[Vaccination project for vocational students]. / Impfprojekt für Berufsschüler.

As part of a North-Rhine-Westphalian state project the district of Unna developed a vaccination programme for continuation schools in 1996. The reason for this programme realized for the first time in a vocational school, was a considerable lack of protection by vaccination in ninth year classes. The present results from the first vocational school show a significant lack of standard vaccination as well as boosters. To improve the current situation it will be necessary to authorize and enable the Public Health Services to carry out even more standard and indication vaccinations at secondary and vocational schools as well as at institutions for the handicapped.

[Promoting self-help by a public health office--the example of the Unna district]. / Selbsthilfeförderung durch ein Gesundheitsamt--Beispiel Kreis Unna.

In the district of Unna support of self-help movement has been enjoying high priority for many years, giving a new orientation to the public health service towards a modern and more customer-friendly public service. Since January 1990 a self-help clearinghouse has been established by the section of health promotion supervised by the public health office. By now, three centres have been opened. The scheme of organisation, staffing and facilities, contents and working procedure, results and experiences are presented. It is quite obvious that support of the self-help movement should be one of the major tasks of public health service in the years to come.

[Health promotion by the public health service (with special reference to promoting the self help movement)]. / Gesundheitsförderung durch den OGD (unter besonderem Aspekt der Förderung des Selbsthilfebereiches).

During the last decade there has been a new orientation in public health policies. The question of prevention is gaining importance and has assumed social and political dimensions alongside the traditional medical issues. In future the public health service will increasingly recognise the value of an interdisciplinary approach, as was emphasised in a Resolution by the 64th German State Health Ministers' Conference. The need for cooperation and coordination in important future fields of action--especially the area of Self-Help--is presented as a major challenge for the Public Health Department. Details are given on the new requirements in terms of organisation, staffing and facilities.

[Diphtheria, an imported disease]. / Die Diphtherie, eine Importkrankheit.

A comparative analysis of 4256 persons living in the Federal Republic of Germany and 4751 applicants for asylum in the FRG allows the conclusion that in the FRG diphtheria is caused by imported toxinogenic strains, originating mostly from developing countries. Since 1975 a total of 109 cases have been observed, 22 ending in death. Such severe cases can be avoided by systematic revaccination even of adults.

[Phage lysis typing and epidemiology of diphtheria 1975-1984]. / Phagenlysotypie und Epidemiologie der Diphtherie-Erkrankungen 1975 bis 1984.

Phage typing of the available diphtheria strains from epidemics and isolated diphtheria infections in the Federal Republic of Germany since 1975 showed that the various waves of the disease were caused by pathogenic strains which differed from each other in lysis type and lysogenetic spectrum. The individual regional outbreaks, therefore, were not epidemiologically interlinked. Both a high incidence of diphtheria cases and isolated cases occurring in a particular region and within the same time period, however, were caused by the same pathogen with identical lysis type and lysogenetic pattern. On the other hand, the toxinogenic strains introduced from countries with a high prevalence of the disease had clearly different typing characteristics. According to our present studies on the incidence of pathogen carriers, no toxin-producing diphtheria bacteria are circulating in the indigenous population. It can be assumed, therefore, that the outbreaks of diphtheria during the last few years were caused by such imported strains. Since the importation of toxin-producing diphtheria bacteria is unavoidable and may occur at all times, universal active immunisation in childhood, as well as timely revaccination of adolescents and adults, are mandatory prophylactic measures to prevent new epidemics.