Infektionsepidemiologisches Jahrbuch meldepflichtiger ... - RKI

Executive Summary
This summary provides an overview of the outstanding
developments and events in infectious
disease epidemiology for 2010 and serves to introduce
the reader to the following respective chapters
of this year’s Annual Report, where further details
and other relevant information about each infectious
disease can be found. Comprehensive analysis
and in-depth reports of important outbreaks are
additionally published in the Epidemiological Bulletin
of the RKI and in various scientifi c journals.
In 2010 the number of Hantavirus illnesses
reached more than 2,000, which is nearly ten
times the number observed in the previous year.
This is the highest fi gure seen since the introduction
of the reporting system in accordance with the
German Protection against Infection Act (IfSG)
in 2001. Similar to trends in 2005 and 2007, the
higher incidences were preceded by mild winters
that were followed by a higher proliferation of voles,
a known carrier of the Hantavirus.
The number of cases of Dengue fever also
reached a new peak in 2010, doubling the number
compared to the previous year. Possible reasons for
this may be the increased circulation of the virus in
endemic areas within the last years, and further
spread of related mosquito-vectors. The year 2010
saw the fi rst autochthonous infections in Southern
Europe, including a case diagnosed in Germany
and infected in Croatia – until then not known to
be a risk area.
Hepatitis E also reached a new peak this year
with twice the number of illnesses compared to
2009. Of particular interest is the growing number
of infections acquired in Germany, since this viral
hepatitis has been historically considered an imported
virus. The causes for this new trend have
not yet been fully researched and understood.
The number of cases of Adenovirus conjunctivitis
in 2010 tripled compared to the previous year.
The cause for this increase, which included outbreaks
and sporadic cases and persisted at a lower
level into the next year, remained unclear. Similar
increases were observed in 2006, when the increased
incidence remained unexplained as well,
and in 2004, when an outbreak could be traced to
several bases of the German Federal Defence Force.
Executive Summary
One of the most clearly defi ned outbreaks in
2010 – with regard to time and area – involved Legionella
in and around the twin cities of Ulm and
Neu-Ulm. Intensive investigations identifi ed an air
cooling system on the roof of an offi ce building
to be the cause. There were 113 illnesses with 10
deaths.
Among rare infectious diseases in Germany,
Cholera, Diphtheria, and Tularaemia showed the
highest incidences since the introduction of IfSG.
Regarding Cholera this was largely due to 4 siblings
who fell ill upon returning from a trip to
Pakistan, of which one infant died after arriving
in Germany. For Diphtheria, an increase was observed
particularly of autochthonous, skin-associated
Diphtheria caused by C. ulcerans. No association
could be determined among the 31 reported
Tularaemia cases.
Infl uenza continued to receive special attention
in 2010. The abating pandemic wave of A(H1N1)
2009 prevailed during the fi rst half of the year,
followed by the onset of the seasonal wave at the
end of the year, which was still dominated by
A(H1N1) 2009, but also had a substantial proportion
of infl uenza B virus.
Among the noteworthy infectious diseases,
HIV infections still keep a prominent place. The
total number of fi rst-diagnoses stabilized further in
2010, a shift to younger age groups was observed
in the group of MSM (men who have sex with
men).
Data reported for invasive MRSA (Methicillin
resistant Staphylococcus aureus) are for the fi rst
time available for an entire year, making possible
an assessment of the importance (and future
trends) of this typically hospital-acquired pathogen.
Measles maintained an important position
among the vaccine-preventable diseases, not least
because of the target of global eradication declared
by the WHO. The increase in case numbers in
2010 shows that Germany is still far away from this
goal, likely due to insuffi cient vaccination rates. An
increasing incidence in young adults warrants further
careful observation.
The analysis of reported cases of vaccine-preventable
diseases can provide important indicators
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