[Notification according to the law for protection against infections]. / Das Meldewesen im Infektionsschutzgesetz (IfSG).

Since January 1st 2001, the Law for Protection Against Infections decrees the duty of notification along two tracks, on the one hand by notification of infectious diseases and on the other hand by reporting the pathogens. However, the names of pathogens change due to scientific progress. Furthermore, these names include in some cases not only harmful agents of infectious diseases but also inoffensive organisms, i. e. Giardia lamblia. There are also problems in the notification of other pathogens such as Brucella sp., Campylobacter sp., Chlamydia psittaci,Clostridium botulinum, Cryptosporidium parvum, Leptospira interrogans, Listeria monocytogenes, Mycobacterium tuberculosis and similar agents, Norwalk-like viruses, Salmonella Paratyphi, Treponema pallidum, Trichinella spiralis and pathogenic serovars of Yersinia enterocolitica. Finally, the abandonment of notification for glanders, lymphogranuloma venereum, ulcus molle and variola appears to be risky, the reasons being partly unconvincing and contradictory.

[Real and irrelevant risks of infection by swimming in recreational bodies of water]. / Uber reale und irreale Infektionsrisiken beim Baden in Oberflächengewässern.

Life-threatening infectious diseases associated with recreational water exposure are possible but occur very rarely. About eighty per cent of all infections due to bathing water produced gastroenteritis, the remaining were spontaneously healing infections of ear, nose and throat as well as eye and respiratory symptoms. They are caused by endogenic and exogenic agents. The risk, i.e. the mean frequency of such commonplace diseases associated with bathing or swimming is already doubled by endogenic infectious agents even without any etiological agents in the recreational water. The additional risk by exogenic infectious agents increases with the concentration of fecal markers. The prescribed limit E coli value of 200 CFU per 100 ml of the EU guidelines for bathing waters corresponds to a risk increased by the factor 7-8. The Bathing Water Committee of the German Federal Environmental Agency issued new recommendations prescribing severely lowered limit values. For example, the Committee called for 100 CFU of E. coli per 100 ml. However, there are economical and legal objections as well as doubts regarding the Committee's scientific competence. The lower limit values are associated with high expenses for communities and bathers without recognizable returns in terms of efficiency. Furthermore, they offend against the legal principle of equality because newly constructed pools are not different from bathing water regulated according to EU guidelines. Finally, the Bathing Water Committee holds scientifically incorrect views on infectious agents and on the risks in recreational waters.

Two new Rahnella genomospecies that cannot be phenotypically differentiated from Rahnella aquatilis.

Fifty-one Rahnella aquatilis and R. aquatilis-like strains from water, snails and human sources were characterized by routine biochemical tests, carbon source utilization tests, DNA relatedness (hydroxyapatite method) and 16S rRNA sequencing. The results of the genetic methods indicated that the strains comprised three closely related species within the genus Rahnella. It was not possible to differentiate R. aquatilis from the two newly recognized species. The new species were therefore given the vernacular names Rahnella genomospecies 2 and Rahnella genomospecies 3.

Blastocystis hominis in animals: incidence of four serogroups.

In toto, 520 faecal samples from mammals, birds, reptiles, amphibians, fish, and snails were investigated (see Table 1). 91 strains of Blastocystis hominis could be isolated by culture. However, only 48 of them were suitable for axenisation. 96 percent of samples belonged to four serogroups detected in humans but two strains, one from a pig and another from a duck, could not be classified, suggesting the existence of one or two further serogroups. While humans showed mainly serogroups I and II, pigs harboured serogroups III and IV. Four serogroups were isolated from monkeys. The question whether the genus Blastocystis consists of one or more species is discussed.

[Acceptance of tuberculosis as an occupational disease]. / Die Anerkennung von Tuberkulose als Berufskrankheit.

The acknowledgment of tuberculosis as an infection due to employment (i.e. as an occupational disease) in medical service applies only to few infected persons. Most of them must prove how they contracted the disease. Since this is largely impossible, many claims for damage, due to tuberculosis are not entertained. The negative decisions by the Occupational Co-Operative Society of Medical Service (BGW) against its own members are based on: 1. a doubtful judgment by the Federal Social Court of Justice (document no. 7 RU 34/72, 28.9.1972) and 2. untenable statements by occupational physicians on the epidemiology of infectious diseases. To substantiate such sentences, it is stated that tuberculosis is very rare and that therefore the probability of an infection during the job in medical service would not be higher than during leisure hours. However, this is an incorrect conclusion for several reasons. Notwithstanding that the time of working on the job is only 27% and leisure time 73%, nevertheless the risk of contracting tuberculosis during the job in medical service is 10 to 40 times higher than during leisure hours. Furthermore, still unpublished statistics by the Co-Operative Society show that the risk of an infection was higher for medical service jobs by a factor 22 compared to all other jobs during 1976 to 1994.

[Cat-scratch disease: historical, clinical, phylogenetic and taxonomic aspects]. / Katzenkratzkrankheit: historische, klinische, phylogenetische und taxonomische Aspekte.

The cat-scratch disease (CSD) is known as a nosological entity since 1950. It was diagnosed by the clinical symptoms, epidemiologic data, and the intracutaneous test of Hanger and Rose. The aetiologic agent is Bartonella (formerly Rochalimaea) henselae occurring in thirty to fifty percent of healthy cats. The gramnegative alpha-2-proteobacteria cause the CSD but also fever in healthy humans. Patients suffering from AIDS show bacillary angiomatosis, bacillary peliosis hepatis, endocarditis, and septicemia. There is an open question for other aetiologic agents causing CSD as cofactors. For example, Afipia felis is found to a certain extent from patients suffering from CSD. Furthermore, Rothia dentocariosa was isolated in lymphnodes of CSD patients, and also other grampositive rods may play an important role together with B. henselae in CSD.

Emended description of Buttiauxella agrestis with recognition of six new species of Buttiauxella and two new species of Kluyvera: Buttiauxella ferragutiae sp. nov., Buttiauxella gaviniae sp. nov., Buttiauxella brennerae sp. nov., Buttiauxella izardii sp. nov., Buttiauxella noackiae sp. nov., Buttiauxella warmboldiae sp. nov., Kluyvera cochleae sp. nov., and Kluyvera georgiana sp. nov.

A total of 219 strains belonging to the genera Buttiauxella and Kluyvera were studied; 171 of these strains were isolated from mollusks, mainly snails and slugs, obtained from around the world. On the basis of DNA-DNA hybridization data, the strains were grouped into 11 genomospecies. A total of 44 phenotypic characters were used to differentiate the genera Buttiauxella and Kluyvera at the genus level and to identify genomospecies. There were significantly higher phenotypic probability distances between the genomospecies in the genus Battiauxella and the genomospecies in the genus Kluyvera than between the genomospecies in the same genus. Therefore, the existence of Buttiauxella and Kluyvera as different genera was confirmed. The existence of new species necessitated broadening the definitions of both genera. In two cases, Buttiauxella species could not be quantitatively differentiated biochemically, and several other pairs of species could be separated only by the results of one biochemical test. Nonetheless, combinations of several characteristics were used in differentiate all of the species with levels of certainly ranging from log 10.79 to log 57.77 (calculated as probability distances). The following new species are proposed: Buttiauxella ferragutiae (type strain, ATCC 51602 [DSM 9390]), Buttiauxella gaviniae (type strain, ATCC 51604 [DSM 9393]), Buttiauxella brennerae (type strain, ATCC 51605 [DSM 9396]), Buttiauxella izardii (type strain, ATCC 51606 [DSM 9397]), Buttiauxella noackiae (type strain, ATCC 51607 [DSM 9401]), Buttiauxella warmboldiae (type strain, ATCC 51608 [DSM 9404]), Kluyvera cochleae (type strain, ATCC 51609 [DSM 9406]), and Kluyvera georgiana (type strain, ATCC 51603 [DSM 9409]).

Isolation of Ewingella americana from mollusks.

Twenty-three of 2446 strains of Enterobacteriaceae isolated from mollusks were identified as Ewingella americana both biochemically and by DNA hybridization with strain S6/1111. The biochemical characteristics of the new strains showed few differences from previously reported strains obtained from human clinical specimens. These are the first strains of E. americana isolated from animals.

Occurrence of sialidase and N-acetylneuraminate lyase in Pasteurella species.

Pasteurella species and related taxa are opportunistic pathogens parasitizing on mucous membranes of higher organisms containing sialic acids. Therefore, sialidase is a virulence factor which up to now has been described to be present in P. haemolytica, P. multocida, and P. volantium. Because of some taxonomic changes and the description of many new species or still unnamed groups, the presence of sialidase and the metabolic successor enzyme, N-acetylneuraminate lyase, was investigated in 65 Pasteurella or Pasteurella-like strains. The detection of enzymes was performed by colorimetry, by paper chromatography and immunoelectrophoresis. Using bovine submaxillary mucin as substrate, sialidases were produced in all strains studied although the activities were different. Most strains but not all were positive in N-acetylneuraminate lyase, too. Taken together, the strains of Pasteurella sensu stricto showed the strongest activities of sialidase, those of the Pasteurella aerogenes complex the lowest. However, because of loss of sialidase activity during subcultivation, there is little feasibility to characterize Pasteurella species by these enzymes.

[Blind alleys and misconceptions in public health]. / Uber Fehlentwicklungen und Missverständnisse in der Hygiene.

The concept of hygiene was created in the 19th century although Hippocrates had already conceived an influence of atmosphere, soil and water on human health. The concept of a public health organisation, however, is a fairly recent one. Environmental and social hygiene were the two poles of the new discipline that focussed on public health. However, the ideologies of capitalism, communism and socialism as well as of social darwinism and "survival of the elite" discredited social hygiene. The decline of totalitarianism was associated with a "loss of face" of state-controlled medicine, including social hygiene. Both the post-World War II German constitution and the previous German statutory health insurance ordinance had blocked it, and hence, no Federal bill on public health was carried. The consequences of this disregard of public health are poor protection by vaccination, a gap in compulsory notification and in epidemics control and high rates of nosocomial infections. Absolutely no development of the science of epidemiology was possible whereas that of medical microbiology is choked by the system now in existence. There is a great misconception within individual hygiene by identifying it merely with cleanliness. Hygiene became a synonym for cleanliness, although that had evolved during a long cultural sociological process centuries before hygiene was established. The modern evolution of the science of hygiene shows the danger that emphasis on healthy lifestyles or on environmental protection may result in regulations and finally in a tyranny that may threaten the liberty of human rights. The so-called "principle of concern" is an example of such irrationality because there is no sensible proportion between risk and expense.

Detection of sialidase activity in Oerskovia (Cellulomonas) turbata.

The enzyme N-acylneuraminate glycohydrolase, E.C. 3.2.1.18 (sialidase or neuraminidase) was detected in all five strains of Oerskovia (Cellulomonas) turbata and in a further strain isolated from clinical material. The detection of sialidase was performed by different methods, i.e. colorimetric determination of liberated chromogen, immunoelectrophoresis and paper chromatography. The Oerskovia turbata sialidase is able to cleave different linkages between N-acylneuraminic acid and the carbohydrate chains of oligosaccharides or polysaccharides and of glycoproteins, i.e. the 2-->3, 2-->6, and 2-->8 linkages. Finally, the ecologic and pathogenic role of neuraminidase is discussed.

Investigations of culture and properties of Afipia spp.

The culture conditions of Afipia felis, A. broomeae, A. clevelandensis and three unnamed Afipia genospecies were investigated on BCY agar supplemented with different substances known as growth factors of Legionella spp. and, furthermore, with sodium chloride and other salts. The organisms were found to be susceptible to a certain degree to byproducts of the autoclaving which are scavenged by activated by charcoal. Growth was weakly enhanced by ferric pyrophosphate, cystein.HCl, and alpha-ketoglutarate. These substances are no obligatory growth factors. The optimal pH value was about 6.8. Afipia spp. showed a strong susceptibility to NaCl and other salts. They possess phosphatase, phosphoamidase, phosphodiesterase, a weak sulfatase, glycine aminopeptidase, and L-lysine aminopeptidase. The strains differed with regard to other proteases and aminopeptidases. The decimal reduction times of A. felis at 55 degrees C and 60 degrees C were 11 min, < 1 min, respectively.

The effect of different water-insoluble anorganic salts on the resistance and storage time of Bacillus stearothermophilus spores used for biological indicators.

The survival of Bacillus stearothermophilus spores was investigated over 7 years. The spores were precipitated with 18 insoluble inorganic salts. There were hydroxides, carbonates, oxalates, phosphates, and sulfate of aluminium, barium, calcium, iron, magnesium, manganese, and tin. The stability of the spores to dry and moist heat was strongest in precipitates of barium and calcium salts. Most phosphates and the heavy metals caused a rapid inactivation of spores. Finally, the survival of the spores in the 7 years of observation was the best in barium sulfate and calcium oxalate.