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Novel Influenza A (H1N1) in Germany:
No fever, no typical ILI, no epidemiological link
Germany?s current definition of a suspected case of novel Influenza A (H1N1) might need an update.
On June 22, 2009, the Robert Koch Institute, Germany?s top institute for the surveillance of infectious diseases and public health published a new report and review concerning the course of novel influenza in between Germany from April 28 to June 11, 2009. Up to that time, there had been a total of 103 confirmed cases in Germany.
Today (June 23, 2009), Robert Koch Institute confirmed a total of 301 cases in Germany, and more then half of these cases (157/301) are in-country transmissions.
Note:
The definition of a suspected case of novel Influenza A (H1N1) in Germany currently is based, both on clinical aspects (ILI and fever) and an epidemiological link (June 18, 2009).
No fever, no typical ILI, no epidemiological link
Germany?s current definition of a suspected case of novel Influenza A (H1N1) might need an update.
On June 22, 2009, the Robert Koch Institute, Germany?s top institute for the surveillance of infectious diseases and public health published a new report and review concerning the course of novel influenza in between Germany from April 28 to June 11, 2009. Up to that time, there had been a total of 103 confirmed cases in Germany.
Novel Influenza A (H1N1) in Germany
Summary:
There had been no fever in about 20 % of the confirmed cases. This clarifies the meaning of diagnostic measures in patients with respiratory complaints, which appear unexpectedly considering the age of the patient and saisonal aspects, even if the complete clinical picture of influenza-like illness (ILI) is missing.
Corresponding exposition, e.g. a history of travelling to foreign countries, and contact to probable or confirmed cases, might substantiate suspicion of novel Influenza. At the beginning of the Influenza pandemic the majority of confirmed cases [in Germany] were imported infections from Mexico. In the meanwhile the predominant fraction of the imported infections has been attributed to US-travelers. But now, while the disease is spreading in Germany, the picture is changing and the importance of in-country-transmissions is rising. (?)
As we see since June 2, 2009, the number of in-country-transmissions [in Germany] is increasing steadily. This aspect has become apparent especially by two major outbreaks in two schools in Cologne and Duesseldorf. As we see in other countries (UK, Japan, Australia), this is a sign of a probable increase in cases of sustained human-to-human transmission within Germany. Because of the fact, that even in Germany more and more of the confirmed cases are no longer imported infections, an epidemiological link no longer should be a precondition for specific testing for novel influenza A (H1N1) [in Germany].
Summary:
There had been no fever in about 20 % of the confirmed cases. This clarifies the meaning of diagnostic measures in patients with respiratory complaints, which appear unexpectedly considering the age of the patient and saisonal aspects, even if the complete clinical picture of influenza-like illness (ILI) is missing.
Corresponding exposition, e.g. a history of travelling to foreign countries, and contact to probable or confirmed cases, might substantiate suspicion of novel Influenza. At the beginning of the Influenza pandemic the majority of confirmed cases [in Germany] were imported infections from Mexico. In the meanwhile the predominant fraction of the imported infections has been attributed to US-travelers. But now, while the disease is spreading in Germany, the picture is changing and the importance of in-country-transmissions is rising. (?)
As we see since June 2, 2009, the number of in-country-transmissions [in Germany] is increasing steadily. This aspect has become apparent especially by two major outbreaks in two schools in Cologne and Duesseldorf. As we see in other countries (UK, Japan, Australia), this is a sign of a probable increase in cases of sustained human-to-human transmission within Germany. Because of the fact, that even in Germany more and more of the confirmed cases are no longer imported infections, an epidemiological link no longer should be a precondition for specific testing for novel influenza A (H1N1) [in Germany].
Today (June 23, 2009), Robert Koch Institute confirmed a total of 301 cases in Germany, and more then half of these cases (157/301) are in-country transmissions.
Note:
The definition of a suspected case of novel Influenza A (H1N1) in Germany currently is based, both on clinical aspects (ILI and fever) and an epidemiological link (June 18, 2009).
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