Diesen Artikel hänge ich gleich mit dran, damit er besser verbreitet wird.
Dieser Forumsbeitrag dient ausschließlich der besseren Verlinkung des Originalartikels!
Die Grafiken usw. sind nur im Original zu sehen!
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18838[*QUOTE*]
--------------------------------------------------------------------------
Immunisation Week
On 17 April 2008, Eurosurveillance is publishing a special issue with
articles on the measles situation in Europe. The publication is linked to
European Immunisation Week which runs from 21-27 April.
Eurosurveillance publishes special issue on tuberculosis
World Tuberculosis Day on 24 March commemorates the date in 1882 when
Robert Koch presented his findings of the causing agent of tuberculosis
(TB) â “ Mycobacterium tuberculosis.
In the run up of this day Eurosurveillance publishes a special issue on
the situation of TB in Europe.
In this issue
European Immunization Week 2008 - time for reflection
European Immunization Week 2008: Progress towards regional goals
Measles is still a cause for concern in Europe
An ongoing multi-state outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and
Norway, March-April 2008
An outbreak of measles including nosocomial transmission in Apulia, south-east Italy, January-March 2008 - a preliminary report
A cluster of rubella in Malta, December 2007 - January 2008
Measles and mumps immunity in Northern Greece, 2004-2007
An increase in the number of mumps cases in the Czech Republic, 2005-2006
Transmission of the L-Zagreb mumps vaccine virus, Croatia, 2005-2008
Related articles
Measles is still a cause for concern in Europe
An outbreak of measles including nosocomial transmission in Apulia, south-east Italy, January-March 2008 - a preliminary
report
Measles and mumps immunity in Northern Greece, 2004-2007
Measles outbreaks in London, United Kingdom - a preliminary report
A cluster of measles cases in northern Italy: a preliminary report
Home Eurosurveillance Edition 2008: Volume 13/ Issue 16 Article 4
Printer friendly version
Back to Table of Contents
Previous
Next
Eurosurveillance, Volume 13, Issue 16, 17 April 2008
Rapid communications
An ongoing multi-state outbreak of measles linked to non-immune
anthroposophic communities in Austria, Germany, and Norway, March-April
2008D Schmid1, H Holzmann2, S Abele2, S Kasper1, S König3, S Meusburger3,
Hubert Hrabcik3, A Luckner-Hornischer3, E Bechter3, A DeMartin3, Jana
Stirling3, A Heißenhuber4, A Siedler4, H Bernard4, G Pfaff 4, D Schorr5,
M S Ludwig5, HP Zimmerman5, Ø Løvoll6, P Aavitsland6, F Allerberger ()1
Österreichische Agentur für Gesundheit und Ernährungssicherheit (Austrian
Agency for Health and Food Safety, AGES), Vienna, Austria
National Measles Reference Centre, Medical University of Vienna, Vienna, Austria
Austrian Public Health Authorities, Salzburg/Linz/Innsbruck/Vienna, Austria
German Public Health Authorities and Robert-Koch institute, Oberschleißheim/Stuttgart/Berlin, Germany
Swiss Public Health Authorities, Liestal/Bern, Switzerland
Folkehelseinstituttet (Norwegian National Institute of Health, FHI), Oslo, Norway
Citation style for this article: Schmid D, Holzmann H, Abele S, Kasper S, König S, Meusburger S, Hrabcik H,
Luckner-Hornischer A, Bechter E, DeMartin A, Stirling J, Heißenhuber A, Siedler A, Bernard H, Pfaff G, Schorr D,
Ludwig MS, Zimmerman H, Løvoll Ø, Aavitsland P, Allerberger F.
An ongoing multi-state outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and Norway, March-April 2008. Euro Surveill.
2008;13(16):pii=18838. Available online:
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18838 Date of submission: 14 April 2008
From the second week of March 2008, public health authorities in the
province of Salzburg observed an increased number of measles cases
compared to previous years. Twenty cases of measles had been were notified
Austria-wide in 2007, 24 in 2006, 10 in 2005, and 14 in 2004.
The current outbreak has affected, as of 14 April, 202 people in Austria,
53 in Germany, and four in Norway, bringing the total number of cases
related to this outbreak to 259. The initial case series investigation
revealed that the common link was attendance of an anthroposophic school
and day care centre in Salzburg city. The majority of the pupils were not
vaccinated against measles.
An outbreak case was defined as a person who
a) became ill with measles after 1 March, fulfilling the clinical criteria
of measles regardless of laboratory confirmation, and
b) was epidemiologically linked to Salzburg city in the period 7 to 18
days prior to clinical onset.
Outbreak investigation
As of 14 April, 183 cases of measles restricted to four public health
districts in the province Salzburg, 16 cases from the neighboring province
Upper Austria, and one case each in the Austrian provinces Tyrol,
Vorarlberg and Vienna fulfilled the preliminary outbreak case definition.
In addition, 50 outbreak cases, most of them with residence in Bavaria,
three cases of measles in the state Baden-Württemberg in Germany, and
four outbreak cases resident in Norway were identified.
Figure 1 illustrates the epidemic curve by onset of rash of 256 notified
cases for whom data on clinical onset were available. In 78.5% (201) of
these cases a link to the particular school and day care centre in
Salzburg city has been identified so far. Questioning of the cases is
still ongoing. Figure 2 summarises age and sex distribution of 259 cases.
Since the third week of March 2008, the Austrian health authority has put
in place a range of outbreak control measures raising awareness in the
overall population and encouraging measles, mumps, rubella (MMR) vaccine
uptake, supported by proactive media releases;
dissemination of information to schools and nurseries;
closure of the particular school and day care centre for one week;
post-exposure prophylaxis for contact persons if appropriate;
control of vaccination documents in all persons of the affected
institution;
access restriction to school for all persons with unclear immune status;
closure of the particular school and day care centre for one week;
after re-opening of the anthroposophic school, access restriction for
pupils other than those vaccinated at least once and those with
serologically documented previous infection;
offering MMR vaccination free of charge to the population younger than 15 years;
and alerting health professionals.
Preliminary results of the outbreak investigation indicate the possible
source case â “ a student from an anthroposophic school in Switzerland who
visited the anthroposophic school in Salzburg city with colleagues. That
student became ill with measles during their stay in Salzburg on 7 March,
a week prior to the primary outbreak case in the anthroposophic school in
Salzburg (13 March).
Since November 2006, Switzerland is experiencing the largest measles
outbreak registered in the country since notification for this disease in
1999 [1].
Conclusions
Recently, ultra-orthodox Jewish communities and travelling communities
have been implicated in outbreak of measles [2,3]. The outbreak described
here indicates that the anthroposophic community also is an at-risk group
of measles spread, because many parents in this group choose not to
vaccinate their children with the MMR vaccine [4]. Anthroposophy, based on
the writings of the mystic and social philosopher Rudolf Steiner
(1861-1925), combines human development with an investigation of the
divine spark found in all of nature.
The movement has marked education (Waldorf/Steiner schools) and medicine.
Anthroposophical doctors emphasise nature-based therapies that support the
body's innate healing wisdom. Antibiotics, fever-reducing agents, and
vaccinations are used at one's own discretion only [5].
Although measles has been eliminated or is under control in several EU
countries, it is still a public health priority [6]. Organisers of
large-scale events attended by international travellers, especially
youths, should consider documentation of adequate participant vaccination
[7].
In view of the current measles outbreak, Austrian and Swiss authorities
advise measles vaccination before travelling to the EURO 2008 soccer
games, starting on 7 June, 2008 in Austria and Switzerland.The current multi-state outbreak of measles once again highlights the need
to improve the vaccination coverage in Austria, along with disease
surveillance and outbreak-control capabilities [8].
Diligent case investigation of every single measles case is a prerequisite
to achieve the goal of measles eradication by 2010, planned by the World
Health Organization European Office [9].
References
Richard JL, Masserey-Spicher V, Santibaenez S, Mankertz A.
measles outbreak in Switzerland - an update relevant for the European
football championship (EURO 2008).
Euro Surveill. 2008;13(
.
Available from:
http://www.eurosurveillance.org/edition/v13n08/080221_1.asp Stewart-Freedman B, Kovalsky N.
An ongoing outbreak of measles linked to the United Kingdom in an
ultra-orthodox Jewish community in Israel.
Euro Surveill. 2007;12(9):E070920.1.
Available from:
http://www.eurosurveillance.org/ew/2007/070920.asp#1 Lovoll O, Vonen L, Vevatne T, Sagvik E, Vainio K, Sandbu S, et al.
An outbreak of measles among a travelling community from England in
Norway: a preliminary report.
Euro Surveill. 2007;12(5):E070524.1.
Available from:
http://www.eurosurveillance.org/ew/2007/070524.asp#1 Hanratty B, Holt T, Duffell E, Patterson W, Ramsay M, White JM, et al.
UK measles outbreak in non-immune anthroposophic communities: the
implications for the elimination of measles from Europe.
Epidemiol Infect. 2000;125(2):377-83.
Alm JS, Swartz J, Lilja G, Scheynius A, Pershagen G.
Atopy in children of families with an anthroposophic lifestyle.
Lancet 1999;353(9163):1485-8.
Van Lier EA, Havelaar AH, Nanda A.
The burden of infectious diseases in Europe: a pilot study.
Euro Surveill. 2007;12(12).
Available from:
http://www.eurosurveillance.org/em/v12n12/1212-222.asp Centers for Disesase Control and Prevention (CDC).
Multistate measles outbreak associated with an international youth
sproting event - Pennsylvania, Michigan, and Texas, August-September 2007.
MMWR Morb Mortal Wkly Rep. 2008;57(7):169-73.
Schmid D, Holzmann H, Popow-Kraupp TH, Wallenko H, Allerberger F.
Mumps vaccine failure or vaccination scheme failure?
Clin Microbiol Infect 2007;13(11):1138-9.
9. World Health Organization.
Eliminating measles and rubella and prevention congenital rubella
infection,
WHO European Region strategic plan 2005-2010.
[cited April 15, 2008]
Available from:
http://www.euro.who.int/document/E87772.pdf Disclamer: The opinions expressed by authors contributing to
Eurosurveillance do not necessarily reflect the opinions of the
European Centre for Disease Prevention and Control (ECDC) or the Editorial
team or the institutions with which the authors are affiliated. Neither
the ECDC nor any person acting on behalf of the ECDC is responsible for
the use which might be made of the information in this journal.
Eurosurveillance [ISSN] - ©2008 All rights reserved
--------------------------------------------------------------------------
[*/QUOTE*]
.
