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1.
Euro Surveill ; 27(27)2022 Jul.
Article in English | MEDLINE | ID: covidwho-2022501

ABSTRACT

BackgroundThe COVID-19 pandemic expanded the need for timely information on acute respiratory illness at population level.AimWe explored the potential of routine emergency department data for syndromic surveillance of acute respiratory illness in Germany.MethodsWe used routine attendance data from emergency departments, which continuously transferred data between week 10 2017 and 10 2021, with ICD-10 codes available for > 75% of attendances. Case definitions for acute respiratory infection (ARI), severe acute respiratory infection (SARI), influenza-like illness (ILI), respiratory syncytial virus infection (RSV) and COVID-19 were based on a combination of ICD-10 codes, and/or chief complaints, sometimes combined with information on hospitalisation and age.ResultsWe included 1,372,958 attendances from eight emergency departments. The number of attendances dropped in March 2020 during the first COVID-19 pandemic wave, increased during summer, and declined again during the resurge of COVID-19 cases in autumn and winter of 2020/21. A pattern of seasonality of respiratory infections could be observed. By using different case definitions (i.e. for ARI, SARI, ILI, RSV) both the annual influenza seasons in the years 2017-2020 and the dynamics of the COVID-19 pandemic in 2020/21 were apparent. The absence of the 2020/21 influenza season was visible, parallel to the resurge of COVID-19 cases. SARI among ARI cases peaked in April-May 2020 (17%) and November 2020-January 2021 (14%).ConclusionSyndromic surveillance using routine emergency department data can potentially be used to monitor the trends, timing, duration, magnitude and severity of illness caused by respiratory viruses, including both influenza viruses and SARS-CoV-2.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Syncytial Virus Infections , Respiratory Tract Infections , Virus Diseases , COVID-19/epidemiology , Emergency Service, Hospital , Germany/epidemiology , Humans , Influenza, Human/epidemiology , Pandemics , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Tract Infections/epidemiology , SARS-CoV-2 , Seasons , Sentinel Surveillance , Virus Diseases/epidemiology
2.
Euro Surveill ; 27(22)2022 Jun.
Article in English | MEDLINE | ID: covidwho-1879391

ABSTRACT

German national surveillance data analysis shows that hospitalisation odds associated with Omicron lineage BA.1 or BA.2 infections are up to 80% lower than with Delta infection, primarily in ≥ 35-year-olds. Hospitalised vaccinated Omicron cases' proportions (2.3% for both lineages) seemed lower than those of the unvaccinated (4.4% for both lineages). Independent of vaccination status, the hospitalisation frequency among cases with Delta seemed nearly threefold higher (8.3%) than with Omicron (3.0% for both lineages), suggesting that Omicron inherently causes less severe disease.


Subject(s)
COVID-19 , SARS-CoV-2 , Germany/epidemiology , Humans , SARS-CoV-2/genetics , Severity of Illness Index
3.
Influenza Other Respir Viruses ; 16(5): 854-857, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1822050

ABSTRACT

Based on our national outpatient sentinel surveillance, we have developed a novel approach to determine respiratory syncytial virus (RSV) epidemic seasons in Germany by using RSV positivity rate and its lower limit of 95% confidence interval. This method was evaluated retrospectively on nine RSV seasons, and it is also well-suited to describe off-season circulation of RSV in near real time as observed for seasons 2020/21 and 2021/22 during the COVID-19 pandemic. Prospective application is of crucial importance to enable timely actions for health service delivery and prevention.


Subject(s)
Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , COVID-19 , Confidence Intervals , Germany/epidemiology , Humans , Infant , Pandemics , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus, Human/genetics , Retrospective Studies , Seasons
4.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327624

ABSTRACT

Objective: With the emergence of coronavirus disease 2019 (COVID-19) countries had to establish COVID-19 surveillance by adapting existing systems, such as the mandatory notification system and syndromic surveillance systems. We estimated COVID-19 hospitalization and ICU burden from existing severe acute respiratory infections (SARI) surveillance and compared it to COVID-19 notification data. Methods: Using data from the ICD-10 based hospital sentinel, we estimated SARI incidence and validated our estimations retrospectively using full population data. We estimated age-specific incidences for COVID-19 hospitalization and ICU for the first three COVID-19 waves in Germany, based on information of SARI cases (COVID-SARI). We compared these estimations to hospitalization and ICU burden of COVID-19 from notification data and described potential underreporting of hospitalizations in notification data. Findings: The estimation of SARI incidence from sentinel data corresponded very well to full population data. The estimated COVID-SARI incidence matched the notified COVID-19 hospitalization incidence in the first wave, but was much higher during the second and the third wave. The proportion of unknown hospitalization status among notified COVID-19 cases was much higher in the later waves compared to the first wave. For all waves, the ICU incidence estimated from COVID-SARI was considerably higher than the results from notification data. Conclusion: The use of SARI sentinel data adds valid and important information for assessing COVID-19 hospitalization and ICU burden, especially in times with high case numbers where notification data may be more incomplete.

5.
J Health Monit ; 5(Suppl 11): 2-19, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1687803

ABSTRACT

As of December 31, 2019, initial reports circulated internationally of an unusual cluster of pneumonia of unknown cause in China. By the end of January 2020, the virus affected Germany with the first case confirmed on January 27, 2020. Intensive contact tracing and infection control measures contained the first two clusters in the country. However, the dynamic of the first wave gained momentum as of March, and by mid-June 2020 over 190,000 laboratory-confirmed cases had been reported to the Robert Koch Institute. This article examines these cases as part of a retrospective descriptive analysis focused on disease severity. Most cases (80%) were mild and two thirds of the cases were younger than 60 years (median age: 50 years). Severe cases were primarily reported among men aged 60 or over who had at least one risk factor (particularly cardiovascular disease, diabetes, neurological disorders and/or lung diseases). Cases between the ages of 40 and 59 years had the longest interval between symptom onset and hospitalisation (median: six days) and - if admitted to an intensive care unit (ICU) - also the longest ICU stay (median: eleven days). This analysis provides valuable information about disease severity of COVID-19 and particularly affected groups.

6.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(9): 1093-1106, 2021 Sep.
Article in German | MEDLINE | ID: covidwho-1349279

ABSTRACT

The first case of coronavirus SARS-CoV­2 infection in Germany was diagnosed on 27 January 2020. To describe the pandemic course in 2020, we regarded four epidemiologically different periods and used data on COVID-19 cases from the mandatory reporting system as well as hospitalized COVID-19 cases with severe acute respiratory infection from the syndromic hospital surveillance.Period 0 covers weeks 5 to 9 of 2020, where mainly sporadic cases of younger age were observed and few regional outbreaks emerged. In total, 167 cases with mostly mild outcomes were reported. Subsequently, the first COVID-19 wave occurred in period 1 (weeks 10 to 20 of 2020) with a total of 175,013 cases throughout Germany. Increasingly, outbreaks in hospitals and nursing homes were registered. Moreover, elderly cases and severe outcomes were observed more frequently. Period 2 (weeks 21 to 39 of 2020) was an interim period with more mild cases, where many cases were younger and often travel-associated. Additionally, larger trans-regional outbreaks in business settings were reported. Among the 111,790 cases, severe outcomes were less frequent than in period 1. In period 3 (week 40 of 2020 to week 8 of 2021), the second COVID-19 wave started and peaked at the end of 2020. With 2,158,013 reported cases and considerably more severe outcomes in all age groups, the second wave was substantially stronger than the first wave.Irrespective of the different periods, more elderly persons and more men were affected by severe outcomes.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Female , Germany/epidemiology , Humans , Male , Pandemics , Travel
7.
Lancet Reg Health Eur ; 6: 100112, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1260816

ABSTRACT

BACKGROUND: During the initial COVID-19 response, Germany's Federal Government implemented several nonpharmaceutical interventions (NPIs) that were instrumental in suppressing early exponential spread of SARS-CoV-2. NPI effect on the transmission of other respiratory viruses has not been examined at the national level thus far. METHODS: Upper respiratory tract specimens from 3580 patients with acute respiratory infection (ARI), collected within the nationwide German ARI Sentinel, underwent RT-PCR diagnostics for multiple respiratory viruses. The observation period (weeks 1-38 of 2020) included the time before, during and after a far-reaching contact ban. Detection rates for different viruses were compared to 2017-2019 sentinel data (15350 samples; week 1-38, 11823 samples). FINDINGS: The March 2020 contact ban, which was followed by a mask mandate, was associated with an unprecedented and sustained decline of multiple respiratory viruses. Among these, rhinovirus was the single agent that resurged to levels equalling those of previous years. Rhinovirus rebound was first observed in children, after schools and daycares had reopened. By contrast, other nonenveloped viruses (i.e. gastroenteritis viruses reported at the national level) suppressed after the shutdown did not rebound. INTERPRETATION: Contact restrictions with a subsequent mask mandate in spring may substantially reduce respiratory virus circulation. This reduction appears sustained for most viruses, indicating that the activity of influenza and other respiratory viruses during the subsequent winter season might be low,whereas rhinovirus resurgence, potentially driven by transmission in educational institutions in a setting of waning population immunity, might signal predominance of rhinovirus-related ARIs. FUNDING: Robert Koch-Institute and German Ministry of Health.

8.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 395-402, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1196564

ABSTRACT

As part of the national influenza pandemic preparedness, surveillance systems have been established in Germany in addition to the mandatory notifications according to the Protection Against Infection Act. The aim of these systems is the description, analysis, and evaluation of the epidemiology of acute respiratory infections (ARIs), the identification of the circulating viruses, and the trend. Since the beginning of the COVID-19 pandemic, the systems have been expanded to enable monitoring of infections with SARS-CoV­2.Three systems are presented: GrippeWeb, the primary care sentinel Arbeitsgemeinschaft Influenza with its electronic reporting module SEEDARE, and the ICD-10-based hospital sentinel ICOSARI. With these systems, ARIs can be monitored at the population, outpatient, and inpatient levels. In combination with the monitoring of mortality, these systems provide important information on the frequency of different stages of disease severity in the population. In order to expand the systems to SARS-CoV­2, only a few adjustments were needed.As the case definitions for ARIs were preserved, historical baselines of the systems can still be used for comparison. All systems are structured in such a way that stable and established reference values are available for calculating weekly proportions and rates.This is an important addition to the mandatory reporting system of infectious diseases in Germany, which depends on the particular testing strategy, the number of tests performed, and on specific case definitions, which are adapted as required.The surveillance systems have proven to be feasible and efficient in the COVID-19 pandemic, even when compared internationally.


Subject(s)
COVID-19 , Respiratory Tract Infections , Germany/epidemiology , Humans , Pandemics/prevention & control , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , SARS-CoV-2
9.
Euro Surveill ; 25(38)2020 09.
Article in English | MEDLINE | ID: covidwho-793083

ABSTRACT

Mitigation of the coronavirus disease (COVID-19) pandemic in Germany included school closures in early March 2020. After reopening in April, preventive measures were taken in schools. We analysed national surveillance system data on COVID-19 school outbreaks during different time periods. After reopening, smaller outbreaks (average: 2.2/week) occurred despite low incidence in the general population. School closures might have a detrimental effect on children and should be applied only cautiously and in combination with other measures.


Subject(s)
Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Coronavirus , Disease Outbreaks/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Population Surveillance/methods , Quarantine , Adolescent , COVID-19 , Child , Child, Preschool , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , Schools , Time Factors
10.
Euro Surveill ; 25(11)2020 03.
Article in English | MEDLINE | ID: covidwho-8667

ABSTRACT

Information on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus/isolation & purification , Influenza, Human/diagnosis , Pneumonia, Viral/diagnosis , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Disease Outbreaks , Female , Hospitalization , Humans , Influenza, Human/epidemiology , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Sentinel Surveillance , Severe Acute Respiratory Syndrome/virology , Severity of Illness Index
11.
Eurosurveillance ; 25(9):2000178, 2020.
Article | WHO COVID | ID: covidwho-4442

ABSTRACT

A cluster of pneumonia of unknown origin was identified in Wuhan, China, in December 2019 [1]. On 12 January 2020, Chinese authorities shared the sequence of a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from some clustered cases [2]. Since then, the disease caused by SARS-CoV-2 has been named coronavirus disease 2019 (COVID-19). As at 21 February 2020, the virus had spread rapidly mostly within China but also to 28 other countries, including in the World Health Organization (WHO) European Region [3-5]. Here we describe the epidemiology of the first cases of COVID-19 in this region, excluding cases reported in the United Kingdom (UK), as at 21 February 2020. The study includes a comparison between cases detected among travellers from China and cases whose infection was acquired due to subsequent local transmission.%R doi:https://doi.org/10.2807/1560-7917.ES.2020.25.9.2000178

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