February 2024

Summary:

• • • Measles virus is currently circulating in Tyrol with ~40 confirmed cases in the past 3 weeks.
    • PCR remains the gold standard for diagnosis, ideally from throat swab or urine.
    • Measles vaccination is highly effective (two doses provide 98% protection) and crucial for herd immunity.
    • WHO recommends a 95% vaccination rate; Austria currently has only 87% coverage among under-5-year-olds.
    • Physicians are urged to actively check and update vaccination records due to rapid transmission.

Currently, the measles virus is circulating in Tyrol. Our laboratory has reported approximately 40 confirmed cases to the EMS within the past three weeks. For diagnostic purposes, both serology and direct pathogen detection (PCR) are available. The gold standard for confirmation remains PCR, preferably performed on throat swabs or urine samples.

The antibody constellation obtained through serology can, in addition to supporting the diagnosis, provide an indication of whether the infection is recent or represents the rare case of a breakthrough infection. By determining the avidity of IgG antibodies, these two forms of infection can be distinguished.

The good news is that reinfections or breakthrough infections occur only very rarely, as the measles vaccination is highly effective (two doses provide 98% protection) (RKI, WHO). This sterilizing immunity, combined with a high vaccination coverage, can lead to sufficient herd immunity to protect individuals who cannot be vaccinated (e.g., newborns, immunocompromised persons).

Since measles virus transmission occurs exclusively from person to person, herd protection — and even complete eradication of the virus — is practically achievable. Due to the high contagiousness (secondary attack rate: >90%), the measles vaccination coverage among eligible individuals must reach 95% (WHO). According to the “Short Report Measles 2022,” however, only 87% of children under five years of age in Austria have received two doses of the vaccine. The MMR vaccine is available free of charge for all age groups.

In light of the current rapid transmission observed in Tyrol, every practicing physician bears a significant responsibility to actively check vaccination records and complete them where necessary.