Gerard Krause

Helmholtz Centre for Infection Research | HZI · Department of Epidemiology

The majority of Hepatitis E Virus (HEV)-related studies are carried out in adults whereas information about HEV seroprevalence, clinical disease manifestation, molecular epidemiology, and transmission patterns in children is limited. To estimate HEV seroprevalence among scholar children living in an urban setting and to analyze risk factors for an...

Current estimates of pandemic SARS-CoV-2 spread in Germany using infectious disease models often do not use age-specific infection parameters and are not always based on age-specific contact matrices of the population. They also do usually not include setting-or pandemic phase-based information from epidemiological studies of reported cases and do...

Throughout the SARS-CoV-2 pandemic, Germany lacked an adaptive population panel for epidemic diseases and a modelling platform to rapidly incorporate panel estimates. We evaluated how a cross-sectional analysis of 9922 participants of the MuSPAD study in June/July 2022 combined with a newly developed modelling platform could bridge the gap and anal...

Background School-level infection control measures in Germany during the early Coronavirus Disease 2019 (COVID-19) pandemic differed across the 16 federal states and lacked a dependable evidence base, with available evidence limited to regional data restricted to short phases of the pandemic. This study aimed to assess the (a) infection risks in st...

SARS-CoV-2 variants accumulating immune escape mutations provide a significant risk to vaccine-induced protection against infection. The novel variant of concern (VoC) Omicron BA.1 and its sub-lineages have the largest number of amino acid alterations in its Spike protein to date. Thus, they may efficiently escape recognition by neutralizing antibo...

Lyme borreliosis is the leading tick-related illness in Europe, caused by Borrelia Burgdorferi s.l.Lower Saxony, Germany, including its capital, Hanover, has a higher proportion of infected ticks thancentral European countries, justifying a research focus on the potential human consequences. Thecurrent knowledge gap on human incident infections, pa...

Background Lyme borreliosis (LB) is the most common tick-borne infectious disease in the northern hemisphere. The diagnosis of LB is usually made by clinical symptoms and subsequently supported by serology. In Europe, a two-step testing consisting of an enzyme-linked immunosorbent assay (ELISA) and an immunoblot is recommended. However, due to the...

Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to...

Während der Gesetzgeber im Rahmen der Pandemie in viele Lebensbereiche weitreichende eingriff, traf er kaum Regelungen zur Digitalisierung des öffentlichen Gesundheitsdienstes (ÖGD). Die immer noch heterogenen IT-Strukturen des ÖGD müssen zugunsten einer einheitlichen, zentral betriebenen open source Anwendung überwunden werden. Ein künftiges digit...

The German National Cohort (NAKO) is a multidisciplinary, population-based prospective cohort study that aims to investigate the causes of widespread diseases, identify risk factors and improve early detection and prevention of disease. Specifically, NAKO is designed to identify novel and better characterize established risk and protection factors...

Haemodialysis patients respond poorly to vaccination and continue to be at-risk for severe COVID-19. Therefore, dialysis patients were among the first for which a fourth COVID-19 vaccination was recommended. However, targeted information on how to best maintain immune protection after SARS-CoV-2 vaccinations in at-risk groups for severe COVID-19 re...

We thank van Tongeren et al for responding to our study on occupational disparities in SARS-CoV-2 infection risks during the first pandemic wave in Germany (1). The authors address the potential for bias resulting from differential testing between occupational groups and propose an alternative analytical strategy for dealing with selective testing....

Background Haemodialysis patients are at-risk for severe COVID-19 and were among the first to receive a fourth COVID-19 vaccination. Methods We analysed humoral responses by multiplex-based IgG measurements against the receptor-binding domain (RBD) and ACE2-binding inhibition towards variants of concern including Omicron in haemodialysis patients...

Background: Lyme borreliosis is the most prevalent vector-borne disease in Europe, and numbers might increase due to climate change. However, borreliosis is not notifiable in North Rhine-Westphalia (NRW), Germany. Hence, little is known about the current human seroprevalence in NRW. However, the proportion of Borrelia burgdorferi sensu lato-infect...

Background The rapid emergence of the omicron variant and its large number of mutations led to its classification as a variant of concern (VOC) by the WHO. Subsequently, omicron evolved into distinct sublineages (e.g. BA1 and BA2), which currently represent the majority of global infections. Initial studies of the neutralizing response towards BA1...

Objective The aim of this study was to identify the occupational risk for a SARS-CoV-2 infection in a nationwide sample of German workers during the first wave of the COVID-19 pandemic (1 February–31 August 2020). Methods We used the data of 108 960 workers who participated in a COVID follow-up survey of the German National Cohort (NAKO). Occupati...

Background Hepatitis E virus (HEV) infection is responsible for inflammatory liver disease and can cause severe health problems. Because the seroprevalence of HEV varies within different population groups and between regions of the continent, we conducted a systematic review on the topic in order to provide evidence for targeted prevention strategi...

Background: The Surveillance Outbreak Response Management and Analysis System (SORMAS) contains a management module to support countries in epidemic response. It consists of documentation, linkage, and follow-up of cases, contacts, and events. To allow SORMAS users to visualise data, compute essential surveillance indicators, and estimate epidemio...

Background There remain gaps in quantifying mortality risk among individuals co-infected with chronic hepatitis B (HBV) and human immunodeficiency virus (HIV) in sub-Saharan African contexts. Among a cohort of HIV-positive individuals in Rwanda, we estimate the difference in time-to mortality between HBV-positive (HIV/HBV co-infected) and HBV-negat...

In recent years, software has evolved from being static, closed source, proprietary products to being dynamic, open source, ecosystems contributing to the global good. To this end, the open source software (OSS) solution and global good, Surveillance Outbreak Response Management and Analysis System (SORMAS), rapidly adjusted to the demands of the C...

Introduction Epidemiological data collection is often challenged by low response and, in the case of cohorts, poor long-term compliance, i.e. a high drop-out. For the correct recording of incident or recurring health events, that are subject to recall difficulties, gathering of data during the event and immediate response of the participants is cru...

Across European countries, there have been large differences in COVID-19 case fatality risk (CFR) estimates, and considerable variation in these estimates over time. CFR estimates vary depending on both the method used for estimation and country-specific characteristics. While crude methods simply use cumulative total numbers of cases and deaths, t...

Introduction Currently, information on infection and transmission risks of students and teachers in schools, the effect of infection control measures for schools as well as the contribution of schools to the overall population transmission of SARS-CoV-2 in Germany are limited to regional data sets restricted to short phases of the pandemic. Method...

The rapid emergence of the Omicron variant and its large number of mutations has led to its classification as a variant of concern (VOC) by the WHO. Initial studies on the neutralizing response towards this variant within convalescent and vaccinated individuals have identified substantial reductions. However many of these sample sets used in these...

BACKGROUND The Surveillance Outbreak Response Management and Analysis System (SORMAS) contains a management module to support countries in epidemic response. It consists of documentation, linkage and follow-up of cases, contacts, and events. To allow SORMAS users to visualise, compute key surveillance indicators and estimate epidemiological paramet...

Background Gaining oversight into the rapidly growing number of mobile health tools for surveillance or outbreak management in Africa has become a challenge. Objective The aim of this study is to map the functional portfolio of mobile health tools used for surveillance or outbreak management of communicable diseases in Africa. Methods We conducte...

Background: SARS-CoV-2 variants accumulating immune escape mutations provide a significant risk to vaccine-induced protection. The novel variant of concern Omicron (B.1.1.529) has to date the largest number of amino acid alterations in its Spike protein. Thus, it may efficiently escape recognition by neutralizing antibodies, allowing breakthrough i...

Introduction: Current estimates of pandemic spread using infectious disease models in Germany for SARS-CoV-2 often do not use age-specific infection parameters and are not always based on known contact matrices of the population. They also do not usually include setting-based information of reported cases and do not account for age-specific underde...

Introduction: Current estimates of pandemic spread using infectious disease models in Germany for SARS-CoV-2 often do not use age-specific infection parameters and are not always based on known contact matrices of the population. They also do not usually include setting-based information of reported cases and do not account for age-specific underde...

Background While SARS-CoV-2 vaccinations were successful in decreasing COVID-19 caseloads, recent increases in SARS-CoV-2 infections have led to questions about duration and quality of the subsequent immune response. While numerous studies have been published on immune responses triggered by vaccination, these often focused on the initial peak resp...

BACKGROUND: Case detection is an important part of TB control programmes. In 2007, the TB programme in Ghana join the WHO´s public-private partnership with community medicine outlet operators to increase referral of persons with presumptive TB for laboratory investigation. Information on factors likely to influence referral is scarce in Ghana. We a...

Objectives Using secondary data from 208 079 Rwandans, we determined the prevalence of chronic hepatitis B virus (HBV) infection among high-risk groups and its demographic, geographical and health-related determinants. Design In this cross-sectional study, we obtained and analysed data from a national hepatitis B vaccination and screening campaign...

Background: Until now, information on the spread of SARS-CoV-2 infections in Germany has been based mainly on data from the public health offices. It may be assumed that these data do not include many cases of asymptomatic and mild infection. Methods: We determined seroprevalence over the course of the pandemic in a sequential, multilocal seropr...

Patients undergoing chronic hemodialysis were among the first to receive SARS-CoV-2 vaccinations due to their increased risk for severe COVID-19 disease and high case fatality rates. To date, there have been minimal longitudinal studies in hemodialysis patients to ascertain whether protection offered by vaccination is long-lasting. To assess how su...

Background: Patients with chronic renal insufficiency on maintenance haemodialysis face an increased risk of COVID-19 induced mortality and impaired vaccine responses. To date, only a few studies have addressed SARS-CoV-2 vaccine elicited immunity in this immunocompromised population. Methods: We assessed immunogenicity of the mRNA vaccine BNT16...

Background Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, intensive care unit (ICU) admission, and death due to COVID-19 is required for deriving national and international recommendations on primary targets for non-pharmacological interventions (NPI) and vaccination strategi...

Background Patients with chronic renal insufficiency on intermittent hemodialysis face an increased risk of COVID-19 induced mortality and impaired vaccine responses. To date, only few studies addressed SARS-CoV-2 vaccine elicited immunity in this immunocompromised population. Methods We assessed immunogenicity of the mRNA vaccine BNT162b2 in at ri...

SARS-CoV-2 is evolving with mutations in the receptor binding domain (RBD) being of particular concern. It is important to know how much cross-protection is offered between strains following vaccination or infection. Here, we obtain serum and saliva samples from groups of vaccinated (Pfizer BNT-162b2), infected and uninfected individuals and charac...

Background For the safety monitoring of vaccinations postlicensure, reports of adverse events after immunization (AEFIs) are crucial. New technologies such as digital mobile apps can be used as an active approach to capture these events. We therefore conducted a feasibility study among recipients of the influenza vaccination using an app for assess...

Prevalence of SARS-CoV-2 antibodies is an essential indicator to guide measures. Few population-based estimates are available in Germany. We determine seroprevalence allowing comparison between regions, time points, socio-demographic and health-related factors. MuSPAD is a sequential multi-local seroprevalence study. We randomly recruited adults in...

BACKGROUND Gaining oversight into the rapidly growing number of mobile health tools for surveillance or outbreak management in Africa has become a challenge. OBJECTIVE The aim of this study is to map the functional portfolio of mobile health tools used for surveillance or outbreak management of communicable diseases in Africa. METHODS We conducte...

Introduction: Antibiotic resistance is a serious threat to global public health. It reduces the effectiveness of treatments for serious bacterial infections and thus increases the risk of fatal outcomes. Antibiotic prescriptions are often not in line with clinical evidence-based guidelines. The process of emergence of resistant bacteria can be slow...

The presence of antibodies against endemic coronaviruses has been linked to disease severity after SARS-CoV-2 infection. Assays capable of concomitantly detecting antibodies against endemic coronaviridae such as OC43, 229E, NL63, and SARS-CoV-2 may help to elucidate this question. We developed a serum screening platform using a bead-based Western b...

The SARS-CoV-2 pandemic virus is consistently evolving with mutations within the receptor binding domain (RBD) being of particular concern. To date, there is little research into protection offered following vaccination or infection against RBD mutants in emerging variants of concern (UK, South African, Mink and Southern California). To investigate...

The humoral immune response to SARS-CoV-2 is a benchmark for immunity and detailed analysis is required to understand the manifestation and progression of COVID-19, monitor seroconversion within the general population, and support vaccine development. The majority of currently available commercial serological assays only quantify the SARS-CoV-2 ant...

T cell immunity is central for the control of viral infections. To characterize T cell immunity, but also for the development of vaccines, identification of exact viral T cell epitopes is fundamental. Here we identify and characterize multiple dominant and subdominant SARS-CoV-2 HLA class I and HLA-DR peptides as potential T cell epitopes in COVID-...

BACKGROUND For the safety monitoring of vaccinations postlicensure, reports of adverse events after immunization (AEFIs) are crucial. New technologies such as digital mobile apps can be used as an active approach to capture these events. We therefore conducted a feasibility study among recipients of the influenza vaccination using an app for assess...

Introduction The PANDORA-ID-NET consortium aims to build capacity for effective outbreak response in sub-Saharan Africa. Part of this mission is to develop a real-time data sharing platform for disease outbreaks that leverages centralised data management and uses mobile technologies for data gathering and feedback. We have committed to using open-s...

Background Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, Intensive Care Unit (ICU) admission, and death due to COVID-19 is lacking leading to inconsistent national and international recommendations on who should be targeted for non-pharmaceutical interventions and vaccinatio...

Given the importance of the humoral immune response to SARS-CoV-2 as a global benchmark for immunity, a detailed analysis is needed to (i) monitor seroconversion in the general population, (ii) understand manifestation and progression of the disease, and (iii) predict the outcome of vaccine development. Currently available serological assays utiliz...

Background: European countries report large differences in coronavirus disease (COVID-19) case fatality risk (CFR). CFR estimates depend on demographic characteristics of the cases, time lags between reporting of infections and deaths and infrastructural characteristics, such as healthcare and surveillance capacities. Methods: We used publicly avai...

The SARS-CoV-2 pandemic calls for the rapid development of diagnostic, preventive, and therapeutic approaches. CD4 ⁺ and CD8 ⁺ T cell-mediated immunity is central for control of and protection from viral infections [1-3] . A prerequisite to characterize T-cell immunity, but also for the development of vaccines and immunotherapies, is the identifica...

We describe a novel dietary assessment strategy to estimate usual food intake in the ongoing large-scale multi-center German National Cohort (GNC). The dietary assessment is based on three 24 h food lists (24h-FL) and a food frequency questionnaire (FFQ) enriched by information from the representative German National Nutrition Survey II (NVS II). T...

European countries report large differences in COVID-19 case fatality risk (CFR) and high variation over the year. CFR estimates may both depend on the method used for estimation and of country-specific characteristics. While crude methods simply use cumulative total numbers of cases and deaths, the CFR can be influenced by the demographic characte...

Background Reporting delays in disease surveillance impair the ability to assess the current dynamic of an epidemic. In continuously updated epidemic curves, case numbers for the most recent epidemic week or day usually appear to be lower than the previous, suggesting a decline of the epidemic. In reality, the epidemic curve may still be on the ris...

Background Musculoskeletal diseases and symptoms are very common in the general population. They lead to high healthcare costs and pose a significant burden to the national economy.Objectives Based on data from the population-based German National Cohort (GNC), frequencies of musculoskeletal symptoms and diseases are reported, including back pain,...

Background: Infectious diseases continue to play an important role for disease perception, healtheconomic considerations and public health in Germany. In recent years, infectious diseases have been linked to the development of non-communicable diseases. Analyses of the German National Cohort (GNC) may provide deeper insights into this issue and pav...

Background In the German National Cohort (NAKO Gesundheitsstudie), the largest prospective cohort study in Germany, data on self-reported cancer diagnoses are now available for the first half of participants.Objectives Description of the methods to assess self-reported cancer diagnoses and type of cancer in the NAKO and presentation of first result...