Summary
Austria has record numbers for two infectious diseases this year: West Nile fever (35 cases) and pertussis (whooping cough): As of 25/09/2024, 12,143 cases of whooping cough have been reported in Austria.
An increase is still being observed for SARS-CoV-2 in wastewater and in the sentinel system.
New measles cases are still being reported sporadically in Austria, totalling 501 this year.
Internationally, we provide updates on the outbreaks of avian influenza in the USA and cholera in Sudan.
In the topic of the month, we present meningitis and its main triggers. Bacterial meningitis can be dramatic and can quickly lead to death in young children.
In our news items, we draw attention to the first free influenza vaccination.
In 2024, more cases of West Nile fever were reported in Austria than ever before; as of 24 September 2024, 35 infections had been confirmed in humans. Only adults in eastern Austria were affected.
Most cases are found during routine testing of donated blood. Some cases were diagnosed due to neurological symptoms, 16 people were hospitalised. Two people were infected abroad.
80 % of human cases are asymptomatic, 20 % develop a flu-like illness and in individual cases (approx. 0.7 %) West Nile virus-associated meningoencephalitis occurs.
The highest number of cases to date has also been recorded in horses and birds. The disease can also be severe in horses, but unlike humans, they can be protected by vaccination.
West Nile virus is transmitted by mosquitoes, mainly of the genus Culex. The high number of cases in humans and animals is probably partly due to the long period of hot weather in Austria this summer. High temperatures ensure better survival of the mosquitoes, they suck blood more often, the development time from egg to adult is shorter and the season lasts longer.
As part of a monitoring programme carried out by AGES, traps have been set up throughout Austria. Standardised, Austria-wide monitoring is guaranteed for the next three years. This year, almost 7,000 mosquitoes have already been caught and tested for West Nile virus, four of the samples were positive.
In addition to Austria, 16 other European countries have reported cases of West Nile fever. The European Centre for Disease Prevention and Control (ECDC) calls on all countries to monitor the safety of blood donations, observes developments and maintains an up-to-date dashboard.
There is no authorised vaccine for humans. As a preventive measure, attempts should be made to avoid gel bites (clothing, repellents).
In Austria, we are currently observing an increase in the number of people testing positive for SARS-CoV-2 in Sentinel. In line with this, rising values have recently been observed in wastewater monitoring ; currently, the data in the affected areas could be influenced by the high water levels.
The number of people affected by acute respiratory infections is stable at a low level on average across Europe, with some countries reporting an increase in activity. In Austria, the numbers of reported sick days suggest that more and more people are currently suffering from respiratory infections. According to Sentinel, a significant proportion of these are caused by SARS-CoV-2. There has been a slight increase in inpatient hospital admissions of Covid-19 sufferers.
An adapted vaccine against the JN.1 variant was approved at the beginning of July and is already available free of charge at vaccination centres. As in the previous year, vaccination with the new JN.1 vaccines is recommended for all people aged 12 and over to provide the best possible protection against severe courses of the disease, especially to protect people aged 60 and over and risk groups from severe courses.
Due to the increasing SARS-CoV-2 activity, hand washing and general hygiene measures are recommended as well as avoiding crowds of people should symptoms of the disease occur. Wearing a mask can help prevent infection if close contact with many people indoors cannot be avoided, for example at the airport or on an aeroplane.
The pertussis figures in Austria and many European countries rose massively in 2024, even in countries with high vaccination coverage rates. We presented details on this in the AGES Radar from 28/03/2024.
While 2,791 cases were reported in Austria in the previous year as a whole, there have already been 12,143 cases of pertussis this year (as of 25/09/2024).
Even with a high vaccination rate, cases must be expected. The primary purpose of the vaccination is to protect infants and young children from serious illness and death.
The vaccination is included in the free vaccination programme for children in Austria. Basic immunisation in infancy should be refreshed at primary school age, preferably when the child starts school. In order to maintain immunisation protection, the vaccination should be boostered regularly, every ten years up to the age of 60 and every five years from the age of 60. The pertussis vaccination is recommended for everyone.
In order to protect infants in the first months of life, pregnant women in particular are advised to be vaccinated in the last trimester of pregnancy, regardless of the interval between the last pertussis vaccination. This provides newborn babies with protection through maternal antibodies.
Further information on the pertussis vaccination can be found in the vaccination plan Austria 2023/2024 version 2.0 (sozialministerium.at).
Whooping cough (pertussis) - AGES
This year, 501 cases of measles were reported in Austria (as of 25/09/2024). For the first time this year, there were no new cases in the week from 16 to 23 September. Even before that, the number of new infections had been low for several weeks, but an increased incidence of measles cases must be expected, also due to the approaching cooler season.
AGES updates the data here on a weekly basis.
Information on the measles-mumps-rubella vaccination can be found in the Austria 2023/2024 vaccination plan (sozialministerium.at).
This year there have been measles outbreaks in numerous countries worldwide. The vaccination rate of children worldwide who had received a first measles vaccination was significantly lower in 2023 than in 2019. Although measles could be eliminated globally with the help of the vaccination, 136,000 people worldwide died of measles in 2022, most of them children under the age of five.
Following the increase in the number of cases and, above all, deaths from cholera last year, the number of people infected with cholera worldwide remains high this year: as of 16 September 2024, the WHO reports 411,800 cases and 3,100 deaths from cholera. Outbreaks are circulating in 30 countries.
One of these countries is Sudan, with 12,344 cases and 405 deaths. On 12 August this year, the Sudanese Minister of Health declared a cholera epidemic.
After more than 16 months of conflict, the situation in Sudan is catastrophic. Many health facilities have been destroyed. Currently, 25 million people in the country are dependent on humanitarian aid and 3.6 million children are suffering from acute malnutrition. Due to the destruction of infrastructure and the displacement of the population, access to safe and clean water and food sources is extremely difficult. The current flooding following heavy rainfall has further exacerbated the situation. All this favours the outbreak of infectious diseases; in addition to cholera, there are currently outbreaks of vaccine-derived polio, measles, malaria, dengue fever and rubella.
Cholera is a diarrhoeal disease caused by toxin-producing strains of the pathogen Vibrio cholerae. It is transmitted via human faeces that contaminate water and food. Direct human-to-human transmission is rare.
With the right treatment and an adequate supply of clean water and electrolytes, the disease is usually mild and mortality is low. In disaster areas, there is often no adequate supply and cholera can lead to death, especially in children. The establishment of a stable drinking water supply, hygiene and the fight against poverty are the most effective means against cholera outbreaks.
A new case of avian influenza in humans has been attracting increased attention since 6 September because it is not clear how the person became infected. No animal contact has yet been established. However, the virus found in this person shows no adaptation to humans, but is genetically very similar to the avian influenza viruses found in dairy cows.
The WHO, CDC and ECDC continue to classify the risk for the general population as low.
Details on the infection rate in the USA can be found in the Radar of 29.08.2024.
Further information on avian influenza in Austria can be found in the animal disease radar.
H5 Bird Flu: Current Situation | Bird Flu | CDC
Dengue virus
A total of 106 autochthonous, domestically acquired cases of dengue fever were reported in Europe in 2024. Of these, 57 are in France, with the first report of the year on 8 July 2024. The Provence-Alpes-Côte d'Azur and Auvergne-Rhône-Alpes regions in the south-east and the Occitanie region in the south are affected. In Spain, as of 25 September 2024, eight cases have been reported in Catalonia, in north-eastern Spain; in Italy 41, in the regions of Lombardy, Emilia-Romagna and Veneto in northern Italy and in Tuscany and Marche, which are located in central Italy. No autochthonous cases have been reported in Austria this year.
According to the ECDC, outbreaks are to be expected in areas where the Asian tiger mosquito, Aedes albopictus, is present.
Dengue fever is a flu-like viral disease that is transmitted by certain mosquitoes.
Travellers are advised to protect themselves against mosquitoes (long clothing, anti-mosquito repellent). In Austria, a vaccine against dengue fever is authorised for children from the age of 4, adolescents and adults. There is currently no general vaccination recommendation against dengue fever for travellers.
5 October is World Meningitis Day. It has been held annually since 2009 to raise awareness of the disease and ultimately save lives.
Meningitis is an inflammation of the skin of the brain and spinal cord, the meninges. Bacterial meningitis can be very serious or even fatal if treatment is given too late. This is particularly the case with meningococcal meningitis.
The different triggers
Bacteria
Meningococci, Neisseria meningitidis, are among the most common bacterial pathogens. In Austria, meningococci of serogroup B are predominant, but infections with serogroups C and Y can also occur.
The bacterium can often be discovered in the nasopharynx during a smear test. It usually colonises there without causing disease, which is referred to as asymptomatic carrier status. If the bacterial colonisation spreads further, an invasive bacterial meningococcal infection can occur, which leads to meningococcal meningitis and sepsis.
This form of meningitis progresses rapidly, with a mortality rate of 8 % to 15 %. The most common cases are in infants, with a second prevalence in adolescents and young adults.
Transmission occurs exclusively from person to person. The risk of infection is low, as the bacteria can only survive for a short time outside the human organism. However, there are frequent outbreaks after large gatherings of people, such as at meetings or large festivals. Infection occurs via droplet or smear infection.
Other bacteria that can cause meningitis include pneumococci and Haemophilus influenzae type B. Virus-related meningoencephalitis and invasive bacterial diseases (meningitis and septicaemia) are subject to mandatory reporting in Austria.
Meningitis caused by bacteria is usually more severe than meningitis caused by viruses and can be fatal. Children under the age of five are more frequently affected than older children or adults.
Viruses
The most common pathogens causing viral meningitis are enteroviruses, especially echoviruses and Coxsackie viruses. Although meningitis caused by a viral pathogen is more common than meningitis caused by bacteria, the symptoms are usually milder or the infection can be completely asymptomatic.
Other triggers
Fungi, parasites, protozoa (protozoa), cancers, inflammatory diseases and autoimmune diseases can also trigger meningitis.
Effective vaccination is available
Vaccinations are available in Austria to protect against the most common bacterial pathogens: one against group B meningococci, one against groups A, C, W and Y and one against Haemophilus influenzae-B. The latter is included in the 6-vaccination programme. The vaccination against pneumococci is administered at the same time as the 6-vaccination in the form of a conjugate vaccine.
All the vaccinations listed are recommended in the Austrian vaccination plan, Haemophilus Influenzae B and pneumococci are included in the free vaccination programme. In Germany, the costs for meningococci B and C are covered by health insurance companies. Vaccination against other pathogens may be recommended when travelling abroad, for example against tuberculosis.
A quarter of invasive meningococcal diseases occur in children in the first year of life - this emphasises the importance of vaccination in infancy.
An example from the African epidemic regions shows how effective the vaccination is. The African meningitis belt stretches from Senegal in the west to Ethiopia in the east and includes 26 countries. Pathogens from serogroups A, C, W135 and Y are common here and epidemics occur repeatedly between November and June. Since the introduction of a meningococcal A conjugate vaccine through preventive vaccination campaigns in 2010, the proportion of serogroup A infections has fallen significantly.
Situation in Austria
The number of invasive meningococcal cases in Austria is low; in 2023 there were 16 reported cases and no deaths. This year there are 13 confirmed cases, including one death (as of 25/09/2024).
Symptoms of meningitis include fever with a pronounced feeling of illness and aching limbs, headaches, painful stiffness in the neck (meningismus), sensitivity to light, nausea and vomiting, back pain, drowsiness and confusion.
Infants and small children often show unspecific symptoms and the typical meningismus is often absent. There may be a tense or bulging fontanel (gap between the skull plates - cranial suture) and pale or blotchy skin; other signs may include refusal to feed, startle, high-pitched shrill crying or whining when touched, stiff body with convulsive movements or a limp body. Due to the unspecific symptoms, it can be difficult to correctly assess the seriousness of the situation in a timely manner, especially in infants.
In adults, the diagnosis can be made through a detailed discussion and a physical examination. The pathogen is detected with a blood test. An examination of the cerebrospinal fluid (CSF) may also be necessary to confirm the diagnosis.
The symptoms of meningitis are particularly severe in the case of bacterial meningitis. Within hours, the initially mild symptoms can worsen dramatically, leading to sepsis and death. It is therefore crucial to recognise the signs of bacterial meningitis at an early stage and seek medical help.
Inflammation of the meninges can cause long-term damage to the nervous system and lead to lifelong impairments such as hearing loss, memory problems, learning difficulties and epilepsy.
Who we are | CoMO (comomeningitis.org)
The influenza vaccination is free for everyone for the first time as part of the public influenza vaccination programme (ÖIP) for the 2024/2025 season. The vaccination programme is a campaign by the federal government, the federal provinces and social insurance.
Information on the vaccination programme: https://impfen.gv.at/impfungen/influenza
A list of vaccination centres is available on the ÖGK website. The Vienna Medical Association has announced that it will publish a list of participating medical practices at the beginning of October.
Following the floods in many areas of Austria, drinking water is contaminated in some regions. Although monitoring works well here in Austria, ECDC also warns that infections could increase in Central Europe as a result of the floods; this concerns pathogens such as Campylobacter, Legionella, Leptospira and E. coli.
ECDC recommends measures such as suitable protective clothing during clean-up operations, water management to slow down the growth of legionella and, above all, communication of risks in the affected areas.
Floods are the most common type of natural disaster in Europe. The direct health consequences are primarily related to drinking water; a major plague of mosquitoes is not expected due to the cooling temperatures; diseases spread by mosquitoes should therefore not be boosted by the floods in Austria.
The situation is currently even more serious in many other parts of the world, which have suffered flooding at almost the same time as Europe. In West and Central Africa, 100,000s had to flee from the masses of water, in Nigeria a dam burst and the city of Maiduguri, with a population of over a million, was largely flooded. Thousands of people also had to be evacuated in Japan after extreme rainfall.
Corynebacteria are irregularly shaped (club-shaped) rod bacteria. Most representatives of this group are opportunistic germs, i.e. they are only pathogenic under special conditions. Corynebacterium(C.) diphtheriae, the classic pathogen of diphtheria, is of the greatest clinical significance, whereby only toxin-producing strains can cause diphtheria. In addition to C. diphtheriae, other species such as C. ulcerans and C. pseudotuberculosis can also cause diphtheria.
In 2023, 128 samples were tested at the National Reference Centre for Diphtheria Laboratory. C. diphtheriae was identified in 30 cases and C. ulcerans in three cases. Toxin production was detected in four of these isolates (three C. diphtheriae, one C. ulcerans). One C. diphtheriae isolate was found to be resistant to penicillin, two isolates each showed resistance to amoxicillin and erythromycin, whereby all resistant isolates were non-toxigenic strains. No combined resistance to penicillins and macrolides was detected. Compared to the previous year, both the number of samples sent in and the number of toxin-producing corynebacteria detected in Austria decreased significantly.
On 19 September, Jordan received confirmation from the WHO that it had eliminated leprosy. There had not been an autochthonous case of this disease in the country for two decades. This makes Jordan the first country in the world in which leprosy was endemic and which was able to eliminate this disease - a disease that has been with people for thousands of years. The WHO sees this as an important milestone in the development of global health.
Mortality indicates the mortality rate in a population over a certain period of time, usually reported as disease-specific mortality:
The number of deaths from a disease in a population in a given period divided by the number of members of this population (e.g. population size)
Mortality therefore answers the question of how many people in a defined group have died of a certain disease within a certain period of time. Synonyms are mortality, mortality rate, death rate.
Mortality is of major importance as one of the foundations of epidemiology. As early as the 17th century, John Graunt laid the foundations for modern epidemiology with his analysis of death registers in London by recognising correlations between deaths and certain causes, thus establishing mortality statistics as a tool of epidemiology.
The AGES Radar for Infectious Diseases is published monthly. The aim is to provide the interested public with a quick overview of current infectious diseases in Austria and the world. The diseases are briefly described, the current situation is described and, where appropriate and possible, the risk is assessed. Links lead to more detailed information. The "Topic of the month" takes a closer look at one aspect of infectious diseases.
How is the AGES radar for infectious diseases compiled?
Who: The radar is a co-operation between the AGES divisions "Public Health" and Risk Communication.
What: Outbreaks and situation assessments of infectious diseases:
- National: Based on data from the Epidemiological Reporting System (EMS), outbreak investigation and regular reports from AGES and the reference laboratories
- International: Based on structured research
- Topic of the week (annual planning)
- Reports on scientific publications and events
Further sources:
Acute infectious respiratory diseases occur more frequently in the cold season, including COVID-19, influenza and RSV. These diseases are monitored via various systems, such as the Diagnostic Influenza Network Austria (DINÖ), the ILI (Influenza-like Illness) sentinel system and the Austrian RSV Network (ÖRSN). The situation in hospitals is recorded via the SARI (Severe Acute Respiratory Illness) dashboard.
Austrian laboratories send SARS-CoV-2 samples to AGES for sequencing. The sequencing results are regularly published on the AGES website.
For the international reports, health organisations (WHO, ECDC, CDC, ...) specialist media, international press, newsletters and social media are monitored on a route-by-route basis.
For infectious diseases in Austria, the situation is assessed by AGES experts, as well as for international outbreaks for which no WHO or ECDC assessment is available.
Disclaimer: The topics are selected according to editorial criteria, there is no claim to completeness.
Suggestions and questions to:wima@ages.at
As the response to enquiries is also coordinated between all parties involved (knowledge management, INFE, risk communication), please be patient. A reply will be sent within one week.
Last updated: 26.09.2024
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