Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011

Lassen, Sofie Gillesberg; Schuster, Melanie; Stemmler, Margaret M.; Steinmüller, A.; Matysiak‐Klose, Dorothea; Mankertz, Annette; Santibanez, Sabine; Wichmann, Ole; Falkenhorst, Gerhard

doi:10.1017/s0950268813001398

Cited by 12 publications

(5 citation statements)

References 17 publications

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“…The restricted length of the identified local chains to two generations of transmission suggests that the immunisation coverage in the affected regions was high enough to prevent sustained MV transmission. We identified once more unvaccinated adolescents and young adults as a vulnerable group in Germany [31], whereas transmission of D8-V in Slovenia was observed in young and middle aged adults, most of whom were vaccinated (10 cases of 15). The finding of a high proportion of SVF (9/14; 64%) among the Slovenian cases emphasises the necessity of laboratory-based case investigation as well as studies assessing population immunity in countries with long absence of MV circulation like Slovenia.…”

Section: Discussionmentioning

confidence: 97%

Measles virus spread initiated at international mass gatherings in Europe, 2011

et al. 2014

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Three parallel transmission chains of measles virus (MV) variant 'D8-Villupuram' (D8-V) originated from two coinciding international mass gathering (MG) events in Rimini, Italy, in June 2011. MV D8-V was independently introduced into Germany by two unvaccinated persons, and into Slovenia by one unvaccinated person who had attended these events. Secondary spread of D8-V was restricted to two generations of transmission in Slovenia as well as in Germany where the virus was further disseminated at another MG. Serological and epidemiological investigation of the D8-V-associated German and Slovenian cases revealed different antibody responses and age distributions. Primary infected young persons between 11 and 27 years-old were affected in Germany, whereas the group of Slovenian cases comprised adults aged from 28 to 47 years and a high proportion (9/14; 64%) of patients with secondary vaccine failure (SVF). Our study demonstrates that monitoring of MV transmission chains in an international context and adequate serological investigation of cases with remote vaccination can contribute to identify susceptibility gaps.

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Section: Discussionmentioning

confidence: 97%

Measles virus spread initiated at international mass gatherings in Europe, 2011

et al. 2014

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“…This was highlighted by the Scandinavian hepatitis A outbreak, which began in Denmark during autumn 2012 and spread during winter 2012 and spring 2013 throughout Scandina- via, with at least 28 persons infected in 2012 (20). One of the two strains causing this outbreak was detected in sewage in weeks 7 and 9, together with samples from three patients infected with these strains.…”

Section: Discussionmentioning

confidence: 99%

“…During the study period, there was an ongoing hepatitis A outbreak caused by two different IB strains in Scandinavia (20). By 17 March 2013, there were 52 hepatitis A cases infected with IB strains in Scandinavia, and at least 28 of these persons were infected by the outbreak strains (20).…”

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confidence: 99%

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Detection of Pathogenic Viruses in Sewage Provided Early Warnings of Hepatitis A Virus and Norovirus Outbreaks

Hellmér

Paxéus

Magnius

et al. 2014

Appl Environ Microbiol

430

302

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dMost persons infected with enterically transmitted viruses shed large amounts of virus in feces for days or weeks, both before and after onset of symptoms. Therefore, viruses causing gastroenteritis may be detected in wastewater, even if only a few persons are infected. In this study, the presence of eight pathogenic viruses (norovirus, astrovirus, rotavirus, adenovirus, Aichi virus, parechovirus, hepatitis A virus [HAV], and hepatitis E virus) was investigated in sewage to explore whether their identification could be used as an early warning of outbreaks. Samples of the untreated sewage were collected in proportion to flow at Ryaverket, Gothenburg, Sweden. Daily samples collected during every second week between January and May 2013 were pooled and analyzed for detection of viruses by concentration through adsorption to milk proteins and PCR. The largest amount of noroviruses was detected in sewage 2 to 3 weeks before most patients were diagnosed with this infection in Gothenburg. The other viruses were detected at lower levels. HAV was detected between weeks 5 and 13, and partial sequencing of the structural VP1protein identified three different strains. Two strains were involved in an ongoing outbreak in Scandinavia and were also identified in samples from patients with acute hepatitis A in Gothenburg during spring of 2013. The third strain was unique and was not detected in any patient sample. The method used may thus be a tool to detect incipient outbreaks of these viruses and provide early warning before the causative pathogens have been recognized in health care.

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“…Measles accounted for 17% of all reports and was considered to be of high importance in the international-, national- and state-level context. The reports varied from descriptions of community outbreaks [ 24 , 25 ], activities at national level [ 26 – 28 ], distribution of ECDC RRA [ 28 ] to updates concerning the measles elimination activities of WHO [ 29 ]. Thereby the EpiLag constitutes a tool to support the process of measles elimination in Germany.…”

Section: Discussionmentioning

confidence: 99%

Ten years of weekly epidemiological teleconference (EpiLag) – an effective and time-efficient tool for infectious disease event information, Germany, 2009–2018

et al. 2021

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In 2009, the Robert Koch Institute (RKI) and the 16 German federal state public health authorities (PHAs) established a weekly epidemiological teleconference (EpiLag) to discuss infectious disease (ID) events and foster horizontal and vertical information exchange. We present the procedure, discussed ID topics and evaluation results of EpiLag after 10 years. We analysed attendance, duration of EpiLag and the frequency of reported events. Participants (RKI and state PHA) were surveyed regarding their satisfaction with logistics, contents and usefulness of EpiLag (Likert scales). Between 2009 and 2018, RKI hosted 484 EpiLag conferences with a mean duration of 25 min (range: 4–60) and high participation (range: 9–16; mean: 15 PHAs). Overall, 2975 ID events (39% international, 9% national and 52% subnational) were presented (mean: 6.1 per EpiLag), most frequently on measles (18%), salmonellosis (8%) and influenza (5%). All responding participants (14/16 PHAs and 9/9 at RKI) were satisfied with the EpiLag's organization and minutes and deemed EpiLag useful for an overview and information distribution on ID events relevant to Germany. EpiLag is time efficient, easily applicable and useful for a low-threshold event communication. It supports PHAs in crises and strengthens the network of surveillance stakeholders. We recommend its implementation to other countries or sectors.

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Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011

Cited by 12 publications

References 17 publications

Measles virus spread initiated at international mass gatherings in Europe, 2011

Measles virus spread initiated at international mass gatherings in Europe, 2011

Detection of Pathogenic Viruses in Sewage Provided Early Warnings of Hepatitis A Virus and Norovirus Outbreaks

Ten years of weekly epidemiological teleconference (EpiLag) – an effective and time-efficient tool for infectious disease event information, Germany, 2009–2018

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