Changing Epidemiology of Human Brucellosis, Germany, 1962–2005

This endemic occupational disease has become a foodborne and travel-associated zoonosis primarily affecting Turkish immigrants

Chemoprophylaxis and Malaria Death Rates

Malaria chemoprophylaxis increases the survival of nonimmune travelers

Leptospirosis in Germany, 1962–2003

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

Increase in malaria cases imported from Pakistan to Germany in 2012

A significant increase of malaria cases imported to Germany from Pakistan was observed in 2012. As of 14 November, Pakistan was the country of infection in 32 out of 434 malaria cases in 2012, compared to zero to eight annual malaria cases (out of over 500 cases) in previous years. Physicians and public health authorities should consider malaria in febrile patients returning or migrating from Pakistan

Erkrankungen an Paratyphus in Deutschland

Die Anzahl der Erkrankungen an Paratyphus in Deutschland hat sich in den letzten Jahren – im Vergleich zu früher – verringert. In den Vorjahren (seit 1997) wurden in jedem Jahr ca. 60 Erkrankungen gemeldet, die zu einem großen Teil aus anderen Ländern importiert wurden. Im Sommer 1999 erhöhte sich die Zahl der erfassten Erkrankungen durch einen Ausbruch von Paratyphus B nach Türkeireisen. In neun verschiedenen Ländern Europas kam es zu insgesamt mehr als 300 Erkrankungen an Paratyphus B. In Deutschland wurden in diesem Zusammenhang 40 Erkrankungsfälle registriert. Die Laboruntersuchungen ergaben, dass alle untersuchten Paratyphus B-Stämme den Lysotyp Taunton/B 7 aufwiesen

Trends in Imported Chikungunya Virus Infections in Germany, 2006–2009

Chikungunya virus (CHIKV) has been previously reported in many African and Asian areas, but it recently reemerged strongly in countries bordering the Indian Ocean as well as caused an outbreak in northern Italy. In Germany, where potential CHIKV vectors are not yet established, CHIKV infection is mandatorily notifiable. Cases reported from 2006 through 2009 were analyzed for travel characteristics and demographic factors. 152 cases of symptomatic CHIKV infection were notified. Both sexes were affected, with a median age of 46 years. Over the years, countries of infection largely followed the outbreaks reported from various travel destinations. India and the Maldives were the countries of infection most frequently named. In Sri Lanka, India, and Thailand, which are also frequently named countries of infection for dengue virus, the median age of CHIKV-affected patients was higher than that of dengue fever patients. Taking traveler numbers into consideration, risk of CHIKV infection was higher in the Seychelles and Mauritius than in Thailand and India. Even though substantial underdiagnosis is suspected, this assessment of CHIKV importation to Germany offers valuable information about the details of travel-associated cases. Between 17 and 53 notified cases per year signify that CHIKV would be occasionally available for local transmission in Germany once a vector becomes present. Although CHIKV most often causes a comparatively mild disease, the high median age of notified cases and the higher age than dengue patients support more severe disease courses in older adults. Travelers to all CHIKV endemic areas should protect against mosquito bites. In Germany, CHIKV surveillance will be continued to monitor ongoing importation of the virus and to detect early potential autochthonous cases

In Deutschland selten auftretende Infektionskrankheiten – Ergebnisse aus der Meldepflicht.

Selten auftretende Infektionskrankheiten haben in Deutschland eine große Bedeutung: Einige von ihnen erfordern bei ihrem Auftreten besondere Maßnahmen und Vorkehrungen, um eine Weiterverbreitung zu verhindern (z. B. virusbedingte hämorrhagische Fieber). Bei anderen stehen Präventionsaspekte im Vordergrund (impfpräventable Krankheiten). Zusammenfassende Darstellungen für einzelne seltene Krankheiten, die die Situation in Deutschland insgesamt beschreiben, sind nur auf Grundlage der Meldepflicht möglich. Die gesetzliche Meldepflicht ist eine gute Voraussetzung, um in Deutschland auftretende Krankheiten zu erfassen. Mit Einführung des Infektionsschutzgesetzes (IfSG) 2001 verbesserte sich die Qualität der verfügbaren Daten durch die Anwendung von Falldefinitionen. Die Auswertung der vorliegenden Meldungen zeigt: Auf der Grundlage der vorhandenen Daten ergeben sich keine Anhaltspunkte dafür, dass sich die Gefährdung durch einzelne seltene Krankheiten in Deutschland in absehbarer Zeit spürbar erhöhen könnte.Rare infectious diseases are of great importance in Germany: Some of them require special measures and precautions to prevent spreading (e.g. virus caused hemorrhagic fevers). For others, e.g. infectious diseases that can be prevented by vaccination, the prevention aspects are important. Summarizing descriptions for several rare diseases which together describe the situation in Germany are only possible on the basis of the notification requirements. The legal obligation for notification represents a good prerequisite to register diseases occurring in Germany. With the introduction of the Protection against Infection Act in 2001 the quality of the available data was improved by using case definitions. The evaluation of existing information indicates: On the basis of the available data there is no evidence that in the foreseeable future a noticeable increase of isolated rare diseases could pose a threat in Germany

Increasing case numbers of adenovirus conjunctivitis in Germany, 2010

In 2010 (as of 13 October 2010), the number of adenovirus conjunctivitis cases reported to the Robert Koch Institute in Berlin, Germany, has increased by more than 250% compared with same period in the previous two years. An investigation was initiated to identify spatial or temporal clusters, possible sources of infection and potential connections to cases abroad. The analysis did not show a disproportionately affected sex or age group, but many infections were preceded by exposure to ophthalmological facilities, communal facilities or public places