Hauptaugenmerk auf die Qualität und Vergleichbarkeit der Daten gerichtet sein, da nur valide und vergleichbare Daten eine gute Grundlage für Entscheidungen im Gesundheitsbereich sind. The basis for EU wide surveillance was Decision 2119/98/EC of the European Parliament and the Council in 1998. Since May 2005 it is the task of the European Centre for Disease Prevention and Control to coordinate and further develop this network. One key function of the ECDC is to standardise European surveillance and especially to harmonise the procedures of the surveillance networks that developed independently of each other. As a first step, the EU case definitions have been revised jointly with the Member States and the Commission. All surveillance networks are evaluated with a standard protocol before a decision is made at the ECDC on the continuation of the individual network activities. Simultaneously, the development of The European Surveillance System (TESSy) progressed. Since the beginning of 2008 data users have been trained and TESSy has been in use since April 2008. In the future the main focus must be the improvement of the quality and comparability of the data as such data are the essential prerequisite for decision making in public health.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2009; · 0.72 Impact Factor
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    ABSTRACT: Investigating and reporting of foodborne outbreaks became mandatory with Directive 2003/99/EC. In 2006 and 2007 the Community reporting system for foodborne outbreaks was further developed in an interdisciplinary approach, which is described in this paper. This involved experts on investigating and reporting foodborne outbreaks as well as experts on communicable diseases in addition to the European Food Safety Authority (EFSA) Task Force for Zoonoses Data Collection, the European Centre for Disease Prevention and Control (ECDC) Advisory Forum and representatives of ECDC, the World Health Organization (WHO), the World Organization for Animal Health (OIE) and the European Commission. European Union Member States participated in a survey regarding their national reporting systems and the needs for information on foodborne outbreaks at the Community level. The acceptability, the functionality and the data quality of the current reporting system were evaluated. The results were used to propose new variables on which data should be reported. Pick-lists were developed to facilitate reporting and better integration of the Community system with Member States' reporting systems. The new system is expected to yield better quality data on foodborne outbreaks relevant for risk assessment and risk management while reducing the work load for Member States.
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 12/2008; 13(45):pii: 19029. · 5.49 Impact Factor
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    ABSTRACT: To gain actual information concerning the oropharyngeal carriage of Neisseria meningitidis among teenagers aged 15-18 years in Germany especially in a region with increased incidence of meningococal-related diseases prompted the study. Each teenager was swabbed three times with an interval of 2 months between the examinations. The 901 recovered N. meningitidis strains were characterized using serological (serogrouping, serotyping/serosubtyping) and molecular methods (PCR, PFGE) each. The results of the study demonstrate an overall average carrier rate of 18.8% for the three collection periods. There were, however, significant differences between the carrier rates within a given school and of different towns and counties. Of all isolates, 60.6% were not serogroupable. Serogroup B dominated (12.3%), followed by serogroup Y (9.0%) and serogroup C (3.6%). After PCR-based serogrouping of not serogroupable strains the percentages for serogroups enhanced to 18.8% for B, 10.8% for Y and 4.1% for C. Serotyping led to 305 different phenotypes with the most common being 29E:NT:P1.2,5 followed by Y:14:NST. In the 6 study towns the number of different N. meningitidis clones (PFGE types) isolated, varied between 30 and 87. In Wenden, where a prolonged outbreak had taken place, serogroup C (14.8%) was predominant. Only in this town C:2a isolates were found, all belonging to the ST-11/ET-37 complex and 12/13 matched identically to the ET-15 clone. Of the colonized teenagers, 26.7% were carriers over at least 23 weeks, 22.6% with the same strain, 36.0% were carrier for at least 15 weeks. Over all three collection periods 36.7% of the adolescents acquired a new strain. The highest acquisition rate was related to PFGE type 12.
    International Journal of Hygiene and Environmental Health 08/2008; 211(3-4):263-72. · 3.05 Impact Factor
  • A Amato-Gauci, A Ammon
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    ABSTRACT: This article presents the steps and considerations that led to the development of the European Centre for Disease Prevention and Control s (ECDC) long-term strategy for the surveillance of communicable diseases in the European Union (EU) for the years 2008 to 2013. Furthermore, it outlines the key features of the strategy that was approved by the ECDC s Management Board in December 2007.
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 07/2008; 13(26). · 5.49 Impact Factor
  • A Ammon
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 06/2008; 13(19). · 5.49 Impact Factor
  • Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 01/2008; 12(12):E071220.6. · 5.49 Impact Factor
  • Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 12/2007; 12(11):E071122.1. · 5.49 Impact Factor
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    ABSTRACT: In 2001, the Robert Koch Institute (RKI) implemented a new electronic surveillance system (SurvNet) for infectious disease outbreaks in Germany. SurvNet has captured 30,578 outbreak reports in 2001-2005. The size of the outbreaks ranged from 2 to 527 cases. For outbreaks reported in 2002-2005, the median duration from notification of the first case to the local health department until receipt of the outbreak report at RKI was 7 days. Median outbreak duration ranged from 1 day (caused by Campylobacter) up to 73 days (caused by Mycobacterium tuberculosis). The most common settings among the 10,008 entries for 9,946 outbreaks in 2004 and 2005 were households (5,262; 53%), nursing homes (1,218; 12%), and hospitals (1,248; 12%). SurvNet may be a useful tool for other outbreak surveillance systems because it minimizes the workload of local health departments and captures outbreaks even when causative pathogens have not yet been identified.
    Emerging Infectious Diseases 11/2007; 13(10):1548-55. · 6.79 Impact Factor

Publication Stats

1k Citations
279.60 Total Impact Points

Institutions

  • 2008–2011
    • European Centre for Disease Prevention and Control
      Solna, Stockholm, Sweden
    • Bundesinstitut für Risikobewertung
      Berlín, Berlin, Germany
  • 1998–2008
    • Robert Koch Institut
      • Department for Infectious Disease Epidemiology
      Berlín, Berlin, Germany
  • 2001
    • Sachsen Anhalt
      Magdeburg, Saxony-Anhalt, Germany
  • 1999
    • Centers for Disease Control and Prevention
      Atlanta, Michigan, United States