Averting Identifying health trends biological dangers and preventive measures The Institute

A man buys castor beans online and manufac- What do children in this country weigh? How and identifies developments that urgently need 1891 Founding of the “Königlich Preußische Institut für The Robert Koch Institute (RKI) monitors public tures ricin. Then he orders material for a cluster does social status influence well-being? What is to be investigated. Moreover, at RKI, National Infektionskrankheiten” (Royal Prussian Institute health. It is the Federal Government’s central bomb. When a special commando unit arrests Castor beans the state of adult psychological health – in short, ­Diabetes Surveillance is being established to for Infectious Diseases) with Robert Koch as ­institution in the field of biomedicine: its core

him in Cologne in summer 2018, the RKI’s task M. Schuppich Fotolia, how are people in doing? RKI has the map the burden of the disease and the care ­Director. He heads the institute until 1904 mission includes the detection, prevention and force is at the ready. In protective clothing they answers: nationwide federal health reporting and ­quality experienced by roughly seven million combatting of infectious diseases as well as the 1905 Robert Koch receives the Nobel Prize in Medicine for and their colleagues from the Bundeskriminal- If there is the suspicion of a bioterror attack RKI health monitoring are signature activities at the adults with diabetes in Germany. improvement of the health situation in Germany. his discovery of the tuberculosis pathogen in 1882 amt – the Federal Criminal Police Office – scour experts support the security services. The insti- institute. RKI epidemiologists study health trends The focus is on research: approximately half of the flat, collect samples and take them to tute is the German centre for the detection, as- and risks. Their findings help form the basis for 1933 During the Third Reich the institute is substantially the roughly 1,200 members of staff are scientists. for analysis. sessment and handling of biological threats. decision-making by government and other actors involved in the National Socialist politics of violence RKI advises the specialist public and government ­Scientists collate information on highly-patho- on issues like preventative measures and the tar- and functions as an important interface in relations 1952 RKI becomes part of the new Federal Health Office ‘It is the responsibility of genic agents and toxins, draw up recommenda- geted development of healthcare. with international actors, such as the European protection to be prepared for events involving tions for protective measures, and offer courses 1978 A new laboratory building at the Nordufer site Centre for Disease Prevention and Control (ECDC) highly pathogenic agents.’ for the emergency services. Employing a whole ‘RKI is data-driven. With our innovative ­becomes operational – one of the most modern and the World Health Organisation (WHO). It is Professor Dr Lars Schaade, Vice President of RKI raft of measures, they are able to identify patho- research data management, we can record in Europe also very active in training scientists and has a gens quickly and efficiently and thus avoid false and evaluate health trends even better.’ broadly-based portfolio of educational opportu­ 1982  Following the first cases of AIDS in Germany, an The term “dirty dozen” refers to a group of patho- alarms. Professor Dr Lothar H. Wieler, President of RKI nities. AIDS case registry is established at RKI gens and poisons that, at least in theory, could be used for terrorist attacks. They include an- RKI does not, however, only focus on attacks, be- Most people in Germany are in good health or 1994 The Federal Health Office is dissolved; RKI is www.rki.de/en THE INSTITUTE FOR PUBLIC HEALTH thrax bacteria, the plague and tularaemia, the cause all pathogens that can be used for attacks very good health and it is pleasing to note that charged with a second major topic: non-commu-  @rki_de Edgar Zippel smallpox and Ebola viruses, the bacterial poison, occur in nature and can trigger spontaneous they reach a greater age. The result of this, how- nicable diseases Examination during RKI health monitoring botulinum toxin, and also the plant poison, ricin. outbreaks. Scientists therefore investigate dis- ever, is that chronic illnesses like cardiovascular The Robert Koch Institute 2001 The new Protection against Act (IfSG) eases like anthrax, botulism and Ebola in order diseases, cancer and diabetes mellitus are on the The publications on health reporting are largely reinforces RKI’s portfolio to understand them better. increase. Scientists want to elucidate the risk fac- based on the data from RKI’s own health moni- Nordufer site, Berlin-Wedding tors relating to these diseases and thus create toring. For this purpose, many thousands of 2003 Launch of the longitudinal study of child and Highly pathogenic viruses like Ebola are studied the preconditions for healthy ageing. ­children, adolescents and adults in the whole of ­adolescent health, KiGGS in the institute’s high-security laboratory, or BSL-4 Germany are regularly examined and inter- 2008 The Bundestag resolves to develop the institute laboratory, for short. The laboratory is hermeti- Almost half a million people per year are diag- viewed. Amongst other things, RKI teams test into a modern Public Health Institute cally sealed off from the rest of the building and nosed with a malignant tumour. RKI’s Centre for physical fitness, register mental health, allergies, staff working there wear full-body protective suits Cancer Registry Data bundles the data from the nutritional and lifestyle habits as well as analyse 2014 RKI helps to contain the largest ever Ebola with their own air supply. After work, several whole of Germany, assembles an overall picture blood and urine samples. outbreak in West Africa minutes are spent in a special shower where 2015 A new laboratory building housing a BSL-4 they are decontaminated. ­laboratory is opened at the Seestraße site

2019 RKI establishes its Centre for International Health Institute 2019 Robert Koch RKI’s BSL-4 laboratory Protection Fighting Analysing Global health Avoiding hospital-acquired infectious diseases data streams protection and antibiotic resistance

The virus strikes in winter, usually at the very start Traffic movements, commodity flows, genome A village in Guinea in December 2013: Whilst In the high-risk regions of Africa, RKI teams Every year in Germany, some 400,000 to 600,000 where the resistant pathogens occur, how their of the New Year. It surges through Germany, year analysis, climate and geo-information: in the digital playing, a two-year-old comes into contact with a search for unknown pathogens in the animal patients are thought to catch infections whilst in spectrum of resistance mutates, and how many after year, sweeping along millions of people in its age, masses of data are generated every day which, bat. A few days later, the child dies, as do his sis- kingdom that could be a danger to humans. RKI hospital – usually surgical site infections after antibiotics are used in Germany’s hospitals: im- wake: the flu (influenza). The influenza experts at when properly evaluated, can help to identify health ter, his mother and his grandmother. This was staff help to fight disease outbreaks – including operations, urinary tract infections and pneumo- proper use of drugs promotes the development the Robert Koch Institute have been monitoring hazards more quickly and precisely. RKI scientists ­almost certainly the start of the worst Ebola epi- the Ebola epidemic in West Africa and the plague nia. Approximately 10,000 to 15,000 of them die. of resistance. the course of flu epidemics for years. They pre- want to open this treasure trove of data – with the demic ever, as scientists at RKI have deduced outbreak on Madagascar in 2017. They also help pare weekly situation reports for Germany, inves- aid of digital epidemiology. Artificial intelligence, from their studies. In 2014/15, more than 39,000 partner countries to build modern laboratories More stringent hygienic measures, such as im- The ways in which the pathogens spread can tigate which flu viruses are in circulation and data science, bioinformatics algorithms and mathe­ people in West Africa contracted the disease. and train colleagues on the spot – in diagnosing proved hand hygiene in all patient contact, could ­be traced in their DNA. It has long been known check the efficacy of the flu vaccine. Electron microscopy matical modelling are some of the methods for shutterstock, Daniel Fung that antibiotic-resistant bacteria are not only National Reference Centres and Consultant Labo- tomorrow’s health protection. passed from person to person but also between ‘From viruses in body cells to obesity in the ratories specialising in various pathogens: scien- hospitals and old people’s homes or by travel- population – RKI investigates disease on all tists investigate how viruses, bacteria, fungi, prions ‘Artificial intelligence opens up completely new lers. Methicillin-resistant Staphylococcus aureus levels.’ and parasites are transmitted and how they can paths in epidemiology.’ (MRSA) is an example of antibiotic-resistant bac- Professor Dr Lothar H. Wieler, President of RKI be diagnosed and rendered harmless. And when Professor Dr Lothar H. Wieler, President of RKI teria that also occur in animals such as pigs and an infectious disease does break out somewhere fattening poultry. RKI therefore advocates a one In order to quickly identify trends and outbreaks, in the world, RKI infection epidemiologists assess Take the example of genome analysis: nowadays, health approach: human, animal and environ- nationwide infection monitoring – also known as the actual risk to Germany and decide what meas- modern sequencers can unravel the entire genome mental health are closely connected – the prob- surveillance – is essential. Data on notifiable dis- ures should be taken – if necessary, they help to of a bacterium in no time – often several million lem of antibiotic resistance can only be solved if eases like HIV, tuberculosis, tick-borne encepha­ fight the outbreak on the spot. building blocks of DNA. One single experiment everybody works together. litis and EHEC from the whole of the country are easily produces huge volumes of data. Using spe- pooled and evaluated at the institute. RKI hosts RKI also continually evaluates the efficacy of vacci- cial computer algorithms RKI bioinformaticians The global flight network Examining a bat in Guinea Ebola virus Traces of bacteria on a hand nations such as those against rotavirus and the can filter out the crucial information, such as speed. At local level, the same is true for commut- Whether we are looking at Ebola viruses, flu patho- Dengue virus in Sri Lanka, for example. Further- avoid some of these infections. The RKI-based human papilloma virus (HPV). These studies help which bacterial strain is responsible for an out- er movements in buses and trains. In order to gens or multi-resistant germs, never has it been more, the institute keeps an eye on non-commu- Commission for Hospital Hygiene and Infection the Standing Committee on Vaccination (STIKO), break and whether it is resistant to antibiotics. ­assess the trends better, scientists can also link easier for pathogens to spread than in our mo- nicable diseases – obesity and cancer have long Prevention (KRINKO) draws up recommenda- an independent expert commission, to adapt its several different data sources, such as air network bile, interconnected world of today. In order to since ceased to be the prerogative of rich indus- tions deriving from studies which present the vaccination recommendations on an annual basis. With these new methods it is even possible to data with data on pathogen genomes and infor- recognise and address health hazards in good trialised countries. most up-to-date medical knowledge. The insti- RKI scientists also monitor vaccination coverage predict epidemic dynamics. The international mation from social media. At the same time, the time, a robust health system is indispensable. tute also prepares a list of disinfectants und in Germany where young people, for example, are flight network, for example, covers thousands of institute’s own research data management ensures The Robert Koch Institute cooperates with part- In its role as the German point of contact for ­disinfection methods that are used for officially often insufficiently protected against , lead- airports, and several billion passengers travel that the diverse research data are well structured ners all over the world to reinforce local systems global health protection, RKI is also an important prescribed measures. ing to repeated measles epidemics. around the world every year. Air network data re- and connected so that they can be used sustaina- and thus pull together to improve the health of collaborative partner for ECDC and WHO in veal the routes which spread infectious diseases bly by scientists worldwide. everyone. ­areas such as measles surveillance, international Some infections are very difficult to treat: ever like influenza across the globe – and at what outbreak control, and advice on new biological more frequently, pathogens like Klebsiellae or ‘RKI is an international hub of health hazards. certain E.coli bacteria are proving to be unaffect- protection.’ ed by conventional antibiotics. RKI experts study EHEC bacteria Professor Dr Lothar H. Wieler, President of RKI these bacteria and collect nationwide data on