title: Epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany: a systematic review.
abstract: OBJECTIVE
  Despite the availability of vaccines and the existence of public vaccination recommendations, outbreaks of vaccine-preventable childhood diseases still cause public health debate. The objective of this systematic review was to provide an overview of the current epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany.
  
  
  METHODS
  We systematically reviewed studies published since 2000. The literature search was conducted using PubMed and EMBASE. Also, we used German notification data to give an up-to-date overview of the epidemiology of the four diseases under consideration.
  
  
  RESULTS
  Thirty-six studies were included in our review. Results suggest that there is still considerable morbidity due to childhood diseases in Germany. Studies providing cost estimates are scarce. Comparative analyses of different data sources (notification data vs. claims data) revealed a potential underestimation of incidence estimates when using notification data. Furthermore, several studies showed regional differences in incidence of some of the diseases under consideration.
  
  
  CONCLUSIONS
  Our findings underline the need for improved vaccination and communication strategies targeting all susceptible age and risk groups on a national and local level.
authors.affiliation: Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany. oliver.damm@uni-bielefeld.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Damm
authors.affiliation: Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Witte
authors.affiliation: GlaxoSmithKline Germany, Prinzregentenplatz 9, 81675, Munich, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Wetzka
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hanover, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Prosser
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hanover, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Braun
authors.affiliation: GlaxoSmithKline Germany, Prinzregentenplatz 9, 81675, Munich, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Welte
authors.affiliation: Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Greiner
mesh_terms: D002644:Chickenpox / Q000191:economics / Q000453:epidemiology; D019433:Chickenpox Vaccine; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008457:Measles / Q000191:economics / Q000453:epidemiology; D022542:Measles-Mumps-Rubella Vaccine; D009107:Mumps / Q000191:economics / Q000453:epidemiology; D017778:Vaccines, Combined; D014777:Virus Diseases / Q000191:economics* / Q000453:epidemiology*; D014917:Whooping Cough / Q000191:economics* / Q000453:epidemiology*
chemical_list: D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined
keywords: Childhood diseases; Economic burden; Epidemiology; Germany