Negligible import of enteric pathogens by newly arrived asylum seekers and no impact on incidence of notified Salmonella and Shigella infections and outbreaks in Rhineland-Palatinate, Germany, January 2015 to May 2016

Introduction The 2015 refugee crisis raised concerns about an import of infectious diseases affecting the German population. Aims: To evaluate public and individual health benefits of stool screening, and explore whether importation of enteric pathogens by newly arrived asylum seekers impacts on the host population. Methods: We used data from mandatory stool screening to determine the overall, age, sex, and country-specific prevalence of enteric bacteria and helminths. We used surveillance data to assess whether the number of incoming asylum seekers influenced notifications of salmonellosis and shigellosis in Rhineland-Palatinate. Results: Salmonella were found in 0.2% (95% confidence interval (CI) 0.2–0.3%) of 23,410 samples collected from January 2015 to May 2016. Prevalence was highest in children under 5 years (0.8%; 95% CI: 0.5–1.3%). No Shigella or invasive Salmonella spp. were detected. In a subset of 14,511 samples, the prevalence of helminth infestation was 2.4% (95% CI: 2.1–2.6%), with highest proportions detected in adolescents (4.6%; 95% CI 3.8–5.4%) and among Eritreans (9.3%; 95% CI: 7.0–12.0%); in the latter particularly Schistosoma mansoni and Taenia spp. The increase in asylum applications did not increase notifications of salmonellosis and shigellosis. No transmission from asylum seekers to German residents was notified. Conclusion: Public health risk associated with imported enteric pathogens is very low overall. Addressing individual and public health risks, we recommend replacing stool screening of all newly arrived asylum seekers by a targeted approach, with target groups and approaches being adapted if necessary. Target groups supported by our data are children, adolescents, and Eritreans.

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Environmental Factors Associated with High Fly Densities and Diarrhea in Vellore, India

Applied and Environmental Microbiology ◽

10.1128/aem.01236-15 ◽

2015 ◽

Vol 81 (17) ◽

pp. 6053-6058 ◽

Cited By ~ 23

Author(s):

Stefan Collinet-Adler ◽

Sudhir Babji ◽

Mark Francis ◽

Deepthi Kattula ◽

Prasanna Samuel Premkumar ◽

...

Keyword(s):

Linear Models ◽

Significant Risk ◽

Enteric Bacteria ◽

Enteric Pathogens ◽

Indian Children ◽

Content Type ◽

E Coli ◽

Relative Risks ◽

Log Linear ◽

Children Under 5

ABSTRACTDiarrhea causes significant morbidity and mortality in Indian children under 5 years of age. Flies carry enteric pathogens and may mediate foodborne infections. In this study, we characterized fly densities as a determinant of infectious diarrhea in a longitudinal cohort of 160 urban and 80 rural households with 1,274 individuals (27% under 5 years of age) in Vellore, India. Household questionnaires on living conditions were completed at enrollment. Fly abundance was measured during the wet and dry seasons using fly ribbons placed in kitchens. PCRs for enteric bacteria, viruses, and protozoa were performed on 60 fly samples. Forty-three (72%) fly samples were positive for the following pathogens: norovirus (50%),Salmonellaspp. (46.7%), rotavirus (6.7%), andEscherichia coli(6.7%). Ninety-one episodes of diarrhea occurred (89% in children under 5 years of age). Stool pathogens isolated in 24 of 77 (31%) samples includedE. coli,Shigellaspp.,Vibriospp.,Giardia,Cryptosporidium, and rotavirus. Multivariate log-linear models were used to explore the relationships between diarrhea and fly densities, controlling for demographics, hygiene, and human-animal interactions. Fly abundance was 6 times higher in rural than urban sites (P< 0.0001). Disposal of garbage close to homes and rural living were significant risk factors for high fly densities. The presence of latrines was protective against high fly densities and diarrhea. The adjusted relative risks of diarrheal episodes and duration of diarrhea, associated with fly density at the 75th percentile, were 1.18 (95% confidence interval [CI], 1.03 to 1.34) and 1.15 (95% CI, 1.02 to 1.29), respectively. Flies harbored enteric pathogens, including norovirus, a poorly documented pathogen on flies.

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Correction: Aljadeeah, S., et al. Barriers to Accessing Medicines among Syrian Asylum Seekers and Refugees in a German Federal State. Int. J. Environ. Res. Public Health 2021, 18, 519

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052464 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2464

Author(s):

Saleh Aljadeeah ◽

Veronika J. Wirtz ◽

Eckhard Nagel

Keyword(s):

Public Health ◽

Asylum Seekers ◽

Federal State ◽

German Federal State ◽

Asylum Seekers And Refugees

In the original article [...]

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Food Consumption Patterns: In Preschool Children

Canadian Journal of Dietetic Practice and Research ◽

10.3148/73.2.2012.66 ◽

2012 ◽

Vol 73 (2) ◽

pp. 66-71 ◽

Cited By ~ 17

Author(s):

Roman Pabayo ◽

John C. Spence ◽

Linda Casey ◽

Kate Storey

Keyword(s):

Public Health ◽

Preschool Children ◽

Food Consumption ◽

Healthy Eating ◽

Food Groups ◽

Dietary Recommendations ◽

Target Groups ◽

Demographic Groups ◽

Public Health Professionals ◽

Grain Products

Purpose: Healthy eating during early childhood is important for growth and development. Eating Well with Canada's Food Guide (CFG) provides dietary recommendations. We investigated patterns of food consumption among preschool children and attempted to determine whether these children's intakes met nutrition recommendations. Methods: Between 2005 and 2007, four- and five-year-old children (n=2015) attending 12 Edmonton-region public health units for immunization were recruited for a longitudinal study on determinants of childhood obesity. The children's dietary intake at baseline was assessed using parental reports. Results: Overall, 29.6%, 23.5%, 90.9%, and 94.2% of the children met recommendations for vegetables and fruit, grain products, milk and alternatives, and meat and alternatives, respectively. In addition, 79.5% consumed at least one weekly serving of foods in the “choose least often” group. Significant differences existed in consumption of food groups across socioeconomic and demographic groups. For example, 82.9%, 84.7%, and 75.9% of preschool children from neighbourhoods of low, medium, and high socioeconomic status, respectively, consumed at least one food in the “choose least often” group (χ2 =16.2, p<0.001). Conclusions: Consumption of vegetables and fruit and grain products was low among participants, and intake of “choose least often” foods was high. Consumption of foods also differed among socioeconomic and demographic groups. To encourage healthy eating among children, public health professionals should target groups who do not meet the CFG recommendations.

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Googling for Ticks and Borreliosis in Germany: Nationwide Google Search Analysis From 2015 to 2018 (Preprint)

10.2196/preprints.18581 ◽

2020 ◽

Author(s):

Cora Scheerer ◽

Melvin Rüth ◽

Linda Tizek ◽

Martin Köberle ◽

Tilo Biedermann ◽

...

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Tick Bite ◽

German Population ◽

Internet Search ◽

Tick Bites ◽

Federal States ◽

Search Terms ◽

Health Studies ◽

Very High

BACKGROUND Borreliosis is the most frequently transmitted tick-borne disease in Europe. It is difficult to estimate the incidence of tick bites and associated diseases in the German population due to the lack of an obligation to register across all 16 federal states of Germany. OBJECTIVE The aim of this study is to show that Google data can be used to generate general trends of infectious diseases on the basis of borreliosis and tick bites. In addition, the possibility of using Google AdWord data to estimate incidences of infectious diseases, where there is inconsistency in the obligation to notify authorities, is investigated with the perspective to facilitate public health studies. METHODS Google AdWords Keyword Planner was used to identify search terms related to ticks and borreliosis in Germany from January 2015 to December 2018. The search volume data from the identified search terms was assessed using Excel version 15.23. In addition, SPSS version 24.0 was used to calculate the correlation between search volumes, registered cases, and temperature. RESULTS A total of 1999 tick-related and 542 borreliosis-related search terms were identified, with a total of 209,679,640 Google searches in all 16 German federal states in the period under review. The analysis showed a high correlation between temperature and borreliosis (r=0.88), and temperature and tick bite (r=0.83), and a very high correlation between borreliosis and tick bite (r=0.94). Furthermore, a high to very high correlation between Google searches and registered cases in each federal state was observed (Brandenburg r=0.80, Mecklenburg-West Pomerania r= 0.77, Saxony r= 0.74, and Saxony-Anhalt r=0.90; all P<.001). CONCLUSIONS Our study provides insight into annual trends concerning interest in ticks and borreliosis that are relevant to the German population exemplary in the data of a large internet search engine. Public health studies collecting incidence data may benefit from the results indicating a significant correlation between internet search data and incidences of infectious diseases.

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Genetic analysis of the role of the conserved inner membrane protein CvpA in EHEC resistance to deoxycholate

Journal of Bacteriology ◽

10.1128/jb.00661-20 ◽

2020 ◽

Author(s):

Alyson R. Warr ◽

Rachel T. Giorgio ◽

Matthew K. Waldor

Keyword(s):

Stress Response ◽

Membrane Protein ◽

Bile Salt ◽

Cell Envelope ◽

Enteric Bacteria ◽

Enteric Pathogens ◽

Inner Membrane ◽

Bacterial Phyla ◽

E Coli ◽

Inner Membrane Protein

The function of cvpA, a bacterial gene predicted to encode an inner membrane protein, is largely unknown. Early studies in E. coli linked cvpA to Colicin V secretion and recent work revealed that it is required for robust intestinal colonization by diverse enteric pathogens. In enterohemorrhagic E. coli (EHEC), cvpA is required for resistance to the bile salt deoxycholate (DOC). Here, we carried out genome-scale transposon-insertion mutagenesis and spontaneous suppressor analysis to uncover cvpA’s genetic interactions and identify common pathways that rescue the sensitivity of a ΔcvpA EHEC mutant to DOC. These screens demonstrated that mutations predicted to activate the σE-mediated extracytoplasmic stress response bypass the ΔcvpA mutant’s susceptibility to DOC. Consistent with this idea, we found that deletions in rseA and msbB and direct overexpression of rpoE restored DOC resistance to the ΔcvpA mutant. Analysis of the distribution of CvpA homologs revealed that this inner membrane protein is conserved across diverse bacterial phyla, in both enteric and non-enteric bacteria that are not exposed to bile. Together, our findings suggest that CvpA plays a role in cell envelope homeostasis in response to DOC and similar stress stimuli in diverse bacterial species. IMPORTANCE Several enteric pathogens, including Enterohemorrhagic E. coli (EHEC), require CvpA to robustly colonize the intestine. This inner membrane protein is also important for secretion of a colicin and EHEC resistance to the bile salt deoxycholate (DOC), but its function is unknown. Genetic analyses carried out here showed that activation of the σE-mediated extracytoplasmic stress response restored the resistance of a cvpA mutant to DOC, suggesting that CvpA plays a role in cell envelope homeostasis. The conservation of CvpA across diverse bacterial phyla suggests that this membrane protein facilitates cell envelope homeostasis in response to varied cell envelope perturbations.

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Salmonella Enteritidis in England and Wales: increases in unusual phage types in 2002

Weekly releases (1997–2007) ◽

10.2807/esw.06.45.01958-en ◽

2002 ◽

Vol 6 (45) ◽

Author(s):

S O’Brien ◽

L Ward

Keyword(s):

Public Health ◽

Salmonella Enteritidis ◽

Phage Type ◽

Enteric Pathogens ◽

Public Health Laboratory ◽

England And Wales ◽

Laboratory Service ◽

The Public ◽

Phage Types

Although Salmonella Enteritidis phage type (PT) 4, responsible for the major epidemic during the late 1980s and early 1990s (1), has continued to decline, there have been increases in a number of the more unusual phage types of S. Enteritidis (2). Isolates of S. Enteritidis PT 3, 6a, 13a and 14b and 21 confirmed by the Public Health Laboratory Service Laboratory of Enteric Pathogens (PHLS LEP) in England have all increased during 2002 (table 1) (3).

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Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.4.30448 ◽

2017 ◽

Vol 22 (4) ◽

Cited By ~ 14

Author(s):

Kassiani Mellou ◽

Anthi Chrisostomou ◽

Theologia Sideroglou ◽

Theano Georgakopoulou ◽

Maria Kyritsi ◽

...

Keyword(s):

Public Health ◽

Symptom Onset ◽

Asylum Seekers ◽

Hepatitis A ◽

Health Interventions ◽

Public Health Interventions ◽

Hygiene Measures

An increased number of hepatitis A cases among refugees, asylum seekers and migrants residing in hosting facilities in Greece were recorded between April and December 2016. In total, 177 laboratory-confirmed symptomatic cases were reported; of these, 149 (84%) occurred in hosting camps mostly among Syrian children under 15 years. All cases reported symptom onset after their entry into the country. Public health interventions focused on hygiene measures and vaccination.

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Occurrence of Enteric Bacteria and Viruses in Oysters

Journal of Food Protection ◽

10.4315/0362-028x-43.2.111 ◽

1980 ◽

Vol 43 (2) ◽

pp. 111-113 ◽

Cited By ~ 21

Author(s):

MARK D. SOBSEY ◽

CAMERON R. HACKNEY ◽

ROBERT J. CARRICK ◽

BIBEK RAY ◽

MARVIN L. SPECK

Keyword(s):

Fecal Coliform ◽

Enteric Bacteria ◽

Total Coliform ◽

Fecal Pollution ◽

Enteric Pathogens ◽

The Other ◽

Fecal Coliforms ◽

Sample Collection ◽

Closed Area ◽

Vibrio Parahemolyticus

Enteric bacteria and virus levels were determined in oysters from paired stations that were opened or closed for commercial shellfishing on the basis of total coliform levels in the water. Six pairs of stations were sampled quarterly over a 1-year period. Enteric viruses were found in 3 of 24 50-g oyster samples from closed areas and in none of 23 samples from open areas. Salmonella was found in 2 of 47 samples of 40 g each, one from an open and the other from a closed area. Although enteric pathogens of fecal origin were found only in oysters that exceeded the recommended market limit of 230 fecal coliforms per 100 g of meat, the fecal coliform levels in some virus-positive samples were much lower than those in Salmonella-positive samples. Vibrio parahemolyticus levels were similar in oysters from both open and closed beds, indicating no particular association with fecal pollution. However, there was a marked seasonal variation in V. parahemolyticus levels. Total but not fecal coliform levels in oysters from open beds correlated with the occurrence of rainfall 1 or 2 days before sample collection. Neither total nor fecal coliform levels in oysters from closed beds correlated with rainfall. These findings suggest that fecal coliforms levels in oysters are less influenced by rainfall than are total coliforms, and therefore may be a more specific indicator of recent fecal pollution.

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