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Impfungen bei gastrointestinalen Infektionen

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Infektiologie des Gastrointestinaltraktes

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Zusammenfassung

Schutzimpfungen sind die effektivsten und kostengünstigsten Maßnahmen im Kampf gegen Infektionskrankheiten; das gilt auch für Infektionen des Gastrointestinaltraktes. Hier stehen uns Impfstoffe gegen Hepatitis A und B, gegen Typhus und gegen Cholera zur Verfügung, demnächst auch wieder ein Impfstoff gegen Rotaviren. Mit den Impfstoffen gegen Hepatitis A und B, die sich als besonders erfolgreich erwiesen haben, verfügen wir über hochwirksame und gut verträgliche Vakzinen, die bei großzügigem Einsatz diese Erkrankungen nicht nur zurückdrängen, sondern unter Umständen auch völlig eliminieren können. Erste Erfolge sind bereits sichtbar.

So hat die Zahl der zum größten Teil im Ausland erworbenen Hepatitis-A-Infektionen in Deutschland, wo die Hepatitis-A-Impfung als wichtigste Reiseimpfung gilt, in den letzten 10 Jahren um zwei Drittel abgenommen. In Taiwan wird die Hepatitis-B-Impfung seit 1986 allen Neugeborenen verabreicht; hier ging die Rate an chronischen Hepatitis-B-Virusträgern unter 6-Jährigen innerhalb von 7 Jahren von 10,5% auf 1,7% zurück, was einer Reduktion um 84% entspricht. Im gleichen Zeitraum sank die Inzidenz des hepatozellulären Karzinoms, das die am schwersten wiegende Folge einer chronischen Hepatitis-B-Infektion darstellt, in der Gruppe der 6- bis 14-Jährigen um die Hälfte [8]. In den Industrienationen, wo die Hepatitis-B-Impfung zunächst nur in bestimmten Risikogruppen zum Einsatz kam, führte sie zu einem deutlichen Rückgang der berufsbedingten Hepatitis-B-Infektionen im medizinischen Bereich.

Diese Erfolge dürfen freilich nicht darüber hinwegtäuschen, dass wir gegen eine Reihe von Erregern des Gastrointestinaltraktes noch keine Möglichkeit einer Impfung haben. Trotz intensiver Bemühungen, Impfstoffe gegen Hepatitis C, enterotoxische Escherichia coli oder Helicobacter pylori zu entwickeln, wird es wohl noch geraume Zeit bis zur Zulassung dieser Vakzinen dauern, und Versuche, Impfstoffe gegen Schistosomiasis oder Wurmerkrankungen zu schaffen, stecken noch in den Anfängen.

Der folgende Artikel soll über die gegen Infektionen im Gastrointestinalbereich verfügbaren Impfstoffe — gegen Hepatitis A, B, Typhus und Cholera — informieren und einen Ausblick auf zukünftige Entwicklungen geben.

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Authors and Affiliations

  1. Institut für Med. Mikrobiologie u. Hygiene, Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg

    Prof. Dr. med. W. Jilg

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  1. Prof. Dr. med. W. Jilg
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  1. Zentrum der Inneren Medizin, Medizinische Klinik I des Universitätsklinikums Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main

    Wolfgang F. Caspary  & Jürgen Stein  & 

  2. Abteilung für Mikrobiologie und Hygiene, Universitätsklinikum Freiburg, Hermann-Herder-Str. 11, 79104, Freiburg

    Manfred Kist

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Jilg, W. (2006). Impfungen bei gastrointestinalen Infektionen. In: Caspary, W.F., Kist, M., Stein, J. (eds) Infektiologie des Gastrointestinaltraktes. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-37211-3_53

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  • DOI: https://doi.org/10.1007/3-540-37211-3_53

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