Niedersächsisches Landesgesundheitsamt (NLGA)
Contact person
Elke Mertens
Tel. +49 511 4505 303
Description of the institute
The Public Health Agency of Lower Saxony (Niedersächsisches Landesgesundheitsamt, NLGA) is the competent state authority responsible for the prevention, detection, and control of emerging health hazards and for health reporting within Lower Saxony. It collaborates with other institutions in the public health system and coordinates measures in incidents affecting more than one district, as well as cooperating closely with the state food safety authority regarding outbreaks of zoonotic diseases, antibiotic resistance, and teaching.
The NLGA provides scientific information on health protection for the government, the ministry of health, local public health departments (LPHDs) and other public health actors (e.g. health professionals) in Lower Saxony.
Further tasks are to collect, analyse, and interpret epidemiological data and to conduct laboratory investigations. These tasks include the identification and examination of disease clusters, as well as the management of the notification system and communication with other institutions of the public health service on national and local levels.
The tasks and activities include:
- Pandemic response.
- Surveillance of notifiable infectious diseases, collected through routine reporting and dedicated epidemiological surveys, e.g. running active and passive surveillance systems on:
- influenza and acute respiratory diseases;
- meningitis and encephalitis;
- tick-borne encephalitis;
- measles and rubella;
- haemolytic uremic syndrome.
- Conducting laboratory investigations (including biosafety level 3 laboratory (BSL3) and Next Generation Sequencing (NGS)) for surveillance and research projects.
- Conducting studies, e.g. on tuberculosis in refugees, antibiotic-resistant pathogens in hospitals, and vaccine effectiveness.
- Outbreak investigations, particularly for STEC, salmonellosis, and other zoonotic diseases as well as for hospital-associated infections.
- Developing guidelines, e.g. on outbreak management.
- Teaching: the NLGA offers advanced training courses on various topics to public health officers, healthcare workers in hospitals, nursing homes, primary care and medical and public health students. In addition, NLGA is involved in the organisation of two annual scientific conferences, one on public health and one on hospital and environmental hygiene.
- Communication: a weekly bulletin is provided to LPHDs on current topics of infectious diseases and study results are published in national and international scientific journals.
Particular strengths are:
- highly motivated, multi-professional team.
- strong national and international network.
- instant access to subject experts in:
- epidemiology;
- statistics;
- microbiology (including BSL3laboratory and NGS);
- geography.
- PAE graduate 2011 and PAE fellow 2022 on site (PAE: Postgraduate Training in Applied Epidemiology, national Programme similar to EPIET).
- interface position between local and national public health actors: the fellow will be acquainted with all perspectives of the German public health system.
- central location in Germany and Europe.
- Hochdeutsch (modern standard German) is spoken throughout the area.
The NLGA comprises four departments:
- Dep. 1: Administration (e.g. internal organisation, personnel management, budget, education and professional training, and health communication/internet).
- Dep. 2: Communicable Diseases (e.g. virology, clinical bacteriology, health protection, hospital hygiene, infectious disease epidemiology, surveillance).
- Dep. 3: Environmental Health (e.g. environmental medicine, hygiene and epidemiology of non-communicable diseases).
- Dep. 4: Special Tasks of the Public Health Authority (e.g. health reporting and Trust authority of the Register for cancer in Lower Saxony (EKN).
Further responsibilities as public relations and the Centre for Health and Infectious Disease Hazards (ZGI, 24/7) are directly subordinated to the president of the NLGA.
Number of employees: 200.
The EPIET fellow will be based in the Microbiology and Infectious Disease Unit. The institute is 10 minutes from downtown Hanover (520 000 inhabitants), the capital of Lower Saxony (the second largest federal state of Germany, with eight million inhabitants). Hanover is a green city with an excellent but budget-friendly infrastructure and a wide range of culture and leisure facilities. Thanks to the central location in Germany, the airport and the express train station, major German and European cities as well as popular destinations are within easy reach (travel time to central Berlin: 100 minutes).
Training opportunities
The EPIET fellow will be involved in routine infectious disease surveillance and encouraged to participate in specific surveillance projects as well as outbreak investigations. They will have the opportunity to attend practical laboratory trainings in the onsite laboratories and to practise health communication and teaching.
We offer project outlines for epidemiological studies but also invite the fellow to contribute their own ideas. NLGA fellows can draw on the experience of the excellent EPIET/PAE infrastructure at the Robert Koch Institute (RKI) in Berlin, including weekly academic sessions (video conferencing) and quarterly face-to-face meetings at RKI.
The NLGA provides the best conditions to fulfil the EPIET requirements and to acquire a sound expertise in infectious disease epidemiology. Short-term international assignments are supported.
Like all EPIET and PAE fellows in Germany, the NLGA fellow has the opportunity to enrol in the Master of Science in Applied Epidemiology programme (MSAE, 120 ECTS, mainly distance learning) which is organised by RKI and Charité University, the medical university of Berlin.
Training supervision
Primary supervision is provided by Elke Mertens and Johannes Dreesman. Elke Mertens is a PAE fellow who graduated from EPIET and the MSAE programme in 2011. Johannes Dreesman is the head of the department and, as well as being an expert in statistics, draws from many years of experience in infectious disease epidemiology.
Other supervisors depend on the projects chosen. There are currently eight infectious diseases epidemiologists, four microbiologists, two WGS experts, one statistician, and one geographer at the department, all of whom are happy to support the EPIET fellow.
Language requirements
Good English skills and basic knowledge of German (and the willingness to improve) are recommended to communicate with municipal partners. Language classes are budgeted by the programme and can be easily organised.
Training history
Number of EPIET fellows trained at the institute: three (2014, 2018, 2020)
Number of PAE fellows trained at the institute: five (2008, 2010, 2012, 2016, 2022)
Number of EPIET alumni working at the institute: none
Number of PAE alumni working at the institute: one
- Acknowledged by EPIET
- Available for next EPIET cohort
Project Proposals 2023
Surveillance projects
Epidemiological and Molecular Surveillance of carbapenemases gene in Acinetobacter spp. and Enterobacterales in Hospitals in Lower Saxony
Development and implementation of a surveillance system regarding carbapenemases genes in Acinetobacter spp. and Enterobacterales. A design for Acinetobacter surveillance was developed in 2019, but the implementation has been hampered by the COVID-19 pandemic.
Redevelopment of the MERIN surveillance system (Meningitis and Encephalitis Register in Lower Saxony, Germany)
Redevelopment of the system following the evaluation conducted in 2021/22:
Anna Luczynska: Evaluating 17 years of the MERIN surveillance program (Meningitis and Encephalitis Register in Lower Saxony, Germany): Acceptability Survey, Completeness and Timeliness of Data.
Evaluation and further development of SurvIN*
SurvIN* has been running since 2013 and will be updated as part of the digitalisation of the public health authorities, 2023-2025. The fellow will conduct an evaluation mainly regarding the benefit for the public health authorities’ and a needs assessment of the public health authorities at local and federal state level.
* Surveillance von Infektionskrankheiten in Niedersachsen
Evaluation of cluster test data and spatial representation of results
Aims and objectives:
- To evaluate the performance of the implemented cluster detection algorithm against other indicators, such as the electronic outbreak reports of the local health departments;
- To develop graphical representation of the outbreaks in maps (requires application of R-software).
Research projects
Development and implementation of strategy for continuous participants’ enrolment in the NLGA’s online panel HuGO*
HuGO *consists of 270 participants and NLGA is currently working on expanding the participant number to about 1 000, which should mirror the main groups in the population of Lower Saxony. The 2023 fellow can join in that process and subsequently develop and implement a strategy for continuous participants’ enrolment, as in every panel there is a continuous drop out of members.
The panel is deployed as control group for outbreak investigations and various research projects (see below).
Control-survey in the general population as extension of gastrointestinal infection surveillance
Using HuGO* to develop a systematic database for hygiene and nutrition behaviours in the population;
* Hygiene und Gesundheit Online Panel in Niedersachsen.
Influenza vaccination in nursing home care workers – Vaccination coverage of staff caring for the elderly, knowledge, attitude, and perception (KAP) and strategies for improving vaccination coverage
Aims and objectives:
- Assessment of vaccination coverage of nursing home care workers;
- Assessment of knowledge, attitude, and perception (KAP) of nursing home care workers towards influenza vaccination;
- Identification of individual and institutional-based factors influencing the influenza vaccination status of nursing home care workers;
- Based on those factors, develop strategies together with stakeholders to improve vaccination coverage in nursing home care workers.
Estimating vaccine effectiveness of influenza and SARS-CoV-2 vaccination from routine laboratory surveillance data
Aims and objectives:
To analyse the associations between laboratory-confirmed influenza/ SARS-CoV-2-infection and vaccination status to derive estimates of vaccine effectiveness (sub-analyses can be performed for different virus strains, age groups, or types of vaccine).
Analysis of mandatory tuberculosis chest X-rays for immigrants from east European countries and assessment of the programme
Aims and objectives:
- Analyses of data on 20 years of chest X-ray investigations conducted at the German immigration centre for immigrants from east Europe.
- Identification of trends concerning the prevalence of tuberculosis in these immigrants and comparison with data from other sources.
- Assessment of the usefulness of the programme.
Establishment of a procedure for infectious disease monitoring through media reports
NLGA has access to the media monitoring for Lower-Saxony.
Aims and objectives:
- To develop, implement and evaluate an automatic procedure for monitoring media sources from Lower-Saxony reporting infectious disease events;
- For an effective use of these sources as an event-based surveillance tool complementary to the existing indicator-based surveillance.
Further projects
- Knowledge, attitude, and perception (KAP) of general practitioners towards the prescription of oral antibiotics;
- Infectious disease surveillance during a local mud race (Steelman Hannover);
- Evaluation of the NLGA ARI surveillance, conducted since 2004;
- Evaluation of the NLGA Norovirus surveillance, conducted since 2010;
- Participation in the routine monitoring of STDs;
- Analyses of routine Hepatitis C serology data of prisoners in Lower Saxony;
- Collaboration with the NLGA department of Non-Communicable Diseases (NCD), for example regarding ‘Long COVID’;
- Ideas from fellows are welcome.