title: Changing epidemiology of human brucellosis, Germany, 1962-2005.
abstract: Trends in the epidemiology of human brucellosis in Germany were investigated by analyzing national surveillance data (1962-2005) complemented by a questionnaire-based survey (1995-2000). After a steady decrease in brucellosis incidence from 1962 to the 1980s, a persistent number of cases has been reported in recent years, with the highest incidence in Turkish immigrants (0.3/100,000 Turks vs. 0.01/100,000 in the German population; incidence rate ratio 29). Among cases with reported exposure risks, 59% were related to the consumption of unpasteurized cheese from brucellosis-endemic countries. The mean diagnostic delay was 2.5 months. Case fatality rates increased from 0.4% (1978-1981) to a maximum of 6.5% (1998-2001). The epidemiology of brucellosis in Germany has evolved from an endemic occupational disease among the German population into a travel-associated foodborne zoonosis, primarily affecting Turkish immigrants. Prolonged diagnostic delays and high case fatality call for targeted public health measures.
authors.affiliation: Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany. sascha.al-dahouk@gmx.de
authors.forename: Sascha
authors.initials: S
authors.lastname: Al Dahouk
authors.forename: Heinrich
authors.initials: H
authors.lastname: Neubauer
authors.forename: Andreas
authors.initials: A
authors.lastname: Hensel
authors.forename: Irene
authors.initials: I
authors.lastname: Schöneberg
authors.forename: Karsten
authors.initials: K
authors.lastname: Nöckler
authors.forename: Katharina
authors.initials: K
authors.lastname: Alpers
authors.forename: Hiltrud
authors.initials: H
authors.lastname: Merzenich
authors.forename: Klaus
authors.initials: K
authors.lastname: Stark
authors.forename: Andreas
authors.initials: A
authors.lastname: Jansen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002006:Brucellosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D013997:Time Factors