Summary
The flu epidemic is over, COVID-19 and RSV are only detected to a small extent in Austria.
The measles outbreak continues, although activity in April was lower than in March. Since the last edition of the radar (as of 26/03/2024), 54 new cases have been recorded in the epidemiological reporting system. As of 23 April 2024, 401 cases have been reported for the current year. All federal states except Carinthia are affected.
As in many other European countries, Austria has also recorded an increasing number of reported cases of pertussis (whooping cough) since the end of the COVID-19 pandemic. Since the last radar (26/03/2024), 964 new cases of pertussis have been reported (as of 18/04/2024).
Avian influenza has attracted media attention with a human case in the USA and its impact on the cattle industry. Read more in our topic of the month.
SARS-CoV-2 is hardly being detected in both wastewater monitoring and the DINÖ sentinel system.
The number of COVID-19 patients in hospitals is at a very low level: in the first week of April, 35 admissions with COVID-19 to normal wards and one admission to an intensive care unit have been registered so far.
The dominant variant since the end of last year is JN.1, daughter line of BA.2.86.
Information on COVID-19 vaccination can be found in the current Vaccination Plan Austria 2023/2024 (Chapter E - COVID-19) dated 05/09/2023.
The diagnostic influenza network DINÖ announces the end of the flu epidemic at the beginning of April, after a significant decline in influenza virus activity was observed in Austria.
The estimated number of influenza and influenza-like illnesses is also decreasing.
Hospital admissions with influenza are at a low level. After peaking at the end of January with 631 admissions to normal wards, there were only 15 at the beginning of April and just one in intensive care units.
There has been no wave of influenza B this year.
The RSV-positive samples have been decreasing for over two months. In calendar week 16, none of the sentinel samples tested positive for respiratory syncytial virus.
This trend is also reflected in hospital admissions: at the peak at the beginning of February, over 400 patients were still admitted to normal wards, at the beginning of April there were 36, and three to intensive care units.
The majority of admitted patients are infants and toddlers aged 0 to 4 years.
Further information on the RSV vaccination can be found at Vaccination plan Austria 2023/2024 (sozialministerium.at)
As of 23 April 2024, 401 confirmed cases have been reported in Austria for the current year, compared with 186 for the whole of 2023.
Who is affected?
The highest incidence rates are found in infants and in the 10 to 14 age group. Most cases have been reported so far this year in Lower Austria (102), Tyrol (83), Vienna (58) and Styria (51). In 2024, 74 (18.8%) of the 394 cases with relevant information have so far been registered as hospitalised, four of them in intensive care.
Of the 266 cases for which information on vaccination status is available, 239 (89.8%) were unvaccinated, eleven (4.1%) had received a post-exposure vaccination, three people had been vaccinated once (1.1%) and 13 (4.9%) had been vaccinated twice against measles according to the documentation.
Measles is a highly contagious viral disease. Infections are characterised by flu-like symptoms with a high fever and a characteristic skin rash. Life-threatening complications such as inflammation of the lungs and brain can occur.
In order to protect infants who are still too young to be vaccinated but have a higher risk of a severe course and complications of measles infection, it is crucial that the entire environment is immune. If older siblings have been immunised twice, it is extremely unlikely that they will bring the virus home with them, for example from school or kindergarten.
Further information on the measles-mumps-rubella vaccination can be found in the Austria 2023/2024 vaccination plan (sozialministerium.at)
Compared to the previous month's report, 964 cases have been added, bringing the total number of cases in 2024 to 3,348 (as of 18 April 2024). All age groups are affected, with most cases affecting children and adolescents.
Vaccination is included in the free vaccination programme in Austria. Basic immunisation in infants should be refreshed at school age. After that, the immunisation should be regularly boosted in adulthood to ensure that the vaccination remains effective. The pertussis vaccination is recommended for everyone.
In order to protect infants in the first months of life, pregnant women in the third trimester in particular are recommended to be vaccinated, regardless of the interval between the last pertussis vaccination.
Further information on the pertussis vaccination can be found in the Austria 2023/2024 vaccination plan (sozialministerium.at).
In the majority of reporting European countries, the positivity rate for influenza tests in primary care is below the epidemic threshold of 10 per cent. This trend has continued for over four weeks. Influenza activity has decreased significantly earlier this season than in the last ten years (2020/21 excluded). For three weeks now, more influenza B viruses have been detected than influenza A viruses, albeit with only a small number of detections overall.
Both RSV and SARS-CoV-2 activity is at a very low level in all European countries (as at 22 April 2024).
Hospitals in European countries are also showing stable or decreasing trends in SARI cases (as of 22 April 2024).
SARS-CoV-2 variants
Neither the WHO nor the ECDC currently classify a virus variant as a Variant of Concern (VOC) or Variant under Monitoring (VUM). Therefore, no virus variant is classified as a variant of concern.
JN.1 is a sublineage of BA.2.86 and accounts for the majority of this variant. On 19 December, the WHO upgraded JN.1 itself to a VOI as it is spreading rapidly. So far, JN.1 is not considered more dangerous than other variants, which is why the WHO considers the risk it poses to be low.
Due to the low SARS-CoV-2 activity, only a few sequencing tests can still be carried out. Based on data from two countries, BA.2.86 (incl. JN.1) circulated at an average of 76% across Europe in week 13 to 14.
You can find more detailed information on the international and Austrian variant situation at: Coronavirus - AGES
Since January 2024, 323 cases of Mpox have been reported in Europe. After a slight increase in the second half of 2023, the numbers fell again, but the outbreak does not appear to have been completely overcome. Men who have sex with men (MSM) account for the majority of cases at 92% (as of 8 April 2024). In Austria, seven cases have been registered in the reporting system since the beginning of the year. The majority of these are MSM.
An Mpox outbreak has been underway in the Democratic Republic of the Congo (DRC) since 2023. By the end of March 2024, there were 4,488 suspected cases. Since January 2024, 279 deaths have been reported. Despite the sharp rise in cases in the DRC, the ECDC estimates the risk to the European population to be low. Even though only around 10% of cases have been confirmed and can be analysed, it can be assumed that the outbreak in the DRC is caused by Mpox viruses (MPXV), which are classified as "clade I". Clade I viruses have not yet been detected in Europe. The Mpox viruses circulating in Europe belong to "clade II", which causes significantly less serious diseases (as of 19 April 2024).
Mpox is an infectious disease caused by MPXV and is mainly transmitted via direct contact of skin or mucous membranes with body fluids or the typical skin lesions.
Safer sex rules are not enough to prevent Mpox, as the virus can be transmitted through skin contact. Nevertheless, condoms can reduce the risk of infection by reducing direct contact with mucosal lesions. Further information can be found under "Stay Safe!" on the BMSGPK website.
Vaccination against Mpox has been available in Austria since 2022. This is available to risk groups. You can find more information under "Vaccination against Mpox" and in the current vaccination plan for Austria (sozialministerium.at).
After Europe was hit by the most severe avian influenza epidemic since 2020, the situation has eased significantly in recent weeks. On 18 April, the "greatly increased risk of avian influenza" was lifted in the relevant areas in Austria. We explain why there is still media excitement about avian influenza and to what extent it affects not only animals but also humans.
Avian influenza is normally a viral disease of birds, caused by influenza A viruses, as in human influenza. There are different types of avian influenza viruses, which are infectious and cause disease in different ways. Avian influenza viruses that are very dangerous for birds are called highly pathogenic (HPAIV), including certain variants of the subtypes H5 and H7. The diseases they cause are known as avian influenza. These viruses pose a serious threat to wild birds, livestock and domestic poultry. To protect the animals and prevent economic damage, risk areas are designated where necessary. In these risk areas, livestock farmers must implement increased measures. The main aim of these measures is to prevent contact with wild birds. If avian influenza breaks out in a poultry farm, the disease usually spreads quickly and the animals die within a short period of time. The surviving animals also have to be killed. It is therefore no wonder that the spread of the disease is monitored very closely and that there are clear rules for dealing with it: Waterfowl and birds of prey found dead must be reported to the district administrative authority, and there is an obligation to report suspected cases in poultry farms. AGES operates the animal disease radar, in which the situation of relevant animal diseases is analysed on a monthly basis. In addition, the genetic material of AI viruses from active and passive surveillance is analysed in order to identify changes that indicate an adaptation to mammals/humans. AGES makes the data from this full genome sequencing available in an international database.
As part of the active surveillance programme, a total of 5,692 poultry blood samples were tested for the avian influenza virus in Austria in 2023. Details on the procedure and results can be found here.
Avian influenza is nothing new, but it is very dynamic. It can be assumed that it will continue to occur worldwide in the coming years. The viruses mutate and birds are not the only ones to become infected and sick.
The European Food Safety Authority (EFSA) published new recommendations on monitoring and risk minimisation in mid-April. The risk of the general population contracting avian influenza in Europe is considered to be low.
From minks, cattle and humans
Occasionally an avian influenza virus makes the jump to a mammal. Such outbreaks are scrutinised particularly closely because the more mammals such a virus infects, the higher the probability that a variant could develop that would be dangerous to humans. Accordingly, mammalian outbreaks attract a great deal of attention and the measures taken are strict: in 2023, thousands of minks, foxes and raccoon dogs had to be killed on fur farms in Finland, among other places, due to infections.
During outbreaks of avian influenza on fur farms in 2022, it was assumed that mink-to-mink transmission had taken place. Mammal-to-mammal infection, and not just bird-to-mammal, would be an important factor in the evolution of the viruses that could accelerate the spread. So far, no human-to-human infection has been detected.
Since 25 March 2024, infections of dairy cattle with the avian influenza virus have been causing a stir in eight states in the USA. (As of 24/04/2024) A farmer became infected with the HPAI A (H5N1) virus at the end of March, making it the second human infection with the H5N1 virus in the USA. This case is special in that a human was presumably infected by a mammal. The genetic makeup of this patient's virus has been decoded and according to the CDC, it has no changes of concern and no special adaptations that would make it more dangerous to humans.
The USDA (U.S. Department for Agriculture) assumes that the virus was transmitted from cow to cow in the cattle herds, how exactly is still being investigated. The virus is also excreted in the milk. This has led to concerns that the virus could infect humans via milk. According to the USDA, this concern is unfounded; pasteurised milk poses no health risk to consumers.
Individual cases in humans
Since 1997, around 900 human cases of influenza A (H5N1) have been reported worldwide. More than half of these reported cases resulted in death. However, this does not mean that half of all infected people die; infections without severe disease progression often remain undetected.
Infections usually occur where there is intensive contact between poultry farmers and infected birds under poor hygienic conditions. The number of transmissions has fallen significantly since 2015. There have been human cases in 23 countries to date; no human has ever been diagnosed with avian influenza in Austria.
In the USA, tests are currently being carried out to determine the extent to which known influenza drugs and vaccinations can also protect people against infections with the currently widespread avian influenza viruses.
Food is not a risk
So far, people have only been infected through direct contact with infected animals. Eggs, poultry and milk pose no risk if kitchen hygiene is appropriate.
An unknown risk
Avian influenza has many aspects that make it significant: it is a major threat to wild bird populations worldwide, even in the most remote areas such as Antarctica. It threatens poultry populations and is therefore relevant for food production. That alone would be reason enough to keep a close eye on these viruses. But one aspect overrides all others: Avian influenza is considered a possible candidate for the next pandemic. Due to the wide distribution in birds and the increased spread to mammals, the viruses have ample opportunity to change and adapt to new hosts. An influenza H5 virus is not common in humans and our immune system would probably not be prepared for it.
How high this risk actually is can hardly be reliably estimated. It is almost impossible to predict when and how viruses mutate and what characteristics they acquire. Nobody knows how pathogenic an AI virus spreading from person to person would be, which not only makes the fight against a possible next pandemic difficult, but also communication. Should we talk about bird flu even though only a few people are infected and no human-to-human transmission is possible? Or is this scaremongering?
The COVID-19 pandemic has made it clear that we need to be better prepared for the next pandemic. This includes transparent communication, including information about risks whose magnitude cannot yet be assessed. In this way, measures can be understood and reports on avian influenza can be better categorised.
Since the beginning of 2024, another AGES research project has been focussing on vector-borne diseases. As part of this research project, all people in Austria are invited to bring any ticks they find to AGES. Our experts will determine the type of tick and analyse it for pathogens. This means that new vector species and new pathogens can be recognised earlier in Austria and their geographical spread can be monitored. Borreliosis bacteria and Crimean-Congo haemorrhagic fever viruses are at the centre of the monitoring of tick-borne pathogens.
To date, the project team has already received over 100 ticks, 88 of which have been analysed. Of these, Ixodes ticks make up the majority (97%), the remainder are the larger and also indigenous Dermacentor ticks. Good quality ticks will soon be tested for borrelia.
Ticks can currently be collected at the following locations:
- Vienna: AGES, Währinger Straße 25a, 1090 Vienna, attn. Anna Schötta
- Lower Austria: AGES, Robert Koch Gasse 17, 2340 Mödling, for the attention of Dr Georg Duscher
The project team needs ticks from as many regions of Austria as possible. If you are travelling a lot in Austria and in nature, keep an eye out for ticks and take them with you.
You can find more information about the project, the best packaging and tick collection at Tick information - AGES
The 2023 annual report on meningococci was published on 25 April: The National Reference Centre for Meningococci registered 16 laboratory-confirmed cases of invasive meningococcal disease. There were no deaths. Two of the isolates were classified as resistant to penicillin, otherwise no resistance to the antibiotics tested was found.
World Immunisation Week takes place every year in the last week of April. This year, the week from 24.04. to 30.04.2024 is dedicated to the theme Humanly Possible: Saving lives through immunisation .
During this week, awareness will once again be raised that vaccinations save lives and protect health.
The Expanded Immunisation Programme was launched in 1974 with the aim of giving all children worldwide access to life-saving vaccinations. This year's Immunisation Week therefore also celebrates the successes of the last fifty years. During this time, vaccinations have protected many generations from serious diseases such as tetanus, poliomyelitis and measles.
World Immunisation Week 2024 (WIW 2024) (cdc.gov)
European Immunisation Week 2024 (who.int)
Immunisation Week Austria
Some Austrian federal states are organising vaccination campaigns to mark World or European Immunisation Week:
Burgenland: Vaccinations - Land Burgenland
Carinthia: Immunisation Advice Week - Carinthia
Lower Austria: Measles vaccination bus tours Lower Austria - Province of Lower Austria (noe.gv.at)
Upper Austria: Province of Upper Austria - Upper Austria intensifies activities against whooping cough and measles (land-oberoesterreich.gv.at)
Salzburg: Vaccinations - Land Salzburg
Styria: Vaccination bus tours Styria - steiermark.ORF.at
Tyrol: European Immunisation Week 2024: Free MMR and HPV vaccinations in all districts | Province of Tyrol
Vorarlberg: Vaccination programmes in Vorarlberg
Vienna: Vaccination service Vienna
25.04.2024 is World Malaria Day. Malaria is one of the most important infectious diseases worldwide. In 2022, 249 million cases and 608,000 deaths were reported(WHO, as of 18 April 2024). Malaria occurs in tropical and subtropical regions of the world, with the African continent being particularly affected, accounting for 94% of all global cases and 95% of all global deaths. Malaria is transmitted by mosquitoes, with symptoms ranging from headaches and fever to seizures and breathing difficulties. Children in the African WHO region have the highest mortality risk. Malaria could be prevented and treated, but the necessary resources are often lacking. The WHO and partners want to reduce the mortality rate by at least 90 % by 2030 compared to 2025, eradicate malaria in at least 35 countries and prevent the return of malaria in malaria-free countries(WHO, as of 18 April 2024).
According to the WHO, zoonoses are "diseases and infections that can be transmitted naturally between humans and other vertebrates."
Originally, the term had a different meaning, it stood for animal diseases.
Today, it refers to infectious diseases that occur in animals and humans and whose pathogens can change from animal to human and vice versa from human to animal.
One example is the avian influenza described in the "Topic of the month". However, more than half of all pathogens that cause disease can be transmitted between humans and animals.
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: 25.04.2024
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