Person: Förster, Christina
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Veröffentlichung Impact of climate change on waterborne infections and intoxications(2023) Dupke, Susann; Buchholz, Udo; Fastner, Jutta; Förster, Christina; Selinka, Hans-ChristophProgressive climate change holds the potential for increasing human health risks from waterborne infections and intoxications, e. g. through an increase in pathogen concentrations in water bodies, through the establishment of new pathogens or through possible changes in pathogen properties. This paper presents some examples of potential impacts of climate change in Germany. Non-cholera Vibrio occur naturally in seawater, but can proliferate significantly in shallow water at elevated temperatures. In the case of Legionella, climate change could lead to temporary or longer-term increased incidences of legionellosis due to the combination of warm and wet weather. Higher temperatures in piped cold water or lower temperatures in piped hot water may also create conditions conducive to higher Legionella concentrations. In nutrient- rich water bodies, increased concentrations of toxigenic cyanobacteria may occur as temperatures rise. Heavy rainfall following storms or prolonged periods of heat and drought can lead to increased levels of human pathogenic viruses being washed into water bodies. Rising temperatures also pose a potential threat to human health through pathogens causing mycoses and facultatively pathogenic micro-organisms: increased infection rates with non-tuberculous mycobacteria or fungi have been documented after extreme weather events. Quelle: Dupke S, Buchholz U, Fastner J, Förster C, Frank C et al. (2023): Impact of climate change on waterborne infections and intoxications. J Health Monit 8(S3): page 62Veröffentlichung Auswirkungen des Klimawandels auf wasserbürtige Infektionen und Intoxikationen(2023) Dupke, Susann; Buchholz, Udo; Fastner, Jutta; Förster, Christina; Selinka, Hans-ChristophDer fortschreitende Klimawandel birgt das Potenzial für eine zunehmende menschliche Gesundheitsgefährdung durch wasserbürtige Infektionen und Intoxikationen, z. B. durch eine Erhöhung von Pathogenkonzentrationen in Gewässern, durch die Ansiedlung neuer Pathogene oder durch mögliche Veränderungen von Erregereigenschaften. Dieser Beitrag stellt exemplarisch einige Beispiele für mögliche Auswirkungen des Klimawandels dar. Nicht-Cholera-Vibrionen kommen natürlicherweise im Meerwasser vor, können sich aber in flachem Wasser bei erhöhter Temperatur erheblich vermehren. Im Falle von Legionellen könnten die Klimaveränderungen durch das Zusammenwirken von warmem und feuchtem Wetter zu temporären oder längerfristig erhöhten Legionellose-Inzidenzen führen. Auch könnten durch wärmeres Kaltwasser oder Senkungen der Temperatur des Warmwassers Bedingungen entstehen, die höheren Legionellenkonzentrationen Vorschub leisten. In nährstoffreichen Gewässern kann es bei Temperatursteigerung zu erhöhten Konzentrationen an toxigenen Cyanobakterien kommen. Durch Starkregenfälle nach Stürmen oder längeren Hitzeperioden mit Trockenheit können humanpathogene Viren vermehrt in Gewässer eingeschwemmt werden. Und auch bei Erregern von Mykosen und fakultativ pathogenen Mikroorganismen besteht bei steigenden Temperaturen eine mögliche Gefährdung für die menschliche Gesundheit. So wurden nach Extremwetterereignissen bereits erhöhte Infektionsraten mit nicht-tuberkulösen Mykobakterien oder Pilzen dokumentiert. Quelle: Dupke S, Buchholz U, Fastner J, Förster C, Frank C et al. (2023): Auswirkungen des Klimawandels auf wasserbürtigeInfektionen und Intoxikationen. J Health Monit 8(S3): Seite 67Veröffentlichung Source attribution of community-acquired cases of Legionnaires' disease-results from the German LeTriWa study(2020) Buchholz, Udo; Adler, Kristin; Jahn, Heiko Jürgen; Bochmann, Jacqueline; Brodhun, Bonita; Förster, Christina; Koch, Madlen; Schreiner, Yvonne; Stemmler, FabianMethods Analysis of secondary patient samples for monoclonal antibody (MAb) type (and sequence type); questionnaire-based interviews, analysis of standard household water samples for Legionella concentration followed by MAb (and sequence) typing of Legionella pneumophila serogroup 1 (Lp1) isolates; among cases taking of additional water samples to identify the infectious source as appropriate; recruitment of control persons for comparison of exposure history and Legionella in standard household water samples. For each case an appraisal matrix was filled in to attribute any of three source types (external (non-residence) source, residential non-drinking water (RnDW) source (not directly from drinking water outlet), residential drinking water (RDW) as source) using three evidence types (microbiological results, cluster evidence, analytical-comparative evidence (using added information from controls)). Results Inclusion of 111 study cases and 202 controls. Median age of cases was 67 years (range 25ââą Ì93 years), 74 (67%) were male. Among 65 patients with urine typable for MAb type we found a MAb 3/1-positive strain in all of them. Compared to controls being a case was not associated with a higher Legionella concentration in standard household water samples, however, the presence of a MAb 3/1-positive strain was significantly associated (odds ratio (OR) = 4.9, 95% confidence interval (CI) 1.7 to 11). Thus, a source was attributed by microbiological evidence if it contained a MAb 3/1-positive strain. A source was attributed by cluster evidence if at least two cases were exposed to the same source. Statistically significant general source types were attributed by calculating the population attributable risk (analytical-comparative evidence). We identified an external source in 16 (14%) cases, and RDW as source in 28 (25%). Wearing inadequately disinfected dentures was the only RnDW source significantly associated with cases (OR = 3.2, 95% CI 1.3 to 7.8) and led to an additional 8% of cases with source attribution, for a total of 48% of cases attributed. Conclusion Using the appraisal matrix we attributed almost half of all cases of CALD to an infectious source, predominantly RDW. Risk for LD seems to be conferred primarily by the type of Legionella rather than the amount. Dentures as a new infectious source needs further, in particular, integrated microbiological, molecular and epidemiological confirmation. Quelle: https://journals.plos.orgVeröffentlichung Auswirkungen des Klimawandels auf wasserbürtige Infektionen und Intoxikationen(2023) Dupke, Susann; Buchholz, Udo; Fastner, Jutta; Förster, Christina; Selinka, Hans-Christoph