[Outbreak with Ralstonia pickettii caused by contaminated magnesium vials]. / Ausbruch mit Ralstonia pickettii durch kontaminierte Magnesium-Ampullen.

HISTORY: In February 2013, 5 patients in an intensive care unit (ICU) were found to have positive blood cultures with Ralstonia pickettii within one week. Because all patients got intravenous therapy, improper work of a staff member was suspected. Some days later, a 6th patient was found with a positive blood culture of Ralstonia pickettii in another department of the hospital. INVESTIGATIONS: Hygienic investigations showed no evidence of failures in preparation of intravenous therapy. All patients were on different intravenous drugs, but every patient had received glucose 5 % and magnesium. We examined samples of glucose and magnesia as well as samples from environment. RESULTS AND COURSE: Glucose and magnesium samples were examined by membrane filter method. Ralstonia pitteckii was detected in some Magnesium vials. We concluded, that contamination of Magnesium vials might have been the reason for blood stream infection of patients. Pharmacists and authorities were informed and all vials were collected and replaced by vials from another company. Later a nationwide recall of Magnesium vials was performed by the producing company. No further Ralstonia pickettii was found in blood cultures in our hospital. CONCLUSION: Unusual pathogens in blood cultures should lead to reflection of rarer causes such as contamination of medicines.

[Combined hepatitis A/B vaccination: evaluation of a vaccination schedule in facilities for handicapped people]. / Hepatitis A/B-Kombinationsimpfung: Evaluation eines Impfprogramms in Werkstätten für Menschen mit Behinderung.

AIM OF THE STUDY: People with mental and physical disabilities have a higher risk of infection with hepatitis viruses. Studies conducted so far show contradictory results on the success of vaccination in this population. These people live and work under special conditions and sometimes have immune defects. METHODS: We investigated the antibody response after combined vaccination against hepatitis A and B in facilities for handicapped people in the city of Essen/Germany. Antibodies were determined in people with disabilities (n=949) and also in social workers taking care of handicapped people (n=115). RESULTS: Protective antibodies against hepatitis A were detected in 98.9% in people with disabilities and social workers. The seroconversion rate against hepatitis B in handicapped people was 90.2% and was comparable to the seroconversion rate in social workers (91.3%). Re-vaccinations were offered to all people with anti-HBs titres below 100 IU/L (28% of handicapped and 23.5% of social workers). In the group of low responders in handicapped people about 50% developed anti-HBs concentration above 100 IU/L. Non-responders showed 30-40% seroconversion rate after re-vaccination. CONCLUSION: Based on this study we would recommend serological tests about 4-8 weeks after vaccination to confirm seroconversion. By this procedure people who need a booster vaccination will be recognized and non-responders should be offered another HBV vaccination. In about 20% of the non-responders included in this study HBs antigen was detected.

Spotlight on measles 2010: measles outbreak in a mainly unvaccinated community in Essen, Germany, March-June 2010.

On 15 March 2010, a case of measles was reported to the District Health Office in Essen. In total 71 cases occurred from 15 March to 19 May (four cases hospitalised), with the majority linked to a Waldorf school. Only one case had been vaccinated twice, two cases had been vaccinated once. Immediate and consequent exclusion of non-immune children from classes for two weeks as well as the adjacent spring break prevented the wider spread of the virus.

[Experiences with anthrax emergency measures during 2001 and 2002 in the city of Essen]. / Erfahrungen mit den Milzbrand-Einsätzen in den Jahren 2001 und 2002 in der Stadt Essen.

After the terrorist attacks of 11 September 2001 suspected cases of anthrax also occurred in Germany. No case could be confirmed. From October 2001 to November 2002 the fire brigade of the city of Essen was called in 110 cases of suspected anthrax contamination. In 78 cases specimens were transported to diagnostic laboratories, in 22 cases persons were transported. Only in the first few days patients with suspected contamination had to stay in hospital and underwent chemoprophylaxis. Cooperation between the fire brigade, the local health authorities and the hygienists of the involved hospitals was very intense. It seems necessary to evaluate all the German experiences with suspected anthrax cases to develop risk estimations for different exposure situations and to develop specific recommendations for decontamination, disinfection and initial therapy.

Two outbreaks of trichinellosis in the state of Northrhine-Westfalia, Germany, 1998.

Illness or death from trichinellosis is statutorily notifiable in Germany. Between nought and ten cases were reported each year from 1987 to 1997. From November 1998 to January 1999, however, 52 cases of trichinellosis were identified by the public health

[Cross-sectional study of elementary school children for assessing suspected effects of regional hemato-toxic environmental pollutants]. / Querschnittsuntersuchung an Grundschulkindern zur Klärung eines Verdachts auf Auswirkungen von regionalen hämatotoxischen Umweltnoxen.

To investigate the suspicion of an increased incidence of leukopenia in school children living in the more industrialised northern region of the city of Essen, blood counts of these children were compared to those of pupils from the southern region in a two-phased study. In 469 1st and 2nd grade children, neither the mean leukocyte count nor the number of individual abnormal results differ between the two regional groups. A difference in the mean hemoglobin value found in the first series of investigations could not be reproduced in a control study of 255 children, the analysis of the data pointing to a methodological reason for the difference. Feasibility, planning and interpretation of results of such a cross-sectional study are discussed.