Measles outbreaks are piling up

Measles outbreaks are piling up

07/06/2013

Already since the beginning of the year, the measles in several federal states are spreading. Initially affected mainly by Bavaria and Berlin, now an entire school in Cologne had to be closed. Since then, demands for vaccination coverage are increasing.

Considerations for a compulsory vaccination
Since the beginning of the year, there are increasing numbers of reports of measles diseases in Germany. So first of all Berlin and Bavaria were in the headlines, now a whole school near Cologne had to be closed because of a measles outbreak. The Waldorf School in Erftstadt near Cologne will remain closed until at least Monday, as so far eleven adolescents have been infected with measles. It is to be feared that the number will increase even more, as only a quarter of the students have been vaccinated. Often, symptoms, such as the typical red pustules only two weeks after infection. The disease should not be taken lightly, experts warn. Reflections on more initiative have also become loud from the policy, such as Federal Health Minister Daniel Bahr (FDP), who said that a vaccination for children could be necessary.

No vaccination - no school
There is no compulsory vaccination in Germany so far. Quite different in many countries around the world, where children need to be immunized against a range of infectious diseases when they want to class. To eradicate measles soon, the World Health Organization (WHO) has set itself the goal. Germany does not fare very well. In the first half of 2013 alone, more than 1,070 cases were reported to the Robert Koch Institute (RKI) in Berlin, most of them from Bavaria (478) and Berlin (400). That other continents are much further, explains Anette Siedler from the RKI Department of Vaccination Prevention: „North and South America are now according to WHO as a free of lasers.“ There the decline of measles is common with the slogan „No vaccination - no school“ connected.

Strong fluctuations
Siedler said it was normal for measles numbers to fluctuate widely. For example, in 2011 there were about 1,600 cases in Germany, in 2012 only 170. The numbers would be related to the amount of people who could get an infection. Settler adds: „After regional outbreaks, many people are immune.“ However, if inadequate vaccination and measles do not appear for a while, the population is more susceptible.

Out of 100, 99 are stuck
Measles are highly contagious and spread mainly through a droplet infection, such as coughing or sniffing. Martin Terhardt, member of the Standing Vaccination Commission, explains: „Out of 100 people in a room with an infected person, 99 are infected.“ He also considers it misleading that measles are still often referred to as teething. According to RKI, about half of those affected this year are older than 20 years old. („“Terhardt sees big pickups in this age group: „It's also because vaccine recommendations have changed over the years.“

Better provision in the GDR
Of the people born before 1970, many had the measles themselves and are therefore mostly immune. From then on an East-West-Schere opens: In the GDR from 1970 a vaccination obligation for children, in the Federal Republic in 1974 only a vaccination recommendation had been issued. After reunification, the citizens in the East, who had become accustomed to duty, would continue to be vaccinated. Differences in the immunization rates of the federal states would show up to today.

More than 90 percent of children have vaccine protection
Since 1991 nationwide, a second vaccine dose advised, because „in about 5 to 10 percent of those vaccinated, sufficient protection does not occur after the first dose“, so Mrs. Siedler. So it is not a question of a refresher, but the second vaccination should fill the mentioned gap. Terhardt relativizes the poor performance of Germany in international comparison: „Germany is almost reaching the WHO goal for today's new school students.“ According to the RKI, more than 90 percent of children over that age have been vaccinated. After that, it looks different again: „Teenagers and young adults feel little responsible for their vaccination record.“ Therefore, the awareness of vaccinations should generally increase.

Infants prone to long-term consequences
Like the Federal Minister of Health, Terhardt also advocated vaccination. It is important to differentiate: „The duty should apply to children and healthcare workers, childcare and teachers.“ A corresponding consequence should also be drawn from a case at the Berlin Charité, where a doctor suffering from measles should have infected a baby. „Especially infants are particularly susceptible to the sequelae of measles“, Terhardt. Since fewer and fewer mothers are immune and babies are vaccinated only from the age of eleven months, special care must be taken, especially if the youngest are cared for in kindergartens.

Alternative and religious vaccine skeptics
Not only against a duty, but generally against vaccination are often well-educated parents from the eco-sector. However, Terhardt said that the measles outbreak at the Waldorf School near Cologne shows that skeptics also need to be aware of the responsibility for others. Serious complications are rare in measles, but they exist. In the Netherlands, vaccine skeptics or refusers are mainly in the so-called „Bible belt“ in which predominantly supporters of the Reformed Church live. The congregation would put pressure there so that the children would not be vaccinated. The competent authorities responded to the problem by offering home visits to administer the vaccine. It was said that the offer was well received.

No pure self-protection
The sequelae of measles can be fatal, as the professional association of children and youth physicians reported. Anette Siedler of the RKI warned: „The vaccine is not just for self-protection.“ Even old myths sometimes hamper a reasonable precaution. For example, it is refuted today that the vaccine could trigger autism, as a British scientist claimed in 1998. On social networks, however, it would always show that some users consider vaccinations to be pathogenic. For example, in an allusion to the recent vaccination initiative of the Federal Center for Health Education „Germany is looking for the vaccination certificate“. In response, more than 2,500 people have joined the group „Germany burns the vaccination certificate“ connected. (Ad)