ドイツ国立細菌研究所(RKI)による北ドイツで発生した病原性大腸菌と溶血性尿毒症症候群の病原の調査について:ドイツの各県の病原性大腸菌(EHEC)と溶血性尿毒症症候群(HUS)の感染者数と感染死者数

ドイツ国立細菌研究所(RKI)による北ドイツで発生した病原性大腸菌と溶血性尿毒症症候群の病原の調査について:ドイツの各県の病原性大腸菌(EHEC)と溶血性尿毒症症候群(HUS)の感染者数と感染死者数

Robert Koc Institute in Germany
http://www.kki.deç/

Notes to the implementation of the EHEC / HUS studies
http://www.rki.de/cln_169/nn_205760/DE/Content/InfAZ/E/EHEC/epi__frageboegen/ehec__epidemiolgischeStudien-Text.html

Notes to the implementation of the EHEC / HUS studies Stand 07.06.2011
ドイツ国立細菌研究所(RKI)による北ドイツで発生した病原性大腸菌と溶血性尿毒症症候群の病原の調査について:
The Robert Koch Institute conducts a series of epidemiological studies to search for the source of the largest in Germany EHEC / HUS outbreak.
In the regions where many very ill patients, most studies have been performed. These included for example Hamburg, Luebeck and Bremen. There, teams of scientists have questioned RKI affected by foods that were eaten during the two weeks before the outbreak of the disease. Foods that could be identified already in previous outbreaks as the cause, such as Beef, vegetables, sprouts or raw milk have been since the start of the outbreak investigations explicitly requested. In addition to the patients in these case-control studies and healthy control subjects to be interviewed. Can be identified which foods are associated with an increased risk of disease. Meanwhile, four different case-control studies were conducted with a total of 100 patients and 2,000 healthy control subjects.
Overall, since the start of the outbreak have been more than 10 teams with a total RKI RKI more than 40 scientists in action. Not all patients are interviewed by the RKI itself. Sick people are sometimes questioned by the health departments or clinics. For this purpose, the health authorities, a questionnaire was made available in an updated version that is used in the RKI-studies. As well as groups representing an important link, they were interviewed in cooperation with authorities in Sweden and Denmark, who were taken ill after a stay in northern Germany on EHEC.
Further the findings of the outbreak team and the results of surveys will be sent out at the Robert Koch Institute, which is working since the start of the outbreak happening seven days a week. The outbreak investigation data and the numerous references from the population and registration data to the Infection Protection Act are evaluated and processed there.
When evaluating the surveys must - be taken a few things - as with all epidemiological studies: Patients were interviewed as soon as possible. Some of them were still ill at the time and only partially able to recall the foods eaten over the past two weeks exactly. Is well known from previous studies that discussed the meantime, the public influenced the replies of suspect food and interviewed patients and control persons. Furthermore, patients can usually remember exactly rare and unusual foods, than healthy control subjects. Thus, differences determined to be greater than the differences in consumption actually were. The current analysis, however, could indicate that the current EHEC / HUS outbreak is clearly associated with the consumption of raw vegetables in northern Germany.
Using epidemiological methods seek to isolate the source of as much as possible. Which food is or precisely carrier of the bacterium was, can not be conclusively proved epidemiologically. For this, the results of epidemiological studies are immediately forwarded to the food control authorities to investigate and targeted food delivery routes can be traced.
To be informed as quickly and comprehensively on current events, the Robert Koch Institute has established itself alongside the regular channels of communication more additional surveillance systems. A reporting system records in selected hospitals, the daily number of patients with bloody diarrhea. A special laboratory monitoring recorded daily in the appropriate reference laboratories and inspection bodies, the latest laboratory findings. With the network of treatment centers, nephrology leads the RKI a screening of HUS and EHEC patients by, among other criteria Secondary infections and food sources are covered.
The following is an overview of ongoing and completed some of epidemiological studies:


Court in the foreground: Fish, 2nd Court: Fish 3 Court: Restaurant pan. Restaurant recipe based cohort study of an affected photo, source: private
Case-control studies (comparative study between healthy and diseased people)
• Case-control study in Hamburg, published on 25.5.2011 (BfR opinion RKI) • Severely affected hospitals in Lübeck, Bremen and Hamburg, as controls were used data from a representative population survey, with results published on 06/03/2011 (RKI BfR press release) • Hospitals that were not previously affected, but the observed current increased incidences of HUS • Expanded case-control study with detailed interviews in residence near Lübeck, Bremen and Hamburg • Case-control studies in collaboration with the ECDC on foreign cases • Detailed analysis of case-control studies to identify sources of associates Meta-analysis of all case-control studies (combining and analyzing the results of individual studies)
Cohort studies (study of patients who became ill at the same time and in the same situation)
• In cooperation with foreign authorities cohort studies in groups • Cluster analysis of various restaurant-associated outbreaks Further investigations
• Analysis of accounting data from visitors of an affected canteen canteen; results already at 3.6. published (RKI BfR press release) • search for possible human-to-human transmission • Representative Germany-wide online survey on the burden of disease detection • A study to detect the secondary attack rate • A study to record the duration of excretion and the rate of co-infection and subsequent • Germany-wide surveillance of patients with bloody diarrhea in hospitals More information Epidemiological studies and questionnaires Stand: 08.06.2011
HUS cases of disease / EHEC by privince
published16/06/2011
:ドイツの各県の病原性大腸菌(EHEC)と溶血性尿毒症症候群(HUS)の感染者数と感染死者数
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:ドイツの各県の病原性大腸菌(EHEC)と溶血性尿毒症症候群(HUS)の感染者数と感染死者数

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