The CAT Scan

Elderly persons, i.e., those >65 years of age, were affected most by C. diffi cile infections; this age group accounted for 1,506 (65%) of all cases (n = 2,306) in 2006. The 45to 64-year age group had the next highest number of cases, 451 (20%). Men and women were affected equally in the different age groups; slightly more women (n = 805) than men (n = 701) with C. diffi cile infection were >65 years of age. According to state and local health departments, there were no major health campaigns since 2004 that might have selectively increased awareness for C. diffi cile notifi cation. Our results show a continuous increase of cases that even reaches seasonal notifi cation levels of Salmonella spp. and rotavirus infections, but the increase is diffi cult to explain entirely by changes in reporting behavior. We emphasize the role of individual German states in setting additional surveillance targets for public health. Given the epidemic potential and the severity of the disease, especially among the elderly, surveillance of C. diffi cile should be introduced throughout Germany along with enhanced prevention and treatment strategies (5).