Abstract
Background
Giardiasis is a common gastrointestinal illness in travellers. Data on the actual giardiasis risk of travellers to different travel destinations are scarce. We aim to estimate the ...risk of giardiasis in travellers from Germany by destination country and region.
Methods
We analysed travel-related giardiasis cases, their countries and regions of exposure and the age and sex distribution of cases reported in 2014–19 in Germany. We defined a travel-related giardiasis case as a laboratory-confirmed (i.e. positive microscopy, antigen test or nucleic acid test) symptomatic individual with outbound travel abroad within 3–25 days before symptom onset. Based on the number of reported cases per exposure country and UNWTO travel data for Germany, we calculated the number of travel-related giardiasis cases per 100 000 travellers and compared the incidence in 2014–16 and 2017–19 to identify potential trends.
Results
In 2014–19, 21 172 giardiasis cases were reported in Germany, corresponding to an overall incidence of 4.3 per 100 000 population. Of all cases, 6879 (32%) were travel-related with a median age of 34 interquartile range (IQR): 25–50, 51% were male. Southern Asia was the most frequently reported exposure region and had the highest incidence in travellers (64.1 per 100 000 returning travellers) in 2017–19, followed by Latin America (19.2) and Sub-Saharan Africa (12.9). We observed statistically significant decreasing trends for Southern Asia and Sub-Saharan Africa. Latin America was the only region with a statistically significant increasing trend.
Conclusions
Almost one-third of recent giardiasis cases in Germany were travel-related. Giardiasis incidence in travellers differs greatly depending on the destination region. Decreasing trends in many regions might be due to improvements in food hygiene or travel conditions. Our results may inform medical consultation pre and post patient’s travel.
This report describes a large international chocolate-associated Salmonella outbreak originating from Germany.
We conducted epidemiologic investigations including a case-control study, and food ...safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE).
From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio MOR: 4.8; 95% confidence interval CI: 1.3-26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2-23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1-47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures.
Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks.
The authors conducted a matched case-control study in Germany to identify risk factors for sporadic illness associated with Shiga toxin-producing Escherichia coli (STEC) infection, regardless of ...serogroup. From April 2001 through March 2003, cases were prospectively enrolled through a laboratory-based sentinel surveillance system located in 14 of the 16 German federal states. One control was identified per case, matched by age and region. Conditional logistic regression was used in the analysis, which was conducted separately for three age groups (<3 years, 3–9 years, and ≥10 years). The median age of the 202 enrolled cases was 2.5 years (range, 3 months–89 years). Hemolytic uremic syndrome developed in five patients. Non-O157 strains accounted for 85% of the isolated STEC. In children under 3 years of age, having touched a ruminant had the highest odds of disease, and raw milk was the only food identified as a risk factor. In contrast, in persons aged 10 years or older, only food items (i.e., lamb meat, raw spreadable sausages) were significantly associated with illness. In this study, risk factors were age-specific. Direct transmission through food played a lesser role in children under 3 years of age, the population at greatest risk of both acquiring STEC infection and developing hemolytic uremic syndrome.
Background
is a major cause of gastroenteritis globally, and is the most common food- and waterborne parasitic infection in Europe.AimTo describe the epidemiology of reported acute giardiasis cases ...in Germany and compare demographic and clinical characteristics between imported and autochthonous cases.MethodsWe conducted a descriptive analysis of giardiasis cases that fulfilled the national case definition and were reported between January 2002 and December 2021. We defined an imported case as having at least one place of exposure abroad in the 3-25 days before symptom onset. We analysed case numbers and incidence by age, sex, month reported and geographic region, both overall and stratified by autochthonous and imported cases.ResultsFrom 2002 to 2021, 72,318 giardiasis cases were reported in Germany, corresponding to a mean annual incidence of 4.4 per 100,000 population. Annual incidence gradually decreased since 2013, declining sharply during the COVID-19 pandemic in 2020-21. Of 69,345 cases reported between 2002 and 2019, 35% were imported. Incidence of autochthonous cases (overall yearly mean: 3.1/100,000) was highest in males and young children (< 5 years); imported cases were predominantly adults aged 20-39 years. We identified seasonal patterns for imported and autochthonous cases.ConclusionsGiardiasis in Germany is typically assumed to be imported. Our data, however, underline the importance of autochthonous giardiasis. Travel advice might reduce imported infections, but prevention strategies for autochthonous infections are less clear. Dietary, behavioural and environmental risk factors need to be further investigated to enhance infection prevention measures for autochthonous giardiasis.
Stewardship of antibiotics used in livestock production has come under increasing scrutiny, from both the animal welfare point of view and due to concerns that antibiotic use in livestock may pose a ...risk to human health through selection pressure to drive development of antibiotic resistant strains of bacteria. Despite this concern, however, antibiotic consumption in the sheep sector is currently poorly described. This study determines the range and quantities of antibiotics used in the Northern Irish (NI) sheep flock as well as exploring drivers for their use. A mixed-methods approach was utilised, with an anonymous online scoping survey, analysis of the medicine records from 52 NI sheep farms and semi-structured interviews undertaken with 27 farmers. Eighteen farmers contributed both records and participated in interviews. Veterinary medicine records were derived from two sources: on-farm medicine books (seven) or veterinary practice sales data (51). As six of these farmers provided information from both sources a total of 52 unique farms participated. Overall, antibiotic use in sheep on the 52 farms sampled was low, with a median value of 11.35 mgPCU−1 (mean 13.63 mgPCU−1, sd 10.7; range 0–45.29 mgPCU−1), with all farms below 50 mgkg−1. Critically important antibiotics accounted for 0.21% of all antibiotics purchased. Lameness was the main driver of antibiotic use identified by this study. Others included a range of prophylactic treatments such as oral antibiotics to prevent watery mouth, injectable antibiotics to prevent abortion and following assisted lambing. Farmers acknowledged some of these uses had become habitual over time. The veterinary medicine sales records demonstrated significant sales of antibiotics not authorised for use in sheep, on an ongoing, rather than case-by-case, basis. Farmers were positive about their veterinarian’s ability and knowledge to improve flock welfare and productivity, but were unwilling to pay for this advice. However, veterinarians may have facilitated weak medicine stewardship through a failure to adequately challenge farmers seeking antibiotics. Farmers did not maintain accurate or up-to-date on farm medicine or production records in the majority of cases. Despite this lack of on-farm recording, veterinary sales records can be studied in consultation with farmers to provide veterinarians with a farm-specific insight into antibiotic use and related attitudes and behaviours. Farmers and veterinarians can then identify areas and behaviours to target collaboratively, improving antibiotic and wider medicine stewardship, whilst simultaneously improving flock health and productivity.
•Median antibiotic use in fifty-two Northern Irish sheep flocks sampled was under 12mgPCU−1.•Attitudes to antibiotic use varied widely among participating Northern Irish sheep farmers.•Lameness is the main driver described by participating farmers for antibiotic use in Northern Irish sheep flocks.•Mixed enterprise farmers could identify antibiotic use for sheep from their veterinary sales records.•Improved stewardship of antibiotic use could start from veterinary sales record analysis.
Flock health planning has been advocated as part of a wider drive within livestock production for veterinarians and farmers to adopt a prevention‐focused approach to veterinary medicine. This ...approach has, at its core, a cyclical process of assessment, evaluation, action and re‐assessment, and is documented, at least in summary, in a health plan (HP). The HP has become a defining pillar of farm quality assurance schemes (QASs), introduced to address calls for greater transparency and accountability in food production. There is limited current information on the attitudes and behaviours surrounding flock HPs in the sheep sector and the barriers to greater involvement in an active process of continual improvement through reflective flock health planning. This study aims to address these issues with reference to the national flock in Northern Ireland. A mixed‐methods approach was used to explore farmers' and veterinarians' opinions and behaviours related to QASs and HP, with data obtained through an online scoping questionnaire, semi‐structured interviews with 27 farmers and 15 veterinarians, and discussion groups with farmers and veterinarians. No evidence of a positive association between a farm having a HP and implementation of 12 industry‐recommended flock health activities was identified using the Fisher's exact test. Farmers reported a reluctance to pay for veterinary advice while some veterinarians reported a lack of time to develop HPs for farmers, and sheep‐related work generally. Farmers predominantly saw the HP as a static, physical document, which had limited impact on their management practices, rather than a proactive, reflective and collaborative planning process. Veterinarians tasked with completing HPs felt restricted by limited knowledge of on‐farm practices, flock production data and a lack of confidence in the accuracy of on‐farm medicine records. This led some to believe that the HPs may fail to address critical issues. A new approach to engage farmers and veterinarians together in active flock health planning needs to be developed. This will need a sustainable delivery plan. Then the focus can be shifted towards ongoing reflective health planning to drive change for the betterment of sheep health and welfare.
This is a predominantly qualitative study of the beliefs and behaviours of sheep farmers, and their veterinarians, from across Northern Ireland, surrounding their flock health plans and flock health planning process. Sheep farmers participating saw their health plan as a static, physical document rather than an ongoing continuous cycle of improvement. Veterinarians saw potential to improve flock health if they could engage farmers and develop an income stream from the work. Farmers and veterinarians concurred that incentivising engagement and support in implementation of the agreed plans was key to drive flock health planning forward.
An energy harvesting device for frequencies of less than 2 Hz with amplitudes of several cm was developed. A pendulum is driving a gear mechanism similar as a clock unit which is driving a wheel ...carrying 36 magnets. Next to the magnets there are mounted 18 coils generating voltage. This way, a maximum voltage and power of 21.5 V and 114 mW are achieved at 1.25 Hz and 57 mm amplitude.
Photons and lepton pairs emerging from decays of virtual photons are the most promising probes of dense hadronic matter. In the energy domain of 1 - 2 GeV per nucleon, HADES has measured electron ...pairs in C+C, Ar+KCl, p+p, d+p and p+Nb collisions. An experimentally constrained N+N reference spectrum was established. Moreover, for the first time at this energy the inclusive production cross sections for light vector mesons were extracted. This result allows putting tight constraints on vector meson production in heavy-ion collisions at beam energies of a few GeV per nucleon. In this contribution I will compare the HADES data to predictions from UrQMD microscopic transport model calculations and introduce an approach which will allow to separate in a transparent way the generation of the event background from the emission pattern of a physics observable under consideration.
•An online survey was distributed to UK equine veterinarians between 2019 and 2020.•Seventy-eight per cent of respondents were aware of O. cervicalis.•Knowledge of O. cervicalis lifecycle amongst ...respondents was relatively low.•Few respondents considered O. cervicalis as a differential for equine dermatoses.•Onchocerciasis prevalence may increase in the future as anthelmintic use declines.
The nematode Onchocerca cervicalis is the most common causative agent of equine onchocerciasis; this condition is characterised by pruritus and dermatitis and is a differential diagnosis for insect bite hypersensitivity. Onchocerciasis is currently presumed of minor importance within the UK, however prevalence may increase if macrocyclic lactone use declines amid concerns about anthelmintic resistance in gastrointestinal nematodes. This survey aimed to establish O. cervicalis awareness and knowledge levels amongst UK equine veterinarians and to determine approximate numbers of UK horses affected with unresponsive cases of dermatoses, including insect bite hypersensitivity. An online survey was distributed to UK equine vets between December 2019 and February 2020. Of 88 respondents, 78% were aware of O. cervicalis, however 49% of these answered less than half the questions presented about the parasite's lifecycle correctly. Approximately 25% of insect bite hypersensitivity cases respondents saw were deemed unresponsive to standard treatments, 84% of respondents had not previously considered onchocerciasis as a differential diagnosis in such cases. Findings suggest knowledge of O. cervicalis amongst UK equine vets is lacking, highlighting a need to raise awareness and consideration of the parasite as a differential when investigating equine dermatoses.
The objective of this study was to determine the effects of diets containing crude glycerol on pellet mill production efficiency and nursery pig growth performance. In a pilot study, increasing crude ...glycerol (0, 3, 6, 9, 12, and 15%) in a corn-soybean meal diet was evaluated for pellet mill production efficiency. All diets were steam conditioned to 65.5 degrees C and pelleted through a pellet mill equipped with a die that had an effective thickness of 31.8 mm and holes 3.96 mm in diameter. Each diet was replicated by manufacturing a new batch of feed 3 times. Increasing crude glycerol increased both the standard (linear and quadratic, P < 0.01) and modified (linear, P < 0.01; quadratic, P </= 0.02) pellet durability indexes up to 9% with no further benefit thereafter. The addition of crude glycerol decreased (linear; P < 0.01) production rate (t/h) and production efficiency (kWh/t). In a 26-d growth assay, 182 pigs (initial BW, 11.0 +/- 1.3 kg; 5 or 6 pigs/pen) were fed 1 of 7 corn-soybean meal-based diets with no added soy oil or crude glycerol (control), the control diet with 3 or 6% added soy oil, 3 or 6% added crude glycerol, and 6 or 12% addition of a 50:50 (wt/wt) soy oil/crude glycerol blend with 5 pens/diet. The addition of crude glycerol lowered (P < 0. 01) delta temperature, amperage, motor load, and production efficiency. The addition of crude glycerol improved (P < 0.01) pellet durability compared with soy oil and the soy oil/crude glycerol blend treatments. Pigs fed increasing crude glycerol had increased (linear, P = 0.03) ADG. Average daily gain tended to increase with increasing soy oil (quadratic; P = 0.07) or the soy oil/crude glycerol blend (linear, P = 0.06). Adding crude glycerol to the diet did not affect G:F compared with the control. Gain:feed tended to increase with increasing soy oil (linear, P < 0.01; quadratic, P = 0.06) or the soy oil/crude glycerol blend (linear, P < 0.01; quadratic, P = 0.09). Nitrogen digestibility tended (P = 0.07) to decrease in pigs fed crude glycerol compared with pigs fed the soy oil treatments. Apparent digestibility of GE tended (P = 0.08) to be greater in the pigs fed soy oil compared with pigs fed the soy oil/crude glycerol blends. In conclusion, adding crude glycerol to the diet before pelleting increased pellet durability and improved feed mill production efficiency. The addition of 3 or 6% crude glycerol, soy oil, or a blend of soy oil and glycerol in diets for 11- to 27-kg pigs tended to increase ADG. For pigs fed crude glycerol, this was a result of increased ADFI, whereas, for pigs fed soy oil or the soy oil/crude glycerol, the response was a result of increased G:F.
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