Characteristics and risk factors for symptomatic Giardia lamblia infections in Germany

Background: 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. Methods: 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, ≥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. Results: 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. Conclusions: 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

Microscopic analysis of gluten network development under shear load—combining confocal laser scanning microscopy with rheometry

A comprehensive in-situ analysis of the developing gluten network during kneading is still a gap in cereal science. With an in-line microscale shear kneading and measuring setup in a conventional rheometer, a first step was taken in previous works toward fully comprehensible gluten network development evaluation. In this work, this setup was extended by an in-situ optical analysis of the evolving gluten network. By connecting a laser scanning microscope with a conventional rheometer, the evaluation of the rheological and optical protein network evolution was possible. An image processing tool for analyzing the protein network was applied for evaluating the gluten network development in a wheat dough during the shear kneading process. This network evaluation was possible without interruption or invasive sample transfer comparing it to former approaches. The shear kneading system was able to produce a fully developed dough matrix within 125% of the reference dough development time in a classical kneader. The calculated network connectivity values from frequency testing ranged over all samples was in good agreement with traditional kneaded wheat dough just over peak consistency

COVID-19 Informationsvermeidungsskala (COVIAS)

This scale was developed at the University of Mannheim. It is based on the Information Avoidance Scale by Howell & Shepperd (2016). Several items were adapted and added to make this instrument applicable to the COVID-19 pandemic

Changing Epidemiology of Human Brucellosis, Germany, 1962–2005

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

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

A SARS-CoV-2 Omicron outbreak among crew members on a cruise ship in Germany in early 2022

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks on cruise shipshave rarely been investigated. In early 2022, we were informed about a SARS-CoV-2 outbreak on a cruiseship calling Port of Hamburg after 10 infections among crew members were detected. We conducted anoutbreak investigation in collaboration between ship owners, the ship physician and Hamburg’s Institutefor Hygiene and Environment, to identify risk factors and to achieve containment. The aim was to identifyrisk factors for SARS-CoV-2 infection and SARS-CoV-2 variants in a cohort of 165 crew members.Materials and methods: For this purpose, we collected data on age, sex, nationality, boarding-time, cabin use(single/shared), work place, and vaccination status of the study participants. Cases were defined as individualswho tested SARS-CoV-2 positive at least once in daily screenings during the outbreak period (10 days)by polymerase chain reaction or antigen test. We investigated risk factors for infection by descriptive, univariableand multivariable analysis. We performed whole genome sequencing to identify SARS-CoV-2 variants.Results: We verified 103 SARS-CoV-2 positive cases (attack rate [AR] 62.4%); 39/41 sequenced sampleswere BA.2.3 Omicron subtype, one BA.1 and one BA.1.1. Among boostered crew members, AR was 38%vs. 65% among those vaccinated once or twice. Among those who stayed < 30 days on board, AR was31% vs. 72% among those staying on board longer. Among Europeans, the AR was 53% vs. 71% in non--Europeans. Adjusting for age and sex, cases were more likely to have received no booster vaccine (oddsratio [OR]: 2.66, 95% confidence interval [CI]: 0.99–7.13), to have spent more time on board (≥ 30 days,OR: 6.36, 95% CI: 2.81–14.40 vs. < 30 days) and to have a non-European nationality (OR: 2.14, 95% CI:1.08–4.27). The outbreak stopped shortly after offboard isolation of cases.Conclusions: This investigation confirms the importance of a booster vaccine against COVID-19. Longerstays onboard could facilitate social mixing. Further studies could investigate the impact of social, cultural/behavioural patterns and public health access on the infection risk. Physical distancing together withscreening and isolation can contain SARS-CoV-2 outbreaks on cruise ships

Neuropeptide S receptor gene - converging evidence for a role in panic disorder

Animal studies have suggested neuropeptide S (NPS) and its receptor (NPSR) to be involved in the pathogenesis of anxiety-related behavior. In this study, a multilevel approach was applied to further elucidate the role of NPS in the etiology of human anxiety. The functional NPSR A/T (Asn¹⁰⁷Ile) variant (rs324981) was investigated for association with (1) panic disorder with and without agoraphobia in two large, independent case-control studies, (2) dimensional anxiety traits, (3) autonomic arousal level during a behavioral avoidance test and (4) brain activation correlates of anxiety-related emotional processing in panic disorder. The more active NPSR rs324981 T allele was found to be associated with panic disorder in the female subgroup of patients in both samples as well as in a meta-analytic approach. The T risk allele was further related to elevated anxiety sensitivity, increased heart rate and higher symptom reports during a behavioral avoidance test as well as decreased activity in the dorsolateral prefrontal, lateral orbitofrontal and anterior cingulate cortex during processing of fearful faces in patients with panic disorder. The present results provide converging evidence for a female-dominant role of NPSR gene variation in panic disorder potentially through heightened autonomic arousal and distorted processing of anxiety-relevant emotional stimuli

GLRB allelic variation associated with agoraphobic cognitions, increased startle response and fear network activation : a potential neurogenetic pathway to panic disorder

The molecular genetics of panic disorder (PD) with and without agoraphobia (AG) are still largely unknown and progress is hampered by small sample sizes. We therefore performed a genome-wide association study with a dimensional, PD/AG - related anxiety phenotype based on the Agoraphobia Cognition Questionnaire (ACQ) in a sample of 1,370 healthy German volunteers of the CRC TRR58 MEGA study wave 1. A genome-wide significant association was found between ACQ and single non-coding nucleotide variants of the GLRB gene (rs78726293, p=3.3x10-8; rs191260602, p=3.9x10-8). We followed up on this finding in a larger dimensional ACQ sample (N=2,547) and in independent samples with a dichotomous AG phenotype based on the Symptoms Checklist (SCL-90; N=3,845) and a case control sample with the categorical phenotype PD/AG (Ncombined =1,012) obtaining highly significant p-values also for GLRB single nucleotide variants rs17035816 (p=3.8x10-4) and rs7688285 (p=7.6x10-5). GLRB gene expression was found to be modulated by rs7688285 in brain tissue as well as cell culture. Analyses of intermediate PD/AG phenotypes demonstrated increased startle reflex and increased fear network as well as general sensory activation by GLRB risk gene variants rs78726293, rs191260602, rs17035816 and rs7688285. Partial Glrb knockout-mice demonstrated an agoraphobic phenotype. In conjunction withthe clinical observation that rare coding GLRB gene mutations are associated with the neurological disorder hyperekplexia characterized by a generalized startle reaction and agoraphobic behavior, our data provide evidence that non-coding, though functional GLRB gene polymorphisms may predispose to PD by increasing startle response and agoraphobic cognitions.PostprintPeer reviewe