Case Study – Germany

  • Christine Uhlenhaut
  • Lars Schaade
  • Ernst-Jürgen Finke
Conference paper
Part of the NATO Science for Peace and Security Series A: Chemistry and Biology book series (NAPSA)


Public health structures in Germany reflect the federal system: health care in general lies within the responsibility of the 16 constituent states and the federal government only acts if a state asks for assistance. There were no bioterror-related intentional releases of biological agents in Germany in recent years. The potentially devastating effects of such an incident require sound public health preparedness planning. The Basic Constitutional Law (Grundgesetz) does not allow the deployment of armed forces within Germany with some rare exceptions. However, there is a well-established civil-military cooperation. The Federal Armed Forces (Bundeswehr) are deployed in humanitarian and multinational UN or NATO crisis containment missions abroad, requiring adequate protection from pathogens and diseases endemic or enzootic to those regions. Both, the military and the civil public health system are complex structures that contain administrative, care giving, medical investigation, and research capabilities in order to cope with natural, accidental or intentional biological incidents.


Japanese Encephalitis Virus Francisella Tularensis Crimean Congo Hemorrhagic Fever Eastern Equine Encephalitis Virus Variola Virus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Allert B (2011) NATO Disease Surveillance Seminar. Medical Corps International Forum (mcif) 3./4.-2011, 70–71. Accessed 21 Dec 2011
  2. 2.
    Australia Group (2011). Accessed 21 Dec 2011
  3. 3.
    Balabanova Y, Gilsdorf A, Buda S, Burger R et al (2011) Communicable diseases prioritized for surveillance and epidemiological research: results of a standardized prioritization procedure in Germany. PLoS One 6:e25691PubMedCrossRefGoogle Scholar
  4. 4.
    BBK (2007) Handbuch für den Bevölkerungsschutz: Biologische Gefahrenlagen, and Biologische Gefahren II. Entscheidungshilfen zu medizinisch angemessenen Vorgehensweisen in einer B-Gefahrenlage, BonnGoogle Scholar
  5. 5.
    BMBF (2011) 21 Dec 2011
  6. 6.
    Bundeswehr (2006) Weißbuch 2006. MmUzMzMyMmUzMTM1MzMyZTM2MzEzMDMwMzAzMDMwMzAzMDY3NmE2ODY1NmQ2NzY4MzEyMDIwMjAyMDIw/WB_2006_dt_mB.pdf.Accessed 20 May 2012Google Scholar
  7. 7.
    Bundeswehr (2011a) Numbers of German personnel deployed on the various missions. "!ut/p/c4/NY1BC4JAFIT_0T6tCOpWhNClLlHZZVndpz7SXXn7VJB-fCvRDMzAfIeBF0Q7M1JthLwzLTwhL2lfTKroxloFKhvkBklC71sSeiskF4zMuhqQtUWnKyaM_QMoM8aVdTE4i2HChuGxnFhUpXcoSwo6oZg1G_Gses_SLmRgjkSRhTxJT8ckTf5KP9vNPbutNuvd-ZJdoe-6wxeABEql/"/> .Accessed 21 Dec 2011Google Scholar
  8. 8.
  9. 9.
    Bundeswehr (2011c) Accessed 21 Dec 2011
  10. 10.
    CDC (2011) Bioterrorism agents/diseases Accessed 22 Oct 2011
  11. 11.
    Dando M, Pearson G, Kriz B (eds) (2001) Scientific and technical means of distinguishing between natural and other outbreaks of diseases. NATO science series. 1. Disarmament technologies, vol 35. Kluwer Academic Publishers, Dordrecht/Boston/LondonGoogle Scholar
  12. 12.
    Darai G, Handermann M, Sonntag HG, Zöller L (eds) (2011) Lexikon der Infektionskrankheiten des Menschen – Erreger, Symptome, Diagnose, Therapie und Prophylaxe. Springer, BerlinGoogle Scholar
  13. 13.
    Fock R, Koch U, Finke EJ, Niedrig M et al (2000) Schutz vor lebensbedrohenden importierten Infektionskrankheiten: Strukturelle Erfordernisse bei der Behandlung und anti-epidemische Maßnahmen. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 42:891–899Google Scholar
  14. 14.
    Fock R, Bergmann H, Bussmann H et al (2002) Influenza pandemic: preparedness planning in Germany. Eurosurveillance 7(1):1–5PubMedGoogle Scholar
  15. 15.
    Gastmeier P, Geffers C (2008) Nosokomiale Infektionen in Deutschland: Wieviel gibt es wirklich? Eine Schätzung für das Jahr 2006. Dtsch Med Wochenschr 133:1111–1115PubMedCrossRefGoogle Scholar
  16. 16.
    Geffers C, Gastmeier P (2011) Nosocomial infections and multidrug-resistant organisms in Germany: epidemiological data from KISS (The Hospital Infection Surveillance System). Dtsch Arztebl Int 108:87–93PubMedGoogle Scholar
  17. 17.
    Gottschalk R, Grunewald T, Biederbick W (2009) Aufgaben und Funktion der Ständigen Arbeitsgemeinschaft der Kompetenz- und Behandlungszentren für hochkontagiöse, lebensbedrohliche Erkrankungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 52:214–218PubMedCrossRefGoogle Scholar
  18. 18.
    Grolla A, Lucht A, Dick D, Strong JE et al (2005) Laboratory diagnosis of Ebola and Marburg hemorrhagic fever. Bull Soc Pathol Exot 98:205–209PubMedGoogle Scholar
  19. 19.
    Grunow R, Finke EJ (2002) A procedure for differentiating between the intentional release of biological warfare agents and natural outbreaks of disease: its use in analyzing the tularemia outbreak in Kosovo in 1999 and 2000. Clin Microbiol Infect 8:510–521PubMedCrossRefGoogle Scholar
  20. 20.
    Hauri AM, Hofstetter I, Seibold E, Kaysser P et al (2010) Investigating an airborne tularemia outbreak, Germany. Emerg Infect Dis 16:238–243PubMedCrossRefGoogle Scholar
  21. 21.
    Hellenbrand W (2003) Neu und vermehrt auftretende Infektionskrankheiten. Gesund-heitsberichterstattung des Bundes No. 18. Robert Koch Institute, BerlinGoogle Scholar
  22. 22.
    Krause G (2008) How can infectious diseases be prioritized in public health? A standardized prioritization scheme for discussion. EMBO Rep 9(Suppl 1):S22–S27PubMedCrossRefGoogle Scholar
  23. 23.
    Laude G, Ammon A (2005) Die Nationalen Referenzzentren und Konsiliarlaboratorien. Bedeutung und Aufgaben. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 48:998–1004PubMedCrossRefGoogle Scholar
  24. 24.
    Mertens M, Wölfel R, Ullrich K, Yoshimatsu K et al (2009) Seroepidemiological study in a Puumala virus outbreak area in South-East Germany. Med Microbiol Immunol 198:83–91PubMedCrossRefGoogle Scholar
  25. 25.
  26. 26.
    Podbielski A, Herrmann M, Kniehl E, Mauch H (eds) (2008) Qualitätsstandards in der mikrobiologisch-infektiologischen Diagnostik. MiQ 26. Hochpathogene Erreger, Biologische Kampfstoffe, Teil I-IV. Elsevier, MunichGoogle Scholar
  27. 27.
    Riem J, Scholz HC, Rahalison L, Pfeffer M et al (2010) Validation von Real-time-PCR-Verfahren zur Detektion/zum Nachweis von Yersina pestis in klinischen Untersuchungsmaterialien von Patienten mit Verdacht auf Beulenpest. Wehrmed Monatsschr 54(3):79–82Google Scholar
  28. 28.
    Rimoin AW, Kisalu N, Kebela-Ilunga B, Mukaba T et al (2007) Endemic human monkey pox, Democratic Republic of Congo, 2001–2004. Emerg Infect Dis 13:934–937PubMedCrossRefGoogle Scholar
  29. 29.
    RKI (2006) Gesundheit in Deutschland. Accessed 20 May 2012
  30. 30.
    RKI (2007a) Epidemiologisches Bulletin 35/2007. Accessed 20 May 2012
  31. 31.
    RKI (2007b) Nationaler Influenzapandemieplan. Accessed 21 May 2012
  32. 32.
    RKI (2010a) Epidemiologisches Bulletin 2/2010. Accessed 21 May 2012
  33. 33.
    RKI (2010b) Epidemiologisches Bulletin 14/2010. Accessed 21 May 2012
  34. 34.
    RKI (2010c) Epidemiologisches Bulletin 49/2010. Accessed 21 May 2012
  35. 35.
    RKI (2011a) Epidemiologisches Bulletin 46/2011. Accessed 21 May 2012
  36. 36.
    RKI (2011b) Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2010. Accessed 21 May 2012
  37. 37.
    RKI (2011c) Das Bund-Länder-Rahmenkonzept zu notwendigen fachlichen Vorbereitungen und Maßnahmen zur Seuchenbekämpfung nach bioterroristischen Anschlägen. Teil: Pocken. Accessed 21 May 2011
  38. 38.
    Schmidt S, Wölfel R, Mossbrugger I, Zöller L (2011) State-of-the-art procedures for in-the-field and stationary laboratory diagnosis of biological agents. Suppl. to mcif 3./4-2011: CHALLENGE: International Forum for Medical Biological Defence. 1/2001 19–22Google Scholar
  39. 39.
    Schmoldt S, Thoma BR, Wölfel R, Georgi E, et al (2011) Coping with quality management requirements in the laboratory diagnosis of biothreat agents and agent-related health disorders. Medical Biological Defense Conference 2011, Munich, 25–28 October 2011, Abstract 0080, in: Medical Corps International Forum 4/4 (2011), Suppl. 30Google Scholar
  40. 40.
    Scholz GJ, Sefrin P, Böttiger BW, Dörges V, et al (eds) (2012) Notfallmedizin, in preparationGoogle Scholar
  41. 41.
    Scholz HC, Joseph M, Tomaso H, Dahouk A et al (2006) Detection of the reemerging of Burkholderia mallei in a recent outbreak of glanders in the United Arabic Emirates by a newly developed fliP-based polymerase chain reaction assay. Diagn Microbiol Infect Dis 54:241–247PubMedCrossRefGoogle Scholar
  42. 42.
    Schutzkommission BMI (ed) (2010) Katastrophenmedizin Leitfaden für die ärztliche Versorgung im Katastrophenfall, MünchenGoogle Scholar
  43. 43.
    Sohns T, Voicu VA (eds) (1999) NBC risks – current capabilities and future perspectives for protection. NATO science series. 1. Disarmament technologies Vol. 25. Kluwer Academic Publishers, Dordrecht/Boston/LondonGoogle Scholar
  44. 44.
    Splettstoesser WD, Matz-Rensing K, Seibold E, Tomaso H et al (2007) Re-emergence of Francisella tularensis in Germany: fatal tularaemia in a colony of semi-free-living marmosets (Callithrix jacchus). Epidemiol Infect 135:1256–1265PubMedCrossRefGoogle Scholar
  45. 45.
    Statistisches Bundesamt (2010) Statistisches Jahrbuch 2010. Accessed 11 May 2011
  46. 46.
    Thibault, FM (2011) RDOIT: the NATO toolbox for suspect outbreak investigation. Medical Biodefence Conference 2011, Munich, 25–28 October 2011, in: Medical Corps International Forum 4/4-2011/Supplement 15Google Scholar
  47. 47.
    Wölfel R, Paweska JT, Petersen N, Grobbelaar AA et al (2009) Low-density macroarray for rapid detection of and identification of Crimean-Congo hemorrhagic fever virus. J Clin Microbiol 47:1025–1030PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Christine Uhlenhaut
    • 1
  • Lars Schaade
    • 1
  • Ernst-Jürgen Finke
    • 2
  1. 1.Centre for Biological SecurityRobert Koch InstituteBerlinGermany
  2. 2.Scientific consultant in medical biological defenceMunichGermany

Personalised recommendations