Increase of cases in NRW Measles on the rise in Cologne - is this expected in Rhein-Sieg too?

Rhein-Sieg district · The NRW Ministry of Health has reported 24 cases of measles in the first two months of the year. The dangerous viral infection causes fever and, in the worst case, can lead to inflammation of the brain. Doctors from the region assess the current infection situation.

Two vaccinations are required for complete protection against measles.

Two vaccinations are required for complete protection against measles.

Foto: dpa/Tom Weller

The number of measles cases is rising worldwide. Infections are also on the rise in NRW: The state's Ministry of Health has already recorded 24 cases in the first two months of 2024. By comparison, it recorded 15 cases for the whole of 2023.

What is measles and how dangerous is it?

Measles is a viral disease. The symptoms: at the beginning, sufferers have a high temperature, cough and runny nose, as well as inflammation of the nasopharynx or conjunctiva. A rash on the face and behind the ears, which later spreads over the whole body, is typical of the disease as it progresses. The Federal Center for Health Education (BzgA) provides information about the disease on its website. It says that the fever usually subsides after three to four days.

"Measles is an easy-to-transmit disease," says Rainer Meilicke, Head of the Rhine-Sieg District Health Office. Even a single contact can lead to infection. Although measles is generally known as a childhood disease, people of all ages can be affected, says Meilicke. A rarer but feared effect of the infectious disease is meningitis, according to the public health department and the BzgA. According to the BzgA, this occurs in around one in 1,000 cases. For 10 to 20 percent of those who become infected, the inflammation ends fatally. According to Meilicke, this hits around one in ten thousand children worldwide.

Are there also new cases in the Rhein-Sieg district?

According to the Ministry of Health, there is currently an increase of cases in Cologne and the Hochsauerland district. The Cologne health authority reports eight known cases for 2024. The Rhine-Sieg Department of Health is not aware of any cases for this year. There were also no cases there in 2023, according to Meilicke. As of now, a cluster of cases is not expected in the Rhein-Sieg district. However: "Due to the close proximity and the fact that vaccination coverage is not totally known, the occurrence of measles in the Rhein-Sieg district cannot be completely ruled out," says Meilicke.

What does the increase in measles cases in NRW mean?

There is a high level of vaccination throughout Germany, says Meilicke. Outbreaks are therefore rare. According to the head of the public health department, many cases are imported, meaning that the sick people presumably come from a country where the vaccination rate is lower than in Germany. In a group without herd immunity against measles, the measles viruses could easily spread.

However, according to Meilicke, the current infections should also be seen in the context of the protective measures taken during the coronavirus pandemic. The current numbers cannot be compared with those from previous pandemic years where influenza cases also decreased because people protected themselves from airborne viruses. Nevertheless, an outbreak of measles is always significant, as it should no longer exist thanks to the measles vaccine. Axel Gerschlauer, pediatrician and spokesperson for the Professional Association of Pediatricians, also advises looking at the statistics in comparison to the pre-pandemic year 2019. At that time, a total of 135 measles cases were reported in NRW, compared to 211 in 2018 and only 20 in the pandemic year 2020.

What does the Measles Protection Act say?

Since March 1, 2020, the German Measles Protection Act has stipulated that all children from the age of one must be vaccinated against measles when they start school or kindergarten. A combination vaccine against measles, mumps and rubella is given. Children and adults need two vaccinations to be fully protected. A previous illness with measles also counts as immunization. Adults born before December 31, 1970 do not need to be vaccinated.

According to the law, schools must notify the health authorities of pupils who do not present the vaccination certificate when they start school. According to Meilicke, 1,900 certificates have been lacking in the Rhein-Sieg district in the last two years. However, this does not automatically mean that the children are not vaccinated, says Meilicke. The public health department then tries to contact the families to find out whether they have been vaccinated or need to catch up with their vaccinations.

Meilicke said that of the 1,900 vaccination certificates that were lacking in the last two years, 600 have been obtained up to now. He is confident that the vaccination records will soon be completed as a result of the checks. The data on the measles vaccinations of school starters is continuously checked by the authorities, always at the beginning of the school year. Pupils who have not been vaccinated cannot be excluded from school; in this case, compulsory school attendance overrides compulsory vaccination. And: In schools, kindergartens and long term care homes, employees are also obliged to provide proof of vaccination. If they are not vaccinated, the health authorities may ban them from entering the workplace.

What is the vaccination rate in Germany?

The health authorities can record vaccination activity using health insurance data. For example, they can see how often a vaccine with a certain number has been administered. According to Meilicke, 99 percent of children for whom the services are billed to the health insurance company are vaccinated. According to data from the Robert Koch Institute, the 2021 school entry examinations in Germany, in which the vaccination status is also asked, show that 95% of children have received a vaccination and 85% have also received a second vaccination against measles. As of 2024, the school entry examinations could become more meaningful again, as they can take place again without protective measures after the pandemic, according to Meilicke.

How can children and adults protect themselves against measles?

"Children should have had their first vaccination by the age of one," says Gerschlauer. According to Stiko (an independent committee of experts who recommend vaccinations for people in Germany), the second vaccination can take place at the earliest four weeks after the first vaccination and is recommended at age 15 months. Gerschlauer recommends that parents check their children's vaccination records for the second vaccination. "The vaccination also helps to protect those children who cannot be vaccinated," says the pediatrician. This is the case, for example, for chemotherapy patients or patients with immune disorders. Meilicke from the public health department points out that cases of infectious diseases have been on the rise again since the end of the mask requirement in February of 2023. Anyone who is worried about infection can protect themselves by wearing masks and reducing contact, the protective measures used during the pandemic.

Promoting vaccination acceptance

Measles cases in Europe

Experts fear a further increase in measles cases in the EU. This is according to a report published on Friday by the EU health authority ECDC. After several years with very few cases, there were more reports of measles again in 2023. According to the ECDC, this trend is likely to continue in the coming months, partly due to insufficient vaccination rates in some countries, but also due to a seasonal increase and the introduction of cases from third countries.

In January and February of 2024, seven deaths caused by the measles virus have already been reported in the EU - six in Romania and one in Ireland, the ECDC reported. In order to contain the spread of the virus, the health authorities recommend that European countries achieve or maintain high vaccination rates and promote vaccination acceptance among the population.

Orig. text: Franziska Klaes, dpa

Translation: ck

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