[Management of the pandemic influenza (H1N1) 2009 in Germany - results from an evaluation of the public health authorities]. / Das Management der Influenza A/H1N1-Pandemie durch die Gesundheitsämter in Deutschland - Ergebnisse einer bundesweiten Befragung.

In 2009, the health-care system was faced with numerous challenges resulting from the emergence and the worldwide spread of a new influenza virus. Public health authorities played a fundamental role in the management of the pandemic. The Advisory Committee for Infectious Disease Protection of the German Medical Association for Public Health Authorities (BVÖGD e.V.) requested the local public health authorities in Germany to take part in a written evaluation of the management of the new influenza pandemic in February 2010, before the official end of the influenza pandemic. The purpose of this timely analysis was to identify areas in need of improvement in preparation for similar incidents that may occur in the future. The survey showed that the communication between the various parties involved, the prompt and appropriate transmission of information, as well as the control over the overwhelming onslaught of information need to be optimised. The participants also found the practicability of the official recommendations to be lacking. The wide scale increase in workload, as seen on a national basis, required to deal with the pandemic indicates that the public health services have only very limited resources for handling crisis situations, and this must be taken into consideration when planning for coping with such matters in the future. The findings of the study participants for the national management of a pandemic coincide in most aspects with the results of other evaluations. Distinct differences in the assessment of policies were noticeable when comparing the experiences in the various German states (Bundesländer). A detailed analysis of the points at issue is necessary before possible best practice models can be developed.

[First exchange of experiences concerning the H1N1 pandemic in Germany 2009/2010: report on a workshop held March 22-23, 2010, in Berlin]. / Erster Erfahrungsaustausch zur H1N1-Pandemie in Deutschland 2009/2010: Bericht über einen Workshop am 22. und 23. März 2010 in Berlin.

In April 2009 the first pandemic of the 21st century developed within a few weeks starting from Mexico. Its first wave reached Germany in autumn 2009 and was responsible for 1.8-3.5 million additional medical consultations. For the public health sector, this pandemic was one of the largest challenges of the last few decades. As a contribution to broader evaluations on national and international level, the Robert Koch Institute invited representatives from different professions involved in the pandemic response to participate in a workshop on 22-23 March 2010. This workshop was structured in short presentations, group work, and plenary discussions. Main experiences were that (a) pandemic preparedness was helpful, (b) the early warning systems were reliable, (c) vaccines were available within a few months, however, in limited amounts. Need for improvement was discussed for (a) effectiveness of vaccination logistics, (b) mechanisms for the reimbursement of the cost of vaccination, (c) availability of surveillance and monitoring systems, (d) integration of physicians in decision-making processes and health education, and (e) proactive communication strategies. Investments in the above mentioned areas can help to improve public health protection in the future.

[Surveillance of acute respiratory illnesses (ARI) in Lower Saxony: first experience from the years 2005-2006]. / Surveillance akuter respiratorischer Erkrankungen (ARE) in Niedersachsen: Erste Erfahrungen aus den Jahren 2005-2006.

In the context of influenza pandemic preparedness planning, a surveillance system for influenza and other acute respiratory illnesses was implemented in Lower Saxony at the beginning of the influenza season 2004/2005 and coordinated by the Governmental Institute of Public Health of Lower Saxony. This surveillance system represents an addition to already existing national monitoring systems. The goal of this surveillance system is to have available prompt information on the beginning, course and end of the influenza season and to recognise the spectrum of pathogens and identify outbreaks of other viral acute respiratory illnesses (ARI). For this purpose an all-season surveillance was established consisting of two supplementary modules. The first module is a symptom-oriented surveillance of acute respiratory illnesses in children of pre-school day care facilities. In the second module a virological surveillance in co-operation with selected medical practices was established. While the temporal course and burden of ARI in all Lower Saxony can be assessed by the surveillance of children in the day-care facilities in a sensitive, but less specific way, the virological surveillance provides highly specific information on the prevailing pathogens in ARI patients at a certain time. This information, in return, gives an indication about the responsible pathogens causing ARI in children of the day-care facilities. The first experience with these two complementary surveillance modules shows that in Lower Saxony a well accepted, prompt and meaningful monitoring system is available for the recognition and description of the occurrence of ARI and concomitantly of influenza. An extension of this surveillance to other pathogens or disease scenarios is possible.