title: Outbreak of Microsporum audouinii in Munich--the return of infectious fungi in Germany.
abstract: After experiencing an unusually high number of Microsporum (M.) audouinii infections at our hospital within only a few weeks, we began to investigate and control an outbreak in Munich, Germany. Main goals of our health management were to treat infected persons, identify extent and form of transmission and to prevent new infections. We analysed data from structured interviews with patients and mycological cultures of swabs taken of patients and investigated involved public facilities. Outbreak management included antifungal treatment of patients, decontamination of affected facilities, the introduction of a temporary kindergarten ban for M. audouinii positive children and the organisation of educational meetings. Between March and August 2011, 16 children and 4 adults were identified with M. audouinii infections. The fungus was brought to Munich by the index patients from a family vacation in Africa and then spread to fellow children in kindergarten and subsequently to their families. All patients were treated successfully and the epidemic was declared ceased after 40 weeks but causing considerable financial damage. Due to travelling and migration, M. audouinii infections will rise in Germany and Europe. Sufficient and sustainable strategies are needed for the management of future outbreaks of highly contagious fungi.
authors.affiliation: Department of Dermatology and Allergy, Biederstein, Technische Universität München, Munich, Germany; Institute of Environmental Medicine, Technische Universität München, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Zink
authors.forename: Vasileios
authors.initials: V
authors.lastname: Papanagiotou
authors.forename: Antonia
authors.initials: A
authors.lastname: Todorova
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Seidl
authors.forename: Andrea
authors.initials: A
authors.lastname: Niedermeier
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
authors.forename: Claudia
authors.initials: C
authors.lastname: Traidl-Hoffmann
mesh_terms: D000328:Adult; D000349:Africa; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods; D003881:Dermatomycoses / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D004196:Disease Outbreaks; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008864:Microsporum / Q000145:classification / Q000302:isolation & purification*; D008875:Middle Aged; D014195:Travel
chemical_list: D000935:Antifungal Agents
keywords: Microsporum audouinii; economic damage; fungi; mycosis; outbreak control; public health; tinea