Critical spread of measles in Berlin

Extension of the measles wave to other regions

03/24/2015

The measles wave in Berlin is drawing ever wider circles and could, according to experts, also skip to other regions of Germany. Furthermore, 15 new cases were recorded per day and the incomplete vaccination favor the spread of infectious disease, warns Professor Hartmut Hengel, scientific advisory board of the study group Measles at the Robert Koch Institute (RKI) to the news agency „dpa“.

The current measles outbreak in Berlin began in October 2014, whereby initially, according to the RKI, primarily asylum seekers from Bosnia, Herzegovina and Serbia were affected who did not have sufficient vaccination protection. In the further episode, however, the new cases of disease predominantly occurred in the rest of Berlin's population, whereby here too the incomplete vaccine protection is cited by the RKI as a significant cause of the spread. Now, the experts fear, given the continuing high numbers of infections, a spread of the measles wave to other regions. „It is scary how long the outbreak will last at this high level“, said Professor Hengel, director of the Institute of Virology at Freiburg's Albert-Ludwigs-Universität, opposite the „dpa“.

Impflücken and deficits in the primary care structures
Since the start of the measles wave in Berlin in October 2014, according to the RKI, 866 people have already become infected in the capital. Although the measles are considered as a supposed childhood disease, but actually were so far the most infections in adults. An infant died as a result of the infection and a quarter of the infected had to be treated in the hospital. Above all, the existing Impflücken makes Hengel responsible for the measles in Berlin. According to the „Doctors newspaper“ citing the analysis of the study on adult health in Germany (DEGS1), every fifth 18 to 29 year old and every second 30 to 39 year old are not vaccinated against measles nationwide. In addition, according to Hengel, however, deficits in health policy and in primary care structures also play a role in the rapid spread of measles in Berlin. For example, the doctors would have „no tradition of catch-up vaccinations that systematically close implants“, so the expert. In addition, the responsibility for themselves and others may not yet be sufficiently communicated.

Virus meets susceptible people
According to the RKI expert, the current measles outbreak in Berlin is one of the biggest outbreaks in Germany in the past ten years. Obviously find the virus in Berlin „constantly susceptible people before“, so Hengel. The Berlin health authorities are currently in the highest alert and school closures and school bans for unvaccinated children have already been initiated. In order to protect even small children, the Impfbeirat has called for a vaccination of babies already at the age of nine months. So far, eleven months have been considered the minimum age, which brings a higher risk of infection for babies. Anyone who picks up a baby has to be protected against measles, the experts say. Although the mothers can pass on some immunity as so-called nest protection to their children, this only works for a limited period of time and the mothers must also have enough antibodies - that is, have been self-vaccinated or have undergone the measles.

Babies rely on high vaccination coverage in the environment
In Berlin, about every tenth measles infection currently affects one child in the first year of life, with vaccination being prevented from the ninth month onwards at the earliest. For example, the professional association of paediatricians has been advising parents in Berlin for weeks to avoid publicizing their babies with their infants because of the high risk of contagion. The small ones depend on a high vaccination rate in their environment, in order to avoid a transmission of the exciters from the beginning. Lack of vaccine protection is an urgent problem, also because it is about the protection of other such as unvaccinated children go, so Hengel. In addition, can only be achieved by sufficiently high vaccination quotas, an eradication of measles.

Spread to other regions by travelers
The expert explains the consequences of the lack of vaccination protection on the example of a father, who comes from Freiburg and was in Berlin for a day on business. He had no knowledge of the measles outbreak and did not know that he himself was not vaccinated, according to Hengel. The man had become infected and subsequently infected other family members at home. In a similar way, the current measles wave could spread from Berlin to other regions of Germany. Therefore, all adults without measles protection should necessarily receive a vaccine, said Hengel. The existing implants in all population and age groups would have to be closed. However, the virologist considers a Impfzwang for rather counterproductive. Hengel hopes that the right lessons can be drawn from the Berlin outbreak and that the gaps in vaccination protection can be eliminated without the introduction of compulsory vaccination. (Fp)