RÉSUMÉ
A cohort study on a barbecue-associated Salmonella outbreak was conducted to describe the burden of disease and to identify the outbreak vehicle. Dose-response relationships were tested with Fisher's exact and Wilcoxon rank sum tests (alpha = 0·05). S. Enteritidis isolates were cultured and phage-typed. Information was available for 11 out of 14 individuals attending the barbecue; all were healthy young adults (median age 27 years). The attack rate was 100%. Three cases were hospitalized and two developed acute pancreatitis. The exposure common to all cases was a vegetable pasta salad that had been stored unrefrigerated for 23 h. Consuming higher doses was associated with longer median symptom duration (7 days vs. 4 days, P = 0·11). S. Enteritidis was found in the stools of nine barbecue guests. Phage type 8/7 was identified in the stools of the salad preparer and one barbecue guest. This outbreak shows that S. Enteritidis can cause serious infection in young healthy individuals without well-known risk factors.
Sujet(s)
Épidémies de maladies , Microbiologie alimentaire , Toxi-infection alimentaire à Salmonella/épidémiologie , Salmonella enteritidis/isolement et purification , Adulte , Lysotypie/méthodes , Études de cohortes , Fèces/microbiologie , Femelle , Allemagne/épidémiologie , Hospitalisation , Humains , MâleRÉSUMÉ
An outbreak of food poisoning (emetic syndrome) occurred in three kindergartens (A, B and C) in Berlin, Germany, on 3 December 2007 after an excursion during which food was served. We conducted a retrospective cohort study among the kindergarten children and personnel who participated in the trip. The overall attack rate among the 155 participants was 30%. It was 31% among the 137 children (aged two to six years) and 17% among adults (n=18). The consumption of rice pudding was significantly associated with disease. Among those who ate rice pudding, the attack rate was 36%, compared with 0% for non-eaters (relative risk: infinite, p<0.001, aetiological fraction: 100%), but differed significantly between kindergartens A (43%), B (61%) and C (3%), probably because groups were served from different pots. Bacillus cereus sensu stricto was identified from one vomit sample. The clinical and epidemiological characteristics suggest that B. cereus emetic toxin (cereulide) was the causative agent, although it could not be proven in the single vomit isolate. Inadequate food handling most probably led to the outbreak. Single-portion ready-to-eat rice pudding was recommended for subsequent excursions and no further cases of food poisoning occurred.
Sujet(s)
Bacillus cereus/isolement et purification , Épidémies de maladies , Maladies d'origine alimentaire/épidémiologie , Établissements scolaires , Vomissement/épidémiologie , Douleur abdominale/diagnostic , Douleur abdominale/épidémiologie , Douleur abdominale/étiologie , Adulte , Berlin/épidémiologie , Enfant , Enfant d'âge préscolaire , Études de cohortes , Femelle , Maladies d'origine alimentaire/diagnostic , Maladies d'origine alimentaire/étiologie , Humains , Mâle , Oryza/intoxication , Études rétrospectives , Syndrome , Vomissement/diagnostic , Vomissement/étiologieRÉSUMÉ
Public health threats are increasingly triggered by events which span across international, national and state level jurisdictions. Innovative surveillance methods are needed to ensure adequate and timely response to such threats. In January 2009 the Department of Infectious Disease Epidemiology at the Robert Koch Institute (RKI) established a system of weekly telephone conferences with all competent authorities of the German federal states to identify, discuss and respond to infectious disease events in real-time. A regular and structured platform was developed for use between participants from state level public health authorities, the military and the RKI. During the first three quarters, 46 infectious diseases were covered, including mandatory reports of measles and meningococcal meningitis and outbreaks of cowpox, which does not have to be notified in Germany. Results of a targeted evaluation and a consistently high attendance rate both indicate that the teleconference has met additional needs for supplemental information exchange among participants. The telephone conference has proven to be a useful resource for rapid and direct communication, coordination and evaluation of signals for public health events in Germany.
Sujet(s)
Maladies transmissibles émergentes/épidémiologie , Surveillance de la population/méthodes , Santé publique/méthodes , Télécommunications/organisation et administration , Maladies transmissibles émergentes/prévention et contrôle , Cowpox/épidémiologie , Cowpox/prévention et contrôle , Notification des maladies/méthodes , Épidémies de maladies/prévention et contrôle , Épidémies de maladies/statistiques et données numériques , Allemagne , Humains , Diffusion de l'information/méthodes , Internet/organisation et administration , Rougeole/épidémiologie , Rougeole/prévention et contrôle , Méningite à méningocoques/épidémiologie , Méningite à méningocoques/prévention et contrôle , Logiciel , Conception de logicielRÉSUMÉ
Pneumococcal meningitis is a subgroup of invasive pneumococcal disease with a case-fatality rate of up to 30% and long-term sequelae in more than 50% of cases in adults in developed countries. We aimed to determine risk factors for this particular form of pneumococcal disease. We conducted a prospective population-based laboratory study of invasive pneumococcal disease in adults in North-Rhine-Westphalia, Germany from February 2001 to August 2006. All isolates underwent serotyping and susceptibility testing at the National Reference Centre for Streptococci in Aachen, Germany. Data were analysed using multiple linear regression. A total of 1043 isolates from bacteraemia and 131 isolates from meningitis were included into the study. Serotype 23F and being female were independent risk factors for pneumococcal meningitis. Being 60 years and serotype 1 were associated with a reduced odds ratio. Season, penicillin and macrolide resistance were not statistically associated with CNS involvement.
Sujet(s)
Infections à pneumocoques/microbiologie , Adolescent , Adulte , Sujet âgé , Femelle , Allemagne/épidémiologie , Humains , Modèles linéaires , Mâle , Méningite à pneumocoques/épidémiologie , Méningite à pneumocoques/microbiologie , Tests de sensibilité microbienne , Adulte d'âge moyen , Infections à pneumocoques/épidémiologie , Études prospectives , Facteurs de risque , Saisons , Sérotypie , Facteurs sexuels , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/isolement et purificationRÉSUMÉ
OBJECTIVE: To describe the impact of change from culture to more sensitive nucleic acid amplification testing (NAAT) tests on the detection of Chlamydia trachomatis in a genitourinary medicine (GUM) clinic population. METHODS: Data were collected between January 1992 and December 2003 on results of C trachomatis tests on male and female attenders at the Lothian GUM clinic (n = 81 590). Routine diagnosis switched from culture to NAAT methods in September 1998. Association of test result with age, sex, year of test, and test type was analysed using logistic regression. RESULTS: 6.1% (95% CI: 5.7% to 6.5%) of women and 7.1% of men (95% CI: 6.7% to 7.5%) tested positive with culture and 9.9% of women (95% CI: 9.4% to 10.3%) and 11.1% of men (95% CI: 10.7% to 11.5%) tested positive with NAATs. This corresponds to a 56% increase for men (95% CI: 47% to 66%) and 62% for women (95% CI: 50% to 67%). Logistic regression showed that a positive test result was strongly associated with test type with or without adjustment for year of test, sex, and young age. CONCLUSIONS: The significant increase in chlamydial infections detected following a change from culture to NAATs has important implications for interpretation of trends ascertained from surveillance data. Not all of this can be a direct effect of enhanced sensitivity and there may be indirect effects that improve ascertainment of existing infections. As more laboratories switch to NAATs similar patterns of stepwise increases in positive results are expected and trend analysis based on such surveillance data might thus show an artefactual rise in chlamydia infection rates. Accumulated surveillance data should therefore include timing of introduction of NAAT, so as to take account of under-ascertainment by previous methods.
Sujet(s)
Techniques bactériologiques , Infections à Chlamydia/diagnostic , Chlamydia trachomatis , Techniques d'amplification d'acides nucléiques/méthodes , Adulte , Sujet âgé , Techniques bactériologiques/méthodes , Techniques bactériologiques/normes , Infections à Chlamydia/épidémiologie , Méthodes épidémiologiques , Femelle , Humains , Mâle , Adulte d'âge moyen , Techniques d'amplification d'acides nucléiques/normes , Écosse/épidémiologieRÉSUMÉ
Shiga toxin producing Escherichia coli (STEC) in sewage influent into surface water are a potential source of human infections with STEC. Eight sewage treatment plants in Bavaria, Germany, were sampled at regular intervals from 2003 to 2004 in order to estimate STEC load and quantify risk factors. 95 of 378 samples (25 %) were tested positive for stx1and/or stx2 with PCR after enrichment culture. STEC elimination after treatment was 44 %. The following risk factors were analysed with logistic regression: location of sewage plant (rural vs. urban), treatment plant technology (two stage vs. three stage treatment) and sampling location (sewage input vs. sewage output). Rural plants had odds-ratios of 1,7 (95 % CI 1.03 - 2.69; p = 0.038) for a positive stx1 and/ or stx2 PCR result, sampling at sewage input of 2.1 (95 %CI 1.28 - 3.36; p = 0.003) and three stage plants of 1.51 (95 % CI 0.94 - 2.44; p = 0.087, not significant). Sampling after rain and after dry spells had no impact on STEC abundance (univariate Chi-square test = 0.01; df1; p = 0.920). Rural sewage plants had higher odds of STEC content. The influence of the sewage plant technology on the STEC load requires further clarification.
Sujet(s)
Surveillance de l'environnement/méthodes , Escherichia coli O157/isolement et purification , Déchets industriels/analyse , Appréciation des risques/méthodes , Eaux d'égout/microbiologie , Shiga-toxines/biosynthèse , Pollution de l'eau/analyse , Microbiologie de l'environnement , Surveillance de l'environnement/statistiques et données numériques , Surveillance épidémiologique , Escherichia coli O157/classification , Escherichia coli O157/métabolisme , Allemagne/épidémiologie , Facteurs de risque , Shiga-toxines/isolement et purificationRÉSUMÉ
HvrBase is a compilation of human and ape mtDNA control region sequences. Sequences and related information on individuals, such as from where the sequences were obtained, is stored in three ASCII files as described previously. Moreover, the collection is also available as Mac/PC database application with a graphical user interface. It can be accessed through the WWW at URL http://www.eva.mpg.de/hvrbase. The current collection comprises 5846 human sequences from hypervariable region I (HVRI) and 2302 human sequences from hypervariable region II (HVRII). From apes, 295 HVRI sequences and 13 HVRII sequences are available.