38 research outputs found
Die Bedeutung von Sentinels für die Implementierung und Evaluation von Impfstrategien
No full textEin Sentinel ist ein Instrument der Surveillance, mit dem über spezifische Ereignisse aus dem Vollzug der gesundheitlichen Betreuung zumeist in einer Stichprobe berichtet wird. Im Infektionsschutzgesetz (IfSG) wird die Bedeutung von Sentinels für die Surveillance von Infektionskrankheiten in Deutschland hervorgehoben. Dem Robert Koch-Institut (RKI) wird bei ihrer Durchführung eine besondere Rolle zugewiesen. Unter Beteiligung des RKI werden z. B. die Praxisnetzwerke der Arbeitsgemeinschaft Influenza und der Arbeitsgemeinschaft Masern sowie das Laborsentinel zur Erfassung mikrobiologischer Befunde bei Kindern durchgeführt. Die mit diesen Systemen erhobenen Daten tragen zur Formulierung von Impfempfehlungen und Impfzielen bei, unterstützen die Argumentation zur Förderung der Impfbereitschaft und dienen der Erfolgskontrolle bei der Umsetzung von Empfehlungen sowie zur Überprüfung und Anpassung von Impfstrategien. Die Daten ermöglichen Trendbeobachtungen (z. B. Erkrankungshäufigkeiten nach Saison, Alter und Region), liefern aber auch sehr spezifische Informationen (z. B. zur Definition von Risikogruppen, zur Verteilung und Ausbreitung von Erregertypen). Methodische Probleme von Sentinelerhebungen (Auswahl stabiler Stichproben, Hochrechnung auf die Grundgesamtheit) können durch geeignete Auswertungs- und Analyseverfahren berücksichtigt und ausgeglichen werden. Die im IfSG genannte Rolle von RKI und Sentinelsurveillance ließe sich wirkungsvoller mit einem Gesamtkonzept umsetzen, das die begrenzt vorhandenen Ressourcen bündelt und Strukturen schafft, in denen inhaltliche und organisatorische Fragen aktuell und flexibel gehandhabt werden können.In sentinel surveillance a prearranged sample of reporting sources—often healthcare providers—agrees to report all cases of defined conditions. The German ldquoProtection Against Infection Actrdquo (IfSG) provides a mandate to the Robert Koch-Institute (RKI) to establish sentinel surveillance of not notifiable diseases relevant to public health. Sentinel systems with RKI involvement include two networks of private practitioners reporting cases of influenza and measles (within the Working Groups on Influenza and Measles, respectively). In addition a laboratory-based sentinel system reports cases of certain bacterial infections in children. Results from these systems serve as a basis for framing vaccination recommendations and goals as well as for the evaluation, adjustment and promotion of vaccination strategies. The data indicate time trends (e. g. number of cases by season, age and region) and supply specific information (e. g. for determination of risk factors, distribution of pathogens). Methodological problems of sentinel surveys (e. g. selection of appropriate samples, population-based estimates) can be accounted for with appropriate methods of analysis. More effective implementation of sentinel surveillance in Germany could be achieved through better coordination of existing structures. This would make more effective use of limited resources and better enable timely and flexible investigation of conceptual and organisational questions
Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation
No full textBackground: Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation. This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. Method: The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Results: Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/− 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back. Conclusion: No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies in the hands of the responsible people taking all relevant information into account
Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation
No full textAbstract Background Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation. This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. Method The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Results Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/− 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back. Conclusion No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies in the hands of the responsible people taking all relevant information into account.</p
Novel zoonotic Borna disease virus associated with severe disease in breeders of variegated squirrels in Germany: Rapid risk assessment
No full textNetworking of Public Health Microbiology Laboratories Bolsters Europe’s Defenses against Infectious Diseases
No full textSpecialist laboratory networks as preparedness and response tool - the Emerging Viral Diseases-Expert Laboratory Network and the Chikungunya outbreak, Thailand, 2019
No full textWe illustrate the potential for specialist laboratory networks to be used as preparedness and response tool through rapid collection and sharing of data. Here, the Emerging Viral Diseases-Expert Laboratory Network (EVD-LabNet) and a laboratory assessment of chikungunya virus (CHIKV) in returning European travellers related to an ongoing outbreak in Thailand was used for this purpose. EVD-LabNet rapidly collected data on laboratory requests, diagnosed CHIKV imported cases and sequences generated, and shared among its members and with the European Centre for Disease Prevention and Control. Data across the network showed an increase in CHIKV imported cases during 1 October 2018-30 April 2019 vs the same period in 2018 (172 vs 50), particularly an increase in cases known to be related to travel to Thailand (72 vs 1). Moreover, EVD-LabNet showed that strains were imported from Thailand that cluster with strains of the ECSA-IOL E1 A226 variant emerging in Pakistan in 2016 and involved in the 2017 outbreaks in Italy. CHIKV diagnostic requests increased by 23.6% between the two periods. The impact of using EVD-LabNet or similar networks as preparedness and response tool could be improved by standardisation of the collection, quality and mining of data in routine laboratory management systems.EVD-LabNet is supported by the European Centre for Disease Prevention and Control (ECDC) under the EVD-LabNet Framework contract ECDC/2016/002. We are grateful to Katrin Leitmeyer and Tamas Bakonyi at ECDC for network support.S
Networking of Public Health Microbiology Laboratories Bolsters Europe’s Defenses against Infectious Diseases
No full textIn an era of global health threats caused by epidemics of infectious diseases and rising multidrug resistance, microbiology laboratories provide essential scientific evidence for risk assessment, prevention, and control. Microbiology has been at the core of European infectious disease surveillance networks for decades. Since 2010, these networks have been coordinated by the European Centre for Disease Prevention and Control (ECDC). Activities delivered in these networks include harmonization of laboratory diagnostic, antimicrobial susceptibility and molecular typing methods, multicentre method validation, technical capacity mapping, training of laboratory staff, and continuing quality assessment of laboratory testing. Cooperation among the European laboratory networks in the past 7 years has proved successful in strengthening epidemic preparedness by enabling adaptive capabilities for rapid detection of emerging pathogens across Europe. In partnership with food safety authorities, international public health agencies and learned societies, ECDC-supported laboratory networks have also progressed harmonization of routinely used antimicrobial susceptibility and molecular typing methods, thereby significantly advancing the quality, comparability and precision of microbiological information gathered by ECDC for surveillance for zoonotic diseases and multidrug-resistant pathogens in Europe. ECDC continues to act as a catalyst for sustaining continuous practice improvements and strengthening wider access to laboratory capacity across the European Union. Key priorities include optimization and broader use of rapid diagnostics, further integration of whole-genome sequencing in surveillance and electronic linkage of laboratory and public health systems. This article highlights some of the network contributions to public health in Europe and the role that ECDC plays managing these networks
Kommunen, Länder, Bund und Europäische Gemeinschaft. Zuständigkeiten und Aufgaben bei Seuchennotfällen im Kontext der neuen Internationalen Gesundheitsvorschriften
No full textDie weltweite Ausbreitung und Zunahme von Infektionskrankheiten sind wesentliche Herausforderungen für den öffentlichen Gesundheitsdienst. Dies gilt nicht nur für eine möglicherweise drohende Influenzapandemie, sondern auch für andere, bislang kaum oder gar nicht bekannte Infektionskrankheiten, z. B. für das Severe Acute Respiratory Syndrome (SARS), wie die erste Pandemie dieses Jahrtausends eindrücklich zeigte. Zunehmend wird auch die Gefahr bioterroristischer Anschläge mit in die Planungen des Managements von Seuchennotfällen einbezogen. In Deutschland sind die diesbezüglichen politischen und fachlichen Zuständigkeiten komplex, da die Gesetzgebungskompetenz für Gesundheitsfragen bei den Bundesländern liegt. Die Ausführungsorgane für die Maßnahmen bei Seuchennotfällen sind die regional zuständigen Gesundheitsämter. Ihnen übergeordnet sind Fachbehörden der Länder und des Bundes. Da Infektionskrankheiten häufig grenzüberschreitend auftreten, ist mit dem European Centre for Disease Prevention and Control (ECDC) eine europäische Behörde zur Identifizierung und Bewertung von Infektionskrankheiten, einschließlich Seuchennotfällen eingerichtet worden.Pandemic preparedness has become a catch phrase for politicians, government agencies and communities, both nationally and internationally. This is due to the increasing number of infectious diseases emergencies that are important challenges for health protection authorities, which was shown impressively when SARS emerged as the first pandemic in this millennium. In Germany, effective and efficient infection control is complex, with local health protection authorities having their own responsibilities. In the case of an emergency epidemic, regional health departments are responsible. Having authority over these are authorities on the federal state level as well as on the federal level. For the European Community, the European Centre for Disease Prevention and Control (ECDC) was established. The mission of this agency is to identify, assess and communicate current and emerging threats to human health posed by infectious diseases
Automated digital reporting of clinical laboratory information to national public health surveillance systems, results of a EU/EEA survey, 2018
No full text
