Niedersächsisches Landesgesundheitsamt (NLGA)

Institute website in English

Contact person

Elke [dot] Mertensnlga [dot] Niedersachsen [dot] de (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 five departments:

• Dep. 1: Infectious Disease Epidemiology, Surveillance, Health Protection; Digitisation.
• Dep. 2: Laboratories for Virology, Bacteriology, NGS
• Dep. 3: Environmental Health (e.g. environmental medicine, hospital hygiene).
• Dep. 4: Drinking and Bathing Water Hygiene, Microbial Monitoring.
• Dep. 5: Health Monitoring and Prevention (e.g. epidemiology of non-communicable diseases, Trust Authority of the Register for cancer in Lower Saxony (EKN))
• Dep. Z: Administration (e.g. internal organisation, personnel management, budget, education and professional training, and health communication/internet).

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 Infectious Disease Epidemiology 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, one statistician, and one geographer at the department, all of whom are happy to support the EPIET fellow. This is fostered by well-established networking with four microbiologists and three WGS-Experts from the Laboratory department in the same building.

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: four (cohort 2014, 2018, 2020, 2023)

Number of PAE fellows trained at the institute: five (cohort 2008, 2010, 2012, 2016, 2022)

Number of EPIET alumni working at the institute: none

Number of PAE alumni working at the institute: two

• Acknowledged by EPIET
• Available for next EPIET cohort

Project Proposals 2026

Surveillance projects

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 like the electronic outbreak reports of the local health departments
• To develop graphical representation of the outbreaks in maps (requires application of R-software)

Evaluation and further development of the infectious disease dashboard 

A Dashboard displaying reported numbers on infectious diseases in Lower Saxony was implemented at the NLGA in 2025. The fellow will conduct an evaluation mainly regarding the benefit for the PH authorities (and a needs assessment of the PH authorities) at local and federal state level.

Dashboard Infektionskrankheiten 

Epidemiological and Molecular Surveillance of carbapenemases gene in Acinetobacter spp. and Enterobacterales in Hospitals in Lower Saxony (CaReNi)

Development and implementation of a surveillance system regarding carbapenemases genes in Acinetobacter spp. and Enterobacterales. A design for Acinetobacter surveillance was developed in 2019. The tasks now are a) to update the methodology and to include Enterobacterales and b) to implement the new system in cooperation with the bacteriology and NGS colleagues at NLGA. 

 

Research Projects

Estimation of frequency of vaccination complication and injuries from two data sources by capture-recapture-method

Germany has a notification system for vaccination complications and injuries and a separated system for another system to apply for compensation for vaccination injuries. Aims and objectives:

• To analyse the data of both data sources concerning distribution of vaccines and type of injuries.
• To perform a linkage of the anonymous datasets to identify the intersection and derive estimates for the number of unreported cases in each system according to a capture-recapture approach.

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/vaccination readiness 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 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 with additional focus on estimation bias

• NLGA runs a sentinel surveillance system for influenza and other acute respiratory infections with pediatricians including laboratory investigation of swabs and collection of data on vaccination status. 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)
• To assess the methodology of estimation the vaccine effectiveness with respect to estimation biases by using current and historical estimates since 2010

Establishment of a procedure for infectious disease monitoring through media reports/event-based surveillance 

NLGA has access to the media monitor for Lower-Saxony as well as to EIOS.

Aims and objectives

• To develop, to implement and to 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.

Addressing current research questions with the NLGA’s online panel HuGO*

HuGO *consists of approx. 1500 participants and mirrors the main groups in the population of Lower Saxony. The fellow 2026 can use the HuGO-Panel to conduct surveys addressing current research questions. For example, the panel can be deployed as control group for outbreak investigations.

* Hygiene und Gesundheit Online Panel in Niedersachsen

Further projects 

• Seroprevalence of antibodies against different infections in blood samples of blood donors (from 2018, measles, rubella and mumps, west Nile, HEV, tickborne encephalitis)
• Knowledge, attitude, and perception (KAP) of general practitioners towards the prescription of oral antibiotics
• Evaluation of the NLGA ARI surveillance, conducted since 2004
• Evaluation of the NLGA Norovirus surveillance, conducted since 2010
• Participation in the routine monitoring of STD
•  Evaluation of vaccine damage reports from the regional office for social welfare (in Lower Saxony)
• Developing an automated method used for diagnosis in the Meningitis and Encephalitis Registry of Lower Saxony (MERIN) (as an alternative to manual expert ratings) 
• Collaboration with the NLGA department of Non-Communicable Diseases (NCD), for example regarding Long Covid 

Ideas from fellows are welcome