Dr. Margarethe Hoenig; Saturday, June 9, 2012, Arrival in Hannover
We are grateful to our sponsors: Dean Whiteley,University of Illinois College of Veterinary Medicine; Boehringer-Ingelheim; Nestle Purina Company
Most of us arrived at a very similar time at the Hannover airport. Zach and Elizabeth, 2 of the 3 students who attended the program from UGA, had taken a flight out of Atlanta and were delayed by several hours. We packed our luggage in the 2 rented vans and drove straight to our hotel at the Klagesmarkt in downtown Hannover, where we would spend the next 5 days. After getting some rest (many of us had been up at that point for at least 24 hours), we went to a Turkish/German restaurant called Kreuzklappe. We enjoyed the mixture of Turkish and German dishes.
June 10, 2012: Sightseeing in Hannover
Professor Hansjoachim Hackbarth, an expert on animal welfare and one of the professors who was going to teach us the following day (also my good friend and classmate from veterinary school) picked us up at the hotel to show us Hannover.
Hannover on the river Leine, is the capital of the federal state of Lower Saxony(Niedersachsen), Germany and was once by personal union the family seat of the Hannoverian Kings of Great Britain. After the Napoleonic Wars ended, the Electorate was enlarged and made into the capital of the Kingdom of Hannover. With a population of 522,944 the city is a major center of northern Germany, known for hosting annual commercial expositions such as the Hannover Fair and the CeBIT. Every year Hanover hosts the Schützenfest Hannover, the world’s largest Marksmen’s Fun Fair, and the Oktoberfest Hannover, which is the second largest Oktoberfest in the world. In 2000, Hanover hosted the world fair Expo 2000. The Hannover fairground, due to numerous extensions, especially for the Expo 2000, is the largest in the world. Hannover also has regional importance because of its universities and medical school, its veterinary school, its international airport, and its large zoo. The city is also a major crossing point of railway lines and highways (Autobahnen), connecting European main lines in east-west-direction and north-south-direction.
On our tour of Hannover, we went to see the beautiful city hall.
It was built in 1913 but really looks like a palace from older times. We all took many pictures from the outside and inside and admired the amazing architecture. It was also interesting to see a display how Hannover looked before and after the second world war. Hannover was almost completely destroyed in the war. This explains the fact that Hannover is a fairly modern city with broad streets because when it was rebuilt, little constraints of space had been left. From there we saw the Maschsee, a large man-made lake in the middle of Hannover, which is used for all kinds of recreational activities. We went on to see the old center of town where we saw the Portikus of the Leine palace. At the wood market, we saw a fountain of iron, copper, and bronze by Luer (1896), the Leibniz Haus, a masterpiece of reconstruction (now owned by the university and used as guest house), and many beautiful timber houses. The main attraction of the old Hannover is the Marktkirche. This church was founded in the 12th century and formed the heart of the medieval town.
It has a beautiful altar dating back to 1480. We also visited the Aegidienkirche, a church dating back to the 14th century, which was almost completely destroyed in 1943. Only a shell is left. The church tower contains a peace bell, which was a gift from the Hiroshima people. An identical bell is located in Hiroshima. Every year on August 6, Hiroshima Day is celebrated with an hour of remembrance followed by meditations by members of Christian faiths, Islam, Bahai, Buddhism and Zen. The ‘peace bell’ can be heard every hour through out the day.
After a great lunch at the “Brunnenhof” and some delicious ice cream at the railway station, we went to see the Herrenhäuser Gärten.
The gardens are a heritage of the Kings of Hannover and have always been one of the most distinguished baroque formal gardens of Europe. The day ended at Riemann’s Eck, a typical North-German neighborhood restaurant with great food.
June 11, 2012: Elizabeth Dale
Day 2 in Hannover: TiHo to Zoo!
We began the day with a visit to Dr. Hoenig’s alma mater, the charming if difficult to pronounce Tierӓrztliche Hochschule, affectionately known as “TiHo” for short. Founded in 1778 and one of the oldest veterinary schools in Europe, TiHo is a uniquely independent university of veterinary medicine with an extensive organization of 19 Institutes, 6 clinics, 3 specialty areas and 2 field stations. The old campus is a picturesque collection of brick buildings, circa the 1920s, which consist of the cattle clinic, several laboratories, the former equine clinic, and former student dormitories, all surrounded by a wall, creating a cozy village-like setting. There is also a new complex just a couple kilometers away and a teaching farm in Ruthe.
At the new campus, we were met by the gracious Dr. Andrea Tipold, vice president for teaching. Dr. Tipold shared with us the history and structure of the university as well as insight from her own career in veterinary medicine. TiHo enrolls over 2,000 students of which 1.546 are veterinary students in the 5 ½ year program directly following high school, 55 are in a master’s program and 869 are pursuing doctorates in specialized subjects. Similar to the U.S., admission is highly competitive with over 1,500 applicants vying for only 260 spots per year. The student to faculty ratio (1:5) and female to male ratio (~85:15) is also similar as are the most commonly underserved areas –research and food animal medicine. Much to our envy however, the students only pay ~ €1,ooo/year, with the rest of the tuition subsidized by the state. Dr. Tipold, who originally did her thesis on colic in horses, is now a professor of neurology in the center for systems neuroscience with research concentrations in neuroimmunology, steroid-responsive meningitis and Schwann cell transplantation for spinal cord trauma.
Following our chat with Dr. Tipold, the inimitable Dr. Hansjoachim Hackbarth gave us a broad-ranging lecture on animal welfare in Germany and Europe. The Institute for Animal Welfare and Behavior, separated into an institute for farm animals and one for pets, horses, and laboratory animals, does research primarily for horses, environmental improvement for lab animals, and on dog behavior, specifically aggression. One of the center’s and Dr. Hackbarth’s recent successes is the creation of a virtual animal welfare center (accessible at: www.animalwelfarecenter.org) and the passage into law of a dog owner qualification test –ensuring a basic knowledge of nutrition, behavior, and husbandry for any prospective dog owners.
Dr. Hackbarth gave us an extensive overview of the history of animal welfare from the hieroglyphs of the codex Hammarabi through the highlights of its development in Germany. The basis of the modern welfare act in Germany is the “fulfillment of needs and avoidance of harm,” as decribed by the Swiss biologist Tschanz, and it protects the lives and well-being of animals under the care of humans. By the end of this year, the protection of life will extend to the fetus in the last trimester of gestation. We also had an engaging discussion on ethics in medicine covering the different areas of ethics (descriptive, normative, and reflective or methaethics), morals and mores), and how to find the balance between extremist on the emotion end of the spectrum and legal and scientific animal welfare. We also discussed recent hot topics within the EU such as the debate over castration of piglets (soon to cease entirely).
Following a hearty lunch in the vet school’s cafeteria –options included stuffed peppers, soy cordon bleu, and the delicious Southern German specialty “Spӓtzle” (a short pasta, which literally translates as “little sparrow,” served with sautéed onion and cheese (Emmenthaler I believe))- we headed to the Hannover Zoo (English site at: http://www.zoo-hannover.de/?L=1).
At the zoo, our amiable and attentive tour guide was Dr. Maya Kummrow, a swiss veterinarian with experience in Dubai, Tufts University, and the University of Guelph and Toronto Zoo. With the help of one other veterinarian and one tech (both part-time), Dr. Kummrow cares for the impressive collection of over 3,000 animals consisting of 250 different species, mostly mammals. With infectious enthusiasm, Dr. Kummrow told us about the newly formed European College of Zoological Medicine, WAZA (the World Association for Zoos and Aquariums), and the wild and often unpredictable world of zoo medicine. We discussed the WAZA goals for zoos, which include entertainment and education, research and ex situ breeding, and how these goals are carried out in the seven different themed areas of the Hannover zoo: Zambezi (African savannah), Gorilla Mountain, Yukon Bay (Canada), Jungle Palace (India/Asia), Outback (Australia), Mullewapp (children’s petting zoo) and Meyer’s Farm (traditional Lower Saxony).
We first visited the solitary and bellicose endangered Black Rhino and Dr. Kummrow explained the difficulty in dealing with dangerous and often sadly, less fashionable (thus less profitable) species in the zoo and conservancy setting. As we progressed through the zoo on our private tour we discussed the benefits and challenges of multispecies exhibits and natural habitat separations such as dry ditches. Multispecies exhibits such as the African savannah area with Eland gazelles, Thompson Gazelles and Zebras provide important enrichment for the animals but at times also leaves them susceptible to cross-species pathogens, such as the alpha herpes virus, Equine Herpes Virus type I, which killed several Thompson gazelles peracutely and then wiped out the zoo’s guinea pigs after it was shed by the clinically unaffected zebras. The zoo’s main conservancy focus is on North African species and it’s had spectacular success developing a hatching and brooding protocol for the red-necked ostrich and a breeding program for Addax antelope. Also unique to the zoo is a pride of impressive Barbary lions (hunted to extinction in the wild), including two playful adolescent cubs.
In the zoo’s small but well-equipped clinic, Dr. Kummrow shared insight on the difficulty of working with wild and/or extremely large animals, the importance of expert resources such as the clinicians at the nearby vet school, the necessity for flexibility and improvisation. She also shared with us several entertaining anecdotes that illustrated how each case is always a learning experience whether it is orthopedics in wallabies or color-indicated anesthesia in chameleons.
In the Canadian exhibit we learned about neonatal care of the sensitive Caribou. We also saw fearsome timber wolves, jovial polar bears diving in their pool, and the antics of the sea lions. Left to explore the zoo before dinner, we made our way through the remaining exhibits catching glimpses of the tigers and leopards as well as the world record-setting 5 elephant calves and their cows. After rounding off the evening with a walk with the wallabies, we had dinner at the traditional Gasthaus Meyer und Biergarten (Meyer’s guesthouse and beer garden) where the drei reibekuchen (potato pancakes) and weizen bier dunkel (dark wheat beer) were excellent.
June 12, 2012: Laura Ward
University of Veterinary Medicine Hannover, Foundation (TiHo) and Georg–August–University, Göttingen
The weather was beautiful today, and we spent the morning in Hannover touring the TiHo Clinic for Cattle. Then, Prof. Dr. Günter Klein warmly welcomed us to his Institute for Food Quality and Food Safety at TiHo, where we learned about dairy hygiene and enjoyed a beautiful lunch. That afternoon, we travelled to the Georg-August-University Göttingen in Lower Saxony to learn about food quality and engage in some fun activities. It was a very interesting and interactive day!
Klinik für Rinder (Clinic for Cattle, TiHo, Hannover)
This morning, Dr. Klaas Strüve gave us a tour through the cattle clinic, where they see mostly Holsteins (~90%) and some meat breeds. At this facility, education is strongly emphasized, and veterinary students engage in all procedures under doctoral supervision. Students first spend two years in lectures, during which they also observe procedures performed on live animals in a large demonstration hall, and they subsequently observe cases in clinics and write reports on what they have seen. This facility typically sees about 5000 patients and takes 80 to 90 students each year, so students often choose this facility for one of their 10-week rotations. Six to eight cows are set aside specifically for students in practicals, who perform rectal exams every two days and practice staging the estrous cycle. Other major teaching procedures include claw treatments and surgeries, such as abomasal fixations, rumenotomies, amputations, joint flushes, Caesarean sections, and surgical lancing of reticular abscesses. Abomasal fixations comprise ninety percent of the surgeries performed at about 1-2 per day, and endoscopy is also available at the hospital for this procedure. Students are also allowed to perform ultrasonographic examinations to investigate several conditions (e.g. foreign bodies in the reticulum, peritonitis, etc.). Sedation isn’t used during these exams based on the results of recent stress hormone studies, but students are able to use local anesthetics if an animal is painful.
Research is also emphasized at the TiHo cattle facility. We touched on ongoing research in embryo transfer and saw the hospital’s resident fistulated cow (a hermaphrodite!), which serves a dual purpose – s/he primarily provides a source of rumen fluid for patients that are very ill but is also used in research. TiHo also houses the smallest bull station in the European Union with a current total of three bulls. They were formerly used in studies but are presently used for education.
Biosecurity is also an important element of this facility, which was evident from the moment we donned our plastic booties and set foot on the grounds. Two trucks are available for transporting patients to and from the facility, and owners are also given the option of bringing the patients in directly. We were told that 20 years ago, the facility had 6 trucks and saw about 4,500 patients per year; the number of trucks has since decreased as infectious disease control has heightened. The trucks are disinfected between every use, and isolation is a critical aspect of both transportation and hospitalization. There are 60 places for in-hospital patients (although the hospital typically doesn’t see more than 40 at one time), and samples are taken weekly for diseases such as IBR and BHV-1. No equipment is shared between the horse and cow facilities.
In light of the cattle facility’s strong emphasis on education, the services provided here are very low-cost and highly subsidized by the government; for instance, transportation to and from the clinic, surgery, and three days of hospitalization can cost merely 250 euros. This experience provided us with a stark contrast to cattle operations within American universities.
Panīr Manufacture at the Institute for Food Quality and Food Safety
Dr. Nils Grabowski provided us with a fascinating lecture on Indian culture, dairy processing, and panīr manufacture…and then allowed us to make and taste our own panīr!
India is a land of many opposing ideas and languages – there are 415 living languages, several different writing systems, and six major religions. Hinduism and Islam make up the two most practiced religions, respectively, and both strongly revere milk as part of Indian culture, as it can be obtained painlessly and holds religious significance. It is illegal to kill cows in most of India (except after some rituals) as they are venerated as holy, but this presents many problems – namely that old and dry cattle are a burden when one has a family to feed, and these cattle are often abandoned or end up in “cow shelters, which are mostly funded by wealthy Hindus.
India is the leading nation in milk production, producing nearly 40 million tons of cow milk (vs. nearly 30 million tons in Germany) and over 50 million tons of buffalo milk each year! While it is possible to directly consume raw milk, contamination from enteric pathogens and resulting diseases such as Q fever, salmonellosis, brucellosis, and listeriosis are always a concern, especially in children. In the U.S., raw milk can be consumed but not sold; in contrast, raw milk can be sold in Germany but is strongly controlled (e.g. must be sold within 96 hours). Many delectable milk products can be made through standard processing protocols. Milk is heated and stirred to make khoa, a common base for desserts, and different types of khoa are produced using evaporation. Fermentation can reduce the growth of pathogens and yield dahi, which can then be used to produce treats like lassi (dahi and water, fruit, and/or spices) or mishit doi (fermented khoa).
Georg-August- Universität in Göttingen
After we had our delicious lunch, Dr. Carsten Krischek took us to learn about sensory research. Dr. Daniel Mӧrlein, who has worked with the University for 6 years, spoke with us about sensory perception, particularly taste and smell, and how these senses relate to food quality. We engaged in an activity to demonstrate the difference between orthonasal and retronasal olfaction and learned of an experiment performed in the 1930s, which determined that one can’t tell the difference between an apple and an onion without retronasal olfaction. Dr. Mӧrlein then took us into the tasting laboratory, which was engineered to minimize distraction (i.e. isolated booths, vigorous ventilation, controlled lighting), and we proceeded to participate in a taste test trial to distinguish the five different tastes – sweet, salty, bitter, sour, and umami. We established that some tastes require more sample than others and saw how the order of samples could change results in that earlier samples could create references for later ones.
We then participated in a series of odor tests. We began with identification of everyday odors and subsequently took part in the triangle test, the most frequently used test in sensory science. This test uses three samples – two of the same and one different – and the assessor tries the 1st and 2nd samples, then the 2nd and 3rd, and then the 3rd and 1st. This exercise was ultimately used to demonstrate how assessors prefer or accept different concentrations of androstenones and skatoles, two compounds present in the meat of intact boars. Low concentrations of these pheromones are often used in perfume and confections, but they can be aversive to some at higher concentrations.
This is an important current issue for Germany to investigate because the country is aiming to stop the castration of piglets, a common, albeit controversial practice to produce taint-free meat, by 2017.
Pizzeria Bei Mario (Hannover)
We ate dinner in a beautiful area outside this classy pizzeria! There was a variety of Italian-style food on the menu. I had the Montepulciano rot (red wine), mixed salad with yellow and red peppers, mushrooms, onions, tomato, and cucumber, and the asparagus and ricotta ravioli with cream sauce. The company was great, and the food was delicious! Che bellissima!
June 13, 2012: Andrea Lin
Sausage Making at the TiHo
We went to the food science department on TiHo’s campus with Dr. Carsten Krischek to learn how to make sausages. There the butcher, Dietmar Küke, demonstrated the different equipment used to make raw bratwurst. A meat grinder with several cutting blades was used to grind the pork and beef into mincemeat. Since this was a relatively small batch, the butcher mixed the nutmeg, pepper, and salt into the mincemeat by hand. The bratwurst filling was then put into a sausage-filling machine. Bratwurst casing is made from intestine that has been turned inside-out with the mucosa removed. For raw bratwurst the casing used was sheep intestine. The package of casing is opened and placed into a bucket of water to help separate it. The machine extrudes the filling out of the pipe into the casing – a process that was harder than it looked. Once the casing is filled, the end is tied off and the bratwurst is twisted into individual sausages.
The boiled bratwurst was made of beef, pork, buccal fat, back fat, nutmeg, pepper, and salt. Here the meat is a much finer grind so a rotating bowl with a spinning blade is used instead. First the beef and pork are added and finely minced. The blade spins at 3600 rpm so ice is added to prevent the meat from getting too hot. Next the fat was added in and then the spices. Another bag of ice was added to the mix before the last of the meat. Küke said he added a portion of the meat at the end to have a variation in the texture of the meat. The finished filling had a much finer texture than that of the raw bratwurst. We brought the mix back to the filling machine where we got to all try stuffing our own bratwurst. The casing used this time was pork intestine, which is stronger than the sheep intestine. This is necessary to prevent the bratwurst from bursting when it is first boiled. It was also helpful to keep us from accidentally breaking the casing as we tried our hand at stuffing the sausage. This was then boiled for 40 minutes before it was ready to be grilled.
Dr. Krischek then taught us about the sausage production in Germany and the food safety measures. Sausage production is very important in German culture and is referred to as “wurst culture”. There are 3 types of sausage: raw/dry fermented sausage, boiled sausage, raw sausage, along with raw mincemeat. Many people in Germany eat minced meat raw and there are many guidelines for production. Minced meat is defined as de-boned meat minced into fragments with less than 1% of salt and must comply with requirements for fresh meat. It may not have undergone any preserving process other than chilling or freezing. Storage and shipping temperatures of meat is <7ºC for pork and beef, <4ºC for poultry, and <3ºC for offal. Mincemeat should be kept <2ºC or frozen as it is very sensitive to spoilage. One major concern with food safety in this process is the meat grinder. Residual amounts of raw material can get stuck to the grinder and it requires intensive cleaning to prevent contamination.
There is the raw/dry fermented type of sausage which is usually cured, stored unchilled (>10ºC), and consumed raw. It is either in a spread form like “Teewurst” or a sliced form like salami. Discerning selection of meat is important for food safety. The meat can be stored up to 3 days, have low bacterial contamination, good color, a pH of 5.4-5.8, and be chilled or frozen prior to processing. The back fat used needs to be fresh, firm, and white in color. Chilling or freezing the fat prior to making the sausage makes it easier for the machine to slice. Flavorings include salt, pepper, garlic, ascorbic acid “curing help”, a starter culture and <2% carbohydrates for the culture. The starter culture is used for taste, lactic acid production, and competition against unwanted bacteria. The ascorbic acid reduces NO2 to NO and Met-Mb to Mb (myoglobin). This helps the formation of NO-Mb which gives the sausage its red coloring. Thus the curing process affects the color, pH, water activity, and flavor.
When filling the raw fermented sausage it is important to keep it at 3ºC as it is eaten raw. The equipment used to grind and fill sausages is important for all types of sausage. Industrial filling machines use vacuum to avoid creating air bubbles in the casing, which are detrimental to the appearance. Casing types are either natural or artificial. Natural casings are cattle oesophagus, pig jejunum and caecum, or sheep jejunum. The use of cattle caecum and colon is banned in the EU due to BSE. Artificial casings can be made of cellulose, collagen or plastic. Cured sausages need to be dried so the casing type must be water-permeable.
The most common type of sausage is the boiled sausage which use fine or coarse ground meat and can be cured or uncured. “Fleischwurst” for example is a fine-ground sausage and “Weisswurst” is an uncured sausage. The meat requirements are not as strict as in raw sausages. Dark firm dry meat which has a higher pH is allowed. Other ingredients include fat, salt, spices, phosphate for its binding properties and ice. If the filling is too cold it can be difficult to fill so the final temperature should be 12-16ºC. The sausage is then boiled or heat treated to create a stable product that can be sold. These sausages need to be heated again before they are consumed.
Then there are the cooked sausages which are made of cooked or cured meat and cooked fat. Depending on the type of sausage it can also include raw or cooked liver, the gelatin layer under the skin of a pig, blood, vegetables, or aspic/gelatin. The gelatin, liver, or blood serves to bind all the ingredients together. These sausages are filled at a temperature of 40 to 45ºC and cooked again after filling. Blood sausages contain 10-30% blood, which is added cold with citrate for an anticoagulant. The aspic sausages look like jelly with meat pieces suspended in them. Liverwurst naturally contains liver and usually is a soft, spreadable sausage.
Lunch was much anticipated as we were eager to try the sausages we made earlier. We sat at picnic tables set up outside the building close to the large animal clinic. There were bowls of “Krautsalat”, potato salad, and baguettes to go along with the sausages. Hot off the grill the sausages smelled wonderful and were fantastic. Two types of mustard and curried ketchup were passed around the table. The raw bratwurst was very good and the texture of the boiled bratwurst was wonderful. After lunch we thanked the doctors for the wonderful lunch and headed off to the TiHo teaching farm.
Visit of Ruthe, the TiHo-owned farm
met with Dr. Christian Sürie who teaches all the TiHo veterinary students during their time at the farm. Ruthe Farm was opened in 1961 and houses beef and dairy cattle, pigs, laying hens, broiler chickens, turkeys, and peking duck. They used to have Muscovy duck but due to welfare issues and laws in Germany they no longer raise them. There are also sheep and chickens used for human medical treatment research on the premises. The farm also grows barley, wheat, corn, and sugar beets for producing silage to feed their animals. TiHo veterinary students live in the farmhouse and take care of the animals during their 6 week study on animal husbandry. The education goals of the farm also extend to teaching farmers proper animal husbandry techniques and teaching the local youth about where their food comes from. Once a year, Ruthe Farm holds an open house where the public can visit their facilities.
The dairy cattle at Ruthe Farm are housed on two different kinds of bedding – either straw or slurry (manure) with rubber mat stalls. Dr. Sürie spoke of the dilemma between public perception of animal welfare versus what may actually be better for the animals. For example he told us that the public loves to see farm animals on straw bedding. Yet straw bedding provides a great environment for bacteria and easily gets soaked through. The manure is taken to be used as fertilizer for the fields. The rubber matting was made of a similar material as used on all-weather running tracks. While the rubber matting does not look as good visually, it provides comfort and a higher level of hygiene. As Dr. Sürie puts it, everyone in Germany is intent on animal welfare but few understand the science behind it.
The average dairy cow in Germany spends 28 months in milk, which seems very short as it takes 24 months for a cow to grow up. Yet by the end of 28 months the health of the cow is usually fairly poor. Dr. Sürie explains that this may be due to genetics – when breeding, people often look only at milk production without taking other health factors into consideration. At Ruthe Farm the dairy is largely a hands-off operation. They have a 12 year old milking robot which is run by a computer system. The cows wear a belt with a chip that the robot reads providing access to each animal’s history. This ensures that cows don’t get milked too often and also tracks the milk quantity and quality. When a cow first enters, the robot uses 28ºC water to wash the teats. To improve milk quality and safety, the teat milk which is highest in bacteria is stripped and discarded. Then the robot attaches each milk cup using laser positioning to find each teat. The cups drop off as each quarter empties. The amount and quality of the milk from each quarter is measured separately. The milk is only sent off to the bulk tank if it is ok. The robot then rinses each teat and opens the gate to allow the cow to leave. Cows are taught to use the milking robot and they get milked when they choose. Each cow is milked about 3 times a day depending on how much milk the cow is producing. Milking is limited because it is stressful and each time it opens the teats up to possible infection.
Occasionally a cow will return too early simply to eat the sweet feed provided by the machine. In this case the robot will open both front and rear gates to allow another cow to push the first one out. This ensures that the cows never have a negative experience associated with the milking robot.
Next we went to see the laying hens which were all housed in a barn with access to an outdoor mesh-enclosed area. Dr. Sürie told us that in 2010 confinement cages for chickens were banned in Germany. They developed furnished cages, which provide a 90 square cm per hen area to walk, 2 levels of perches, and a 90 square cm per hen scratching area. By 2025 such furnished cages will be banned as well. Ruthe Farm houses chickens in different settings to determine the best ways for their health to manage them. With barn or pasture type housing they saw an increase in aggression. Chickens start by feather-picking which then leads to cannibalism. Since cutting off the top of the beak is also banned, farms lose a lot of chickens to cannibalism. Farm workers need to be very attentive and react quickly to train the chickens to stop their aggressive behaviors.
Visit of Marienburg Castle
We stopped at the Marienburg Castle in Hannover for dinner. This castle was built from 1857 to 1867 in the Gothic Revival architectural style. In the evening the museum is closed while the restaurant stays open. We had the courtyard almost all to ourselves. Dinner was enjoyed and many pictures were taken in the lingering summer sunlight. It was a wonderful end to an extraordinary day.
June 14, 2012: Jennifer La Vigne
After we had breakfast at the hotel, we drove to the Mobile Infectious Disease Center (MEC) in Barme to learn about animal disease control in Lower Saxony, Germany, from Dr. Josef Diekmann. The European Union sets animal health laws for its members regarding movement and import of animals and disease control, which takes priority over national regulations. In Germany, each federal state organizes its own food surveillance and monitoring. In the state of Lower Saxony, the Lower Saxony State Office for Consumer Protection and Food Safety (LAVES) is responsible for monitoring, surveillance, and laboratory analysis of food animal diseases. There are various departments in LAVES which set standards for food surveillance, sample taking, approval of feed and food business establishments, managing epidemics, and setting animal welfare guidelines.
Devastating disease outbreaks of the past like the Foot and Mouth outbreak in the UK in 2001 and Avian Influenza in the Netherlands in 2003 resulted in enormous losses to the livestock industry. These have provided incentive for development of structured crisis management centers and training professionals how to handle future outbreaks. The mobile eradication center is a facility that’s easy to move in the event of a crisis. It provides veterinary materials and protective clothing and allows a response team to collect data from farms and restriction zones and decontaminate materials in order to prevent contamination from farm to farm. In the event of a crisis, the mobile eradication center can be called upon within 24 hours to travel to farms and perform an outbreak investigation and other veterinary services. It was fascinating seeing how well organized the mobile eradication center was and how specific the logistics were in order to rapidly address potential crises and prevent further contamination.
We had sandwiches for lunch at the Mobile Infectious Disease Center and then traveled to the Institute for Milk Analysis in Verden/Aller. First, we learned about the animal tracking system in Lower Saxony. All cattle must receive a ‘passport’ and ear tags no later than one week after birth. Passports include the animal’s barcode, farm ID, name of farmer, date of birth, sex, breed, and Bovine Viral Diarrhea status. Producers are obligated to notify the control database of movement between farmers, dealers, and to slaughter. The local veterinary authority reports unregistered cattle. If an animal is not registered, the farmer loses privilege of owning the animal. Tracking of swine, goats, sheep, and horses is fairly similar.
Jörg Buermeyer gave us a presentation on quality management of the Lower Saxony dairy industry. At this facility, over 3.5 million samples are analyzed each year for levels of fat, protein, urea, somatic cell count, bacteria, and antimicrobials. In Germany, farms must provide milk samples to be tested for fat, protein, and somatic cell count 4 times each month and bacteria and antimicrobials two times a month, minimum. The standards for acceptable somatic cell count, bacteria, and no antimicrobial residues are the same in Germany as in the rest of the EU. The laboratory and technology used for testing was very impressive and we really enjoyed having a tour of the facility!
Next, we went to visit the MARS pet food production plant in Verden and listened to a presentation given by Cornelia Evering about the company. MARS also manufactures chocolate and drinks for human consumption, but 50% of their sales are pet care products. MARS has over 150 scientists working for them to develop wholesome, nutritious food for pets. There are many quality control points and safety parameters set in order to assure their food is produced safely without contamination by pathogens, toxins, or foreign material. Veterinary authorities visit the facility to check the procedures and take samples to evaluate each batch. The MARS facility houses cats and dogs for a food preference study to help with creating new pet food products that are appealing to pets. Health checks are performed on the animals and they are adopted to families after the study is over.
After our MARS visit, we drove back to Hanover to eat a delicious Indian style dinner at Shalimar. We enjoyed our last night in Hanover by walking around the town, eating gelato, and watching the European football tournament.
June 15, 2012: Serena Lawfer
On Friday, June 15th, we drove to Betzhorn, a small village which belongs to Wahrenholz, Germany, to visit Drs. Helmut and Ingrid Surborg. Dr. Helmut Surborg is a veterinary school classmate of Dr. Hoenig’s and practices food animal veterinary medicine. His wife, Ingrid, is a mixed animal veterinarian and their small animal clinic is located within their house. In Betzhorn, we received a tour of a dairy farm owned and operated by Helmut Evers. Mr. Evers started the tour by giving us a history of the farm. The farm has been in his family since 1486 and it was passed onto Mr. Evers from his father in 1985. The farm used to have all kinds of animals, including cows and pigs. Now that Mr. Evers owns the operation, it is primarily a dairy farm. Mr. Evers also works with area farmers to manage the local crop land, where they raise rice, grass for silage, potatoes, sugar beets, wheat, hops, and corn.
Mr. Evers keeps all heifers born on the farm and sells the bull calves by 14 days of age. His herd is considered “closed” since he does not currently buy any cattle from outside sources. Whenever a calf is ID tagged, a piece of ear tissue is sent to the laboratory for BVD testing. The test results are printed onto the mandatory “passports” that are given to each individual bovine.
The calves are kept with their mothers for one feeding and then moved to a separate hutch to be fed colostrum for five more days. The next pen contains calves that are anywhere from five days to five weeks of age. These calves wear transponder neck bands, which enable them to receive milk from a computerized feeder. The following pen contains calves five weeks of age up to five months. They are in an open headlock pen that is covered by a tarp and has an “igloo” hutch. There is a separate pasture for the dry cows and another pen available for cows that are close to parturition. The cows are artificially inseminated, which is performed by Mr. Evers.
The dairy cows are kept in a free-stall barn, with headlocks and a feed alley in between the two pens. Mr. Evers currently milks 66 cows in a herringbone parlor, with six spaces on each side. The cows are milked twice daily and it takes a total of 75 minutes to complete milking. The farm’s milk production is approximately 2100 liters per day. Milk is kept in the bulk tank at 12°C and is picked up by a carrier every two days. It goes to a creamery to make butter as well as to a local bakery. Milk samples of individual cows are taken once a month by the Milk Quality Laboratory.
After completing our wonderful tour of the dairy farm, we then traveled to the local biofuel plant. Area farmers bring their manure to the plant, including Mr. Evers. Six years ago, the mayor of the village came up with the idea of the plant to provide electricity and heat for the village. He then talked to the farmers and got 22 of them to come together and construct it. It is currently operated by a supervisor and workers, most of which are farmers. Our tour guide was a retired farmer who typically works two-to-three hours every week. He did not speak very fluent English; fortunately, Dr. Hoenig came to the rescue and translated for us. He informed us that the corn silage pits were built first, followed by the manure containers. It takes one ton of corn silage to produce two megawatt hours (one ton of corn silage is equivalent to seven tons of manure). The manure is needed to keep the mixture “fluid-like” and 12.5 tons of corn silage is placed into each container to help “stir the manure.” The containers are then kept reasonably full and are emptied only twice a year. They are kept at 40°C to keep an optimum bacterial growth.
The gas within the domes on top of the containers is made up of 50% methane, 47% carbon dioxide, and varying amounts of nitrogen, oxygen, and sulfur. If there’s a problem with the manure, such as antibiotics within the feces that kills the container bacteria, it takes about four weeks to correct the problem. Currently, the regulation of the antibiotics in the manure is an honor system between the farmers. Random sampling occurs periodically. The containers are monitored by a computer and controllers. The generator creates the heat and electricity, providing warm water to be sent to all public buildings and electricity generated for about 2,000 households in Wahrenholz. It is quite fascinating to learn how sustainable energy is being done, even in small cities like Wahrenholz, where there are approximately 5,000 inhabitants!
Once we finished our tour of the biofuel plant, we drove back to Dr. Surborg’s house, where he gave us a presentation on what life is like for a bovine practitioner in Germany. There are currently 13 million cattle in Germany, with 4.1 million dairy cattle. There are all sizes of farms, anywhere from 50 to 220 head. The northern and eastern parts of Germany mainly have Holstein-Frisians and the southern part has Fleckviehs. All medical work on farms is done by the veterinarian and not the farmer. Lameness and mastitis are the top medical problems for dairy farms. Examples of emergency cases for a cattle veterinarian include uterine torsions, caesarean sections, fetotomies, and prolapsed uteruses. Internal medicine cases include retained placentas, metritis, mastitis, hypocalcemia, metabolic disorders, lameness, displaced abomasum surgeries, and reproductive medicine. Umbilical hernias are always brought into the veterinary clinic to receive surgery. Continuing education is 20 hours per year for a regular veterinarian and 40 hours per year for a specialist. Over time, the number of farms has decreased and the numbers of new veterinary graduates have increased. In 1982, Dr. Surborg serviced 160 dairy farms. In 2011, there are only 20 dairy farms left.
After our informational lecture, we received a WONDERFUL lunch at the Surborg home. It was my favourite meal of the entire trip! There was meat, potatoes, broccoli, red cabbage, tomato/corn salad, and French fries. Dessert consisted of vanilla ice cream with strawberries and a luscious sauce.
We then drove to a nearby church, where a stork had built a large nest on top of the chimney. After taking pictures, we went back to the Surborg home and enjoyed coffee and cookies. It was such an amazing experience, thanks to the generous Surborg family, that we sadly bid farewell to them and drove three hours to Berlin, Germany.
Once we arrived in Berlin, we checked into our hotel (near Checkpoint Charlie). After settling in, a small group of us went out to explore the city. We walked around the area and enjoyed a few hours of sightseeing. As the darkness set in, we realized it had gotten quite late and there was not many eating places open. Luckily, there was a McDonalds nearby, so we enjoyed a late-night meal there. Overall, I felt this day was quite eventful! Since I am interested in dairy medicine, I thoroughly enjoyed what I learned!
June 18, 2012: Erika Eigenbrod
After spending a beautiful weekend in Berlin, Monday started bright and early with nice breakfast at our hotel. After breakfast the group loaded our bags into the vans to leave for the three hour drive to the Friedrich Loeffler Institute located on the Island of Riems just outside of the gorgeous sea town of Greifswald, Germany. During the drive we were able to see the German countryside and just how beautiful it was! The old barns, cows grazing in the green pastures and the wild poppies growing along side of the road were picturesque! Once we reached Greifswald we checked into our hotel and headed to the Friedrich Loeffler Institute, which as I said before is located on the Island of Riems. The Island is just outside of Greifswald and can be reached from the mainland by a manmade bridge.
We were greeted by the president of the Friedrich Loeffler Institute, Professor Thomas Mettenleiter, who took time out of his busy schedule to show us the institute and explain its history.
The Friedrich Loeffler Institute was founded by Friedrich Loeffler in 1910 and is under the control of the German Ministry of Food, Agriculture and Consumer Protection. It is the oldest virology research facility and the island is sometimes referred to as the “island of viruses,” or “Island of plagues.” Friedrich Loeffler worked with Robert Koch and in the Late 1880’s moved to Greifswald. In the early years, the animals in Loeffler’s experiments were housed in barns in the middle of Greifswald. There was little to no biosecurity and he was order to stop his experiments due to outbreaks of Foot and Mouth disease. He moved his experiments to the Island of Reims which is where it remains today.
Loeffler is credited for the discovery of the causative agent of diphtheria (Corynebacterium diphtheriae). Loeffler and Paul Frosch’s experiments found that Foot and Mouth disease was caused by a particle smaller than bacteria using a system of filters and that’s why many consider him the founder of virology. In 1938 and Foot and Mouth vaccine was created on the island and Foot and Mouth disease along with many other viral diseases continue to be a major areas of research for the institute.
The rest of our first day on Riems consisted of a seminar on International Animal Health given by Wolfgang Bochle and a tour of Riems. The seminar discussed different projects going on in the world to eradicate or at least control diseases both zoonotic and non-zoonotic. The Friedrich Loeffler Institute opened a new building (which among others contains a BSL4 facility) on October 10, 2010, exactly one hundred years after Friedrich Loeffler started working on the island. Several other new buildings are in process.
As we were driving from the island you could see sail boats in the water and Dr. Hoenig pointed out Denmark and the Island of Rugen. The rest of the evening was spent in Greifswald. The group ate together at a local brewery where I ordered a Zwicklefritz to drink. It is a lighter beer, and was very tasty. The restaurant is right on the cobblestone square, which is lined with beautiful buildings. Greifswald is home to the University of Greifswald and after dinner the group was given some free time to explore. Greifswald is a quiet little town in the northern part of Germany located in the German Federal state of Mecklenburg-Vorpommern. As we were walking up and down the cobblestone streets, stopping to get ice cream and window shopping, I could help but feel that it was a perfect way end to the day in Greifswald, Germany.
June 19, 2012: Jilliam Zientek
Friedrich Loeffler Institut – Day #2
After our fascinating introduction and tour of the FLI on Monday, we returned to Insel Riems for the privilege of spending the day with a number of the FLI staff, who presented to us on various topics of interest and study at the FLI. The amount of information we’ve received each day on this trip is truly fantastic, and it’s been incredibly humbling to be in the presence of experts who have shaped the field of veterinary medicine and public health. Along those lines, we had the once-in-a-lifetime opportunity to attend the inaugural Loeffler Lecture, given by internationally renowned influenza specialist Dr. Ron Fouchier. This day was full of fascinating information, stimulating discussion, and of course, great food!
Lecture #1: Transmissible Spongiform Encephalopathy (TSE)
Given by: Dr. Anna Buschmann
Dr. Buschmann is the Deputy of the FLI Institute for Novel and Emerging Infectious Diseases, a department that had its beginnings in addressing and responding to TSEs, including Scrapie and BSE (“Mad Cow” Disease). Since these beginnings, this department has expanded to include many other new and emerging infectious diseases.
Responding to the BSE Crisis: Although the UK is perhaps the most notorious country impacted by the BSE crisis, the whole of Europe was greatly impacted by this disease. In Germany, greater than 50% of the animals diagnosed were healthy slaughter animals, identified during mandatory screening of carcasses. The implementation of mandatory screening of cattle above a certain age (72mo for healthy slaughter animals, 48mo for risk animals) was one of the eradication measures implemented early in the crisis, in January 2001. FLI plays an important role in facilitating this measure as the reference laboratory for BSE testing – as such, repeat positives identified at local labs by rapid testing come to FLI for confirmation.
Testing for BSE:
- Local laboratories use a Protein Kinase K-dependent rapid test: normal prion protein is PKK-labile, but the altered prion protein in an animal with BSE is not.
- FLI uses a variety of other confirmatory methods such as histopathology, electron microscopy, and – most commonly – immunohistochemistry or SAF-immunoblot.
- The obex region of the brain is the optimal sample site for classical BSE – this is where the protein is most readily found.
The second measure in responding to the BSE crisis was removal of specified risk materials from the food supply – these include the skull, vertebrae, tonsils, and small intestine. The only difference in these rules from the United States standards is the removal of the entire small bowel: in the US, only the ileum is removed. These standards were built upon BSE pathogenesis studies conducted at FLI, which identified Peyer’s patches in the gut as the route of infection in calves. Interestingly, however, the pathogenesis studies never demonstrated infectivity via the lymphoreticular system – instead, once the prions have been absorbed via Peyer’s patches, they travel via the alimentary nervous system and eventually the splanchnic and vagus nerves to infect the CNS. These studies also found that in late stage (ie symptomatic) disease, spillover from the CNS could result in the presence of prion protein in peripheral nerves and muscles (until then, it is confined to the CNS). Frighteningly for those of us who consume red meat in the US, infectivity studies did demonstrate an infective load in the gut outside of the distal ileum. Infectivity of the tongue has also been called into question, as some cultures consume tongue. While no PrPsc could be detected in the tongue, the mouse bioassay from this site was in fact positive.
The final measure in Germany’s BSE eradication effort was a ban on the feeding of animal-derived protein and fat to livestock. Currently, this measure is in debate regarding the feeding of processed animal protein to aquaculture and fish.
Atypical BSE is a current buzz topic in US news, as several cases were recently diagnosed in California. Dr. Buschmann touched on the pathophysiology of this disease, which differs from the typical form in several ways:
- There are two types of atypical BSE, the H-type and the L-type, depending on the molecular weight of the protein involved
- The anatomical distribution in the brain is different, such that the obex region is not diagnostic. This has important implications for the rapid testing.
- This form of disease is only seen in older cattle, and is thought to develop spontaneously.
- During pathogenesis studies, animals exposed to infectious doses of atypical BSE prions develop disease faster than expected.
That said, typical and atypical BSE are impossible to differentiate based on clinical picture, and infectivity distribution in the tissues is the same.
In contrast to BSE in cattle, TSEs in small ruminants are detectable in peripheral nerves, lymph nodes, and muscles – this more disseminated distribution represents a greater risk to the consumer. In small ruminants, BSE cannot be differentiated from scrapie based on clinical signs. This lecture was the first time I’d heard about atypical Scrapie, which is much less resistant to protein kinase K digestion and may therefore go undetected by rapid tests. This form of Scrapie heavily affects the cerebellum, and can occur in all sheep, even those of the ARR genotype, which are typically considered resistant to Scrapie.
Lecture #2: Foot and Mouth Disease (FMD)
Given by: Dr. Bernd Haas, Institute of Diagnostic Virology
Given the intimate role of FMD in the founding and history of FLI and Insel Riems, it seems only appropriate that we learn about the current research addressing this disease. FMD is a very challenging virus in that the seven serotypes, 46 topotypes, and hundreds of sublineages and strains make a universal vaccine impossible. It is dangerous due to its characteristics such as low infectious dose, high virus excretion and aerosolization, environmental stability, creation of subclinical carriers, and tropisim in a variety species. In addition, in both pigs and sheep, the peak of viral excretion precedes clinical signs. FLI studies have determined that pigs excrete about 1000X more virus than cattle. Other studies at FLI demonstrated that esophageal samples from cattle and sheep showed intermittent shedding of the virus for months to years following infection.
Perhaps the most unique research conducted by FLI regarding FMD is that done in wild boars. FLI maintains a herd of wild boars for research purposes (pictured below), and has demonstrated that while these animals are highly susceptible to infection with FMD, they remain quite ambulatory despite the presence of lesions on their feet. Their behavior is so unaffected that diseased animals are difficult to detect until closely examined. This finding suggests that these wild animals could play an important role in spreading the disease should an outbreak occur in Europe.
Epidemiology of FMD is very different between the developing world and the developed world. The “red belt” of FMD encompassing North Africa and the Middle East describes regions where FMD is endemic. In the Eurozone, the current fear of incursion is focused on spread from Turkey or introduction by smuggled feedstuff belonging to refugees from endemic areas. An outbreak in a developing nation generally follows a typical epidemic curve and control revolves around culling, with the greatest concern being overwhelming of rendering capacity. The decision regarding whether or not to vaccinate is guided by population density, the availability of a suitable vaccine, and the distribution of the outbreak. FMD must be handled in BSL3+ laboratories, which makes studying this agent quite cumbersome and expensive.
As such, the study and regulations surrounding BSE are a hotbutton political issue. Testing of vaccines costs millions of Euro, and EU trade restrictions are very strict. Dr. Haas was refreshingly frank and candid regarding the external factors governing the study of this disease. This open discussion of political issues and how they impact scientific activities and other aspects of the field is something that seems common to many German academics and professionals – in stark contrast to American classrooms, where elaboration of such issues is often regarded as inappropriate or taboo. As such, Dr. Haas’ willingness to openly discuss these factors prompted many questions from the students, and a lively discussion of sociological factors governing vaccine use, trade restrictions, and other intersectional issues ensued.
Lecture #3: Schmallenberg Virus
Given by: Dr. Martin Beer, Head of the Institute of Diagnostic Virology
Dr. Beer shared with us the fascinating story behind the discovery of this emerging disease. Schmallenberg is a disease of ruminants similar to bluetongue, causing fever, decreased milk production, and diarrhea. Milking robots, which are gaining popularity in Germany, were instrumental in detecting this cluster of clinical signs. Concerns at the beginning of the outbreak included BHV and Rift Valley Fever, but exhaustive diagnostic evaluation turned up completely negative for known agents. As such, the hunt for a new agent began.
Metagenomics. It was a word I had vaguely heard before, but probably couldn’t have defined before this lecture. Metagenomics refers to the process of analyzing a host sample with new sequencing technology, which utilizes software to distinguish host nucleic acids from pathogen. This software than uses a server to compare to a database. Within hours of beginning the metagenomic analysis, a novel Akabane virus had been identified & sequenced, and PCR primers could be developed. Utilizing this technology, only 2-3 weeks elapsed between first detection and virus isolation – astounding speed when compared with “old” methods of virology. Interestingly, this virus was only able to replicate on Culicoides cell lines, not any of the mammalian cell lines such as bovine or hamster. This pointed towards an insect vector.
Meanwhile, the saga of the new disease took a dramatic twist and reared its ugly head in a new way: horrendously malformed lambs were being born to sheep in the affected area. Up to 50% of lambs on some farms were born with the classical clinical signs: arthrogryphosis, torticollis, and hydrancephaly. Although the virus has been isolated, the pathogenesis of both the diarrhea and disease in cattle and the malformation in sheep remains unknown.
Thanks to metagenomics, diagnostics such as RT-PCR and a serological assay (neutralization) were rapidly developed. The virus has spread quickly despite the short viremia, implicating replication within the Culicoides vector.
This lecture was fascinating not only because it provided a real-world introduction to metagenomics, but because it detailed an emerging disease issue in such recent history. In many of our classes, we are used to hearing about notable outbreaks from the distant past, and seeing the dates from 2011 and 2012 on Dr. Haas’ slides was an unsettling reminder than emerging diseases are a reality of the present and future, not just the past.
Lecture #4: Avian Influenza
Given by: Dr. Timm Harder, Institute of Diagnostic Virology
FLI boasts the OIE/FAE reference laboratory for Avian Influenza. As its’ director, Dr. Harder gave us a great overview of the pathobiology and clinical picture of Type A influenza, and proceeded to discuss the issue as it pertains to Germany. All infections of AI in Germany are the result of introduction by wild birds. As such, surveillance efforts for HPAI revolve around passive surveillance of wild birds.
Lecture #5: Rabies
Given by: Dr. Thomas Müller
Dr. Müller gave us an informative overview of Rabies with a focus on how the disease burden differs between Europe and the developed world as compared to the developing world. In the early 1980s, rabies remained widely distributed in Europe, whereas today it has basically disappeared from western Europe. This eradication success is largely attributable to legislation such as sanitary policy, dog registration, and movement restrictions.
The unfortunate caveat to this success story is that fox rabies has arisen as dog rabies declined. Conventional “elimination” efforts resulted in decimation of the fox population but were ineffective at controlling the disease. The problem was most effectively addressed in the 1970s by oral vaccination campaigns. Switzerland was the first to show field viability of the oral vaccinations. For an oral vaccination campaign to be successful, large-scale efforts must take place, requiring strong political support. In the case of fox rabies, Switzerland, Germany, and France became the driving force behind the oral vaccination campaign. In the current moment, EU support for the ongoing effort remains crucial, and legislation governing pet travel and financing have been integral to its success.
In the developing world, human rabies remains a major problem. Greater than 90% of human rabies deaths occur in Asia and Africa, and more than half of these occur in children less than 15 years old. Dog bites account for the overwhelming majority of human rabies deaths, and the great bulk of these occur in rural areas where access to post-exposure prophylaxis is essentially nonexistent. Dr. Müller attributes the ongoing problem with rabies in certain countries to a “circle of neglect”, and suggested that the key to human rabies control is canine rabies control.
Lecture #6: Pathology Overview and Insel Riems Trivia
Given by: Dr. Jens Peter Teifke
Dr. Teifke capped off our day of lectures at FLI with a whirlwind overview of various animal diseases, pathology, and Insel Riems history. We learned that the quaint city of Greifswald where we’d been staying boasts one of the oldest universities in Germany and even in Europe, the Ernst Moritz Arndt Universität Greifswald. We discussed the pathological and clinical findings of Rabbit Hemorrhagic Disease, which provides a good potential model for human hemorrhagic diseases. We heard about the 2006 H5N1 outbreak in swans near Insel Rügen, which sparked rumors of a biosecurity breach at FLI (these were false, of course). This grab-bag of applied pathology was an ideal capstone to a day of learning in the Loeffler house!
The First Annual Loeffler Lecture
Topic: The Influenza Virus Riddle – Pandemic Potential or Not?
Presenter: Dr. Ron Fouchier, Erasmus University, Rotterdam
After a brief break to spend some time in downtown Greifswald, a quaint and cobblestoned little square, we attended the First Annual Loeffler Lecture at the Alfried Krupp Wissenschaftskolleg. Dr. Fouchier was named one of Time Magazines 100 Most Influential People this past year for his work studying the evolution of pandemics in humans. His research team investigates species jumps and tries to predict disease spread, and their recent focus is H5N1 influenza.
Since its first recognition in Hong Kong in199, H5N1 has been documented in numerous countries on three continents. This virus circulates primarily in poultry but transmission events to mammals, including humans, have been highly lethal. This begs the question: Could H5N1 cause the next pandemic?
To answer this question, Dr. Fouchier’s research team first determined what the virus would need to acquire for human-to-human transmission:
- Replication in the upper respiratory tract
- Replication at high titers
- Shedding of single particles (to facilitate aerosolization)
His lab demonstrated that when the virus is serially passed between ferrets (the current model for human infection), it naturally acquires adaptation to the upper respiratory tract, easily meeting the first criteria. When these adapted viruses were sequenced, the researchers discovered that the newly transmissible virus had only undergone five mutations from the wildtype virus to gain this adaptation – all of these occurred in the hemagglutinin protein. Frighteningly, sequence comparison to circulating strains identified viruses in Japan and Mongolia that only needed three more mutations to acquire this ability. This points strongly to a pandemic potential for the virus.
Dr. Fouchier’s lab become somewhat notorious when Science imposed a moratorium on the publication of their research, due to fears that in the wrong hands, his research could contribute to manipulation of these viruses by bioterrorists. When addressing these concerns, Dr. Fouchier pointed out that any one with the tools to study and synthesize these viruses already has the tools to do the work that he did. Moreover, he made the strong point that the conduction and communication of this work is the only way to advance scientific understanding of this important disease threat.
This talk sparked a lively discussion of research ethics and the principles behind Dr. Fouchier’s work. Afterwards, Laura, Elizabeth, and I got a great picture with Dr. Fouchier, who is incredibly tall in addition to being incredibly intelligent!
We capped off a brilliant day of lecture and discussion with a fantastic dinner at the Hotel Utkiek. Everyone enjoyed wonderful seafood dishes while watching the sunset over the Baltic. Thus ended another truly fantastic day on our journey!
June 21, 2012: Ian Sweeney
Today we drove to the Berlin-Marienfelde location of the Bundesinstitut fur Risikobewertung (BfR), which roughly translates to the Federal Institute for Risk Assessment. The location is west of the former Berlin wall by about 1 km, and the facilities appeared modern and spacious. Juergen Thier-Kundke, of the Press and Public Relations unit, kindly gave us a tour of the main grounds. They have facilities for lectures and offices, as well as for research, which is their primary focus.
After showing us around, Juergen gave us a talk about the history and function of the BfR. It was founded in November, 2002 when the Federal Institute for Health Protection of Consumers and Veterinary Medicine was reorganized. The BfR is essentially the Risk Assessment arm of the former agency, and the Risk Management duties fall on a different organization. This makes the BfR free to conduct independent scientifically based studies without political influence. It is also entirely funded from public sources, and can therefore be independent from private influence as well. The independence of this agency from outside influence has been very deliberately structured so as to eliminate any doubt of bias of their research and risk communication.
The main areas of work for the BfR include food safety (microbial and chemical) and risk assessment, safety of chemicals, plant products and biocides, and safety of selected consumer products and products that contact people indirectly. They are also responsible for independent risk communication, meaning that they do not need oversight or permission from governing bodies or from higher up in the Health Organization. However, they can only give advice; they do not have the power to enforce recalls. And they are responsible for conducting research independent of academic or private research. They also run National Reference Laboratories which monitor infectious pathogens such as Salmonella and E. coli and review methods being used for research of these pathogens. Another area of work is on alternative methods to animal research, which address some animal welfare concerns, but also reduces the cost and time of conducting risk assessment studies.
After Juergen’s talk, we were introduced to Dr. Katrin Stolle from the research coordination unit, who gave us a talk on their research and international collaborations. We were reminded that their main focus is producing quality scientific data for risk assessment, and that any research they do is independent by design. Although they do conduct their own research experiments, they also gather data from other sources, such as the scientific literature, routine surveillance, and self-assessments. The research they conduct is focused on refining methods used in their reference laboratories, supplying data for risk assessments, creating a base of knowledge for communication and perception of risk, and reducing the need for animal experimentation. Much of the national research they conduct is centered in one of their 14 National Reference Laboratories, each of which is focused on a particular pathogen or product. They are also involved in several international research products, including some for QSAFFE (which is a European Collaboration for monitoring food safety), a study on ESBL and flouroquinolone resistance in Enterobacteriaceae, and a study looking for MRSA in the food chain. These international studies are primarily done in coordination with other international laboratories, and funding for these studies comes from sources like the EU, or the European Food Safety Authority (EFSA). The BfR works particularly close with the EFSA, and data sharing, research coordination, working groups and pacts are commonplace between the two agencies. Katrin also talked about the role of the BfR in the EHEC outbreak last year, in which they established a joint committee with the Robert Koch Institute to research the origin of the outbreak, conducted an epidemiological study, and were ultimately able to trace the outbreaks back to one farm that had produced sprouts from Egyptian seeds.
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After these two talks, we were brought over to the laboratories where some of the National Reference Laboratories are centered, and we donned lab coats for a tour. Dr. Alexandra Fetsch from the Microbial Toxins unit was kind enough to take us on an extensive tour of the Staphylococcal reference laboratory, including where specimens were first cultured and isolated, and where further identification tests, PCR, and resistance testing were run. They were primarily focused on monitoring Staphylococcus aureus strains for antimicrobial resistance, especially for methicillin resistance. Specimens are collected from production animals directly (ie; cattle, swine, etc.) using nasal and anal swabs, from the environment of farms and slaughterhouses, and from samples of meat. If Staphylococcus is isolated, they run PCR and look for the presence of the mecA gene, which is a mobile genetic element which confers methicillin resistance to the bacteria. Then they are further typed based the spa (staphylococcal protein A) gene, and in some cases by multiplex PCR (if it is of particular interest). The result is a comprehensive food chain monitoring program for MRSA. The results they have found are surprising; apparently in Germany 60% of farms have MRSA in the environment, 80% of slaughterhouses test positive for MRSA, and about 10-20% of consumer ready meat is also positive for MRSA.
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The next tour was of the National Reference Laboratory for antimicrobial resistance, which was given by Dr. Andreas Schroeter of the Antibiotic Resistance and Resistance Determinants unit. He also gave us an informative and thorough explanation of what his laboratory did using Salmonella as an example. When they receive a sample, they identify it based on serotype, then on phage type. Once they have established this, they identify whether it is a wild type strain or a vaccine strain. Once they have adequately identified the strain, they run the isolate through a serotiter machine to determine the resistance profile, which they then record. We were shown the lab where they do all of the identification, as well as the resistance profiles. They are also responsible for running similar identification tests and resistance profiles on other food-borne pathogens such as Campylobacter and E. coli. Monitoring these bacteria for resistance is an important for monitoring animal health and food safety. Researchers at the BfR are not only concerned with resistance in these pathogen species, but also hope to gain insight into the resistance present in commensal bacteria of the gastrointestinal system.
After touring the National Reference Laboratories, we had one more lecture given by Eline Basilio-Janke, who gave us a presentation to illustrate food safety studies performed by her unit, Safety in the Food Chain. After the Deep Horizon Oil Spill in the Gulf of Mexico, concern has been focused on the impact of a large oil spill on food derived from the ocean, especially fish and shellfish. In response, the BfR did a study to evaluate the potential for different oil constituents to be concentrated in sea-life (bioconcentration) after dispersants have been used to solubilize spilt crude oil. Based on past studies, they focused on poly-aromatic hydrocarbon compounds (PAHs), which are considered to be the most toxic constituent of crude oil, and of these they focused on four PAHs which as a group are considered to be a good marker of total PAH concentration (there are 16 priority pollutant PAHs). They also chose a scenario that would mimic a North Sea oil spill, using the PAH profile of North Sea oil as the basis for their experiments. From this study, they were able to determine that shellfish, especially mussels, tend to accumulate PAHs much more than fish. With this information the BfR has been able to prioritize the testing of mollusks, especially mussels, in its planned monitoring of the impact of an oil spill on food safety.
<a title=”June_21_3 by Illinois College of Veterinary Medicine, on Flickr” href=”http://www.flickr.com/photos/illinoisvetmed/7950897746/”><img src=”http://farm9.staticflickr.com/8176/7950897746_73760fcea1.jpg” alt=”June_21_3″ width=”500″ height=”334″ /></a>
Before we wrapped up our visit, we said our goodbyes and visited the on-sight cafeteria at the BfR for lunch. The rest of the day we had to ourselves in Berlin. Some of us went shopping for gifts, while others saw some of the sights they weren’t able to see over the weekend. Dinner was on our own as well, and some of us chose sushi, while others explored the music festival taking place that evening in Berlin. Berlin has a lot to see, so it was easy to find things to do.
June 22, 2012: Anna Jeffers
Today we had the pleasure of visiting the Koch Institute and the Berlin Zoo.
I was particularly excited for the Koch Institute, not only because it is named after a brilliant epidemiologist but because of its crucial role in controlling and preventing disease in Germany. We heard fascinating talks from Dr. Klaus Stark, Dr. Tanja Ducomble, and Hendrik Wilking, who discussed the Koch Institute’s role in public health as well as their own research.
The Koch Institute tracks epidemiological data across Germany, providing regular reports for the scientific and medical community and writing medical recommendations for local practitioners. In addition to commonplace outbreaks such as food-borne illnesses and annual influenza, the Koch Institute has preparation strategies for high-risk exotic threats such as Ebola virus.
Our hosts spoke on such diverse topics as the role of vaccination in reducing Salmonella enteritidis infection to the presence of Yersinia enterocolitica in German wildlife. I was surprised to learn that Lyme disease is a problem in Germany as well as in the United States, though ticks in the region carry Borrelia species unknown in the United States, such as Borellia garinii.
After a morning of stimulating scientific discussion, we took the metro to the Berlin Zoo, stopping for lunch at the nearby train station. I was surprised at the variety and quality of affordable food near the metro – I would never dream of finding such tasty curried tofu at Atlanta’s MARTA stations. During the afternoon, we were guided through the historically rich Berlin Zoo by biologist Dr. Renate Foerg. Dr. Foerg spoke candidly about the museum’s history and the problems a modern zoo faces.
Some of the exhibits were very old, such as the giraffe exhibit, which dates back to 1871. I was struck by the fact that several of the habitats feature simulated human dwellings – the giraffe habitat looks like a Middle Eastern palace, for example. Dr. Foerg explained that this is a feature of the changing values of zoos, shifting away from exhibits shaped to human tastes towards more natural imitations of the animals’ homelands.
A particularly charming sight was that of the life-sized bronze statue of a hippo named Knautschke. During the second World War, the zoo was struck by bombs, and Knautschke was thought dead. To the surprise and delight of many, Knautschke actually wandered down to the local train station and survived on his own for several days. This famous hippo bred 34 offspring and lived to the ripe age of 45, five years longer than average.
Dr. Foerg candidly discussed issues such as overcrowding and euthanasia in zoos. One disadvantage of the Berlin Zoo’s location in the heart of the city is that they are unable to expand outward. Instead, the zoo keepers must carefully manage the space they have and
limit breeding that isn’t necessary for conservation. It was clear from Dr. Foerg’s statements that animal welfare is an important issue for the zoo.
Overall, today was an exciting, informative day, and I could have spent weeks discussing infectious disease with the Koch Institute’s scientists, or combing through the diverse wildlife exhibits at the Berlin Zoo.
The evening was spent writing “thank you” notes to our gracious hosts who spent their time so generously with us and enjoying our last German meal together. Joining the University of Illinois Study Abroad Germany program has been one of the best decisions I have made as a veterinary student.
Germany 2012 Summer Summary: Alison Hadden
Through the generous donation of the Study Abroad Stipend, I was able to spend two weeks in July at the University of Veterinary Medicine, Hanover. The University of Veterinary Medicine Hannover helped me with housing, so I was able to stay in an apartment literally across the street from the small animal clinic. During my time at the hospital, I observed and volunteered on an anesthesia rotation and on a small animal reproduction rotation.
On the anesthesia rotation, I was able to intubate animals, place IV catheters and give IM and IV drugs as well as participate in morning rounds and teaching rounds. I was also able to scrub into and assist in surgeries. It was great to see the similarities and differences between the teaching hospitals in Illinois and Hanover. On the reproduction service I was able to perform vaginascopy exams, prepare and look at vaginal cytology, and assist the clinicians with patients in routine reproductive exams. In addition to the clinical skills that I was able to practice, being at a teaching hospital in another country gave me a great appreciation for how other hospitals and schools are set up.
The University of Veterinary Medicine in Hannover has a brand new teaching hospital with state of the art equipment and technology. One of the aspects of the hospital that struck me the most was how cat-friendly the hospital is. The owner check-in and waiting area is comprised of many small rooms with noise-proof doors so owners can wait with their animals in private. Once admitted to the hospital, cats are taken to a ward two floors above the dogs, also with sound proof doors. There are multiple small rooms in the cat ward, which hold two to four cages, but also have windows and space for the cats to walk around. During my time at the teaching hospital, most of the cats were able to have their own room—while they had beds set up in stainless steel cages, the cage doors were open and they had IV extension sets long enough to be able to get up and walk around the room. Litter boxes were placed outside the cages, which gave the cats significantly more space. Cats that were considered to be painful were given multimodal analgesia that most often included methadone as the opioid. Between the housing set up, pain control and the extreme sensitivity by all members of faculty, staff and students to treat each cat calmly, gently, and with respect (and not as small dogs!), these were the happiest, most relaxed, least stressed cats I have ever seen in an animal hospital.
Overall, the University of Veterinary Medicine was a wonderful place to be. It was great to be able to practice and learn clinical skills, as well as seeing how much impact different set ups and ideas can benefit the patients. Everyone I encountered, from my roommates in the apartment, to the administration who helped me get organized, to the clinicians, professors and students, was enormously friendly and helpful. It was an amazing experience.