Timeliness of Surveillance during Outbreak of Shiga Toxin–producing<i>Escherichia coli</i>Infection, Germany, 2011

Altmann, Matthias; Wadl, Maria; Altmann, Doris; Benzler, Justus; Eckmanns, Tim; Krause, Gérard; Spode, Anke; Heiden, Matthias an der

doi:10.3201/eid1710.111027

Cited by 41 publications

(21 citation statements)

References 8 publications

(7 reference statements)

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“…Previous timeliness studies have been conducted for a number of countries and reportable diseases, including salmonellosis, but no standardised method has been established [1,7,[9][10][11]. The impact of individual factors, such as reporting method (paper or electronic), has been studied [12,13]; however, the effect of multiple factors, including those related to the structure of the surveillance system (primary laboratory type and location) or to the disease in question (seasonality, serotype), has not been explored.…”

Section: Introductionmentioning

confidence: 99%

The French human Salmonella surveillance system: evaluation of timeliness of laboratory reporting and factors associated with delays, 2007 to 2011

et al. 2014

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Section: Introductionmentioning

confidence: 99%

The French human Salmonella surveillance system: evaluation of timeliness of laboratory reporting and factors associated with delays, 2007 to 2011

et al. 2014

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“…Epidemiological and surveillance studies were conducted at the same time by German federal institutions to identify the origin of infection. These studies led to the hypothesis that contaminated vegetables like cucumbers or tomatoes might be involved in spreading of the human pathogenic bacterium [3-5]. Press coverage also hypothesized that digestates from agricultural biogas reactors could have been a source causing these infections.…”

Section: Introductionmentioning

confidence: 99%

Detailed analysis of metagenome datasets obtained from biogas-producing microbial communities residing in biogas reactors does not indicate the presence of putative pathogenic microorganisms

Eikmeyer

Rademacher

Hanreich

et al. 2013

Biotechnol Biofuels

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BackgroundIn recent years biogas plants in Germany have been supposed to be involved in amplification and dissemination of pathogenic bacteria causing severe infections in humans and animals. In particular, biogas plants are discussed to contribute to the spreading of Escherichia coli infections in humans or chronic botulism in cattle caused by Clostridium botulinum. Metagenome datasets of microbial communities from an agricultural biogas plant as well as from anaerobic lab-scale digesters operating at different temperatures and conditions were analyzed for the presence of putative pathogenic bacteria and virulence determinants by various bioinformatic approaches.ResultsAll datasets featured a low abundance of reads that were taxonomically assigned to the genus Escherichia or further selected genera comprising pathogenic species. Higher numbers of reads were taxonomically assigned to the genus Clostridium. However, only very few sequences were predicted to originate from pathogenic clostridial species. Moreover, mapping of metagenome reads to complete genome sequences of selected pathogenic bacteria revealed that not the pathogenic species itself, but only species that are more or less related to pathogenic ones are present in the fermentation samples analyzed. Likewise, known virulence determinants could hardly be detected. Only a marginal number of reads showed similarity to sequences described in the Microbial Virulence Database MvirDB such as those encoding protein toxins, virulence proteins or antibiotic resistance determinants.ConclusionsFindings of this first study of metagenomic sequence reads of biogas producing microbial communities suggest that the risk of dissemination of pathogenic bacteria by application of digestates from biogas fermentations as fertilizers is low, because obtained results do not indicate the presence of putative pathogenic microorganisms in the samples analyzed.

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“…Local intelligence in the form of professionals reporting on events, e.g., in schools, or health care institutions, are the cornerstone of detecting the onset of events at the local level, as shown for example, during the 2009 A/H1N1 pandemic [ 8 , 9 ]. Still, there is a risk to overlook patterns that might be detected only when taking a wider perspective beyond the patients treated by one clinician or in one institution [ 10 , 11 ]. Surveillance systems that pool information from multiple institutions or jurisdictions can potentially detect events that are not represented in the data of any single region or institution.…”

Section: Introductionmentioning

confidence: 99%

Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe: the added value of syndromic surveillance

et al. 2015

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Background: The revised World Health Organization's International Health Regulations (2005) request a timely and all-hazard approach towards surveillance, especially at the subnational level. We discuss three questions of syndromic surveillance application in the European context for assessing public health emergencies of international concern: (i) can syndromic surveillance support countries, especially the subnational level, to meet the International Health Regulations (2005) core surveillance capacity requirements, (ii) are European syndromic surveillance systems comparable to enable cross-border surveillance, and (iii) at which administrative level should syndromic surveillance best be applied? Discussion: Despite the ongoing criticism on the usefulness of syndromic surveillance which is related to its clinically nonspecific output, we demonstrate that it was a suitable supplement for timely assessment of the impact of three different public health emergencies affecting Europe. Subnational syndromic surveillance analysis in some cases proved to be of advantage for detecting an event earlier compared to national level analysis. However, in many cases, syndromic surveillance did not detect local events with only a small number of cases. The European Commission envisions comparability of surveillance output to enable cross-border surveillance. Evaluated against European infectious disease case definitions, syndromic surveillance can contribute to identify cases that might fulfil the clinical case definition but the approach is too unspecific to comply to complete clinical definitions. Syndromic surveillance results still seem feasible for comparable cross-border surveillance as similarly defined syndromes are analysed. We suggest a new model of implementing syndromic surveillance at the subnational level. In this model, syndromic surveillance systems are fine-tuned to their local context and integrated into the existing subnational surveillance and reporting structure. By enhancing population coverage, events covering several jurisdictions can be identified at higher levels. However, the setup of decentralised and locally adjusted syndromic surveillance systems is more complex compared to the setup of one national or local system. Summary: We conclude that syndromic surveillance if implemented with large population coverage at the subnational level can help detect and assess the local and regional effect of different types of public health emergencies in a timely manner as required by the International Health Regulations (2005).

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Timeliness of Surveillance during Outbreak of Shiga Toxin–producingEscherichia coliInfection, Germany, 2011

Cited by 41 publications

References 8 publications

The French human Salmonella surveillance system: evaluation of timeliness of laboratory reporting and factors associated with delays, 2007 to 2011

The French human Salmonella surveillance system: evaluation of timeliness of laboratory reporting and factors associated with delays, 2007 to 2011

Detailed analysis of metagenome datasets obtained from biogas-producing microbial communities residing in biogas reactors does not indicate the presence of putative pathogenic microorganisms

Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe: the added value of syndromic surveillance

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