Brucellose-Erkrankungen in Deutschland

[Transmission pathways for resistant bacteria between animals and humans: antibiotics resistance in the One Health context]

People and animals share the same environment and antibiotics are used in both. Thus, antibiotics resistance is a major common issue for human and veterinary medicine. The potential impact of antibiotics use in animals on resistance in humans is frequently the focus of debate. In this paper the transmission pathways of resistant bacteria between animals and humans are described and the question is addressed whether a reduction in antibiotics use in animals contributes to the improvement of the resistance situation in humans. Direct contact between humans and animals, transmission of bacteria via food, and indirect transmission via emissions in the environment and the subsequent exposure of humans via the environment are the major transmission routes to be considered. It can thus be established that the relevance of these various transmission routes varies significantly among bacterial species. Furthermore, despite numerous investigations, the exact significance of transmission pathways and the bacteria transferred for the resistance situation in humans cannot yet be precisely quantified. There is evidence that antibiotics use in animals fosters the spread of resistant organisms in animals. Recent studies also suggest that there might be a relationship between antibiotics use in animals and the occurrence of resistance in humans. However, this relationship is complex, and for a better understanding of it and the role of the various transmission pathways, further collaborative studies between veterinary and medical science are needed.

[Rare infectious diseases in Germany. Obligatory notification results]

Rare infectious diseases are of great importance in Germany: Some of them require special measures and precautions to prevent spreading (e.g. virus caused hemorrhagic fevers). For others, e.g. infectious diseases that can be prevented by vaccination, the prevention aspects are important. Summarizing descriptions for several rare diseases which together describe the situation in Germany are only possible on the basis of the notification requirements. The legal obligation for notification represents a good prerequisite to register diseases occurring in Germany. With the introduction of the Protection against Infection Act in 2001 the quality of the available data was improved by using case definitions. The evaluation of existing information indicates: On the basis of the available data there is no evidence that in the foreseeable future a noticeable increase of isolated rare diseases could pose a threat in Germany.

Changing epidemiology of human brucellosis, Germany, 1962-2005

This endemic occupational disease has become a foodborne and travel-associated zoonosis primarily affecting Turkish immigrants.

Trends in the epidemiology of human brucellosis in Germany were investigated by analyzing national surveillance data (1962–2005) complemented by a questionnaire-based survey (1995–2000). After a steady decrease in brucellosis incidence from 1962 to the 1980s, a persistent number of cases has been reported in recent years, with the highest incidence in Turkish immigrants (0.3/100,000 Turks vs. 0.01/100,000 in the German population; incidence rate ratio 29). Among cases with reported exposure risks, 59% were related to the consumption of unpasteurized cheese from brucellosis-endemic countries. The mean diagnostic delay was 2.5 months. Case fatality rates increased from 0.4% (1978–1981) to a maximum of 6.5% (1998–2001). The epidemiology of brucellosis in Germany has evolved from an endemic occupational disease among the German population into a travel-associated foodborne zoonosis, primarily affecting Turkish immigrants. Prolonged diagnostic delays and high case fatality call for targeted public health measures.