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Volume 6, Number 6—December 2000

Perspective

Developing National Epidemiological Capacity to Meet the Challenges of Emerging Infections in Germany

Lyle R. Petersen*†Comments to Author , Andrea Ammon*, Osamah Hamouda*, Thomas Breuer*, Sonja Kießling*, Baerbel Bellach*, Ursula Niemer‡, Franz Josef Bindert‡, Stephen Ostroff†, and Reinhard Kurth*
Author affiliations: *Robert Koch Institute, Berlin, Germany; †Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ‡Federal Ministry of Health, Bonn, Germany

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Table

Outbreaks investigated by the Robert Koch Institute, 1996-1999

No. Year Setting Syndrome Pathogen Cases (no.) Comment (references)
1 1996 Statewide Hemolytic-uremic syndrome Escherichia coli O157 28 Raw, spreadable sausage,new sorbitol-fermenting E. coli O157 strain (10)
2 1996 Community Q fever Coxiella burnetii 45 Community downwind from sheep farm. Climatic factors promoted airborne transmission (11-13)
3 1996 4 day-care centers Meningitis Echovirus 30 71 Clinical illness increased risk of transmission to family members, high attack rate (14)
4 1996 Vacation center for veterans Gastroenteritis Norwalk-like virus 86 Bottled mineral water; national diagnostic capability for Norwalk-like viruses established as a result of outbreak
5 1997 Ski group Upper respiratory syndrome, toxic shock syndrome Influenza A virus Staphylococcus aureus 38 Followed foreign travel (15)
6 1997 Ski group Upper respiratory syndrome Influenza A virus 39 Followed foreign travel
7 1997 6 day-care centers Gastroenteritis Campylobacter jejuni 186 Common source from one kitchen
8 1997 Community Meningitis Echovirus 30 353 High attack rate, person-to-person transmission (16)
9 1997 Case investigation Hepatic failure, rhabdo-myalysis, bleeding Unknown 1 False-positive test for Lassa fever virus, 3 other persons of same ethnic origin identified with similar clinical syndrome (17)
10 1998 Residence for elderly Gastroenteritis Norwalk-like virus 189 Person-to-person transmission
11 1998 Nationwide Gastroenteritis Salmonella livingstone 119 Europe-wide outbreak following foreign travel
12 1998 Community Fever, sudden death Unknown 3 Infants, no common risk factors identified
13 1998 Community Meningitis, death Neisseria meningitidis 9 Associated with discotheque attendance during carnival season (18)
14 1998 Company employees Gastroenteritis Salmonella enteritidis 531 Common source from a single kitchen
15 1998 Community Gastroenteritis S. enteritidis 103 Common source from a single kitchen, alcohol protective
16 1998 Hospital employees Myocarditis Unknown 40 Pseudo-outbreak
17 1998 Multiple states Gastroenteritis S. blockley 12 Imported eel smoked at multiple smokeries (19)
18 1998 Community Q fever Coxiella burnetii 101 Urban area in close proximity to sheep grazing and shearing
19 1999 10 communities Trichinosis Trichinella spiralis 52 Investigation revealed two simultaneous outbreaks from different sources (20)
20 1999 Hospital patients Sepsis, death Methicillin- resistant S. aureus 26 Cardiac surgery intensive-care unit
21 1999 Home for elderly Gastroenteritis Norwalk-like virus 71 Person-to-person transmission
22 1999 Nation-wide Gastroenteritis S. enteritidis 48 National convention attendees, common source from one kitchen
23 1999 Community Q fever C. burnetii 81 Urban area in close proximity to sheep farm; uninvestigated outbreak from same sheep farm occurred 6 yrs earlier
24 1999 Case investigation Yellow fever Yellow fever virus 1 Originally thought to be hemorrhagic fever (21)
25 1999 Romania Meningitis Echovirus >5000 Widespread outbreak involving multiple serotypes
26 1999 Nationwide Gastroenteritis S. paratyphi 43 Europe-wide outbreak from foreign travel
27 1999 Hospital patients Sepsis, death Methicillin-resistant S. aureus 18 Cardiac surgery intensive-care unit

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