Routine varicella vaccination with one dose for children of 11 to 14 months was recommended in Germany in 2004 to reduce disease incidence and severe complications. A country-wide varicella sentinel surveillance system was initiated in 2005 to detect trends of disease frequency and vaccine uptake and to evaluate the vaccination programme. A convenient sample of about 1,000 paediatricians and general practitioners was recruited to report on a monthly basis on varicella cases by age groups seen in their practice, and on varicella vaccine doses administered. Sentinel data from April 2005 to March 2009 show a reduction of 55% of varicella cases in all ages; 63% in the age group 0-4 years and 38% in 5-9 year-olds. The number of vaccine doses per reporting unit in all regions and physician groups increased during the same period. The number of reported cases as well as administered vaccines differed between physician groups and regions with different reimbursement policies. Where reimbursement was settled early and vaccine doses were increasing varicella cases started to decrease early as well. Besides reimbursement policies the availability and vaccination schedules influenced vaccine uptake. Sentinel surveillance provided valid data on trends for varicella associated morbidity, vaccine uptake and the age distribution of cases. The results confirm that following the introduction of routine varicella vaccination, varicella morbidity started to decline in Germany.
It is evident that the complete elimination of measles, mumps and varicella has not yet been accomplished, as various outbreaks have shown. In the recent past the number of infections of teenagers and adults with these so called 'children's diseases' have been increasing. The course of the infections in these cases are often severe. To improve the current situation it will be necessary to: strictly undertake (re-)vaccination of all persons who may not be protected; extensive immunization for occupational indications (including apprentices, trainees and students); broad postexposure vaccinations; outbreak response immunizations of persons having no proof of proper vaccination (twice) or immunity. Teenagers and adults, in addition to children should obtain protection by being immunized against measles, mumps, rubella and chickenpox (varicella).
At the 54(th) Scientific Congress of the German Professional Association of Public Health Service Physicians and Dentists in Marburg on 6th May 2004 the working group on meningococci (Arbeitsgemeinschaft Meningokokken, AGMK) organised the international workshop "Public Health Management of invasive Meningococcal Disease". In recent years significant changes in the epidemiology of meningococcal disease took place in Europe: in some countries and regions the number of disease caused by meningococci serogroup C has increased significantly. In the Netherlands this increase led to the introduction of an immunisation programme with conjugated meningococcal vaccines targeting children aged 1 up to 18 years. In Switzerland a peak in the number of reported meningococcal group C cases could be observed in some regions. Therefore, a regional vaccination programme has been introduced. Nevertheless, compared with Germany, the indications for vaccination against meningococci in Switzerland are more extensive. In the workshop, Professor Ulrich Vogel and Dr. Ingrid Ehrhard presented the epidemiological situation in Germany and the recommended prophylaxis regimen against meningococci.
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