[How to assess the elimination of viral hepatitis B, C, and D in Germany? Outcomes of an interdisciplinary workshop]. / Wie lässt sich die Eliminierung von Hepatitis B, C und D in Deutschland messen? Ergebnisse eines interdisziplinären Arbeitstreffens.

BACKGROUND: In 2016, the World Health Organization (WHO) released a strategy to eliminate hepatitis B, C, and D and defined indicators to monitor the progress. The Robert Koch Institute organized an interdisciplinary working meeting in 2019 to identify data sources and gaps. OBJECTIVES: The objectives were to network, to create an overview of the data sources available in Germany on hepatitis B and C, and to discuss how to construct indicators. MATERIALS AND METHODS: We extracted the WHO indicators relevant for Germany and determined how they can be constructed on the basis of available data. Stakeholders from public health services, clinics, laboratories, health insurance companies, research institutes, data holders, and registries attended a workshop and discussed methods of constructing the indicators for which data are lacking. Data sources and data were evaluated and prioritized with regard to their quality and completeness. RESULTS: Indicators on prevalence, incidence, prevention, testing and diagnosis, treatment, cure, burden of sequelae, and mortality for the general population can be constructed using secondary data such as diagnosis, health service, and registry data, data from laboratories and hospitals as well as population-based studies. Data sources for vulnerable groups are limited to studies among drug users, men who have sex with men, and about HIV coinfected patients. Data for migrants, prisoners, and sex workers are largely lacking as well as data on burden of disease from chronic viral hepatitis in the general population. CONCLUSIONS: We identified data sources, their limitations, and methods for construction for all selected indicators. The next step is to convert the ideas developed into concrete projects with individual stakeholders.

[Vaccination coverage of children and adolescents in Germany: New data from KiGGS Wave 2 and trends from the KiGGS study]. / Durchimpfung von Kindern und Jugendlichen in Deutschland: Aktuelle Daten aus KiGGS Welle 2 und Trends aus der KiGGS-Studie.

Since the baseline study of the "German Health Interview and Examination Survey for Children and Adolescents (KiGGS)" in 2003-2006, vaccination conditions in Germany have changed and additional vaccinations have been included in the immunization schedule. The current KiGGS data can be used to assess the current vaccination status of 3­ to 17-year-olds and trends in the 1985-2013 birth cohorts.Of the 15,023 total participants in KiGGS Wave 2, 3238 aged 3-17 years participated in the KiGGS Wave 2 examinations and submitted the complete vaccination certificate or were, according to their parents, unvaccinated. In this group, vaccination coverage was high for the majority of vaccinations for both girls and boys. Vaccination coverage has increased in children and adolescents in the last 10 years. This is especially true for vaccines for which there were strong deficiencies in the KiGGS baseline study, such as the hepatitis B and second measles vaccinations in all age groups, the booster dose against pertussis (11- to 17-year olds), as well as the booster dose against tetanus in the 7­ to 10-year-olds.Sociodemographic factors are still determinants of vaccination status. Less than one child in two is vaccinated against hepatitis B (45.9%) when parents state fear of side effects or indicate vaccine skepticism as reasons against vaccinations. Despite significant increases, vaccination coverage at the end of the second year of life is still far below 95% for all vaccinations (measles: 1st dose: 88.6%; 2nd dose: 64.4%) even in the most recent birth cohorts.The results show where further efforts are needed to increase vaccination coverage by the remaining last percentage points, achieve the timely delivery of all vaccinations listed in the immunization schedule, as well as meet the defined elimination goals.

Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018.

From January to June 2018, two ongoing hepatitis A outbreaks affected travellers returning from Morocco and cases in Europe without travel history, resulting in 163 patients in eight European countries. Most interviewed travel-related cases were unaware of the hepatitis A risk in Morocco. Molecular analysis revealed two distinct hepatitis A virus (HAV) strains (subgenotype IA DK2018_231; subgenotype IB V18-16428). Vaccination recommendations should be emphasised to increase awareness among non-immune travellers to Morocco and HAV-endemic countries.

Cross-border outbreak of listeriosis caused by cold-smoked salmon, revealed by integrated surveillance and whole genome sequencing (WGS), Denmark and France, 2015 to 2017.

In August 2017, an outbreak of six listeriosis cases in Denmark was traced to cold-smoked salmon, using epidemiological investigations and whole-genome sequencing (WGS) analyses. Exchange of genome sequences allowed identification in France of a food isolate from a salmon-derived product and a human isolate from 2016 within the same cgMLST cluster as the Danish isolates (L2-SL8-ST8-CT771). The salmon product came from a third European Union country. WGS can rapidly link human cases and food isolates across Europe.