AGES radar for infectious diseases - 15.05.2025

Summary

A case of leprosy has been reported in Austria, involving a man who has travelled extensively in remote regions of the world. He is currently undergoing treatment.

With the rising temperatures, the number of tick encounters is increasing. AGES is monitoring the situation: so far this year, over 1,800 ticks have been handed in and analysed for pathogens.

Hepatitis A is very rare in Austria, but there has been an increase in cases this year. The Institute for Infectious Disease Epidemiology at AGES is analysing the outbreak.

Pertussis cases reached a new high last year, with a total of 15,465 cases reported. This year there are 1,101 as of 13 April 2025.

A recent study determined the origin of the outbreak of avian influenza in dairy cows in the USA: a single contact between a wild bird and a cow at the end of 2023.

How can we recognise serious health information and reliably distinguish it from misinformation? We explain this in the topic of the month, together with experts from the Department of Evidence-based Medicine and Evaluation at the University of Krems.

In the news, we report on International Hand Hygiene Day. Europe is also unlikely to achieve its 2030 health targets .

Situation in Austria

A total of 58 cases of hepatitis A have been reported in Austria so far in 2025 (as of 12 May 2025). In comparison: in the previous year, there were 74 cases in the entire year. This year, men between the ages of 25 and 44 are the most affected.

The National Reference Centre for Hepatitis A is sequencing samples from hepatitis A cases to find out whether there are links between individual cases. A genetic match was found for some virus strains: Between June 2023 and May 2025, 20 infections with hepatitis A genotype IB were registered in three federal states (Lower Austria n=5, Upper Austria n=1, Vienna n=14). One case of hepatitis A genotype IB occurred in each of the years 2023 and 2024, and there has been a clear increase since the beginning of 2025: two cases in January, six in March, eight in April and two in May. On 15 April, the Institute for Infectious Disease Epidemiology at AGES was commissioned to investigate this cluster of hepatitis A cases. Of the 20 cases attributed to the outbreak, 18 are male. It is mainly people between the ages of 30 and 49 who are affected. The outbreak investigation has not yet been finalised. The situation is being continuously monitored so that protective measures can be taken if necessary.

Hepatitis A is transmitted via the faecal-oral route, through contact infection in the context of close personal contact, e.g. in kindergarten or in a shared household, or during sexual contact, especially among men who have sex with men (MSM). People without symptoms can be a source and spread the virus. In addition, transmission is possible through contaminated food (such as shellfish or berries), water or contaminated utensils. Transmission can also occur through blood and blood products, e.g. through repeatedly used syringe sets in drug addicts. After contact with the hepatitis A virus, it can take two to seven weeks for the disease to break out. The typical symptoms of hepatitis A are fever, jaundice (yellow skin and eyes), loss of appetite, abdominal pain and fatigue. A safe and effective vaccination against hepatitis A is available and is recommended in certain life situations (e.g. travelling to endemic areas, social professions, people working in food and catering establishments, people with sexual behaviour that can be risky with regard to hepatitis A, especially men with same-sex partners).

Hepatitis A - AGES

 

 

A case of leprosy was diagnosed at Vienna General Hospital (AKH). The patient, a 60-year-old man from the travel industry, suffered from progressive symptoms such as numbness and skin changes for around a year and a half before the diagnosis was made. According to the AKH, there are currently no indications of further infections.

Leprosy is a chronic bacterial infectious disease. It is caused by the pathogen Mycobacterium leprae and primarily affects the skin and peripheral nerves, but can also spread to the mucous membranes of the upper respiratory tract, bones, testicles and eyes. Typical symptoms are skin spots, numbness, muscle weakness and, in advanced stages, deformities. The incubation period can last from a few months to 20 years. The risk of infection from untreated patients is very low and occurs through droplet infection during very long, close contact (e.g. in shared flats). People undergoing treatment are no longer contagious. Leprosy is considered to have been eradicated in Europe. Isolated cases occur after stays in endemic areas, i.e. in regions where the disease still occurs. The last case of leprosy in Austria was imported from Brazil in 2018.

Around 200,000 new cases are reported worldwide every year - mainly in India, Indonesia, Brazil and parts of Africa, and occasionally in theUnited States of America (USA). The case diagnosed at the AKH was most likely also infected abroad, having travelled extensively in remote regions of the tropics and Africa on business.

Leprosy is completely curable, especially if diagnosed early. Treatment is carried out on an outpatient basis with a combination of several antibiotics over about a year, wound cleansing and treatment of the affected limbs.

According to the Federal Ministry of Labour, Social Affairs, Health, Care and Consumer Protection, close contact with infected, untreated people should be avoided. In the event of close contact, a preventive examination and early treatment are important. There is no vaccination.

As part of the OH SURVector(One Health surveillance and Vector monitoring for cross-border pathogens) and RAISE (Reinforce Austrian Integrated Surveillance and Epidemiology) projects, Austria-wide surveillance of mosquitoes and ticks is being established.

The Austrian population plays an essential role in the research projects: they are called upon to send any ticks they find to AGES, for example by handing them in at AGES locations in Vienna Währingerstraße, Mödling, Graz, Linz, Salzburg and Innsbruck, as well as at the Carinthian Provincial Museum in Klagenfurt. This allows data to be generated for a wide variety of regions in Austria.

This year, a total of more than 1,800 ticks have already been submitted to AGES. The majority of ticks belonged to the genus Ixodes (94.8 %), followed by Dermacentor ticks (4.9 %). Most ticks have so far come from Lower Austria (37.7% of all ticks), followed by Upper Austria (22.1%), Styria (17.1%), Tyrol (7.3%), Burgenland (3.9%), Vienna (3.7%), Salzburg (3.2%), Vorarlberg (2.6%) and Carinthia (2.4%). In addition, an Amblyomma tick was delivered from the USA and travelled to Austria. The first Hyalomma tick, also known as the "giant tick", was also reported in Austria in April. It is likely to be a traveller's import from Croatia, as was confirmed in several cases last year.

The most common tick-borne diseases in Austria are Lyme disease and tick-borne encephalitis (TBE). A total of six cases of TBE have been reported since the beginning of 2025, five in April alone. Lyme disease is not notifiable, but its occurrence in ticks is being investigated as part of the AGES research project. The Lyme disease bacterium was detected in 15.4% of the 480 ticks analysed for 2025 to date. Last year, the proportion was 20-25%. Whether this shows an actual decline or is due to other factors is still being investigated.

The results of the study will be published on the AGES website on an ongoing basis. Due to capacity and logistical reasons, no individual results can be issued in the course of the research project.

If you discover a tick, please remember the research project. Important: Indicate where the tick was found, otherwise it cannot be utilised. You can find more information about the project and how to participate at Tick information - AGES.

Absolute protection against ticks is not possible, but you can wear long, closed clothing as a preventative measure and check your body for ticks after spending time outdoors. Removing the tick quickly can reduce the risk of infection. A vaccination against TBE is available and is recommended for everyone living in Austria. No vaccination is available against Lyme disease; antibiotic treatment is necessary.

You can find everything you need to know about ticks at Tick information - AGES

You can also listen to more information on ticks in the AGES podcast "Courage to take risks": Episode 004 - On blood meals & tick bites: How do I protect myself from little vampires? - AGES

In 2023, a total of 2,791 cases were reported in Austria, compared to 15,465 in 2024. 1,101 cases have been reported so far this year (as of 13 May 2025). This is around a third of the figure for the same period last year.

The cases per 100,000 inhabitants for each federal state for 2025 are shown in Figure 1. The age distribution (Figure 2) 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 provides newborn babies with protection through maternal antibodies. Vaccination is also recommended for all other people around a newborn in order to reduce the risk of infection for other transmission routes.

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

Whooping cough (pertussis) - AGES

International outbreaks

At the end of April, the journal Science published a study on the origin of the outbreak of avian influenza A(H5N1) in dairy cows that has been affecting the USA since March 2024. In 2024, the USA was the first country in the world to report cases of avian influenza in dairy cows, which spread across 17 US states over the course of the year.

The origin of the outbreak had not yet been clarified. The study by Nguyen et al. uses phylogenetic analyses, which examines the relationship of viruses, to show that there was a single transmission from a wild bird to a dairy cow in December 2023, and from there further transmissions have taken place: from dairy cow to dairy cow, from dairy cow to poultry, and from dairy cow to other mammals, including humans. Since March 2024, 41 people in the USA have been infected with the avian influenza virus through contact with infected cows(CDC, as of 9 May 2025). Human-to-human infections have not been detected.

The more infections occur in cows or other mammals, the higher the risk that humans will come into contact with the virus and that the virus will develop the ability to infect humans more easily.

In Europe, the first case of bird flu in humans was reported in the UK in January. The risk of infection for the general public in Europe is still considered to be low, and low to medium for those exposed in the workplace. A vaccination against avian influenza is available in Austria for people who have (intensive) contact with infected birds.

Emergence and interstate spread of highly pathogenic avian influenza A(H5N1) in dairy cattle in the United States | Science

On 26 April 2025, the Ugandan Ministry of Health officially declared the end of the outbreak of SudanVirus Disease ( SVD) after no new cases had occurred for 42 days, i.e. two complete incubation periods. The last confirmed case tested negative for the second time on 14 March 2025. The situation is still being monitored.

On 30 January 2025, Uganda's Ministry of Health reported an outbreak of Sudan Ebola virus disease (Sudan virus for short), a form of Ebola fever, after a case was confirmed in the capital Kampala. A total of 14 cases were reported during the outbreak, including 12 laboratory-confirmed and two probable cases. Four people died (two confirmed and two probable cases), which corresponds to a case fatality rate of 29%.

More information on the Sudan Ebola virus outbreak in Uganda can be found in the AGES Radar of 20 February 2025 and 13 March 2025.

Sudan virus disease - Uganda

 

Topic of the month

We are bombarded with health information via countless channels: Media, internet, social media, they are all full of health tips and information on diseases and therapies. In cooperation with medizin-transparent.at, we show you how to recognise reliable information.

Checklists for reliable information

We all like to consult Dr Google, but depending on the search query, the search engine doesn't spit out the most reliable information. How do we recognise what is reliable? Various institutions have published checklists that should enable us to distinguish good information from misleading information as quickly and reliably as possible. Scientists from the Department of Evidence-based Medicine and Evaluation at the University for Continuing Education in Krems have reviewed the best tips from various checklists and summarised the seven most useful tips:

  1. The information is free of advertising.
  2. The information is balanced: Advantages and disadvantages are discussed and there is a comparison with other options.
  3. Technical terms are used sparingly and their meaning is explained.
  4. The information comes from an independent organisation that does not make money from treatment or sales. Prerequisite: It must be clear who is behind the information, i.e. who is responsible for the website.
  5. All important statements are backed up with sources , there is a list of references and/or links.
  6. The information indicates how well or poorly the claims are scientifically substantiated; for example, whether the statement is based on a methodologically weak study or on a large number of good studies. The level of proof/evidence is assessed.
  7. It is clear when the information was created or updated.

These tips should be easy to apply and, thanks to the research from Krems, we know that they work: they help to recognise reliable information. There are further checklists for specific target groups: the social insurance organisation has developed a detailed guide for patients that contains practical examples. For organisations that want to provide reliable information, the Austrian Platform for Health Literacy has compiled 15 quality criteria.

The seven tips above were developed and tested for websites, but most of them can be applied to any health information. The decisive questions always include: Who created the information, when, how and why? Warning signs include when I cannot answer these questions, i.e. no date is given, I cannot find out who is behind the information and conflicts of interest remain invisible.

Exaggerated promises of salvation are another reason to be suspicious. Claims of 100 per cent efficacy or no side effects are often characteristics of misleading information. Uncertainties are an integral part of medicine and science in general. Good health information must therefore address them: How well is the knowledge validated? How likely is a desired effect to occur and how likely is which undesired effect? And how does all this compare with possible alternatives? All these questions must be answered for information to be balanced.

The flood of information has long been spilling over us on all social media channels. Similar rules apply here as for websites, but the team in Krems is currently working on its own checklist. Social media posts are shared a lot when they trigger emotions. Accordingly, advertisers, but basically anyone who wants our attention, try to generate emotions and therefore get shared a lot. False information is also spread particularly often if it strikes a nerve and triggers emotions, very often negative ones. Anyone who wants to protect themselves from misinformation - and who does not want to contribute to the spread of misinformation themselves - should therefore be particularly sceptical when a report triggers emotions. There is a great risk of being manipulated here. Taking a deep breath and asking yourself "Can this even be true?" is an important first step in social media to avoid becoming a fake news slinger yourself.

Better informed, better decisions

Those who find their way through the flood of information make better decisions. We save ourselves the fear of invented risks, money for ineffective remedies and turn to the right people when we have health problems. No false expectations are raised.

AGES is an independent expert organisation, reliable information is part of its legal mandate and conflicts of interest are largely excluded. You can find a list of other providers of reliable information on the "Information without side effects" page.

Messages

On World Hand Hygiene Day on 5 May, theWorld Health Organisation (WHO) reminds us that gloves are no substitute for hand hygiene. Although medical gloves play a certain role in preventing the transmission of diseases, they do not offer perfect protection and should always be used in combination with hand sanitiser. In addition, errors in use can easily occur, which can lead to contamination - for example when changing gloves. Excessive glove use also contributes significantly to environmental pollution. According to a WHO report, one fifth of healthcare facilities worldwide did not have sufficient hand hygiene infrastructure (e.g. enough disinfectant dispensers) in 2023.

Adequate hand hygiene is one of the most effective ways to prevent healthcare-associated infections. The WHO is calling for hand hygiene to be established as a national performance indicator by 2026 and for gloves to be used only selectively.

Gloves do not replace hand hygiene - reminder from WHO

Global report on infection prevention and control 2024

Water, sanitation, hygiene, environmental cleaning and waste management in health care facilities: 2023 data update and special focus on primary health care | JMP

 

A recent report by the EuropeanCentre for Prevention and Disease Control (EC DC) indicates that the European Union and the European Economic Area (EU/EEA) will not achieve the health targets for HIV, tuberculosis, hepatitis B/C and othersexually transmitted infections ( STIs) by 2030 if the trend continues.

Although the number of new HIV infections has fallen by 35% since 2010, this is not enough to fulfil the interim target for 2025, which was 75%. The incidence of tuberculosis has also fallen by 35% since 2015, but treatment success rates remain below the target of 90% - particularly for forms that are resistant to one or more antibiotics.

The situation is particularly critical for hepatitis B and C, which together with HIV and tuberculosis cause almost 57,000 deaths per year in the EU/EEA. Testing and treatment rates remain well below the targets and mortality rates are not falling. At the same time, reported cases of STIs such as syphilis and gonorrhoea continue to rise, reaching record levels since ECDC surveillance began in 2009.

Concrete steps are needed by 2030, including more education, expansion of pre-exposure prophylaxis (PrEP) programmes, vaccinations against hepatitis B and better support services for people who use drugs.

Making the next five years count: Europe not on track to reach 2030 Sustainable Development Goal targets on HIV, TB, viral hepatitis B and C and STIs

 

Technical term epidemiology

With regard to infectious diseases, a risk group refers to a group of people who, due to general conditions, behaviour or personal characteristics, are more likely to be infected by a certain pathogen or contract a certain disease compared to another group under otherwise similar conditions.

Behaviours that can define a risk group are, for example, smoking or alcohol, personal characteristics would be genetic dispositions or previous illnesses.

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), please be patient. A reply will be sent within one week.

The next AGES-Radar will be published on 12 June 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 14 May 2025).

Pathogens 2025 2024 2020-2024 (median)
Apr Jan-Apr Jan-Apr Jan-Apr
Amoebic dysentery (amoebiasis) 2 3 7 2
Botulism b 0 0 0 0
Brucellosis 0 2 4 3
Campylobacteriosis b 302 1.424 1.701 1.538
Chikungunya fever 0 0 4 0
Cholera 0 0 0 0
Clostridioides difficile infection, severe course 49 314 278 189
Dengue fever 13 56 82 32
Diphtheria 0 2 1 1
Ebola fever 0 0 0 0
Echinococcosis caused by fox tapeworm 1 7 11 6
Echinococcosis caused by dog tapeworm 1 5 11 11
Spotted fever (rickettsiosis caused by R. prowazekii) 0 0 0 0
Tick-borne encephalitis (TBE) 5 6 10 2
Yellow fever 0 0 0 0
Haemophilus influenzae, invasive a 10 53 47 18
Hantavirus disease 5 11 8 11
Hepatitis A 21 53 21 16
Hepatitis B 78 325 426 320
Hepatitis C 95 367 384 314
Hepatitis D 1 2 4 3
Hepatitis E 6 22 20 20
Whooping cough (pertussis) 139 1.072 4.375 93
Polio (poliomyelitis) 0 0 0 0
Lassa fever 0 0 0 0
Legionnaires' disease (legionellosis) d 15 105 66 56
Leprosy 1 1 0 0
Leptospirosis 1 4 10 1
Listeriosis b 1 8 17 11
Malaria 5 20 14 14
Marburg fever 0 0 0 0
Measles 18 95 423 25
Meningococcus, invasive c 2 18 7 7
Middle East respiratory syndrome (MERS) 0 0 0 0
Anthrax 0 0 0 0
Mpox e 1 7 8 1
Norovirus gastroenteritis b 281 2.073 1.838 930
Paratyphoid fever 0 0 0 0
Plague 0 0 0 0
Pneumococcus, invasive c 108 510 417 222
Smallpox 0 0 0 0
Psittacosis 0 0 2 2
Rotavirus gastroenteritis b 134 494 369 216
Glanders (Malleus) 0 0 0 0
Rubella 0 0 0 0
Relapsing fever 0 0 0 0
STEC/VTEC b 41 216 132 75
Salmonellosis b 78 241 267 249
Scarlet fever 27 132 329 2
Severe acute respiratory syndrome (SARS) 0 0 0 0
Shigellosis b 12 81 67 10
Other viral meningoencephalitis 20 48 29 29
Rabies 0 0 0 0
Trachoma (grain disease) 0 0 0 0
Trichinellosis 0 1 4 1
Tuberculosis 37 125 157 133
Tularemia 1 8 35 7
Typhoid fever 0 0 5 2
Bird flu (avian influenza) 0 0 0 0
West Nile virus disease 0 0 0 0
Yersiniosis b 6 22 45 44
Zika virus disease 0 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: 16.05.2025

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