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Biomedical subjects

K Bögel

Publications and source records attributed to K Bögel.

At least 19 recordsLinked to original sources
PubMed1995

Pattern analysis of human Salmonella enteritidis infection.

Information on salmonella serovar, community, and date of isolation concerning 10,368 cases of S. enteritidis (SE) infection and 1163 cases of S. typhimurium (ST) infection reported in 1992 to the Salmonella Data Bank of the Land of Brandenburg have been analyzed for clusters and trends on case/time diagrams. A breakdown by district provided a suitable degree of "resolution" for discrimination of "Episodes of Increased Case Frequency" (EICF) and 7 days moving averages. Thus 39 of the 44 districts of the Land were included in the evaluation of SE cases. The population size of the remaining 5 districts was too high for clear episode discrimination. EICFs were subdivided into (a) 16 outbreaks (another 10 outbreaks occurred outside EICFs), which had also been identified and officially reported by local health services as a result of compulsory investigation of cases and their social environment, and (b) 44 "case accumulations" (ACCs), which were only identified by retrospective analysis of the case/time diagrams. By this procedure, three case categories of distinct properties have been found for SE transmission from the animal reservoir to the human population: outbreaks, ACCs, and "truly sporadic cases" scattered over the district outside outbreaks and ACCs (Table 3). Truly sporadic cases (Table 6) represented the largest proportion of SE cases. ACCs accounted for 37% and outbreaks, for 12%. The most striking result concerns the ACCs, which cover slightly larger geographical areas (mean: 3.5 communities) and last longer (mean: 3 weeks, but up to 7 weeks) than officially recorded outbreaks (means: 2 communities and 2 weeks). SE-ACCs differed from SE outbreaks also in the seasonal pattern. Otherwise, ACCs met outbreak characteristics including the average number of persons involved (mean: 64, for outbreaks: 42; Table 4). The results suggest that SE-ACCs represent an important and distinct element in the SE epidemic. This conclusion is supported by a comparison of the findings with results obtained by the same procedure for ST cases. ST outbreaks do not differ from ST-ACCs in any respect, and both types of ST-episodes are of significantly shorter duration and comprise less people than episodes due to SE. The public health significance of the SE-ACCs as a newly detected and particular element of the current SE epidemic is discussed. In view of the epidemiological significance, i.e. the high proportion of all SE cases involved, it appears justified to develop methods for the early detection of ACCs and the search for the "missing link" between the cases and their source at the community level.

Humans↗
PubMed1994

[Integrated quality assurance].

The definition of terms and connotation of "Quality", "Quality Assurance" and "Integration" lead to an analysis and understanding of inhibiting and fostering factors of the "Health Triad" of people, animals and environment. Although "Quality" is largely or ultimately determined by the consumer, there are considerable differences as this term is applied by (a) the individual consumer, (b) the dynamic producer defending or gaining markets, (c) those engaged in traditional product manufacturing, or (d) governments setting (minimum) requirements for the sake of free trade. "Quality Assurance" offers cooperation of partners all along the food chain from "pasture to table". The managerial process turned into a continuum of responsibility and agreement on processes and product characteristics. This overcomes the disadvantages of strategies stressing distinct defense barriers. In practice this philosophy of a predominant role of defence barriers proved largely partnership destructive, in that it permitted to shift responsibilities for failures and to claim administrative competence according to momentary situations and interests. "Integrated Quality Assurance" means mutual agreement of two or more partners along the food chain (e. g. feed producers, farmers, animal health industry, veterinarians and food processors) on product characteristics and production methods. It involves essential system elements including facilities, materials, manpower, information, transport, management etc. Different principles and procedures of quality assurance have been introduced in practice, including agriculture and food processing. These different approaches are not mutually exclusive but largely of complementary nature.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Veterinary public health perspectives: trend assessment and recommendations.

In a world of increasing populations, new patterns of land use and new biotechnologies, the orientation towards population veterinary medicine within the health triad of environment, animals and people will be of growing importance. This orientation should be accompanied by a dramatic expansion of veterinary public health (VPH) practices and considerable modification of veterinary training, with emphasis on interdisciplinary approaches under multifocal leadership. A high level of specialisation and, at the same time, integration into the major goals of the health triad will be important factors. The management of integration will also influence the coherence of the veterinary profession in research and education. Major issues in VPH concern new biotechnologies, urbanisation (particularly in developing countries), the control of "hidden infections" entering the food chain, new agricultural practices and ethical questions associated with these developments.

Animals↗
PubMed1992

Intersectoral collaboration in animal and human health.

A review is made of the health fields where collaboration between veterinarians and physicians and with other professions is most needed. The main obstacles encountered in this collaboration are recognized in institutional and attitudinal factors such as the type of administration in which veterinary services are located, economic interests, isolated spheres of activity of both veterinarians and physicians, reactions of the public to Veterinary Public Health action, insufficient fund allocation, etc. Control of echinococcosis/hydatidosis and brucellosis is given as an example of fruitful intersectoral collaboration supported by health institutions at local and international levels. It is stressed that the need for intersectoral collaboration is being increasingly and universally accepted with the active involvement of concerned organizations at all levels.

Animals↗
PubMed1991

Historical perspective of the origins and development of international veterinary public health in the World Health Organisation.

The World Health Organisation (WHO) worked vigorously to implement and develop veterinary public health (VPH) activities during the first twenty years of its existence. These activities have continued and expanded into new fields in subsequent years, and will no doubt continue. The initial challenge was to establish the importance and usefulness of the veterinary profession to human medical and public health problems. Collaborative actions and coordinated research on the major zoonoses, food hygiene and comparative medicine helped to achieve this result along with programmes applying this knowledge in member nations, and particularly developing countries which comprise the vast majority of world population. The VPH discipline must now take into account and adapt its effort to the ever-changing social and economic conditions affecting human health. The veterinary profession can help to improve human health, and VPH structures offer an effective channel for doing so.

Animals↗
PubMed1990

Economics of human and canine rabies elimination: guidelines for programme orientation.

Analysis of the present situation in canine-rabies-infected countries shows that in most cases the levels of activities for controlling the disease in man and in dogs are far too low to prevent human deaths due to rabies and to eliminate the disease in the dog population. This article compares the two major orientations of a rabies control programme, i.e., prevention of the disease in man by intensifying and modernizing post-exposure treatment (strategy A) and canine rabies elimination by controlling the disease in the animal reservoir (strategy B). The operation of both strategies (A + B) together is also analysed. Based on the available data and assumptions for calculations of the costs, the results show that when the strategies are applied independently of each other, the annual cost of strategy B amounts to 25-56% of that of strategy A. When the two strategies are applied together, the actual annual spending related to the implementation of A + B becomes less than that of strategy A alone as from the fifth year following programme initiation. The sensitivity of the results was tested against selected fluctuations in the assumptions. An estimation of the costs of control activities per avoided death, according to the strategy applied, is also given. In countries where resources allocated to rabies control are inadequate in both the health and veterinary sectors, the comparison in costs and effectiveness of the two programme strategies for rabies elimination strongly suggests that consideration should be given to a national programme of dog rabies elimination. On the other hand, for obvious ethical reasons, if attention is paid to improvement of post-exposure treatment, then the national authorities should consider a planning horizon close to 15 years.

Animals↗
PubMed1990

Accessibility of dog populations for rabies control in Kathmandu valley, Nepal.

The accessibility of dogs in urban areas of Kathmandu valley was measured using the following approaches: determination of the proportion of dogs that bore signs of having been the objects of religious worship and other signs of household association, supplemented by information obtained by interviewing people in the neighbourhood; and the vaccination coverage attained in a rabies control campaign that was preceded by intensive activities to encourage the community to participate. An accessibility rate of 90-95% was determined using the first of these approaches, whereas 75-80% of the total dog population was reached in the vaccination campaign.

Animals↗
PubMed1986

Incidence of rabies and post-exposure treatment in developing countries.

The results are reported of a ranking analysis of epidemiological data of reservoirs of canine rabies in 30 countries. For those countries where combined antibody and vaccine are not routinely administered and the control of canine rabies is inadequate, "standard conditions" of 2000 human post-exposure treatments per million population per annum and 3 cases of human rabies per million population were derived. These parameters can be used to predict the cost-effectiveness of various strategies of rabies prevention and control.

Animals↗
PubMed1981

Assessment of fox control in areas of wildlife rabies.

This paper describes a technique for the analysis of the interaction between rabies control measures and the annual turnover of a fox population. The basic conditions are deduced from data on the turnover of a steady fox population, which have been found to be representative for large parts of central Europe. These conditions, together with field data on the critical density for rabies transmission and the recovery of reduced fox populations, provide a model for the prediction and evaluation of various measures of rabies control. The method is simplified by the introduction of a semigraphical procedure using the relative density of a reduced fox population, defined as the ratio of the actual population density to that of a non-reduced population.Simulation of epidemics and control measures over consecutive population cycles shows the limited effect of population control in a rabies-free area and demonstrates the questionable impact of measures that reduce a regular fox population by less than 40%, even when such reduction is effected annually.The method is easy to apply in the field and helps in assessing a number of disease and service indicators, as well as ecological factors in the planning and evaluation of comprehensive rabies control programmes.

Animals↗
PubMed1978

Comparative study on antibody determination by different methods in sera of persons vaccinated with HDCS rabies vaccine.

The comparative studies undertaken by 7 laboratories in 6 countries show that the calculation of I.U.'s did not, as anticipated, minimize but actually enhanced the variability of results of rabies antibody estimations in the sera of HDCS vaccinees. The high biological variance in the method(s) may not have been considered by individual laboratories and any neglect of fundamental biostatistical laws unfortunately diminishes the theoretical advantage of using the "International Standard (I.S.)" as a "tertium comparationis". Perhaps the intrinsic variability of the I.S. should be re-evaluated and it is conceivable that a pure IgG fraction of rabies antiserum would show less variability. Intralaboratory variation might be reduced by agreeing that only a geometric mean of the I.S., and not a single value obtained in an individual test, should be used for calculation of I.U.'s. Application of the principles of biochemical and pharmacological methods, such as test-to-test control of the I.S. and its analytical variances might well enhance the reproducibility of the results. MNT, RFFIT, PRT and CFT were unable to detect antibodies in HDCS vaccinees until 7 days after the first vaccination. The establishment of methods for detecting early antibody requires further investigation.

Analysis of Variance↗
PubMed1978

Cost analysis of wildlife rabies and its control in Europe.

Within the WHO/FAC Coordinated Research Programme on Wildlife Rabies, a comprehensive survey of all costs involved in wildlife rabies and its control was carried out from 1972 to 1974 by the Government of the Land Nordrhein-Westfalen with the support of the Government of the Federal Republic of Germany and in collaboration with the World Health Organization. For extrapolation of data, administrative costs at the level of the State government and the provinces are considered as relatively constant figures, whereas all other cost components appear to depend largely on the local epidemiological conditions in counties and communities, e.g. administrative costs at county level, cost directly related to rabies cases in animals as well as costs of medical services for episode investigation and post-exposure treatment. The economic burden of wildlife rabies was estimated for the whole Land in 1974 to be in the order of DM 4.02 million. Of this amount, DM 0.77 million concerned costs of control measures in wildlife (intensified hunting and gassing operations for fox control). Assuming use of the most efficient measures according to newer concepts of wildlife rabies control in infected areas, the total expenditure for rabies control in wildlife would have been DM 1.36 million. These costs could be paid by the savings of less than one rabies-free year. This saving in the whole Land would be in the order of DM 1.9 million under the assumption of rabies being prevalent in adjacent "Länder". The paper contains guidelines for the extrapolation of the different cost factors to other periods and European areas for comparative analyses.

Animal Population Groups↗
PubMed1978

Comparative study on antibody determination by different methods in sera of persons vaccinated with HDCS-vaccine.

The comparative studies undertaken by 7 laboratories in 6 countries show that the calculation I.U.s did not as anticipated minimize but actually enhanced the variability of results of Rabies antibody estaminations in the sera of HDCS vaccines. The high biological variance in the method(s) may not have been considered by individual laboratories and any neglect of fundamental biostatistical laws, unfortunately, diminishes the theoretical advantage of using the "International Standard (I.S.)" as a "tertium comparationis". Perhaps the intrinsic variability of the I.S. should be re-evaluated and it is conceivable that a pure IgG fraction of Rabies antiserum would show less variability. Intralaboratory variation might be reduced by agreeing that only a geometric mean of the I.S., and not a single value obtained in an individual test, should be used for calculation of I.U.s. Application of the principles of biochemical and pharmacological methods, such as test-to-test control of the I.S. and its analytical variances might well enhance the reproducibility of the results. MNT, RFFIT, PRT and CFT were unable to detect antibodies in HDCS vaccinees until 7 days after the first vaccination. The establishment of methods for detecting early antibody requires further investigation.

Antibodies, Viral↗
PubMed1977

The significance of martens as transmitters of wildlife rabies in Europe.

In two areas of the Federal Republic of Germany, 191 rabies cases in martens were investigated for the occurrence of clusters. The length of the interval between cases recorded in the same community showed an uneven distribution. Most such cases occurred at intervals of less than 6 months. No close correlation was found between such associated cases in martens and the frequency of cases in foxes. The results suggest that short chains of infection do occur in martens. Though these episodes in martens are rare and tend to cease after 3-4 months, their significance in the epidemic should be considered locally during the final stage of control operations.

Animals↗