Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs. Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel. Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1–25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0–88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE- syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%—subcutaneous; 29%—intravenous; 1%—unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy. Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.

We report 15 imported louse-borne relapsing fever (LBRF) cases in refugees in Bavaria, Germany. One patient died. Epidemiological findings confirmed that all were young males from the Horn of Africa (12 from Somalia), who had similar migration routes converging in Sudan continuing through Libya and Italy. The majority likely acquired their infection during migration. Healthcare workers should be aware of LBRF in refugees passing through north Africa to ensure correct treatment and preventive measures.

C hildren have been disproportionately affected by public health measures in the current coronavirus disease (COVID-19) pandemic (1). In contrast to other age groups, children have shown lower rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive cases; lower risk for symptomatic, acute, COVID-19; a generally milder course of disease with the exception of some rare manifestations and the post-COVID-19 multisystem infl ammatory syndrome in children; and lower secondary attack rates (2-4). Susceptibility to infection in <10 years of age is estimated to be lower than that for teenagers. Accumulating evidence shows that, given limited infection control measures, SARS-CoV-2 might spread sustainably in secondary/high schools but to a lesser degree in primary schools and nurseries (2,5).Closure of childcare facilities and schools has been shown to negatively affect the physical and emotional well-being of children, teenagers, and parents, potentially having a long-term impact on their lives (6). Thus, various expert groups called for avoiding closing of these institutions (7,8). Against the background of presymptomatic transmission found in adults, it is critical to public health authorities to be able to rely on real-life data monitoring the number of asymptomatic yet infected children attending educational institutions (9). Some studies have reported low numbers of infected cases in primary schools or childcare facilities but were conducted during a lockdown or semi-lockdown period (5,10). The aim of our study (the Münchner Virenwächter Study) was to implement a real-time sentinel program in a representative number of 5 primary schools and 5 (6 in phase 2) nurseries/kindergartens in Munich, Germany. The StudyThis study was approved by the ethics committee of the Ludwig-Maximilians University under project no. 20-484. We intended to accomplish a timely detection of infected cases and offer an additional level of safety to participating institutions during regular operating mode. The study spanned over 2 phases (Figure 1): phase 1, June 15-July 26, 2020; and phase 2, September 7-November 1, 2020. Participating institutions were randomly selected, and written informed consent was obtained in the fi rst week of each phase. To correct for underrepresentation of younger children (<5 years of age), we included an additional nursery/ kindergarten into phase 2.We tested oropharyngeal swab specimens for SARS-CoV-2 by using real-time reverse transcription PCR (rRT-PCR); weekly samples were obtained from randomly selected children (n = 20) and staff (n = 5) in each institution. Swab specimens were taken on-site by trained medical personnel, and results were timely reported. For rRT-PCR, we processed specimens

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The incidence of varicella-associated neurologic complications in children decreased approximately by 60% during the first 7 years following the recommendation for universal vaccination.