[Strategies for sustainable management of commensal rodents. Definitions of control objectives at communal level]. / Strategien nachhaltiger Bekämpfungen kommensaler Nagetiere. Definitionen von Bekämpfungszielen auf kommunaler Ebene.

The German Act on the Prevention and Control of Infectious Diseases in Man (Infektionsschutzgesetz, IfSG) provides a legal framework for activities and responsibilities concerning communal rodent control. However, actual governance of communal rodent control is relatively heterogeneous, as federal states (Bundesländer) have different or even no regulations for prevention and management of commensal rodent infestations (e.g. brown rats, roof rats and house mice). Control targets and control requirements are rarely precisely defined and often do not go beyond general measures and objectives. Although relevant regulations provide information about agreed preventive measures against rodents, the concept of sustainability is not expressed as such. A centrally managed database-supported municipal rodent control is a key factor for sustainability because it allows a systematic and analytical approach to identify and reduce rodent populations. The definition of control objectives and their establishment in legal decrees is mandatory for the implementation of a sustainable management strategy of rodent populations at a local level. Systematic recording of rodent infestations through municipal-operated monitoring provides the essential data foundation for a targeted rodent management which is already implemented in some German and European cities and nationwide in Denmark. A sustainable rodent management includes a more targeted rodenticide application which in the long-term will lead to an overall reduction of rodenticide use. Thus, the benefits of sustainable rodent management will be a reduction of rodenticide exposure to the environment, prevention of resistance and long-term economical savings.

[Mosquitoes as vectors for exotic pathogens in Germany]. / Stechmücken als Überträger exotischer Krankheitserreger in Deutschland.

As a result of intensified globalization of international trade and of substantial travel activities, mosquito-borne exotic pathogens are becoming an increasing threat for Europe. In Germany some 50 different mosquito species are known, several of which have vector competence for pathogens. During the last few years a number of zoonotic arboviruses that are pathogenic for humans have been isolated from mosquitoes in Germany including Usutu, Sindbis and Batai viruses. In addition, filarial worms, such as Dirofilaria repens have been repeatedly detected in mosquitoes from the federal state of Brandenburg. Other pathogens, in particular West Nile virus, are expected to emerge sooner or later in Germany as the virus is already circulating in neighboring countries, e.g. France, Austria and the Czech Republic. In upcoming years the risk for arbovirus transmission might increase in Germany due to increased occurrence of new so-called "invasive" mosquito species, such as the Asian bush mosquito Ochlerotatus japonicus or the Asian tiger mosquito Aedes albopictus. These invasive species are characterized by high vector competence for a broad range of pathogens and a preference for human blood meals. For risk assessment, a number of mosquito and pathogen surveillance projects have been initiated in Germany during the last few years; however, mosquito control strategies and plans of action have to be developed and put into place to allow early and efficient action against possible vector-borne epidemics.

Desperately seeking diarrhoea: outbreak of haemolytic uraemic syndrome caused by emerging sorbitol-fermenting shiga toxin-producing Escherichia coli O157:H-, Germany, 2009.

Infection with sorbitol-fermenting Shiga toxin-producing Escherichia coli O157:H- (sf STEC O157:H-) is rare, but emerging in Europe. The pathogen is typically isolated from paediatric patients with life-threatening haemolytic uraemic syndrome (HUS). It is unclear whether this observation primarily reflects the pathogen's virulence or its complex laboratory diagnosis, not routinely conducted in diarrhoeal patients. In summer 2009, four boys living in the same suburb in Germany developed diarrhoea-associated HUS: three were infected by sf STEC O157:H- and one died. We conducted two analytical epidemiological studies, an extensive search for diarrhoeal cases in potentially exposed groups, and an environmental investigation. Outbreak cases were residents of the suburb diagnosed with HUS, sf STEC O157:H- infection, or both between 24 July 2009 and 25 August 2009. Overall, we ascertained eight cases with a median age of 4 years (range: from 8 months to 9 years). Stool screening of 220 persons led to the identification of only four additional cases: two asymptomatic carriers and two diarrhoeal cases. HUS was strongly associated with visiting a local playground in July, particularly on 16th July (odds ratio = 42.7, P = 0.002). No other commonality, including food, was identified, and all environmental samples (n = 24) were negative. In this localized non-foodborne outbreak, the place of likely infection was a local playground. Sf STEC O157:H- infection apparently limits itself rarely to diarrhoeal illness and progresses frequently to HUS. Therefore, detection of and response to this hypervirulent pathogen primarily relies on HUS surveillance.

Exposure to toluene in the printing industry is associated with subfecundity in women but not in men.

OBJECTIVE: To examine the possible influence of exposure to toluene on human fertility. METHODS: In a cross sectional study, a sample of 150 male and 90 female printing industry workers were interviewed retrospectively on reproductive experience with a modified version of the European study of infertility and subfecundity questionnaire. Exposure categories comprised job descriptions and information on exposure measurements obtained by industrial hygienists. The fecundability ratio (FR) was estimated on the basis of time to pregnancy (TTP) or periods of unprotected intercourse not leading to pregnancy (PUNP) by means of survival analysis with proportional hazard models. Confounders such as age, ethnicity, smoking, parity, pelvic inflammatory diseases, and frequency of sexual intercourse were controlled for in the analyses. RESULTS: 256 Periods of TTP or PUNP were reported by men and 174 by women. After exclusion of induced abortions, birth control failures, and periods without employment for female workers we were able to analyse 169 periods in men and 100 periods in women. Male workers who had been exposed to different concentrations of toluene and their partners did not show a reduction in fecundity. In women (39 periods occurred during exposure) fecundity was reduced (FR 0.47, 95% confidence interval (95% CI) 0.29 to 0.77). Neither, restriction to only the first period nor exclusion of PUNPs changed the results (FR 0.48, 95% CI 0.24 to 0.97). CONCLUSION: After considering possible biases, low daily exposure to toluene in women seems to be associated with reduced fecundity. This result is in accordance with other findings for organic solvents and supports both the hypotheses that (a) organic solvents could affect hormonal regulation, and that (b) organic solvents increase early fetal losses which in turn contributes to longer times of unprotected intercourse.

Distribution of mast cells and their correlation with inflammatory cells around Onchocerca gutturosa, O. tarsicola, O. ochengi, and O. flexuosa.

In recent years, bovine Onchocerca species have been used as models for human onchocerciasis in drug screens. They have been suggested for immunology studies and evaluation of vaccine candidates. Therefore, mast cells and their association with other inflammatory cells were studied in five onchocercal species of cattle and deer using immunohistology. Intact mast cells occurred in large numbers in the capsule and septae of nodules, in fibrous tissue adjacent to nonnodular worms, and perivascularly. Inactive and, more frequency, activated and degranulating mast cells were observed within infiltrates in the nodule center or around nonnodular filariae. They were not detected in direct contact with the cuticle of adult worms or of microfilariae or among the macrophages, giant cells, and neutrophils forming the innermost layer around the worms. Eosinophils, but not mast cells, were obviously associated with microfilariae-producing females. The distribution, frequency, and activity of mast cells were similar for all five species and O. volvulus.

The chemotherapy of onchocerciasis XX: ivermectin in combination with albendazole.

Ivermectin is a potent microfilaricide that also blocks microfilarial release while albendazole is toxic to all intrauterine stages. We investigated whether their combination would permanently sterilize the adult worms. In the first open phase, all 69 patients received 150 micrograms/kg of ivermectin. In the second double-blind phase one week later, 35 patients were randomized to receive 800 mg of albendazole with a fatty breakfast for three consecutive days while 34 patients received matching placebo tablets. Detailed clinical and laboratory examinations were done before treatment and were repeated at intervals over one year. Nodules were excised at three and six months. There was a rapid reduction in skin microfilariae, maximal at four weeks (99.9%). Counts increased subsequently and were between 11 and 18% of initial values at one year. Nodule histology showed no macrofilaricidal activity of the combination. A high proportion of the stretched intrauterine microfilariae were degenerate in both groups. Anterior chamber microfilarial counts were unchanged until day 18 and then fell successively. Low levels persisted in several patients at one year. Dead corneal microfilariae and corneal punctate opacities increased initially, fell with time and then disappeared in most patients. Systemic and ocular reactions were mild to moderate and biochemical abnormalities were minor. A pronounced posttreatment eosinophilia subsided by day 30. There was no significant difference between the two groups in clinical and laboratory tolerance or in alterations in skin and ocular parasites and no important differences in the effect on the adult worms. The combination of ivermectin with albendazole given one week apart is well tolerated but produces no additional effect against Onchocerca volvulus when compared to ivermectin given alone.

Light and electron microscopy studies on Onchocerca jakutensis and O. flexuosa of red deer show different host-parasite interactions.

Adult filariae of two intranodular Onchocerca species of red deer (Cervus elaphus) were examined at the ultrastructural level. In all, 90 nodules of O. flexuosa and 20 nodules of O. jakutensis were studied by histology. O. jakutensis caused cystic and pus-filled nodules in which the female and male worms were motile. Female worms possessed a thick cuticle and a well-developed somatic musculature. The basal lamina of the muscular syncytia was connected with the transhypodermal fibers through long protrusions. The epicuticle had only few protuberances and no visible surface coat. Female O. flexuosa showed morphological features similar to those of other intranodular filariae. A surface coat could not be detected. In 24% of 33 nodules with young live female worms and 40% of 38 nodules with older live female O. flexuosa the worms were surrounded by giant cells apparently attacking a cuticle. This was found even in nodules obtained from animals no older than 9 months. It is probable that the lack of a surface coat protecting the female worm and the inability to move due to the reduced somatic muscles lead to an early elimination of O. flexuosa by the host's immune system.