To assess the incidence of Lyme borreliosis in Central Europe, a 12-month, prospective, population-based surveillance study of Lyme borreliosis was conducted in the Wurzburg region of central Germany, following an aggressive awareness campaign. The diagnosis of Lyme borreliosis required the presence of (i) erythema migrans (diameter > or =5 cm); (ii) lymphocytoma; or (iii) another specific manifestation including Lyme arthritis, neuroborreliosis, carditis or acrodermatitis chronica atrophicans in conjunction with serological confirmation. A total of 313 cases of Lyme borreliosis was diagnosed, giving an incidence of 111 cases/100000 inhabitants, the highest rates occurring in children and elderly adults living in wooded as opposed to agricultural areas. The incidence in city dwellers and inhabitants of rural areas was not significantly different. Erythema migrans was the only manifestation in 279 (89%) patients. Of the 34 patients with manifestations other than erythema migrans alone, 15 had arthritis, nine neuroborreliosis, six lymphocytoma, four acrodermatitis chronica atrophicans and one carditis. Children were more likely than adults to have manifestations other than erythema migrans alone. Lyme borreliosis was very common in central Germany, and one of the most frequent bacterial infections. The observation of more cases of arthritis than neuroborreliosis was similar to that in the USA. These results may be representative for many parts of central Europe and suggest the need for development of a vaccine against borreliosis caused by European strains of Borrelia species.

The human uterus is generally considered to be an immunologically privileged site that isolates the implanted allogeneic embryo from an aggressive maternal immune response. This is in contrast to the fact that the decidua, like other mucosal surfaces, must be able to respond to different types of foreign antigens, including pathogenic organisms, seminal plasma, and fetal trophoblasts (FTBs). However, during hemochorial placentation, the direct contact between FTBs (which invade uterine mucosa, the decidua) and maternal immunocompetent cells in the decidua 1 suggests that mechanisms of tolerance must exist to avoid rejection of the conceptus.The human decidua is invested with a significant (up to 75% of all major histocompatibility complex (MHC) class I ϩ cells are CD45 ϩ ) and diverse population of leukocytes. 2,3 Nearly one fifth of decidual leukocytes are positive for MHC class II and are thought to be mostly macrophages. 4 The most abundant cell type of decidua are uterine-specific natural killer cells, the large granular lymphocytes (LGLs), 5 whereas T cells are sparse and B cells are virtually absent. 3,5 The decidual leukocyte population has been a center of interest for the understanding of the balance between maternal control of the extent of invasion of FTBs in the uterine wall 2-6 as well as acceptance of the allogeneic fetus in successful pregnancy.

In developed countries, acute gastroenteritis (AGE) is a major source of morbidity. However, only a few studies have estimated its incidence and the associated medical burden. This population-based study determined the incidence of community-acquired AGE patients seeking medical care and the relative role of various pathogens. Stool samples from patients with AGE presenting to a general practitioner (GP), pediatrician, or specialist in internal medicine for that reason were screened for various bacterial and viral enteropathogens. A control group was established as well.