AGES radar for infectious diseases - 17.04.2025

Summary

The flu season has been over since 14 April. It was an intense flu year, while RSV was less active than in previous years. SARS-CoV-2 activity has been very low for months and there was no seasonal pattern in Europe.

Pertussis cases reached a new high last year, with a total of 15,465 cases reported. This year there are 982 as of 14 April 2025.

The USA has now reported its third measles death this year. This means that as many people have died from measles in the USA since the beginning of 2025 as died in total between 2000 and 2024.

To mark European Immunisation Week at the end of April, our Topic of the Month shows what is planned in Austria this week and explains the role of AGES in vaccinations.

In Latvia , severe diarrhoea has been occurring more frequently since March due to shiga toxin-producing E. coli . The cause is still being investigated.

In the news section, we present a publication by an AGES employee on the Marburg virus disease. The following annual reports from national reference centres have also been published: Yersinia and pneumococci.

Situation in Austria

The flu season has been over since 14 April 2025. This marks the end of an intense and exceptionally long 2024/2025 influenza season.
The start of the flu epid emic was confirmed as 23 December 2024. The flu epidemic peaked in early to mid-February, with over 700 hospital admissions in one week.
This season saw a simultaneous circulation of influenza A and B quite early on, with influenza B ultimately predominating in the number of cases. This brings the trend closer to the pre-pandemic flu seasons.

The respiratory syncytial virus (RSV) had significantly less impact in the 2024/2025 season than in previous years: While over 400 people were hospitalised with RSV per week at the peak of the previous 2023/2024 season, there were a maximum of 172 admissions per week in the current season. Activity started late at the beginning of February and is still continuing.

SARS-CoV-2 activity increased as early as summer 2024 and reached its moderate peak in October 2024. With the subsequent decline in SARS-CoV-2 detections, the virus no longer played a significant role in the rest of the season.

A similar picture was observed in the member states of the European Union: The 2024/2025 season was characterised by an intense influenza season and a simultaneous RSV epidemic. A SARS-CoV-2 winter epidemic was also not observed in the other European countries. Clear seasonal activity in the winter months has not yet been observed for COVID-19.

More details on the autumn/winter season 2024/2025 can be found in MedUni Vienna's Virus Epidemiology Information.

You can also listen to more information on influenza in the AGES podcast "Courage to take risks": Episode 003 - Influenza & Co: How do I surf safely through the flu wave? - AGES

Current information on influenza, RSV and COVID-19 vaccinations can be found at: Home | Vaccination simply protects.

Influenza - AGES
RSV - AGES
Coronavirus - AGES
erviss.org
Wastewater monitoring
2025 | MedUni Vienna

 

A total of 2,791 cases were reported in Austria in 2023, compared to 15,465 in 2024.
This year , there have been 982 so far (as of 14 April 2025). This is around a third of the figure for the same period last year. Figure 1 shows the number of cases since 2015. The green line marks the number of cases as at 14 April, which enables a comparison with the current situation.

The cases per 100,000 inhabitants for each federal state for the year 2025 are shown in Figure 2. The age distribution (Figure 3) shows that infants are particularly affected.

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 gives newborn babies protection through maternal antibodies.

Further information on the pertussis vaccination can be found in theVaccination Schedule Austria 2024/2025 Version 1.1 (www.sozialministerium.at).

Whooping cough (pertussis) - AGES

International outbreaks

Another child died of measles in the USA at the beginning of April. This means that a total of three deaths have been reported in the course of the current measles outbreaks in the USA since the start of 2025. There is also an outbreak in Mexico which, according to initial analyses, is likely to be linked to the one in Texas and in which an unvaccinated man has died so far.

This number of deaths in such a short time is exceptional. Normally, there are 1 to 3 deaths per 1,000 unvaccinated cases. So far, 712 measles cases have been reported in the US since the beginning of the year, 97% of which are unvaccinated or have an unknown vaccination status (1% have received one MMR dose, 2% have received two MMR doses)(CDC, as of 10/04/2024). In comparison, 285 measles cases were reported in the US last year. Three deaths could be a statistical outlier, but it is also conceivable that by no means all infections are recorded.

In Europe, the reported number of measles cases for 2024 is the highest in 25 years. In 2024, 127,350 measles cases were reported in the WHO Europe region, twice as many as in 2023. The vaccination rate had fallen sharply during the pandemic and has not yet returned to pre-pandemic levels.

Factors currently leading to this sharp increase in measles cases are low vaccination rates, public distrust of health authorities, vaccine scepticism and misinformation circulating. US Secretary of Health and Human Services Robert Francis Kennedy Junior, who has been an active anti-vaccination campaigner in the past, has publicly recommended vitamin A or cod liver oil for the treatment of measles. Following this statement, several children in Texas had to be treated for vitamin A poisoning after being hospitalised for measles complications. Vitamin A is only used by doctors in a controlled manner in special cases when patients have a deficiency, but not for general treatment. If you take it yourself, there is a risk of overdosing and thus poisoning, which can damage the liver.

Measles is a highly contagious viral disease characterised by fever, cough and a characteristic skin rash. It can lead to life-threatening complications such as inflammation of the lungs and brain. The measles virus is mainly transmitted by droplets when coughing or sneezing.
In Austria, 82 cases have been reported so far this year (as of 16/04/2025).

The most effective way to protect against measles infection is vaccination. A total of two doses of vaccine are generally recommended from the age of 9 months. The vaccination is part of the free vaccination programme of the federal government, the federal states and social insurance companies and is available free of charge at public vaccination centres for all age groups.

More information on the measles vaccination can be found at:
Measles-Mumps-Rubella (MMR) - Vaccination Service Vienna

It is advisable to check your own vaccination status and update your vaccinations if necessary.

Measles - AGES
Measles - United States of America
Measles Cases and Outbreaks | Measles (Rubeola) | CDC
European Region reports highest number of measles cases in more than 25 years - UNICEF, WHO/Europe

At the end of March, the avian influenza virus A(H5N1) was detected for the first time in a sheep in the United Kingdom. Poultry had previously tested positive in the neighbourhood. With the sheep, another animal species joins the list of animals in which an infection with the avian influenza virus A(H5N1) has been detected. Never before have so many different hosts been found to harbour H5N1. In the USA, dairy cows, pigs, cats and rodents, among others, have been infected with avian influenza virus A(H5N1) since March 2024. In Europe, too, there have been cases of avian influenza in ferrets and foxes on fur farms in recent years. This range of hosts shows that the virus can adapt quickly. With each additional infected animal, the likelihood of it coming into contact with humans and making the leap to a human host also increases.

In the USA, 70 people have tested positive for the avian influenza virus A(H5N1) since last year, and one person died from it in early 2025. Most of them had been infected either by sick dairy cows or sick poultry(CDC, as of 14 April 2025).

In Mexico, an A(H5N1) infection was first detected in a human, a three-year-old child, at the beginning of April. The girl died of the infection shortly afterwards. How she became infected is still being investigated.

There is no evidence of continued human-to-human transmission. There are no cases of bird flu in humans in Europe. Furthermore, the risk of infection for the general public in Europe is considered to be low, and for occupationally exposed persons to be low to moderate.

In Latvia, 58 cases of infection with Shiga toxin-producing Escherichia coli (STEC) have been reported since the beginning of March (as of 03/04/2025). The majority of those affected are children.

Bacteria of the Escherichia coli species are part of the normal intestinal flora in humans. Some E. coli bacteria acquire the ability to produce a specific toxin, shiga toxin, and can thus cause illness in humans; they are called shiga toxin-producing E. coli (STEC). Infection usually occurs via contaminated food or water sources.

The disease causes watery diarrhoea, which often becomes bloody after a few days and can be accompanied by severe nausea, vomiting and abdominal pain. In around 5-10% of cases, especially in young children, a secondary illness can occur, the life-threatening haemolytic uraemic syndrome (HUS). HUS leads to kidney failure, anaemia and other severe symptoms.

The Latvian Centre for Disease Prevention and Control (SPKC) is carrying out investigations. Large-scale measures have already been taken: Affected persons are being interviewed, contact persons are being identified and the pathogens are being analysed. The first results from the laboratory are available; two STEC serotypes (O103 and O26) have been identified. It is not yet clear whether these are two separate outbreaks with two different contaminated products or a combined outbreak in which a single product is contaminated with different pathogens.

Epidemiological investigation of E. coli infection cases continues | Centre for Disease Prevention and Control

Topic of the month

The European Region of the World Health Organization (WHO) organises the annual European Immunisation Week (EIW) to highlight the importance of vaccination in preventing disease and protecting human lives. This year's campaign runs under the motto "Immunisation for all is humanly possible" and focuses on leaving no one behind in efforts to protect public health through vaccination.

Campaigns in Austria

The vaccination week will focus on MMR (measles-mumps-rubella) and DTPP (diphtheria-tetanus-pertussis-polio), particularly due to the high number of cases of measles and pertussis in 2024. In Austria, some federal states are taking up the EIW and are increasingly focussing on information, education and vaccination offers. In Upper Austria, for example, there are already immunisation campaigns in the municipalities of Urfahr-Umgebung, Eferding, Lichtenberg and Steyr. Carinthia is focussing on extended opening hours and a "vaccination advice week" at the health authorities. Tyrol is increasingly focussing on long vaccination afternoons on different days in the health departments of the district authorities/municipal authorities and the public health department. Vienna is also starting a four-week vaccination campaign and is offering vaccinations against TBE (tick-borne encephalitis) at the TownTown vaccination service.

Service: Vaccination offers in the federal states:

Austria in international comparison

In Austria, some vaccination gaps are widening, which has very real consequences. If there are larger groups in the population who are not immunised, outbreaks are more likely and there are more people affected. This explains, for example, the rising number of measles cases, not only in Austria, but throughout Europe and currently also in the USA.

93% of five-year-olds in Austria have received the recommended two doses of vaccine. Austria is above the EU average of 88% for measles vaccination, but below the recommended level of 95% for population protection.

In the 2021/22 flu season, the influenza vaccination rate for people aged 65 and over in Austria was 22%. This is significantly lower than the EU average of 48%. Austria is therefore among the EU member states with the lowest vaccination rates.

Austria is in the bottom third of EU Member States in terms of HPV vaccination rates. In 2021, around 53% of 15-year-old boys and girls had received both doses of the HPV vaccine. The HPV vaccination is free of charge for children, adolescents and young adults from the age of 9 to 21. With a limited offer until 31 December 2025, it is possible for people after their 21st to 30th birthday to get the HPV vaccination free of charge. After this date, the catch-up vaccination programme for the 21 to 30 age group will no longer include free HPV vaccinations or second vaccinations. Up to the 30th birthday, two HPV vaccinations are recommended at intervals of at least 6 to a maximum of 12 months. In order to receive both partial vaccinations free of charge, people aged between 21 and 30 should therefore receive their first vaccination before the end of June 2025 .
You can find more information on HPV vaccination at: impfen.gv.at/hpv

The role of AGES

AGES plays a central role in connection with vaccinations in Austria. In the EU, the authorisation procedure for COVID-19 vaccines is coordinated by the European Medicines Agency (EMA). The national medicines authorities are involved in the technical assessment, in Austria this is AGES. AGES also conducts scientific studies to analyse the efficacy and safety of vaccines. One example of this is a study on the effectiveness of COVID-19 vaccinations, which showed that vaccinated people had a lower risk of re-infection.

In addition, a batch release by an officially appointed medicinal product control laboratory is required in Austria. AGES operates such a laboratory, the OMCL - Official Medicines Control Laboratory. A batch is a quantity of a vaccine produced in the course of a standardised manufacturing process.

The National Vaccination Committee (NIG)

The National Vaccination Committee (NIG) in Austria is a commission that prepares all vaccination recommendations for Austria in close cooperation with the Federal Ministry of Labour, Social Affairs, Health, Care and Consumer Protection (BMASGPK). The committee is made up of experts from various fields, including general medicine, epidemiology, immunology and public health. On the AGES side, Barbara Tucek, Daniela Philadelphy and Bernhard Benka are members of the NIG.

Messages

At the beginning of April, a scientific article on Marburg virus disease (MVD) was published, to which AGES employee Ziad El-Khatib contributed.

The study focusses on the early detection of Marburg virus disease in Rwanda. The early symptoms of MVD are non-specific and resemble other diseases such as malaria, which makes diagnosis difficult. The aim of the study was to gain a better understanding of MVD symptoms in order to improve early diagnosis. To this end, data from 6,613 suspected cases during an outbreak in Rwanda in 2024 were analysed. One finding was that haemorrhagic symptoms are less suitable for early detection than constitutional (fever, etc.) and gastrointestinal symptoms.

Refining early detection of Marburg Virus Disease (MVD) in Rwanda: Leveraging predictive symptom clusters to enhance case definitions - ScienceDirect

World Tuberculosis Day takes place every year on 24 March. The date marks the day in 1882 when Dr Robert Koch announced that he had discovered the bacterium that causes tuberculosis.

Tuberculosis (TB) is the most common deadly infectious disease in humans worldwide, even though it was briefly replaced by COVID-19 during the pandemic. In 2023, 1.25 million people died of TB worldwide. TB is caused by the bacterium Mycobacterium tuberculosis and mainly affects the lungs.

Unfortunately, there are also negative developments in Europe:

  • For the first time in 20 years, the number of TB cases is on the rise, with a four per cent increase in the EU/EEA region.
  • In children, the increase was as high as ten per cent, which is seen as an indication of current infections and therefore failures in prevention and diagnosis.
  • Antibiotic resistance remains a challenge: although progress has been made in detecting such cases, treatment success rates remain low.
  • TB continues to affect particularly vulnerable groups, such as people with HIV or with poor access to the healthcare system.

The WHO's major goal is to reduce global TB deaths by 90 % and global TB incidence by 80 % by 2030, but we are currently lagging behind this target, including in Austria. So far this year, 85 cases have been reported, which is slightly below the median of recent years (see download table).

Tuberculosis - AGES

The 2024 annual report of the National Reference Centre for Pneumococci was published on 13.03.2025. In 2024, 812 invasive pneumococcal infections (IPE) were registered by the epidemiological reporting system. 57 people died from the disease. This represents a continuation of the upward trend seen in recent years.

Distribution of serotypes

Of the 812 registered cases of IPE, the serotype could be determined in 802 (98.8 %). 43 different serotypes were identified.

Recommended and new vaccination

Vaccination for children with the 15-valent conjugate vaccine is available free of charge in the first two years of life as part of the childhood vaccination programme. A total of three vaccinations should be administered in the 3rd, 5th and 12th-14th month of life.

The Austrian vaccination plan of the Federal Ministry of Labour, Social Affairs, Health, Care and Consumer Protection(Impfplan Österreich 2024/2025, Version 1.1) currently recommends sequential vaccination of healthy adults over the age of 60 with the 15-valent (PCV15) or 20-valent (PCV20) (PCV20) conjugate vaccine and after ≥1 year with the 23-valent polysaccharide vaccine (PPV23).

50.5 % of the pneumococcal serotypes registered in 2024 in the 60+ age group would theoretically have been covered by the PCV15 vaccine recommended for adults, 62.9 % by the PCV20 vaccine and 67.6 % by the PPV23 vaccine. A new 21-valent conjugate vaccine (PCV21) for adults, which has already been positively assessed by the European Medicines Agency EMA, would have covered 80.7% of the IPE serotypes occurring in Austria in 2024 in the 60+ age group.

Since 1 April 2025, admissions with the diagnosis "pneumococcal pneumonia" have also been reported on the SARI dashboard.

Pneumococci - AGES

 

The 2024 annual report of the National Reference Centre for Yersinia was published on 13.03.2025. In 2024, an increase of 17% in the number of human primary isolates submitted was recorded compared to the previous year. Of 225 human isolates, 98 were classified as pathogenic and 127 as apathogenic.

The incidence of yersiniosis culturally confirmed by the reference centre was 1.07 per 100,000 inhabitants in 2024. Of the 96 pathogenic, i.e. disease-causing, Y. enterocolitica isolates, 18 were resistant to amoxicillin/clavulanic acid. All pathogenic Y. enterocolitica isolates were resistant to ampicillin.

The genus Yersinia includes 14 species, three of which are considered pathogens relevant to humans: Y. pestis, Y. pseudotuberculosis and Y. enterocolitica. Y. pestis is not endemic in Austria and is covered by the AGES reference centre at the Institute for Medical Microbiology and Hygiene in Vienna.

Yersinia - AGES

On 14 April 2020, the food manufacturer Wojnar's issued a recall for several hummus varieties and batches. The reason was that salmonella was found in the raw material tahini during an internal quality control. It cannot be ruled out that products contaminated with salmonella have been placed on the market. The products were temporarily available in Austria in branches of Kröswang, Wedl, Kastner, Transgourmet, Eurogast, Nöm Gast and Julius Kiennast. They can be returned to the respective shops and the purchase price will be refunded even without proof of purchase.

A detailed list of the affected products and batches can be found on our website.

Whether there are salmonella illnesses associated with these products has yet to be determined by laboratory tests (as of 16.04.2025).

Salmonella - AGES

Technical term epidemiology

It indicates the proportion of people in a population who have been immunised against a particular disease, often referred to as the "vaccination coverage rate" or "vaccination coverage". For some diseases, such as measles, there is a critical immunisation rate: if more than a certain proportion of the population were vaccinated, the disease could be eliminated. For measles, this would require a vaccination rate of 95%.

About the radar

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), we ask for your patience. A reply will be sent within one week.

The next AGES-Radar will be published on 15 May 2025.

Data on notifiable diseases

Case numbers of notifiable diseases according to the Epidemics Act, the figures are shown for the previous month and, in each case for the period from the beginning of the year to the end of the previous month, the figures for the current year, for the previous year, as well as the median of the last 5 years for comparison (Epidemiological Reporting System, as of 16.04.2025).

Pathogens 2025 2024 2020-2024 (median)
Mar Jan-March Jan-Mar Jan-Mar
Amoebic dysentery (amoebiasis) 0 0 4 2
Botulism b 0 0 0 0
Brucellosis 0 2 2 2
Campylobacteriosis b 294 1.092 1.300 1.201
Chikungunya fever 0 0 3 0
Cholera 0 0 0 0
Clostridioides difficile infection, severe course 74 260 208 159
Dengue fever 21 43 63 28
Diphtheria 0 2 1 1
Ebola fever 0 0 0 0
Echinococcosis due to fox tapeworm 2 6 8 3
Echinococcosis due to dog tapeworm 0 4 7 8
Spotted fever (rickettsiosis caused by R. prowazekii) 0 0 0 0
Tick-borne encephalitis (TBE) 0 1 3 1
Yellow fever 0 0 0 0
Haemophilus influenzae, invasive a 8 43 40 18
Hantavirus disease 0 6 7 7
Hepatitis A 14 28 16 12
Hepatitis B 76 248 317 243
Hepatitis C 90 274 305 249
Hepatitis D 1 1 3 3
Hepatitis E 6 20 15 15
Whooping cough (pertussis) 245 926 2.762 72
Polio (poliomyelitis) 0 0 0 0
Lassa fever 0 0 0 0
Legionnaires' disease (legionellosis) d 20 88 54 44
Leprosy 0 0 0 0
Leptospirosis 1 2 9 1
Listeriosis b 2 7 15 7
Malaria 4 15 13 13
Marburg fever 0 0 0 0
Measles 20 75 378 25
Meningococcus, invasive c 7 16 6 5
Middle East respiratory syndrome (MERS) 0 0 0 0
Anthrax 0 0 0 0
Mpox e 1 6 7 0
Norovirus gastroenteritis b 512 1.786 1.532 769
Paratyphoid fever 0 0 0 0
Plague 0 0 0 0
Pneumococcus, invasive c 109 378 335 208
Smallpox 0 0 0 0
Psittacosis 0 0 1 1
Rotavirus gastroenteritis b 161 378 335 208
Glanders (Malleus) 0 0 0 0
Rubella 0 0 0 0
Relapsing fever 0 0 0 0
STEC/VTEC b 62 173 98 59
Salmonellosis b 51 153 190 186
Scarlet fever 42 104 223 2
Severe acute respiratory syndrome (SARS) 0 0 0 0
Shigellosis b 19 65 43 16
Other viral meningoencephalitis 2 28 19 21
Rabies 0 0 0 0
Trachoma (grain disease) 0 0 0 0
Trichinellosis 0 0 1 1
Tuberculosis 21 85 112 101
Tularemia 2 6 24 7
Typhoid fever 0 0 3 1
Bird flu (avian influenza) 0 0 0 0
West Nile virus disease 0 0 0 0
Yersiniosis b 1 16 32 32
Zika virus disease 1 1 7 0

 

a The diseases are assessed according to the case definition. Diseases for which a case definition exists are shown, with the exception of transmissible spongiform encephalopathies. As a rule, confirmed and probable cases are counted. Subsequent notifications or entries may result in changes.

b Bacterial and viral food poisoning, in accordance with the Epidemics Act.

c Invasive bacterial disease, in accordance with the Epidemics Act.

d Includes only cases with pneumonia.

e Mpox has been notifiable since 2022; the median is only calculated for the years in which notification is mandatory.

 

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Last updated: 18.04.2025

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