Julia Enkelmann1, Klaus Stark2, Mirko Faber3. 1. Department of Infectious Disease Epidemiology, Division for Gastrointestinal Infections, Zoonoses and Tropical Infections, Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany. Electronic address: enkelmannj@rki.de. 2. Department of Infectious Disease Epidemiology, Division for Gastrointestinal Infections, Zoonoses and Tropical Infections, Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany. Electronic address: starkk@rki.de. 3. Department of Infectious Disease Epidemiology, Division for Gastrointestinal Infections, Zoonoses and Tropical Infections, Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany. Electronic address: faberm@rki.de.
Abstract
OBJECTIVE: We describe epidemiological trends of human brucellosis in Germany over a 13 year period based on national surveillance data. METHODS: We analyzed demographic, clinical, laboratory and exposure information of symptomatic laboratory-confirmed brucellosis cases notified 2006-18. Using official population data, we calculated incidences and risk ratios (RR). RESULTS: From 2006 to 2018, 408 brucellosis cases were notified in Germany (mean annual incidence: 0.38/1,000,000 population), of which 75% were travel-associated. Yearly notifications peaked in 2014 (n = 47) and remained elevated compared to 2006-2013 (mean: n = 25). Asylum seekers (AS) arriving in Germany accounted for 9/44 (2015) and 15/36 (2016) cases, respectively. RR AS/non-AS 2015-2016: 28, 95% CI: 17-45. Unpasteurized milk products were most frequently notified as source of infection. Imported food and occupational exposure played a role in autochthonous cases. CONCLUSIONS: The incidence of human brucellosis has markedly increased in recent years. Most of the observed rise in notifications can be explained by infections in AS. Exposure still predominantly occurs abroad. Risk factors for autochthonous infections need to be investigated further, though imported dairy products seem to play a role. Physicians should consider brucellosis as differential diagnosis in AS and people with travel to endemic regions with compatible symptoms.
OBJECTIVE: We describe epidemiological trends of humanbrucellosis in Germany over a 13 year period based on national surveillance data. METHODS: We analyzed demographic, clinical, laboratory and exposure information of symptomatic laboratory-confirmed brucellosis cases notified 2006-18. Using official population data, we calculated incidences and risk ratios (RR). RESULTS: From 2006 to 2018, 408 brucellosis cases were notified in Germany (mean annual incidence: 0.38/1,000,000 population), of which 75% were travel-associated. Yearly notifications peaked in 2014 (n = 47) and remained elevated compared to 2006-2013 (mean: n = 25). Asylum seekers (AS) arriving in Germany accounted for 9/44 (2015) and 15/36 (2016) cases, respectively. RR AS/non-AS 2015-2016: 28, 95% CI: 17-45. Unpasteurized milk products were most frequently notified as source of infection. Imported food and occupational exposure played a role in autochthonous cases. CONCLUSIONS: The incidence of humanbrucellosis has markedly increased in recent years. Most of the observed rise in notifications can be explained by infections in AS. Exposure still predominantly occurs abroad. Risk factors for autochthonous infections need to be investigated further, though imported dairy products seem to play a role. Physicians should consider brucellosis as differential diagnosis in AS and people with travel to endemic regions with compatible symptoms.
Authors: Chenxi Zhao; Kun Liu; Chenghao Jiang; Xiao Wei; Shuxuan Song; Xubin Wu; Xiaohui Wen; Ting Fu; Li Shen; Zhongjun Shao; Qian Li Journal: Front Public Health Date: 2022-07-22