ABSTRACT
Since early May 2011, an increased incidence of haemolytic uraemic syndrome (HUS) and bloody diarrhoea related to infections with Shiga toxin-producing Escherichia coli (STEC) has been observed in Germany, with most cases in the north of the country. Cases reported from other European countries had travelled to this area. First results of a casecontrol study conducted in Hamburg suggest an association between the occurrence of disease and the consumption of raw tomatoes, cucumber and leaf salad.
Subject(s)
Disease Outbreaks/statistics & numerical data , Hemolytic-Uremic Syndrome/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Germany/epidemiology , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Population Surveillance , Risk Factors , Young AdultSubject(s)
Disease Outbreaks , Escherichia coli Infections/epidemiology , Hemolytic-Uremic Syndrome/epidemiology , Shiga Toxin/analysis , Shiga-Toxigenic Escherichia coli/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Disease Notification , Escherichia coli Infections/microbiology , Female , Food Contamination , Food Microbiology , Germany/epidemiology , Hemolytic-Uremic Syndrome/microbiology , Humans , Incidence , Infant , Male , Middle Aged , Serotyping , Shiga-Toxigenic Escherichia coli/classification , Travel , Vegetables/microbiology , Young AdultABSTRACT
Physicians mention patients' expectations as a reason for prescribing antibiotics for common (viral) upper respiratory tract infections despite clinical evidence against their use and the physicians' better judgement. We aimed to assess the prevalence of such expectations and factors of influence (knowledge and attitudes) in Germany's general population. In November 2008, 1,778 persons registered with a large market research company were invited to complete an online questionnaire on expectations concerning prescription of antibiotics and on knowledge and attitudes regarding the effectiveness and use of antibiotics for upper respiratory tract infections. A total of 1,076 persons aged 15-78 years participated (response: 61%), of whom 91.8% reported using antibiotics 'only if absolutely necessary'. Prescription of antibiotics was expected by 113 (10.5%) of the 1,076 respondents for the common cold and by 997 (92.7%) for pneumonia. In a logistic regression analysis, predictors for expecting a prescription for antibiotics for the common cold included the following opinions: 'common cold or flu can effectively be treated with antibiotics' (prevalence: 37.6%; odds ratio (OR): 9.6; 95% confidence interval (CI): 3.8 to 24.3) and 'antibiotics should be taken when having a sore throat to prevent more serious illness' (prevalence 8.6%; OR: 7.6; 95% CI: 3.9 to 14.5). Among those expecting a prescription (n=113), 80 (71%) reported that they would trust their physician when he or she deems a prescription unnecessary; a further eight (7%) would be unsatisfied, but would accept the decision. Our results suggest that only a minority expects antibiotics for the treatment of cold symptoms. Physicians should be educated that their decisions not to prescribe antibiotics for the common cold, even when against patients' expectations, are apparently accepted by the majority.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Common Cold/drug therapy , Health Knowledge, Attitudes, Practice , Respiratory Tract Infections/drug therapy , Adolescent , Adult , Aged , Common Cold/psychology , Cross-Sectional Studies , Drug Prescriptions , Drug Utilization , Female , Germany , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Practice Patterns, Physicians' , Respiratory Tract Infections/psychology , Surveys and Questionnaires , Young AdultABSTRACT
From January to April 2010, 396 hantavirus infections were notified in Germany, a considerable increase compared with previous years (mean: 83 for January-April 2004-2009) including the record-setting year, 2007 (n=232 January-April). Most patients are residents of known Puumala virus endemic areas in southern Germany. The recent increase in notified hantavirus infections is probably due to an increased population density of the main animal reservoir, the bank vole (Myodes glareolus).
