[Vaccination recommendations for health care workers in Austria]

In Austria the vaccination coverage among health care workers (HCW) - particularly among hospital personnel - is not sufficient. This is of specific concern, because not only the individual protection but also the prevention of disease transmission of vaccine preventable diseases between HCW and patients needs to be guaranteed. Particularly immunosuppressed patients, who are at higher risk for morbidity and mortality due to certain infections, but cannot be vaccination themselves, must be able to rely on herd protection, i.e. not being infected by surrounding/caring persons. The following publication provides for the first time detailed guidelines for vaccination programs for HCWs in Austria, including personnel within hospitals, medical institutions and laboratories, as well as Medical Universities including students. Moreover, these guidelines are also recommended to medical personnel in outpatient clinics, social service institutions and medical practices. Additionally to the vaccination schedules this publication also includes a chapter on ethical as well as legal background underlying these recommendations.

Tick-borne encephalitis from eating goat cheese in a mountain region of Austria

We report transmission of tick-borne encephalitis virus (TBEV) in July 2008 through nonpasteurized goat milk to 6 humans and 4 domestic pigs in an alpine pasture 1,500 m above sea level. This outbreak indicates the emergence of ticks and TBEV at increasing altitudes in central Europe and the efficiency of oral transmission of TBEV.

An ongoing multi-state outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and Norway, March-April 2008

From the second week of March 2008, public health authorities in the province of Salzburg observed an increased number of measles cases compared to previous years. Twenty cases of measles had been were notified Austria-wide in 2007, 24 in 2006, 10 in 2005, and 14 in 2004. The current outbreak has affected, as of 14 April, 202 people in Austria, 53 in Germany, and four in Norway, bringing the total number of cases related to this outbreak to 259. The initial case series investigation revealed that the common link was attendance of an anthroposophic school and day care centre in Salzburg city. The majority of the pupils were not vaccinated against measles.

Vaccine strategies of meningococcal disease: results of a 10-year population-based study

Invasive meningococcal disease (IMD) is an important cause of morbidity and mortality in children and adults. This study was conducted to determine a possible increase in IMD in recent years with special interest focused on serogroup C disease. From January 1st 1993 to December 31st 2002, IMD was studied in one million residents of Austria. We used active, population-based surveillance data from the Office of Public Health. A total of 126 patients with positive blood and/or cerebrospinal fluid culture or positive swabs for Neisseria meningitidis were studied. The median age of all patients was 9.5 years (range 1 month to 63 years). The average incidence of all IMD subgroups was 1.05 cases per 100,000 person years and was highest in children 0-4 years old (7.08 cases per 100,000 person years) followed by young adults aged 15 to 19 years (4.35 cases per 100,000 person years). Serogroup C IMD occurred in 1.30 cases/100,000 person years in patients aged 0 to 4 years and in 1.92 cases/100,000 person years in patients aged 15 to 19 years. Overall mortality was 11.1%. There was a significant increase (P =0.001) in IMD due to serogroup B disease within the last 10 years. In contrast, serogroup C disease did not increase during the last decade.

CONCLUSION

Currently, we do not recommend mass vaccination against serogroup C disease in Austria, but young adults aged 15 to 19 years display a high incidence of meningococcal C disease. In this age group, vaccination against serogroup C disease should be considered.

Cellular characterisation of p53 mutants with a single missense mutation in the beta-strand 326-333 and correlation of their cellular activities with in vitro properties

Recent evidence has shown that missense mutations in the p53 tetramerisation domain can inactivate the protein. However, most of these studies have been done only in vitro or concern proteins whose physico-chemical properties have not been fully investigated. Alanine mutants of the beta-strand 326-333 from the tetramerisation domain have been characterized in vitro and studied for their thermodynamic stability. They therefore offer a unique opportunity to establish a correlation between in vitro and cellular activities of proteins with a mutated tetramerisation domain. The eight mutant proteins resulting from the mutation of the eight residues of the beta-strand 326-333 to alanine were analysed for their ability to stimulate transcription, to inhibit the growth of Saos-2 cells and to repress the promoter of the multidrug resistance gene 1. The experimental results show a perfect correlation between in vitro and cellular data. The Leu330Ala and Ile332Ala proteins are inactive, the Phe328Ala protein has a moderate activity. The Glu326Ala, Tyr327Ala, Thr329Ala, Gln331Ala and Arg333Ala proteins show activity similar to that of wild-type protein. This work is based on an exhaustive analysis of p53 mutants both in vitro and in cells and shows that mutations in the tetramerisation domain might be of importance in cancer development since they inactivate the p53 protein.

p53 mutants without a functional tetramerisation domain are not oncogenic

p53 is altered in about 50 % of cancers. Most of the p53 mutants have lost the wild-type tumour suppressor activity but show oncogenic properties. The majority of the p53 alterations are missense mutations of residues located in its DNA binding domain (DBD). Only a few mutations concern residues in its tetramerisation domain (TD). However, the study of mutant proteins identified in tumors that do not form tetramers has shown that they have lost the wild-type activity like most of the p53 DBD mutants. Here, we show that two of such mutant proteins, Arg342Pro and Leu344Pro are not dominant negative and do not stimulate the expression of a reporter gene under the control of the multi-drug resistance gene-1 (MDR-1). This suggests that to be oncogenic, p53 mutants need to form tetramers. Accordingly, the dominant negative effect and the ability of a tetrameric mutant protein, Asp281Gly, to stimulate the MDR-1 promoter are abolished when its TD is rendered non-functional by the mutation of leucine 344 to a proline residue. These results suggest that mutations in the TD, are less selected in tumors than mutations in the DBD because they do not lead to oncogenic proteins.

[Cooperation in public health in the Bodensee district from the viewpoint of Vorarlberg]

Following a brief presentation of a few significant data and specifications in respect of the structure and organisation of the Austrian Public Health administration, general basic rules for across-the-border cooperation in the region of Lake Constance are outlined. The following subjects for such cooperation are listed: epidemiology and how to fight spring-summer meningoencephalitis, rabies, echinococcosis, AIDS/HIV. Other areas of cooperation are, for example. Health protection within the framework of prostitution, drugs and drug substitution, states of emergency (natural or other catastrophes), incidents or cases or topics concerning pharmaceuticals, pharmacology or pharmacies in general, and especially environmental protection and protection of natural resources in connection with the large drinking water reservoir Lake Constance. Future perspectives are roughly sketched in respect of possible closer cooperation and communication if occasion arises.