13672 research outputs found
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GrippeWeb-Wochenbericht KW 42
No full textDie Aktivität akuter Atemwegserkrankungen (ARE-Inzidenz) in der Bevölkerung ist in der 42. KW im Vergleich
zur Vorwoche leicht gesunken und lag insgesamt bei rund 8.200 ARE pro 100.000 Einw. (Vorwoche: 8.700).
Die Inzidenz der grippeähnlichen Erkrankungen (ILI) ist in der 42. KW ebenfalls gesunken und lag bei rund
1.800 ILI pro 100.000 Einw. (Vorwoche: 2.000). Sowohl die ARE- als auch die ILI-Inzidenz befinden sich
weiterhin auf einem vergleichsweise hohen Niveau. Die geschätzte COVID-19-Inzidenz in der Bevölkerung
basierend auf Angaben der GrippeWeb-Teilnehmenden war in den letzten Wochen rückläufig und lag in der 42.
KW bei rund 900 COVID-19-Erkrankungen pro 100.000 Einw. In der virologischen Überwachung in der
Bevölkerung (GrippeWeb-Plus) wurden seit der 40. KW 2024 hauptsächlich Rhino-/Enteroviren und
SARS-CoV-2 nachgewiesen sowie vereinzelt andere Viren oder Bakterien des Erregerpanels.
Die für die Bevölkerung in Deutschland geschätzten Inzidenzen beruhen auf den Selbstauskünften von
Personen, die sich bei GrippeWeb registriert haben. Für die 42. KW 2024 haben bisher 8.268 GrippeWeb-
Teilnehmende eine Meldung abgegeben, von diesen hatten 666 eine ARE und 148 eine ILI (Datenstand:
22.10.2024, 0:00 Uhr). Durch Nachmeldungen, die bis zu vier Wochen lang möglich sind, können sich noch
Änderungen ergeben. Durch die Nachmeldungen können aktuell über 11.000 Meldungen pro Woche für die
Auswertungen berücksichtigt werden.
Neue Teilnehmende sind herzlich willkommen. Mehr Informationen zu GrippeWeb finden Sie hier. Eine
Registrierung ist jederzeit und in wenigen Schritten möglich
Author Correction: Germany’s fourth COVID-19 wave was mainly driven by the unvaccinated
Get PDFPeer Reviewe
Molecular and serological diagnosis of multiple bacterial zoonoses in febrile outpatients in Garissa County, north-eastern Kenya
Get PDFBacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of non-malarial fevers in Kenya, yet their epidemiology remains unclear. We investigated brucellosis, Q-fever and leptospirosis in the venous blood of 216 malaria-negative febrile patients recruited in two health centres (98 from Ijara and 118 from Sangailu health centres) in Garissa County in north-eastern Kenya. We determined exposure to the three zoonoses using serological (Rose Bengal test for Brucella spp., ELISA for C. burnetti and microscopic agglutination test for Leptospira spp.) and real-time PCR testing and identified risk factors for exposure. We also used non-targeted metagenomic sequencing on nine selected patients to assess the presence of other possible bacterial causes of non-malarial fevers. Considerable PCR positivity was found for Brucella (19.4%, 95% confidence intervals [CI] 14.2–25.5) and Leptospira spp. (1.7%, 95% CI 0.4–4.9), and high endpoint titres were observed against leptospiral serovar Grippotyphosa from the serological testing. Patients aged 5–17 years old had 4.02 (95% CI 1.18–13.70, p-value = 0.03) and 2.42 (95% CI 1.09–5.34, p-value = 0.03) times higher odds of infection with Brucella spp. and Coxiella burnetii than those of ages 35–80. Additionally, patients who sourced water from dams/springs, and other sources (protected wells, boreholes, bottled water, and water pans) had 2.39 (95% CI 1.22–4.68, p-value = 0.01) and 2.24 (1.15–4.35, p-value = 0.02) times higher odds of exposure to C. burnetii than those who used unprotected wells. Streptococcus and Moraxella spp. were determined using metagenomic sequencing. Brucellosis, leptospirosis, Streptococcus and Moraxella infections are potentially important causes of non-malarial fevers in Garissa. This knowledge can guide routine diagnosis, thus helping lower the disease burden and ensure better health outcomes, especially in younger populations.Peer Reviewe
Survival after cryptococcosis in Germany: A retrospective multicenter cohort study of patients diagnosed between 2004 and 2021
Get PDFCryptococcosis is the most prevalent fungal infection of the central nervous system worldwide. We performed a retrospective multicenter cohort study to gain insights into the epidemiology of cryptococcosis in Germany. We describe the use of diagnostic tests, clinical management and patient outcome. We included 64 patients with underlying HIV infection (55%) or other predispositions. Molecular typing by MLST documented 20 individual sequence types among 42 typed isolates. A fatal outcome was documented in 14% of patients in the first two months after diagnosis.Peer Reviewe
Normal Values for the fT3/fT4 Ratio: Centile Charts (0–29 Years) and Their Application for the Differential Diagnosis of Children with Developmental Delay
Get PDFPrimary congenital hypothyroidism is easily diagnosed on the basis of elevated plasma levels of thyroid-stimulating hormone (TSH). In contrast, in the rare disorders of thyroid hormone resistance, TSH and, in mild cases, also thyroid hormone levels are within the normal range. Thyroid hormone resistance is caused by defects in hormone metabolism, transport, or receptor activation and can have the same serious consequences for child development as congenital hypothyroidism. A total of n = 23,522 data points from a large cohort of children and young adults were used to generate normal values and sex-specific percentiles for the ratio of free triiodothyronine (T3) to free thyroxine (T4), the fT3/fT4 ratio. The aim was to determine whether individuals with developmental delay and genetically confirmed thyroid hormone resistance, carrying defects in Monocarboxylate Transporter 8 (MCT8), Thyroid Hormone Receptor alpha (THRα), and Selenocysteine Insertion Sequence-Binding Protein 2 (SECISBP2), had abnormal fT3/fT4 ratios. Indeed, we were able to demonstrate a clear separation of patient values for the fT3/fT4 ratio from normal and pathological controls (e.g., children with severe cerebral palsy). We therefore recommend using the fT3/fT4 ratio as a readily available screening parameter in children with developmental delay for the identification of thyroid hormone resistance syndromes. The fT3/fT4 ratio can be easily plotted on centile charts using our free online tool, which accepts various SI and non-SI units for fT3, fT4, and TSH.Peer Reviewe
Diagnostic electron microscopy in human infectious diseases – Methods and applications
Get PDFDiagnostic electron microscopy (EM) is indispensable in all cases of infectious diseases which deserve or profit from the detection of the entire pathogen (i.e. the infectious unit). The focus of its application has shifted during the last decades from routine diagnostics to diagnostics of special cases, emergencies and the investigation of disease pathogenesis. While the focus of application has changed, the methods remain more or less the same. However, since the number of cases for diagnostic EM has declined as the number of laboratories that are able to perform such investigations, the preservation of the present knowledge is important. The aim of this article is to provide a review of the methods and strategies which are useful for diagnostic EM related to infectious diseases in our days. It also addresses weaknesses as well as useful variants or extensions of established methods. The main techniques, negative staining and thin section EM, are described in detail with links to suitable protocols and more recent improvements, such as thin section EM of small volume suspensions. Sample collection, transport and conservation/inactivation are discussed. Strategies of sample examination and requirements for a proper recognition of structures are outlined. Finally, some examples for the actual application of diagnostic EM related to infectious diseases are presented. The outlook section will discuss recent trends in microscopy, such as automated object recognition by machine learning, regarding their potential in supporting diagnostic EM.Peer Reviewe
Association between Socioeconomic Position of the Family and Adolescent Obesity in Germany—Analysis of the Mediating Role of Familial Determinants
Get PDFBackground: Obesity’s negative impact on young people’s health has long been known. The family and its socioeconomic position (SEP) are key determinants in adolescent obesity. However, understanding which familial determinants explain the association remains limited. Method: The analyses are based on data from the “German Health Interview and Examination Survey for Children and Adolescents” (KiGGS) (1,384 females and 1,332 males aged 11 to 17 years). Logistic regression models explored how familial determinants (family stress, family cohesion, parental smoking, parental sporting activity, and parental overweight) mediated the association between family SEP (parental education, occupational status, and household income) and adolescent obesity. Results: Significant total effects for the associations between family SEP in childhood and adolescent obesity were found. Splitting the total effect of the family SEP on obesity into direct and indirect effects, all direct effects turned out to be significant. However, all associations involved also indirect effects of familial determinants, except for household income for female adolescents. Parental smoking and overweight were the most relevant mediators for males and females. For male adolescents, parental sporting activity additionally mediated the association between SEP and obesity. Conclusion: A low SEP in childhood was associated with adolescent obesity. Parental health and health behaviors partly explained the association. For increasing health equality in adolescent health, the consideration of parental health behavior in the planning and implementation of health promotion programs seem to be important.Peer Reviewe
Influenza vaccine effectiveness in Europe: Results from the 2022–2023 VEBIS (Vaccine Effectiveness, Burden and Impact Studies) primary care multicentre study
No full textBackground:
Influenza A(H3N2) viruses dominated early in the 2022–2023 influenza season in Europe, followed by higher circulation of influenza A(H1N1)pdm09 and B viruses. The VEBIS primary care network estimated the influenza vaccine effectiveness (VE) using a multicentre test-negative study.
Materials and Methods:
Primary care practitioners collected information and specimens from patients consulting with acute respiratory infection. We measured VE against any influenza, influenza (sub)type and clade, by age group, by influenza vaccine target group and by time since vaccination, using logistic regression.
Results:
We included 38 058 patients, of which 3786 were influenza A(H3N2), 1548 influenza A(H1N1)pdm09 and 3275 influenza B cases. Against influenza A(H3N2), VE was 36% (95% CI: 25–45) among all ages and ranged between 30% and 52% by age group and target group. VE against influenza A(H3N2) clade 2b was 38% (95% CI: 25–49). Overall, VE against influenza A(H1N1)pdm09 was 46% (95% CI: 35–56) and ranged between 29% and 59% by age group and target group. VE against influenza A(H1N1)pdm09 clade 5a.2a was 56% (95% CI: 46–65) and 79% (95% CI: 64–88) against clade 5a.2a.1. VE against influenza B was 76% (95% CI: 70–81); overall, 84%, 72% and 71% were among 0–14-year-olds, 15–64-year-olds and those in the influenza vaccination target group, respectively. VE against influenza B with a position 197 mutation of the hemagglutinin (HA) gene was 79% (95% CI: 73–85) and 90% (95% CI: 85–94) without this mutation
Conclusion:
The 2022–2023 end-of-season results from the VEBIS network at primary care level showed high VE among children and against influenza B, with lower VE against influenza A(H1N1)pdm09 and A(H3N2).Peer Reviewe
Empfehlungen der Ständigen Impfkommission (STIKO) beim Robert Koch-Institut 2024
No full textDie Impfempfehlungen der Ständigen Impfkommission (STIKO) wurden auf der 106. Sitzung der STIKO verabschiedet. Die folgenden Ausführungen ersetzen die im Epidemiologischen Bulletin des RKI 4/2023 veröffentlichten Impfempfehlungen. Inhaltliche Änderungen gegenüber 2023 sind geblaut und zusätzlich mit einem Balken am Rand gekennzeichnet. Die aktuellen Empfehlungen werden auch im Pocket-Format veröffentlicht oder können über die STIKO-App aufgerufen werden
ARE-Wochenbericht KW 51/52
No full textDie ARE-Aktivität in den letzten Wochen ergibt sich aus der hohen Zahl an COVID-19, Influenza und RSV-Erkrankungen. Die Influenza-Aktivität nahm seit der 49. KW deutlich zu, die Grippewelle 2023/24 hat laut RKI-Definition mit der 50. KW 2023 begonnen. Von Influenzaerkrankungen sind bisher vornehmlich Kinder im Schulalter und junge Erwachsene betroffen. Influenza A(H1N1)pdm09-Viren werden am häufigsten detektiert. Die RSV-Aktivität und die COVID-19-Aktivität sind weiterhin hoch. Insbesondere Kinder unter zwei Jahren sind von einer Krankenhauseinweisung mit RSV-Infektion betroffen, bei älteren Menschen führt weiterhin COVID-19 am häufigsten zu schwer verlaufenden Erkrankungen. Die Surveillancedaten der 52. KW 2023 sind nur mit Einschränkungen interpretierbar. In diesem Zeitraum gab es auch in den Vorjahren während der bundesweiten Ferien und Feiertage Abweichungen bzw. größere nachträgliche Änderungen der Ergebnisse.
Die Aktivität akuter respiratorischer Erkrankungen (ARE) in der Bevölkerung ist von der 50. KW zur 52. KW 2023 in allen Altersgruppen und insbesondere bei den Kindern im Schulalter deutlich gesunken. Im ambulanten Bereich ist die Zahl der Arztbesuche wegen ARE von der 50. KW zur 52. KW ebenfalls gesunken.
Im NRZ für Influenzaviren wurden in der 51. KW und 52. KW 2023 in insgesamt 199 der 301 eingesandten Sentinelproben respiratorische Viren identifiziert, darunter hauptsächlich Influenzaviren (22 %), SARS-CoV-2 (17 %), RSV (15 %) und Rhinoviren (11 %).
Im Rahmen der ICD-10-Code basierten Krankenhaussurveillance (ICOSARI) ist die Zahl schwerer akuter respiratorischer Infektionen (SARI) in den letzten Wochen leicht gestiegen. In der 51. KW 2023 ist die Fallzahl im Vergleich zur Vorwoche stabil auf einem insgesamt hohen Niveau geblieben, in der 52. KW sind die SARI-Fälle in unterschiedlichen Altersgruppen zurückgegangen. Unter allen in der 51. KW und 52. KW wegen einer schweren Atemwegserkrankung hospitalisierten Patientinnen und Patienten lag der Anteil der COVID-19-Diagnosen bei 23 % und damit niedriger als in den Vorwochen. Der Anteil der RSV-Diagnosen ist weiter gestiegen und lag bei 21 %. Bei Kindern unter zwei Jahren war der Anteil der RSV-Diagnosen mit etwa 70 % in der 51. KW und 52. KW weiterhin hoch. Influenzadiagnosen nahmen weiterhin zu und wurden bei 11 % aller SARI-Fälle vergeben.
Bei den Daten aus dem Meldewesen gemäß IfSG setzte sich der steigende Trend bei Influenza und RSV-Infektion auch in der 51. KW fort. Die SARS-CoV-2 BA.2.86-Sublinie JN.1 ist in Deutschland dominierend, ihr Anteil lag in der 50. KW 2023 bei 53 %. In der Abwassersurveillance ist seit Ende Juni 2023 (26. KW) eine kontinuierlich steigende SARS-CoV-2-Viruslast zu beobachten