of Veterinary Medicine
Our last day in Germany, sadly, but it was a good way to end an amazing trip.
In the morning we visited the Robert Koch Institute (RKI) in Berlin, named for the physician who discovered the bacterium that causes tuberculosis and is considered by many to be one of the fathers of microbiology. Professor Klaus Stark gave us an introduction to what they do at the institute.
Founded in 1891, the RKI functions much like the Center for Disease Control and Prevention in the United States, focusing on surveillance, prevention and control of infectious diseases affecting humans. Germany has 82 million people living in 440 counties in 16 states, with one local health department per county in addition to the state health departments. The local and state health departments report to the RKI, which in turn reports back to the Federal Ministry of Health.
One example that highlights the work of the RKI is the investigation of the Salmonella Bovismorbificans outbreak in Germany in 2005. A case-control study was performed to determine the source of the outbreak, and it was found that the consumption of two specific raw pork products, Schweinehackfleisch (minced pork) and Zwiebelmettwurst (a type of sausage), was strongly associated with the illness. The meat was then traced back to the supermarket, distributor, slaughterhouse, and eventually to seven Dutch pig farms.Playing a particularly important role in disease surveillance in Germany is the Protection Against Infection Act (Infektionsschutzgesetz or IfSG), as outlined to us by Ed Velasco of the surveillance unit at RKI. This law requires physicians, laboratories and other healthcare professionals to notify the local health department of any reportable disease, and this information is then passed on to the RKI for epidemiological studies. The reporting is done electronically through a system called SurvNet@RKI. The epidemiological studies done at the RKI involve determining risk factors for various diseases, a few of which we discussed during our visit. For example, Dr. Bettina Rosner discussed with us risk factors identified for Campylobacter, the most frequently reported bacterial disease in Germany, which include poultry, unpasteurized milk, undercooked pork, animal contact and untreated drinking water. Additionally, it was found that risk was increased in the summer, males were more likely to be affected and the incidence of disease peaked at less than 5 years of age and at 20-40 years of age. This information can then be used to come up with strategies to prevent or reduce the incidence of infection in the future.Next to lecture was Dr. Astrid Milde-Busch, who discussed the bacterial infection listeriosis. Particularly at risk for this disease are pregnant women, elderly or immunocompromised individuals and newborns, and consumption of certain food items such as raw meat, raw or cold-smoked fish, raw milk, or pre-cut raw vegetables can put a person at risk. A very recent outbreak of listerosis associated with Quargel cheese occurred in 34 individuals in Austria and Germany. It was traced back to a production plant in Austria, where the bacterium was found to be an environmental contaminant. Finally, Dr. Helen Bernard and Dr. Niels Kleinkauf discussed two studies to determine occupational exposure of veterinarians to different infectious agents. Dr. Bernard’s study tested antibody prevalence of Coxiella burnetii, the causative agent of Q fever, in German veterinarians attending a conference in Bavaria. From this study it appeared that the seroprevalence of Q fever antibodies was greater in veterinarians when compared with the general population, and at greater risk were veterinarians who worked with cattle. Dr. Kleinkauf’s study determined the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) in a cross-section of veterinary personnel attending a national conference. Unlike Dr. Bernard’s study, Dr. Kleinkauf looked not only at veterinarians but also at veterinary technicians, students and other veterinary staff. Among the 687 people who participated in the study, 9.2% were found to be carriers of MRSA, compared to only 0.2-0.3% carriers in the general population. Those with occupational exposure to pigs were found to be at a particularly high risk. These findings led to the recommendation that all veterinarians should be considered to be at a higher risk for carrying MRSA. After visiting the RKI, we took the S-Bahn to the Berlin Zoo for a personal tour, wonderfully and enthusiastically given by Daniela Walewski, a tour guide at the Zooschule (Zoo School) who was planning to become a teacher. Built in 1844, the zoo is the oldest in Germany and has a fascinating history. It was built under the reign of King Friedrich Wilhelm IV of Prussia and eventually became a popular place to socialize in Berlin. The animals were initially kept in cages, but in the early 20th century, inspired by Carl Hagenbeck’s zoo in Hamburg, the cages were replaced with enclosures that mimicked the animals’ natural habitats, with a moat separating the animals from zoo visitors.Unfortunately, the zoo was completely destroyed by bombing in World War II. Only one building remained intact and only 91 animals survived. One of these animals was a hippopotamus who was found in a bathroom in the Bahnhof Zoo (the main train station that sits adjacent to the zoo), apparently attracted to the water that had flooded the bathroom after the bombing. Many buildings were rebuilt or newly built after the war. One of the newer buildings is the hippopotamus house, which provides an impressive environment for the hippos, with rain and thunder twice a day to simulate their natural rainforest habitat. We were lucky enough to enjoy a behind the scenes tour of the hippo house, and we were able to feed the hippos from the balcony overlooking their habitat. After the tour, we had some free time to walk around the zoo, and I made sure to visit Knut, the polar bear who became famous as a cub after being rejected by his mother and hand raised by one of the zookeepers.Finally, we made our way through the crowds of “Fußball” fans decked out in black, red and gold as they cheered on Germany in the World Cup, arrived at our last hotel, and enjoyed our last dinner together as a group. The trip was over too soon, but in just two short weeks I met so many amazing people, and perhaps I speak for the whole group when I say that I learned so much about public health, food safety, veterinary medicine, German history, culture and government, and I even learned a lot about myself. It was an unforgettable experience, and I’m glad I was able to share it with such a great group of people!
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