Epidemiology conducts research on health and disease at the population level – infection epidemiology is concerned with contagious diseases. Their tools and methods are systematic queries, clinical examinations and laboratory diagnostic documentation for both healthy and afflicted individuals, as well as statistical analysis of the compiled data. Causes and risk factors for infections can thus be identified. Infectious diseases epidemiology contributes to the development of preventive measures, early detection and therapy for diseases. Moreover, it examines the efficacy of such measures. Thus epidemiology ties in with scientific findings in basic research as well as medicine, and examines these processes at the population level.


Epidemiological Lab

One of the tasks of the epidemiological laboratory is to investigate infections on population level, irrespective of the memory of the affected individuals (e.g. studies subjects). For this reason, we use biosamples of subjects such as nasal swabs, faeces, saliva and blood to either screen for the pathogens themselves or identify traces of pathogens that have developed because of an infection.
Our strategic direction covers the development of methods of pathogen detection as well as the support and implementation of infection epidemiological field studies to assess the health status as well as the burden of a given disease on population level in Germany and worldwide. Our main goal is to use our expertise to improve measures to counteract the spread of infectious diseases. 

In the past, for example, we used direct pathogen detection to measure the spread of antibiotic-resistant pathogens on population level using the example of methicillin-resistant Staphylococcus aureus (MRSA) in the nose (s-swab study) [1,2]. 
In a current project to determine the prevalence of the hepatitis B virus in a region of West African Burkina Faso, we are transferring our expertise in pathogen detection into epidemiological field research in order to support the researches at the African partner site.
In the area of indirect pathogen detection, we are focusing on the developing of a differential multiplex serology as molecular tool to determine the antibody repertoire in the blood of individuals. This technique allows us either to determine the presence of a pathogen or whether the immune response of an individual was triggered by a past infection or in response to a vaccination. This specifically addresses the unmet need for a tool to measure the effectiveness of prevention strategies, like vaccination campaigns against pathogens with a high burden for the general population, e.g. viral hepatitides and measles.
Particularly, for these measurements, we use differential multiplex serology to investigate a large number of samples in very small quantities (few blood drops) for a multitude of pathogens or antibodies at the same time (multiplex serology).
Here, a first success was the development of a differential multiplex serology specifically for infections with the hepatitis A virus. This allows us to identify immune responses based on past infections and at the same time distinguish them from immune responses in response to vaccinations against the hepatitis A virus [3,4]. In the future, we plan to use the differential multiplex serology as a key technology to assess the burden of disease for pathogens, which are target of global elimination goals, such as measles. This allows us to reveal reproducible sero-epidemiological indicators for successful elimination. Furthermore, we intend to deploy this tool as key technology as accompanying laboratory diagnostics in the introduction of newly developed vaccines.   

Precise and reliable research demands high-quality biomaterials in order to conduct sound infection epidemiology. Due to the integration of new technologies, the level of knowledge on molecular detection technology has developed much faster than the field of actual biospecimen collection. Due to insufficiently standardized sampling procedures in the field, small amounts of low quality samples are routinely used in infection epidemiological field research. This dilemma of sample generation is becoming a growing bottleneck in complex studies, especially large-scale infection-epidemiological field studies conducted outside a controlled, highly standardized environment. In order to define solutions, we develop new concepts and devices for the self-sampling of study participants. These are based on new approaches of sampling, preservation and stabilization methods, which are developed by us with special attention to user-friendliness, reproducibility and safety. The novel devices are developed in close cooperation with experts from various scientific and engineering disciplines in close cooperation with clinicians to translate the initial idea into an applicable concept.
The key features of novel devices are non-invasive, inexpensive, simple and intuitive to use, easy to transport and safe.

  1. Mehraj, J., et al., Methicillin-sensitive and methicillin-resistant Staphylococcus aureus nasal carriage in a random sample of non-hospitalized adult population in northern Germany. PLoS One, 2014. 9(9): p. e107937.
  2. Mehraj, J., et al., Epidemiology of Staphylococcus aureus Nasal Carriage Patterns in the Community. Curr Top Microbiol Immunol, 2016. 398: p. 55-87.
  3. Bohm, K., et al., Validation of HAV biomarker 2A for differential diagnostic of hepatitis A infected and vaccinated individuals using multiplex serology. Vaccine, 2017. 35(43): p. 5883-5889.
  4. Krause, G., K. Bohm, and C. Sievers, Method for differentiation of immune response in an individual. 2017, Google Patents.


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Audio Podcast

  • Staphylococcus aureus – ein Leben in der Nase2000 zufällig ausgewählte Braunschweiger Bürger haben in diesem Juni Post vom HZI erhalten – mit der Bitte, an einer Studie über die Verbreitung von Staphylococcus aureus teilzunehmen. Varianten des Bakteriums sind unter dem Kürzel MRSA als Krankenhauskeime zu trauriger Berühmtheit gelangt. Unsere Wissenschaftler wollen nun erforschen, wie viele Gesunde – außerhalb von Krankenhäusern – mit diesem Keim Leben. Und sie suchen nach Risikofaktoren, die Staphylococcus aureus die Besiedlung des Menschen erleichtern. Begleiten Sie Frank Pessler und Jaishri Mehraj ein Stück in die Welt der Epidemiologie...
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