Search

OBJECTIVE The aim of this study is to present data concerning children's participation in the German preventive medical examinations for children ("U2" to "U8") in accordance with sections 26 and 92 of the German Social Code (Book V) as retrospectively recorded by the Public Health Service ("Offentlicher Gesundheitsdienst") of the German Province of Saxony-Anhalt during school entry medical examinations. Also we wanted to analyse the additional variables recorded per child in the areas of social factors, diagnostic findings and levels of therapeutic care in connection with their degree of participation in the preventive medical examinations. METHODOLOGY The statistical analysis of 73 628 anonymised data sets from the health monitoring system of the German Province of Saxony-Anhalt that were collected by the 14 health authorities in Saxony-Anhalt during school entry medical examinations between 2008 and 2012. An analysis of the data for 20 variables per child was performed with regard to the influence of their degree of participation in the U2 to U8 medical examinations using differences in frequency in the examination groups and checking the significance of these differences by means of the chi-squared test. RESULTS 99-96% of children in Saxony-Anhalt underwent the 5 preventive medical examinations U2-U6. As the children get older, the participation rates decrease (U2=98.7% down to U8=88.5%). By the time the school entry medical examinations are carried out (at an average age of 63 months), 83% of the children have -undergone all 7 preventive medical examinations for children, while 0.4% have not -undergone one single "U" examination. A child's gender has no influence on its parents' decision as to whether or not it should undergo the examinations. The results also reveal that children who attend day care -facilities are significantly more likely to have undergone all of the U examinations (84.8%) than children who are cared for at home (55.1%). CONCLUSION The retrospective comprehensive collection of data concerning the children's degree of participation in preventive medical examinations using the school entry medical examination is suitable for identifying connections between participation rates and the social factors, diagnostic findings and levels of therapeutic care of the children in question.

Introduction: On May 3, 2009, a first case of influenza A/H1N1 infection occurred in the federal state of Saxony-Anhalt, Germany. In order to stop the possible spread of the virus and to study the epidemiological and clinical characteristics of the infection, an investigation was launched by the local health authorities and the RKI. Methods: Standardised questionnaires were used to assess demographic and clinical data. Specimens were collected from case patients and close contacts and were analysed for influenza A/H1N1 using real-time PCR. Results: The index patient showed fever and coughing 3.5 days after returning from a holiday in Mexico. The local health authorities were informed on May 3, and measures were rapidly implemented. These measures included a trace-back of possible contact persons, isolation of the case and close contacts, prophylactic treatment with Oseltamivir. Virological investigations showed that the case shedded viral genome up until the last day of antiviral therapy. Viral genome was also detected in the spouse and the son of the patient. Both showed no symptoms under a prophylactic treatment with antiviral medication. No viral genome was detected in three other family members, and in six other contact persons outside of the family. Discussion: The spread of the virus was contained due to the fast response of the local health authorities. Two secondary cases occurred in the family. These cases remained asymptomatic, possibly due to antiviral prophylaxis. Epidemiological and virological results suggest that the influenza A/H1N1 virus has a longer incubation period and that viral shedding may probably be prolonged when compared with seasonal influenza.

On October 5th, 2006, the German Reference Centre for Meningococci (NRZM) held the 3rd Workshop on Epidemiology, Prevention and Treatment of Invasive Meningococcal Disease, in collaboration with the German Society for Hygiene and Microbiology (DGHM). Given the recent recommendation of the German Standing Committee on Vaccination (STIKO) for conjugate meningococcal C vaccination of all children in the second year of life, observations from meningococcal C conjugate vaccination campaigns in other European countries were presented and compared to the German situation. Moreover, the newly implemented cluster detection routines employed at the NRZM and their integration into the interactive geographical information system EpiScanGIS were shown. Based on recent experiences from regional outbreaks in Oberallgau, Sangerhausen, and Greater Aachen, examples for public health intervention were given at the conference. In addition, current developments in the area of meningococcal research, as well as trends in antimicrobial susceptibility were covered. Finally, the latest evidence concerning the clinical management and chemoprophylaxis of this invasive bacterial disease was discussed.

From August 2004 to January 2005 a cluster of 7 cases of serogroup B meningococcal disease occurred in the state of Saxony-Anhalt in the town of Sangerhausen and the surrounding area. This led to an investigation of meningococcal carriage in 816 high school students (grades 9 to 13). The students were also asked to fill out a questionnaire regarding possible risk factors for carriage. The goal of the study was the evaluation of a possibly persistently increased risk for further cases in the region. Results of the study were to be used for a comprehensive and targeted education of the public. The percentage of students found harbouring N. meningitidis in the nasopharynx in Sangerhausen (9.0 %) was not elevated compared to that found in the two control regions of Kelbra, County of Sangerhausen (8.2 %) and Jessen, County of Wittenberg (9.9 %). The serogroup B fine type responsible for the cluster (P1.7-2,16:F3-3:PorB3-24) was found only in one student each in Sangerhausen and Kelbra. Thus, there was no evidence of an increased risk for further cases at the time of the study at the end of January, 2005. This may have been due to intensive contact tracing and provision of chemoprophylaxis in Sangerhausen. Visiting a disco or bar and smoking were identified as risk factors for meningococcal carriage. However, these factors were associated with carriage only in boys but not in girls. This may be explained by sex-specific differences in physical interaction with others. Efforts to prevent further cases during clusters of meningococcal disease should consider sex-specific risk behaviour.

Purpose In spring and summer 2004, a multistate outbreak of infections caused by Salmonella enterica serovar Give (S. Give), a relatively rare serovar in Germany, was detected. In order to identify a common exposure and to describe the characteristics of infections caused by S. Give, an outbreak investigation was performed. Materials and methods In addition to passive surveillance through mandatory case-reporting, active case-finding was conducted. A case-control study was undertaken in order to identify the probable vehicle of infection. S. Give strains were isolated and molecular subtyping was performed by pulsed-field gel electrophoresis (PFGE). Rates of hospitalization were assessed in patients with S. Give infection, and compared to the rates found in patients infected by the most common serovar in Germany, S. enteritidis. Results From March to July 2004, 115 cases of gastroenteritis caused by S. Give were identified, with highest incidences being observed in the states of Lower Saxony and Saxony-Anhalt. Consumption of raw minced pork was strongly associated with S. Give infections (OR: 8.0; 95% CI 2.3-27.7; P = 0.001). This result was confirmed by the detection of common outbreak strains in isolates from both patients and pork, using PFGE. Infections caused by S. Give lead to hospitalization in 55% of patients > or = 60 years, but only in 17 % of younger patients (OR: 6.0; 95% CI 2.1-16.3; P or = 60 years with infections caused by S. enteritidis (OR: 2.5; 95% CI 1.1-5.4; P = 0.02). Conclusion This is, to our knowledge, the first documented multistate outbreak of salmonellosis associated with the consumption of raw minced pork in Germany. Since contamination of pork meat with Salmonella cannot be avoided, people with risk factors for severe infection should generally avoid the consumption of raw minced pork. The high hospitalization rates in patients > or = 60 years infected with S. Give possibly indicate a higher virulence of this specific serovar. Even in non-typhoidal salmonellosis, early antibiotic therapy should be considered depending on infecting serovar, age and medical history of the patient.

Aim: Aim of the study is to examine the hypotheses of a steeper increase in allergies and allergic sensitisations in East than in West German children between 1991 and 2000. Method: Between 1991 and 2000 we yearly repeated cross-sectional studies (SAWO: Study on school beginners) and asked 36,645 parents about diagnoses and symptoms of allergies in their six-year old children (response: 79%). The study was done in Leipzig, Halle, Merseburg, Magdeburg, small towns in the Altmark region, Duisburg, Essen, Koln and Borken during spring. An allergological investigation was included 1991, 1994,1997 and 2000. Dermatologists diagnosed a prevalent atopic eczema, administered a skin prick test (n = 7,229) and blood was taken for the determination of specific IgE antibodies against common allergens (n = 7,714, RAST). Odds Ratios (OR) for trend were calculated separately for the data from East and West Germany and are given along with their 95% confidence intervals. Results: Allergies and their symptoms (exception: atopic eczema) were less prevalent in East German children born before the reunification than in West German ones. In East as well as in West Germany bronchial asthma was diagnosed more often in 2000 than in 1991 (OR East: 2.42 [1.78-3.28] West: 2.07 [1.43-3.00]). In contrast the prevalence of atopic eczemas was more than halved between 1991 and 2000. Of all symptoms and diagnoses of allergies only hay fever and its symptoms showed an upward trend in East Germany which was steeper than the trend in West Germany (OR East: 4.41 [3.17-6.13] West: 1.74 [1.19-2.57]). This can partly be explained by a parallel trend in sensitisation against grass pollen. Conclusion: The spatial and temporal pattern of the allergic diseases bronchial asthma, hay fever and atopic eczema in six-year old children from Germany is different. The expected steeper increase of allergies in East than in West Germany could only be shown for hay fever.

The interrelation between biological pollution of indoor spaces and health disorders, allergic symptoms and health issues in general is well known. Besides animal epithelia, the exposure to house dust mites and mould fungi is considered a serious risk factor. In the scope of a comparative study involving school beginners in East and West Germany (launched in 1991), dust was vacuumed from a total of 218 mattresses of children's beds and checked for their content of house dust mites and mould fungi. This investigation aimed at assessing the degree of exposure, to determine regional differences, if any, and to uncover the correlation between exposure and symptoms. Dust mite infestation was highest in the small town of Borken in Westphalia (in 86 % of the specimens > 2 μg mite allergens/g of dust) and lowest in Magdeburg in Saxony-Anhalt (55.3 %). Total concentrations of mould fungi varied from 1.4×10 3 CFU/g of dust and 300×10 3 CFU/g of dust with a geometric mean of 26.5 x 10 3 CFU/g of dust. A total of 41 different genera/species were identified. Most frequent were the following genera: Penicillium, Eurotium, Aspergillus, Alternaria, Epicoccum and Cladosporium. The importance of individual factors influencing was confirmed. Humidity decreases the higher the flat is situated in a building. This partly explains the differences in concentrations between Borken where children live mainly on the ground floor, and the other cities with taller buildings. Spores of mould fungi were discovered more frequently in mattresses from humid flats. An association between biological indoor space factors and some allergological parameters seemed obvious, however, due to the small size of the test group most of them were not significant.