Various infectious diseases play a major role in occupational health. Next to classical diseases such as tuberculosis [1
], new diseases including SARS [2
] or the novel influenza A H1N1/2009 virus [5
] are endangering occupational health in the last years. The novel influenza A H1N1/2009 virus was first identified in Mexico and led to pandemic warning of the WHO in June 2009 [7
Novel influenza A H1N1/2009 virus is often called "swine flu" and represents a result of the reassortment of different influenza viruses [8
]. It was reported that the hemagglutinin (HA) gene of A H1N1/2009 was similar to that of swine flu viruses which are present in United States pigs since the year 1999. By contrast, the matrix protein (M) and neuraminidase (NA) genes are found in European swine flu isolates. Phylogenetic analysis of the pandemic H1N1/2009 virus shows that six genome segments stem from a triple-reassortant virus circulating in North American swine, seeded from human, avian and classical swine lineages.
Concerning the pandemic, a first outbreak of Influenza-like illness occurred in Mexico and the USA in April 2009 and the US Centers for Disease Control and Prevention reported seven cases of novel A/H1N1 influenza by this time.
By April 24 the WHO issued a health advisory on the outbreak of "influenza like illness in the United States and Mexico". Despite measures by the Mexican government against the spread of the virus, the number of confirmed cases raised to 2,099 by May 7 2009 [10
]. One month later, on June 11, 2009, the WHO officially declared a H1N1 pandemic [11
]. This was the first pandemic since the 1968 Hong Kong flu pandemic. The WHO alert level was lifted to phase 6.
Different vaccines were generated: In autumn 2009, GlaxoSmithKline produced the vaccine Pandemrix®
]. Other vaccines were Focetria®
, made by Novartis and Celvapan®
, made by Baxter.
The safety of influenza vaccine is in the focus of research since many years [13
]. Due to a special debate on the safety of the pandemic influenza vaccines [18
], it was the objective of the present study to analyse the safety using a self reporting questionnaire approach in the acute event of a pandemic and a novel vaccine which was debated for its safety by the general population and healthcare worders (HCWs). We chose a population of healthcare workers (HCWs) and medical students after vaccination with Pandemrix®
since according to German federal recommendations HCWs had a top priority for vaccination [19