First international diagnostic accuracy study for the serological detection of West Nile virus infection

<p>Abstract</p> <p>Background</p> <p>The diagnosis of an acute or convalescent West Nile (WN) virus infection can be confirmed by various serological assays such as enzyme immunoassay (EIA), immunofluorescence assay (IFA), or neutralisation test (NT) which are conducted by a growing number of laboratories. However, as the degree of proficiency may vary between laboratories, quality control measures for laboratory diagnostics are essential.</p> <p>Methods</p> <p>We have performed an external quality assurance (EQA) programme for the serological detection of WN virus infection to assess the diagnostic quality of laboratories. The participating laboratories received a proficiency panel of 10 coded lyophilised test samples comprising four antisera positive for WN antibodies as positive controls, three antisera positive for antibodies against other heterologous flaviviruses plus one multireactive unspecific serum as specificity controls, and two negative serum samples.</p> <p>Results</p> <p>Twenty-seven laboratories from 20 different countries in Europe, the Middle East, the Americas and Africa participated in this EQA programme. Applying the proficiency criteria of this study, only eight laboratories correctly analysed all samples with their respective EIA, IFA or NT methods. Eighteen laboratories correctly identified between 77.8 and 90% of the samples, and one laboratory identified only 70% correctly with a clear need to eliminate cross-reactivity with other antisera, particularly those elicited by yellow fever virus. Differentiation between the results for IgM and IgG was considered separately and revealed that IgM-antibodies were detected less frequently than IgG-antibodies (p < 0.001). However, the assay used was not a significant technical factor influencing laboratory performance.</p> <p>Conclusion</p> <p>The EQA programme provides information on the quality of different serological assays used by the participating laboratories and indicates that most need to improve their assays, in particular to avoid cross-reactions with antibodies to heterologous flaviviruses.</p

Timeliness of Surveillance during Outbreak of Shiga Toxin–producing Escherichia coli Infection, Germany, 2011

In the context of a large outbreak of Shiga toxin–producing Escherichia coli O104:H4 in Germany, we quantified the timeliness of the German surveillance system for hemolytic uremic syndrome and Shiga toxin–producing E. coli notifiable diseases during 2003–2011. Although reporting occurred faster than required by law, potential for improvement exists at all levels of the information chain

Automatic Outbreak Detection Algorithm versus Electronic Reporting System

To determine efficacy of automatic outbreak detection algorithms (AODAs), we analyzed 3,582 AODA signals and 4,427 reports of outbreaks caused by Campylobacter spp. or norovirus during 2005–2006 in Germany. Local health departments reported local outbreaks with higher sensitivity and positive predictive value than did AODAs

Geographical differences of carbapenem non-susceptible Enterobacterales and Acinetobacter spp. in Germany from 2017 to 2019

Background Since May 2016, infection and colonisation with carbapenem non-susceptible Acinetobacter spp. (CRA) and Enterobacterales (CRE) have to be notified to health authorities in Germany. The aim of our study was to assess the epidemiology of CRA and CRE from 2017 to 2019 in Germany, to identify risk groups and to determine geographical differences of CRA and CRE notifications. Methods Cases were notified from laboratories to local public health authorities and forwarded to state and national level. Non-susceptibility was defined as intermediate or resistant to ertapenem, imipenem, or meropenem excluding intrinsic bacterial resistance or the detection of a carbapenemase gene. We analysed CRA and CRE notifications from 2017, 2018 and 2019 per 100,000 inhabitants (notification incidence), regarding their demographic, clinical and laboratory information. The effect of regional hospital-density on CRA and CRE notification incidence was estimated using negative binomial regression. Results From 2017 to 2019, 2278 CRA and 12,282 CRE cases were notified in Germany. CRA and CRE cases did not differ regarding demographic and clinical information, e.g. proportion infected. The notification incidence of CRA declined slightly from 0.95 in 2017 to 0.86 in 2019, whereas CRE increased from 4.23 in 2017 to 5.72 in 2019. The highest CRA and CRE notification incidences were found in the age groups above 70 years. Infants below 1 year showed a high CRE notification incidence, too. Notification incidences varied between 0.10 and 2.86 for CRA and between 1.49 and 9.99 for CRE by federal state. The notification incidence of CRA and CRE cases increased with each additional hospital per district. Conclusion The notification incidence of CRA and CRE varied geographically and was correlated with the number of hospitals.The results support the assumption that hospitals are the main driver for higher CRE and CRA incidence. Preventive strategies and early control measures should target older age groups and newborns and areas with a high incidence.Peer Reviewe

Completeness of tuberculosis case notifications in Germany in 2013–2017: first results of an inventory study

Background Evaluating the completeness of tuberculosis (TB) notification data is important for monitoring of TB surveillance systems. We conducted an inventory study to calculate TB underreporting in Germany in 2013–2017. Methods Acquisition of two pseudonymized case-based data sources (national TB notification data and antibiotic resistance surveillance data) was followed by two-source Capture-recapture (CRC) analysis, as case-based data from a third source was unavailable. Aggregated data on consumption of a key anti-TB drug (pyrazinamide [PZA]) was compared to an estimated need for PZA based on TB notification data to obtain an independent underreporting estimation. Additionally, notified TB incidence was compared to TB rate in an aggregated health insurance fund dataset. Results CRC and PZA-based approaches indicated that between 93 and 97% (CRC) and between 91 and 95% (PZA) of estimated cases were captured in the national TB notification data in the years 2013–2017. Insurance fund dataset did not indicate TB underreporting on the national level in 2017. Conclusions Our results suggest that more than 90% of estimated TB cases are captured within the German TB surveillance system, and accordingly the TB notification rate is likely a good proxy of the diagnosed TB incidence rate. An increase in underreporting and discrepancies however should be further investigated.Peer Reviewe

Accuracy of single beam timing lights for determining velocities in a flying 20-m sprint: Does timing light height matter?

Background: The purpose of this study was to evaluate the accuracy of timing lights (TL) at different heights for measuring velocities during sprinting. Methods: Two sets of single beam TL were used to determine velocities reached in a flying 20-m sprint in 15 healthy and physically active male participants. In TL64, all TL were set up at a height of 64 cm, and in TL100, all TL were set up at 100 cm, respectively. Participants performed three valid trials. The recordings of high-speed video cameras were used as a reference. Results: ICC and Pearson’s r values between both timing light heights and the reference system were almost perfect (0.969–0.991). Bland & Altman’s LOA (95 %) indicated low systematic and unsystematic errors, with somewhat smaller LOA for TL100 (-0.013–0.121 m/s) than for TL64 (-0.060–0.120 m/s). Measures of between-trial reliability of running velocities showed a high relative (ICC) and absolute (RMSE) reliability, with the reference system showing slightly better values in all reliability measures (ICC=0.935; RMSE<0.001 m/s) compared to TL64 and TL100 (ICC=0.894, 0.887; RMSE=0.107 m/s, 0.124 m/s, respectively). The usefulness, determined by comparing the typical error (TE) with the smallest worthwhile change (SWC), was considered as “OK” (TE ≈ SWC) for all three systems. Conclusions: Results suggest that TL at both heights (TL64 and TL100) can be considered as accurate, reliable, and useful in computing velocities during a flying 20-m sprint, and therefore can be recommended to both coaches and researchers

Aproximación a la psicopatología de una paciente con colitis ulcerosa: su relación con los procesos de simbolización

Los autores se proponen abordar el difícil y oscuro capítulo de la enfermedad psicosomática, y comprender algunas implicaciones del conflicto psicológico en juego en una paciente adolescente, que sufre de una grave colitis ulcerosa y, por indicación medica, inicia una psicoterapia de orientación analítica. La literatura específica sobre el tema es escasa, lo cual estimuló nuestro interés en esta comunicación

SurvNet Electronic Surveillance System for Infectious Disease Outbreaks, Germany

Electronic Surveillance System for Infectious Disease Outbreaks, German