According to the Robert Koch Institute (RKI), there has been a significant increase in measles infections in Germany in 2024, with 435 documented incidences as of August 31. This figure is already six times larger than the total number of cases in 2023, which was 79. Concerns have arisen due to the dramatic spike, as it surpasses the National Vaccination Plan's objective of fewer than one case per million people annually.

Germany has made significant progress in lowering measles incidence since implementing obligatory reporting for acute cases in 2001. The availability of vaccines for more than 50 years, as well as constantly growing immunisation rates, have been critical to this accomplishment. However, the unexpected increase in incidents this year raises concerns about the root causes. 

A decrease in vaccine coverage, particularly in specific groups or regions, is likely to contribute to the surge. Despite generally high vaccination rates, there may be pockets of unvaccinated or under-vaccinated people where the virus can spread rapidly. Disinformation and scepticism regarding vaccine safety, particularly in the aftermath of the COVID-19 pandemic, can fuel vaccine hesitancy, compounding this problem.

Another contributing factor could be the pandemic's disruption of routine immunization programs. Many healthcare systems experienced overload during the peak of COVID-19, leading to the delay or cancellation of regular vaccination appointments. This disruption may have led to a temporary decrease in vaccination rates, thereby exposing certain individuals, particularly children, to illnesses such as measles.

Furthermore, increased worldwide travel and migration may have contributed to malaria's comeback. As global travel restrictions lifted, there was a greater risk of virus transmission from places where measles is more common. This can cause a chain reaction, particularly in places with low immunity levels. 

Measles is a highly contagious virus, which complicates matters even more. Airborne droplets can transmit measles, enabling the virus to spread quickly in close-contact conditions. Even brief contact with an infected person can result in transmission, highlighting the significance of maintaining high vaccination coverage to develop herd immunity. 

This surge has far-reaching consequences beyond the acute outbreak. Studies have shown that measles weakens the immune system for an extended period, making it more susceptible to subsequent infections. Furthermore, complications include encephalitis, pneumonia, and the rare but deadly subacute sclerosing panencephalitis (SSPE), which are serious health risks. 

To address this resurgence, public health officials must prioritise bridging immunisation gaps, particularly in vulnerable areas. This includes focused outreach and education to overcome vaccine hesitancy, as well as rapid administration of missed immunisations. Furthermore, monitoring and responding quickly to any new clusters of infections will be critical in preventing further spread. 

The 2024 measles outbreak is a sharp reminder of the significance of ongoing immunisation efforts and attention in public health. Without timely and effective intervention, the decades-long effort towards reducing measles infections could be jeopardised, resulting in preventable sickness and death.