Volume 6, Number 6—December 2000
Perspective
Developing National Epidemiological Capacity to Meet the Challenges of Emerging Infections in Germany
Lyle R. Petersen*†
, Andrea Ammon*, Osamah Hamouda*, Thomas Breuer*, Sonja Kießling*, Baerbel Bellach*, Ursula Niemer‡, Franz Josef Bindert‡, Stephen Ostroff†, and Reinhard Kurth*
, Andrea Ammon*, Osamah Hamouda*, Thomas Breuer*, Sonja Kießling*, Baerbel Bellach*, Ursula Niemer‡, Franz Josef Bindert‡, Stephen Ostroff†, and Reinhard Kurth*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 |
