A cluster of two human cases of tick-borne encephalitis (TBE) transmitted by unpasteurised goat milk and cheese in Germany, May 2016.

In May 2016, two cases of tick-borne encephalitis (TBE) were confirmed by serology (positive IgM and IgG antibodies against TBE virus (TBEV) in serum), with a possible link to raw milk and cheese from a goat farm in a region in Baden-Württemberg, Germany not previously known as TBE-endemic. The outbreak investigation identified 32 consumers of goat dairy products (29 consumers, one farm employee, two owners) of whom none had IgM antibodies against TBEV 3-8 weeks after consumption. Of the 27 notified TBE cases in the State, none reported consumption of raw goat milk or cheese from the suspected farm. Five of 22 cheese samples from 18 different batches were RT-qPCR-positive for TBEV -genome, and two of the five samples were confirmed by virus isolation, indicating viability of TBEV in the cheese. Nine of the 45 goats had neutralising TBEV antibodies, two of them with a high titre indicating recent infection. One of 412 Ixodes ricinus was RT-qPCR-positive, and sequencing of the E gene from nucleic acid extracted from the tick confirmed TBEV. Phylogenetic analyses of tick and cheese isolates showed 100% amino acid homology in the E gene and a close relation to TBEV strains from Switzerland and Austria.

[The new preschool examination in Baden-Wuerttemberg: what determinants influence the school medical evaluation special need for language promotion in childhood development?]. / Die neue Einschulungsuntersuchung in Baden-Württemberg: Welche Determinanten beeinflussen die schulärztliche Gesamtbewertung Intensiver pädagogischer Förderbedarf im kindlichen Entwicklungsfeld Sprache?

BACKGROUND AND AIMS: The new examination before primary school enrollment in Baden-Wuerttemberg aims at detecting problems in infant development with regard to later school success in time to initiate supporting measures, especially to improve the language skills of children with other native languages. By a 2-level process composed of a screening of language skills (HASE and KVS) and an additional test (SETK 3-5) of children who did not pass the screening, the school physicians attested special needs for language promotion in the kindergarten. This study looked for associated risks of children with special needs for language promotion. The degree of test quality of the 2-level process for identifying special needs for language promotion was determined. METHODS AND RESULTS: This cross-sectional analysis explored findings of n=80,781 children in the new examination before primary school enrollment of the data-set of Baden-Wuerttemberg (children with school enrollment 2011). 56,352 children (69.8%) were speaking German, 24,429 children (30.2%) had other family languages. 20,461 children (25.3%) had special needs for language promotion in the kindergarten. A logistic regression model to determine main risks of special needs for language promotion was developed. Main effects were other native languages (OR 5.1 [4.8; 5.2]), problems in subitising (OR 2.8 [2.7; 3.0]) and language development lags in the questionnaire of the nursery school teachers (OR 3.5 [3.3; 3.7]). Protective effects were an elevated graduation of the mother (OR 0.7 [0.7; 0.7]) or the father (OR 0.8 [0.7; 0.8]). Risk scores of the effects were defined. The corresponding predictive probability to different levels of risk scores was calculated. The true positive rate of the screening of language skills (HASE/KVS) in regard to special needs for language promotion was 0.95, the true negative rate was 0.72 and the -positive predictive value was 0.53. The school physician's findings of special needs for language promotion acted as gold standard. With the additional test (SETK 3-5) the positive predictive value improved to 0.9, if at least one of the subtests of the SETK 3-5 was not passed. The risk score-level corresponded with the pretest-probability and the consecutive positive predictive value of the screening of language skills. CONCLUSIONS: This study showed an adequate degree of test quality of the 2-level process in the new examination before primary school enrollment in Baden-Wuerttemberg (screening of language skills and additional test, if the screening is not passed). In addition children with special needs for language promotion had associated risks. Risk scores, that have been defined, offer an information tool to the school physicians concerning the positive predictive value of the screening of language skills without additional testing.

[Language promotion in kindergartens in Biberach county--an analysis of the state foundation subsidized language intervention project]. / Sprachförderung im Kindergarten im Landkreis Biberach -- Ein mit Mitteln der Landesstiftung gefördertes Projekt.

The Programme Sprachförderung im Kindergarten was carried out in 83 nursery-schools in the Landkreis Biberach/Germany from fall 2003 till summer 2004. The Programme was offered by the Kreisgesundheitsamt des Landkreises Biberach in cooperation with the Sozial- und Jugendamt and the Hör-Sprachzentrum Ravensburg and contained a language-intervention programme and a training for the nursery-school teachers. Language screenings where conducted at the beginning and the end of the programme including 1479 Children of the age of 4 - 6 years. 23 % of the native German and 62 % of the migrant children showed a need for intervention. These children where fostered with the Ravensburger Modell for 6 months. The increase in performance was highly significant. Nevertheless the fostered children could not achieve the performance level of the native German children without language retardation with the exception of two tasks (word families and understanding of questions). The most significant increase in performance showed the poorest performers of the intervention-group. According to the increase in performance the programme was successful, but also obviously too short for the poorer performers to catch up. Therefore we advise further language-intervention programmes in nursery-schools to be conducted as early as possible. Furthermore analytical observation and supervision must be standard to maintain a high level of effectiveness.