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A notification from a laboratory concerning the detection of Campylobacter jejuni in a 6-year-old boy initiated the investigation carried out by the health authorities from Stendal district, in order to explain the morbidity rate caused by the germ. The day after the boy's pediatrician informed about a visit to a farm, which was confirmed by the head of the nursery. She told the health authorities about the consumption of raw milk during their visit at the farm.The following days more children fell sick. Within 10 days the total number of diseased children was 21. The health authorities asked for stool samples of the diseased children, nursery nurses and the head of the farm since raw milk presents a potential cause of infection. The health authorities together with the Saxony-Anhalt State Office for Consumer Protection conducted a retrospective cohort study. The aim was to explain the association between the exposure from raw milk consumption and the occurrence of the disease from C. jejuni. Based on a questionnaire data about the food and milk intake at the nursery and at home and about the trip to the farm were collected. 91% of the children's cohort and 86% of the adults' cohort were captured.The exposed group at risk showed a higher risk of falling ill than the group, which was not exposed. The risk factor raw milk explained the difference. Furthermore, the analysis of milk samples taken by the district veterinary office from 2 cows and from the farm's tank was able to detect the germs. The correlation of the illness, the consumption of raw milk, the detection of C. jejuni in the samples taken from the children and the samples taken from the cows was evident. Based on the case the health authorities recommended that heads of nurseries as well as heads of dairy farming in the district of Stendal needed to be advised on raw milk. Nurseries are still allowed to take trips to farms. However, raw animal derivates including milk must not be consumed., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Campylobacter is the most frequently reported cause of acute infectious diarrhea in Germany. Campylobacter outbreaks are rare events. However, their investigation provides useful information on risks of infection and unused prevention potentials., Methods: We analyzed the Hessian database for notifiable diseases for cases of campylobacteriosis reported from 2005 through 2011. For campylobacter outbreaks including five or more cases we prospectively obtained additional information from local public health authorities., Results: From 2005 through 2011, 29,473 cases of campylobacteriosis were reported in Hesse, Germany (approx. 6 million inhabitants), yielding an annual incidence ranging from 53.4 to 81.4 cases per 100,000 inhabitants. Only 236 cases were part of 16 outbreaks with five or more cases. Among these, six outbreaks occurred among groups traveling outside Germany, four were associated with the consumption of raw milk. For eight outbreaks consumption of poultry was considered a probable or - based on the frequent consumption of poultry during group travel - possible vehicle of infection. Two of the raw-milk associated outbreaks were reported among two groups who visited the same farm within 18 days. Five of 14 members of several families and 77 of 117 students fell sick. The local public health authority was only informed when both groups had visited the farm., Conclusion: The reported outbreaks can be attributed to known risk factors for campylobacteriosis - consumption of raw milk and poultry and international travel. This underlines that prevention possibilities are insufficiently used. These include avoiding the consumption of unpasteurized milk and milk products, the hygienically correct handling of raw poultry and timely identification and notification of outbreaks to public health authorities., (© Georg Thieme Verlag KG Stuttgart · New York.)

Over the last few years, infections with Campylobacter have significantly increased in Europe and Germany and these bacteria have even surpassed Salmonella as the most prevalent bacteria, causing gastroenteritis. Especially contamination during the handling and consumption of meat products seems to be the most important risk factor which plays a prominent role for transmission to man. In addition, contact with pets and other animals, drinking raw or improperly pasteurized milk, and the tenacity of Campylobacter in different environments, especially water, have also to be considered for an adequate risk assessment. Besides gastroenteritis, arthralgia, and Guillain-Barré syndrome are important clinical complications of Campylobacter infections in man. At the same time, it is mostly unclear why the course of infection in man and in reservoir animals differs significantly, especially as only a few classical bacterial virulence factors have been identified so far. For these reasons, the development of efficient prevention strategies is of utmost importance in order to control campylobacteriosis.

In Austria, a total of 606 food borne outbreaks, affecting 1,910 people altogether (including 368 hospitalized patients and 1 fatal outcome) were documented in 2005. Salmonella spp. and Campylobacter spp. accounted for 99% of all reported outbreaks. Fortysix (8%) of the 606 outbreaks were acquired abroad. Bacteria caused all but one of the 560 domestically acquired food borne outbreaks: 427 (76%) were due to Salmonella spp., 128 (23%) due to Campylobacter spp. and two outbreaks each due to enterohaemorrhagic Escherichia coli and Yersinia enterocolitica. Norovirus caused an outbreak affecting 22 persons. The respective hospitalization rate for domestically acquired Salmonella spp. and Campylobacter spp. infections was 20% and 16%. Of those outbreaks where information as to the source was provided, eggs were implicated in 57%, meat products (especially poultry) in 30% and milk or dairy products (especially raw milk) in 4%. The ratio between family outbreaks and general outbreaks was 89% to 11%. For general outbreaks the following locations of exposure were given: commercial food suppliers (incl. restaurants, cafeterias) 34 x, family celebrations 14 x, nursery schools 4 x, festivities (e.g. fairs) 3 x, nursing homes twice and once a mixed outbreak involving commercial food suppliers plus homes (Austria-wide S. Enteritidis PT19 outbreak). In our opinion, the relatively high number of family outbreaks merely reflects the still insufficient quality of epidemiological outbreak investigation in Austria, i.e. lack of consolidating individual clusters into larger food borne outbreaks which exceed district or provincial borders.

This article presents the results of a study on the occurrence of two bacteria that cause zoonoses, Campylobacter spp. and Yersinia enterocolitica. The study was carried out in 30 fattening herds in Lower Saxony, Germany, in 2004 and compares the results of bacteriological and serological methods of detection. Bacteriological findings of Campylobacter spp. in the faeces indicated that 69.7% of the fattening pigs were positive, but 81.2% tested positive serologically. All herds tested here were both bacteriologically and serologically positive for Campylobacter spp. Furthermore, only 8.4% tested positive for Yersinia enterocolitica in the faecal samples, but 66.8% of the animals were serologically positive for that bacterium. While bacteriological examination did not detect Yersinia enterocolitica in 56.7% of the herds tested, serological testing showed that only 16.7% of the units were without reacting animals. The great difference between the results of bacteriological and serological testing, especially in the case of Yersinia enterocolitica, can be explained by the intermittent intestinal excretion and predominance of this bacterium in the animals' tonsils. Low faecal excretion is also the reason for the low detection rate of 3.4% of Yersinia enterocolitica in the environmental samples, while that of Campylobacter spp. was 33.3%. These results indicate that the environment plays only a secondary role in the distribution of Yersinia enterocolitica in pig herds.

The aim of this study was to evaluate the impact of the slaughter process on the Campylobacter (C.) coli prevalence on pig carcasses and finally pork. To detect C. spp., faecal samples, organ samples and surfaces of slaughter pigs were sampled. Additionally, various abattoir surfaces (n=208) and 227 pork and minced meat samples were included in our study. Whereas a high C. spp. prevalence (64.0%) was detectable in the faeces of slaughter pigs (all isolates were identified as C. coli), low detection rates were observed on pig carcasses after the slaughter process before the chilling period (21.1%). The impact of chilling reduced the detection rate of C spp. on pig carcasses even further to 0.8%. Only C. jejuni strains were isolated after the chilling process. Chilling and the associated drying of the skin are responsible for that massive reduction of C. spp prevalence. Significantly more C. spp. were isolated from livers compared to the corresponding carcasses. Only 5 out of 208 swab samples from different surfaces of the abattoir were C. coli positive. Bacteriological investigation could not detect any C. spp. strains from pork and minced pork meat. The low detection rates at the end of the slaughter and processing line indicate that pork may only play a minor role in the transmission of C. coli infections to humans. By genotyping C. coli-isolates from selected animals we were able to demonstrate three possible ways of contamination of the slaughter carcass surface. Genetically highly related strains were detectable on carcass surfaces of consecutively slaughtered animals. Faecal isolates and isolates from the carcass surface showed occasional high similarities. C. coli-genotypes from tonsils and genotypes from the corresponding slaughter carcasses formed a close cluster.

The aim of a national study of a "Quantitative Risk Assessment of Campylobacter infections and broiler chicken" at the Federal Institute for Risk Assessment is to estimate the chicken meat associated risk of Campylobacteriosis in Germany by using probabilistic models. Furthermore, process parameters (modelling parameters) with the most vital impact on the risk of Campylobacteriosis due to chicken meat have to be elaborated to give recommendations for risk management options in the whole food chain. The outcome of Joint FAO/WHO Expert Consultations on Risk Assessment of Microbiological Hazards in Foods (JEMRA) with respect to Campylobacter spp. in broiler chickens are the baseline for the national approach. In addition, national studies from Canada, Denmark and The Netherlands have to be considered. Typical regional data with respect to the disease, to risk factors in Germany and to the qualitative and quantitative occurrence of Campylobacter in broiler chickens along the "farm-to-fork" continuum have to be collected and validated for elaboration of the four elements of a risk assessment. Data on the prevalence of the agent at different stages of the food chain given in available surveillance systems in Germany are limited with respect to their suitability as incoming parameters for the models. A monitoring programme, as required in the Directive 2003/99/EC on the monitoring of zoonoses and zoonotic agents, as well as coordinated programmes for the official food control authorities, could improve the data baseline for risk assessment studies for instance. To collect all necessary information on the quantitative load of Camylobacter in broiler chickens will go beyond the scope of any existing or future monitoring systems. Results can only be achieved by detailed studies. Beside this, regional data on production and processing of broiler chicken, consumption data and information on the behaviour of consumers in households when preparing broiler chicken products are relevant for assessing the final risk to the consumers. For some questions, especially with respect to the dose-response-relation, internationally used models have to be applied. The national study is embedded in a national epidemiological network of "Foodborne Infections in Germany" which is coordinated by the Robert-Koch-Institute and supported by the Federal Ministry of Education and Research (BMBF).

For some time now there have been several projects dealing with the assessment of campylobacteriosis risks for consumers. Dose-response relationships form a crucial part of such assessments, as they specify disease probabilities depending on different microbial concentrations in foods. Evaluation of such models, however, is difficult because of problems to find data on which reliable assumptions could be based. Ongoing risk analyses for Campylobacter mainly refer to a single administration study with human volunteers published by Black et al. (1988). However, whether results from this study can be transferred to target populations envisaged in risk assessments remains questionable for several reasons. In this paper some alternative dose-response models, their fit to the data of Black et al., and risk estimates resulting in a fictitious scenario are discussed and compared. Depending on the dose-response model assumed risk estimates can differ remarkably. Therefore it is hardly possible to make reliable quantifications of risks in reality, however, it can be determined how much they may vary assuming different scenarios.

Foodborne infections with Campylobacter spp. are increasing, especially antibiotic resistant strains are emerging. Quinolone resistant isolates can cause failure of therapy in severe clinical infections. Molecular characterisation is needed for the detection of resistant variants of C. jejuni. Therefore 23 isolates from poultry and human medicine as well as three control strains were tested for their minimal inhibitory concentration, their Single-Strand-Conformation-Polymorphism (SSCP)-PCR pattern (a method for the detection of resistance determining point mutations), and their sequence of the quinolone resistance determining region (QRDR). Six different SSCP types could be identified: two types for quinolone resistant isolates and other types containing so called silent mutations without influence on the resistance. A genotypic monitoring of the quinolone resistance in C. jejuni can be useful for the early detection of new resistance variants. As a screening method for detection of point mutations in the QRDR the SSCP-PCR can be applied. Compared to other genotypic methods the SSCP-PCR is less time and cost consuming and needs only standard technical equipment.

One of the most promising genotyping methods for microorganisms is the AFLP (amplified fragment length polymorphism)-analysis, originally developed to genotype plants. The AFLP method has a high discriminatory power and an excellent reproducibility. Thus it is suitable for solving taxonomic and epidemiological questions. AFLP analysis was used to reveal the genetic diversity of Campylobacter (C.) jejuni strains from turkeys. The aim was to detect and genotype C. jejuni strains on individual turkeys throughout the complete slaughter process. A broad spectrum of genotypes was detectable on the turkey skin at the beginning of the slaughter line. At the end of the slaughter process-after chilling, only a diminished spectrum of genotypes was detectable by AFLP-analysis, suggesting, that slaughter specific environmental stressors may exert a selective pressure on the strain diversity. Our results proved, that AFLP analysis is an excellent tool for subtyping large numbers of Campylobacter strains.

Over the period 1983-1993 10,344 stool cultures were undertaken in children with gastrointestinal symptoms at the pediatric department of the Landeskrankenhaus Leoben. Campylobacter jejuni was diagnosed as pathogen in 238 cultures taken from 196 patients aged one month to 16 years. Thus, Campylobacter jejuni infections (2.3% of all stool cultures) were second in frequency to various forms of salmonella (6.1% of all stool cultures; 332 patients). Apart from diarrhea (92% of cases), the most frequent clinical features were fever exceeding 38 degrees C (61%), abdominal pain (58%), blood in the stools (48%) and vomiting (34%). Treatment was based on appropriate diet. Fluid replacement with glucose-electrolyte infusions was required in 24% of the patients and erythromycin was administered orally in 30% of cases.

At the end of the production period, 29 layers each from 70 different flocks were examined for the occurrence of campylobacters in their caecal contents. All flocks were found campylobacter positive. Up to 20 individuals of 13 flocks and 21 to 29 birds of 57 flocks were carriers of Campylobacter spp. Material of the liver was additionally cultured from birds of 36 flocks. The isolation of the organism from livers was possible only from 1 to 6 birds of 16 flocks. In two experiments, chickens were infected at an age of 4 weeks with campylobacter strains inducing different excretion rate. The birds were infected again with a further campylobacter strain at 10 weeks of age. Birds at the same age which were not infected before, served as control. After this superinfection, the excretion of the organisms occurred at the same rate in all groups and did not depend on the strain chosen for the first infection. After an additional second superinfection in the second experiment, the period of excretion of the organism at a high rate was diminished.

Investigating the cause of an outbreak of mild diarrhoea in a boar rearing unit with about 750 animals, C. coli was found in all diseased animals, i.e. it was isolated from the intestines of culled boars and from faeces samples; often the amount of C. coli was very high. The intragastric application of C. coli to 5 weaning pigs (about 35 kg) resulted in the shedding of large numbers of C. coli via the faeces at days 3 and 5 post infectionem only. The development of the animals was undisturbed during the 17 days of the experiment. Carrying out follow-up investigation, C. coli was isolated at least once per animal from all healthy animals (n = 40) from the 3 farms, delivering young boars to the unit. C. coli is regarded as an opportunistic microorganism in the intestines of swine, able to cause diarrhoea only when combined with infection-promoting factors. In the case presented, these factors were nitrate-enriched water, changes in the composition of feed and the rapid shift from winter conditions to a warm spring.

Out of a total of 207 gulls--20 Black headed gulls, 185 Herring gulls and 2 Common gulls--128 (62%) and 23 (11%) birds, respectively, were infected with Campylobacter spp. (C.) and Salmonella spp. C. jejuni was predominant in gulls less than two years old (89%) and C. coli in older birds (75%). Furthermore, the infection rate with Campylobacters was depending on the habitats of the birds. The rate for C. jejuni and C. coli, respectively, was in gulls from regional garbage dumps 78% and 4%, from the coast 58% and 21%, and from islands 47% and 47% of the isolations in the corresponding area. Salmonellae were mainly isolated in the period from September to February from gulls less than one year old and from birds from the coast.

Experiences, including results of original experimental work on Campylobacter fetus, C. jejuni and C. coli induced diseases of cattle, sheep, dogs, rabbits poultry and men in Hungary are reviewed. Out of 31 cases of abortion in cows 29 (93.5%) were causes by C. fetus subsp. venerealis and only one case each (3.2%) by C. fetus subsp. fetus and C. jejuni, respectively. Out of the 29 strains of C. fetus subsp. venerealis, 26 belonged to serogroup 01 (A) and only 3 to serogroup 02 (B). Campylobacter abortions in sheep flocks were caused in 18 cases (78.3%) by C. fetus subsp. fetus and in 5 cases (21.7%) by C. jejuni. The latter strains belonged to Penner's serogroup 1 (6 strains), 5 (4 strains) and 8 (5 strains), respectively. In scouring dogs 12.7% of the cases were caused by C. jejuni. The same pathogen caused diarrhoea also in young rabbits. Isolated strains belonged to serogroup 2. In cases of Campylobacter hepatitis of laying hens, egg production has been reduced by 8 to 15% for 2 to 3 weeks. Row poultry meat represents often the source of infection for men. The 32 strains of C. jejuni isolated from faecal samples of men affected with diarrhoea belonged to 12 serogroups.

The endemic behaviour of Helicobacter pylori (H.p., formerly known as Campylobacter pylori) among the population of the town (57,000 inhabitants) and rural district (116,000 inhabitants) of Landshut was investigated with consideration being given to nationality, socio-economic status, housing and the local supply of drinking water. The study involved 894 patients, whose consecutive gastric biopsies were sent to the pathological institute of the Municipal Hospital in Landshut. The overall H.p. incidence was 51.1%, the average age of those infected being 56.9 years. No difference was found in the rate of infection between the municipal and rural populations (54.5%, average age 57.4 years/48.3%, average age 56.4 years). The population of foreigners revealed a significantly higher H.p.-positive rate (72.3%, average age 41.7 years) as compared with the native population (49.9%, average age 57.7 years). In the case of parts of the town whose inhabitants generally lived in smaller apartments with a lower standard of hygiene a considerable greater incidence of H.p. (up to 73.6%, average age 54.2 years) was observed as compared with areas with a low population density and detached houses (38.5%, average age 59.2 years). Considerable differences in rates of infection were established in the individual small towns and marketplaces of the rural district (between 40 and 71.4%, average age 58.6-59.1 years). No correlation was found to the supply of drinking water. Overall, the results of this study indicate a person-to-person transmission of H.p., possibly favoured by more frequent physical contact under more cramped living conditions in socio-economically disadvantaged strata of the population and by ethnological factors.

An outbreak of C. jejuni enteritis involving participants of a jogging rally is described. Information was obtained by questionnaire about food consumption, incubation period, duration of illness and symptomatology. A drink prepared with raw milk was incriminated as vehicle of the outbreak. More than 500 runners were symptomatic with an attack rate of over 75%. Secondary cases were rare. Using serotyping, milk from a single cow fecally excreting C. jejuni type 2 was suspected to be the outbreak vehicle.

During 1980 out of 3,680 stool specimens of children aged up to 6 years with diarrhea routinely screened for enteropathogenic bacteria, 72 cases of Campylobacter fetus ssp. jejuni infection were found. They were more common during the summer months, in children aged less than 4 years, and in boys rather than in girls (2, 9:1). The most common symptoms were watery, mucus, and haemorrhagic diarrhea, fever, vomiting and abdominal pain. All strains exhibited nearly identical sensitivity patterns for the chemotherapeutics tested.

Report on a outbreak due to contaminated food involving 556 schoolchildren who got their lunch from a school kitchen. The outbreak occurred abruptly without any secondary infectious. Examinations for Salmonellae, Shigellae, Enteritis-coli, Yersiniae and Rotaviruses were negative. However, Campylobacter jejuni were isolated from 105 specimens of faeces in Rostock. Sixty of these strains and another 2 that had been isolated at the same time but had no relation to the outbreak in Rostock, were further differentiated in Berlin-Buch. All of them proved to be Campylobacter jejuni biotype 2. Serotyping according to Lauwers revealed that 58 out of the 60 strains isolated belong to serotype 19. One of the two remaining strains could not be typed, the other was identified as serotype 1. One of the two cultivated strains that were not related to the outbreak in Rostock, was untypable, the other being of serotype 2. Therefore it can be assumed that the outbreak came from the same source of infection. Epidemiological investigations pointed to some food which had been served 6 days prior to the outbreak. The meal had consisted of white cabbage stew with beef. The kitchen supplies the cooked food to several institutions; 3 different dishes being prepared each day, referred to as dish, A, B and C. The institutions receiving dish A - which on November 1, 1985 was the above-mentioned white cabbage stew - actually included several classes of a school as well as a kindergarten. On that particular day however the kindergarten had not been supplied with dish A but, as an exception, with dish B.(ABSTRACT TRUNCATED AT 250 WORDS)

Stool specimens of 478 children with enteritic symptoms were screened for enteropathogenic bacteria over a 5-month period. 28 cases of infection due to Campylobacter jejuni were found. The incidence of Campylobacter enteritis exceeded that of salmonella and shigella infections recorded over the same period (17 and 11 cases, respectively). Infected children-aged between 2 months and 15 1/2 years-presented with symptoms of mild gastroenteritis. 18 patients had bloody diarrhoea, whilst 4 children aged between 4 and 9 years with abdominal pain showed a clinical picture mimicking acute appendicitis. Two severely dehydrated infants required parenteral fluids, but in the remaining cases dietetic treatment alone proved satisfactory.

In 1983, bacteriological examinations of gastric epithelium isolated a new species of bacteria, the so-called Campylobacter pyloridis. These bacteria were found in 50% of the gastroscopic examinations from patients with dyseptic disorders. C. pyloridis is a gram-negative curved bacterium. Up to now it has been found on the surface of the human gastric epithelium. C. pyloridis is rarely isolated from the healthy gastric epithelium. The gastric epithelium containing C. pyloridis mostly suffers from inflammatory infiltration or from pathological changes like chronic gastritis of type B. The route of infection is unknown. C. pyloridis has not yet been isolated outside of the human stomach. For laboratory diagnosis of a disease caused by C. pyloridis, the bacterium has to be isolated from gastric bioptic specimen. Another possibility is to check for high serum antibody levels against C. pyloridis. Direct microscopic examinations of gastric epithelium are also possible. The positive urease test is the main criterion to differentiate C. pyloridis from other human pathogenic campylobacter species. As therapeutic agents are recommended: bismuthates, amoxicillin, furazolidone and tinidazole. These agents are able to eliminate C. pyloridis from gastric epithelium and to fade away the gastritis.

The prevalence of Campylobacter pylori in gastric mucosa was investigated prospectively (by histology, cytology, bacterial culture and urease rapid-test) in 302 patients of a routine gastroenterological endoscopy programme. According to the histopathological findings the following prevalence of C. pylori was established: 3 of 35 normals (9%); 116 of 167 with antral gastritis (69%), 28 of 40 with gastric ulcers (70%); 26 of 33 with duodenal ulcers (79%); 5 of 27 with other conditions (19%). The activity degree of the gastritis correlated closely with the presence of C. pylori. In a prospective open trial 110 patients with antral gastritis or gastroduodenal ulcer were treated according to the following schedule: (a) bismuth subsalicylate, 1800 mg/d for four weeks (35 patients); (b) amoxycillin 2250 mg/d for two weeks (6); (c) ranitidine 300 mg/d for four weeks (26); (d) bismuth plus amoxycillin (20); (e) bismuth plus ranitidine (23). Immediately after the end of treatment and four weeks later the elimination rates were: (a) bismuth 51% (18) and 23% (8), respectively; (b) amoxycillin 50% (3) and 17% (1); (c) ranitidine 0% (0); (d) bismuth plus amoxycillin 60% (12) and 25% (5); (e) bismuth plus ranitidine 43% (10) and 17% (4). These data indicate that treatment with bismuth plus amoxycillin will achieve a negative bacterial result in about half the patients. But frequently as early as four weeks later C. pylori can again be demonstrated, so that the long-term elimination rate is only 15-30%.

In a two-center study (Zurich and Berne) covering a 5-month period (September 1979 to January 1980) 665 faeces from patients with diarrhoea and 800 faeces from people without diarrhoea were examined for Campylobacter jejuni. By selective culture Campylobacter jejuni was isolated from 28 faeces of 35 patients with diarrhoea (5,7%) while none of the normal faeces yielded a positive culture. Isolation rates for Salmonellae and Shigellae from the same material (patients with diarrhoea) were 12.6% and 0.9% respectively. Infection with Campylobacter usually causes unspecific enteritis with spontaneous remission after 2--10 days. Occasionally, however, a more severe course initially simulating acute abdominal illness can lead to hospital admission and even to surgical procedures. Symptomatic treatment is suggested for mild cases. In more severe cases, antibiotic therapy is recommended, erythromycin being the drug of choice.

In a prospective study of 120 gastroenterological patients in Berlin, Germany, the prevalence of Campylobacter pylori was determined. When the gastric mucosa was normal, the prevalence was one in 19 patients (5.3%). In 101 patients with chronic gastritis it was cultured in 55 (54.5%). In 31 patients with chronic atrophic gastritis the organism was cultured in 25 (81%); in 60 patients with severe gastritis it was present in 75%, in 35 with moderate or severe chronic active gastritis in 82.8%. The diagnosis of gastric ulcer (9) or duodenal ulcer (12) was associated with the isolation of Campylobacter pylori in 55.6 and 91.7%, respectively. The prevalence of this organism in antral mucosa of this group of patients thus corresponds to that in Australia, England and North America. The organism was also demonstrated in the duodenum of 10 among 25 patients examined. But in none of 25 patients was it demonstrated in the sigmoid colon.

Next to acute respiratory diseases accounting for about 80% of all cases of notifiable infectious diseases acute gastrointestinal diseases with 12% are the group second in importance. Since many years the number of reported cases with diarrhoea is increasing. The aetiology of merely a small part of these cases (less than 5%) is being determined. Next to the Salmonellae at present Campylobacter species are detected most frequently. The percentage of viral gastroenteritis is under-estimated considerably on account of insufficient diagnostics. Most important for improving the situation is the improvement of hygienic conditions in kindergartens, crèches and nursing homes; in food processing plants and kitchens as well as the reduction of human pathogens-particularly Salmonellae and Campylobacter-spreading in livestock.

Enteritis by Campylobacter jejuni/coli is by far the most frequent clinical entity of campylobacter-infection. It may be compared to salmonella-enteritis as for its epidemiologic importance. The course of the disease may be dramatic, but can be successfully treated as soon as the pathogen is known. In prematures and newborn babies infections with Campylobacter fetus ssp. fetus are life-threatening and early diagnosis is of life-saving importance. Five observations of campylobacter-enteritis in children aged 2, 8, and 10 years are reported. They were characterized by high fever frequent loose, watery stools with blood, leucocytosis or leucopenia and elevated BSR. All children became asymptomatic with symptomatic treatment, without specific antibacterial therapy. The importance of campylobacter-infections, their diagnosis and course of disease in children are discussed.