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. 2007 Dec;13(12):1895-900.
doi: 10.3201/eid1312.070527.

Changing epidemiology of human brucellosis, Germany, 1962-2005

Sascha Al Dahouk  1 , Heinrich Neubauer, Andreas Hensel, Irene Schöneberg, Karsten Nöckler, Katharina Alpers, Hiltrud Merzenich, Klaus Stark, Andreas Jansen
Affiliations

Changing epidemiology of human brucellosis, Germany, 1962-2005

Sascha Al Dahouk et al. Emerg Infect Dis. 2007 Dec.

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.

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Figures

Figure 1
Figure 1
Reported brucellosis cases, Germany, 1962–2005.
Figure 2
Figure 2
Incidence (per 100,000 inhabitants) and case-fatality rate for brucellosis, Germany, 1962–2005. Error bars indicate 95% confidence intervals.
Figure 3
Figure 3
Regional distribution of brucellosis cases and percentage of immigrants per county, Germany, 1995–2005.
Figure 4
Figure 4
Age and sex distribution of brucellosis cases (n = 245), Germany, 1995–2005.
Figure 5
Figure 5
Seasonal distribution of brucellosis cases (n = 207), Germany, 1995–2005.
See this image and copyright information in PMC

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