Outbreak in Nordrhein Westfalen, western Germany
Between mid-January and 23 March 2006, 246 cases of measles were notified in the federal region of Nordrhein Westfalen. One hundred and seven of these cases have been laboratory confirmed. This is more than 20 times the number reported during the same period in 2005. Ninety-five cases were detected in the city of Duisberg, where there was an outbreak of 30 cases in a secondary school.

The number of notifications from this region continues to increase. Fifty-two patients required hospital admission, and some of these were treated for lung infections and/or otitis media. Over 90% of the patients had not been vaccinated against measles, or vaccinated incompletely (only one dose).

The average age of patients is about 15 years. Most of the patients are aged between 10 and 19 years. Younger children are less affected. The oldest patient was 52 years of age.

The regional public health office has informed all local branches about the measles outbreaks, and of the necessity of eliminating pockets of susceptibility.

Figure. Distribution of cases in Nordrhein Westfalen by age group (n = 246)

Outbreak in southern region of Baden Wuerttemberg
At the beginning of January 2006, several cases of measles in children were notified to local public health authorities in Stuttgart, Baden Wuerttemburg. The primary case in this outbreak was in a five year old child who was clinically diagnosed with measles on 28 December 2005.

The clinic which notified the case in the child from Hamburg then notified two more cases in children: a 12 year old on 4 January and a 5 year old on 5 January, who was taken to the family home in the city of Tuebingen (also Baden Wuerttemburg) where the child’s brother and sister also became ill with measles. The parents had refused vaccination for them.

Two more children became ill on 15 January and by 17 March, 58 measles cases had been reported, most of them in patients aged 1-9 years. Four of the patients required hospital admission as a result of the infection. Nine cases were laboratory confirmed, and seven cases have been found to be caused by measles genotype B3.

None of the patients had been immunised. The patients belong to a social group where measles vaccination is viewed as unnecessary. After the first cases were diagnosed, a prompt appeal to get vaccinated by local health authorities to families and in schools was unsuccessful, and further cases were not prevented.

An alert was sent to public health authorities in other European countries about these outbreaks on 17 March 2006 via the European Early Warning and Response System (EWRS).

This report was translated from references 1 and 2. Thanks to Dr Ulrich van Treeck, Landesinstitut für den öffentlichen Gesundheitsdienst, Nordrhein-Westfalen, Germany