In addition to whooping cough, the Czech Republic has seen a year-on-year increase in several other infections in the first quarter of this year, including measles, legionellosis, scabies and diphtheria, and monkeypox has also returned, according to information from the National Institute of Public Health (SZU).
The Association of Health Insurance Companies (SZP) warned in a press release that diseases against which vaccination is compulsory, such as measles, diphtheria and whooping cough, are returning.
“From a certain level of vaccination, collective immunity works,” said SPZ expert Ludmila Plskova. “The more contagious the disease, the more people need to be vaccinated for collective immunity to develop. While 80% vaccination is sufficient for polio, for other diseases it must be higher; for measles it is 95%.”
Immunity declines with age, with about 7% of people refusing vaccinations and the impact of migration being seen in some diseases, such as tuberculosis. “In any case, it is necessary to take into account that if the vaccination rate decreases in the population, we will encounter some diseases more often than we have been used to,” Plskova said.
Vaccination with the hexavaccine against polio, tetanus, diphtheria, whooping cough, hepatitis B and diseases caused by Haemophilus influenzae type b, as well as vaccines against measles, rubella and mumps, are compulsory, and required for admission to kindergarten except for the last year before their primary school attendance.
96% of babies born in 2022 received at least one dose of the hexavaccine. For quadruple vaccination against diphtheria, whooping cough, tetanus and polio at ages five and ten, vaccination coverage ranges from 86 to 90% of the population.
Vaccination coverage is lower for non-compulsory vaccinations, which are often not fully covered by public health insurance. These include pneumococcus and meningococcus (70-75%), human papillomavirus (70% for girls and 43% for boys), and tick-borne encephalitis (40%).
According to SZU data, the numbers of various types of hepatitis, tropical dengue and malaria have also increased year-on-year to the end of March, in addition to whooping cough, whose current case numbers are the highest since 1959. After a lull during the COVID-19 epidemic, doctors have recorded 14 cases of measles this year, up from fewer than five cases in each of the last four years, though there were 590 cases in 2019.
Since 2020, the number of patients with scabies has been gradually increasing. It is transferred by contact with the skin of an infected person, or their clothes or bedding. Last year over 9,000 people were infected, and this year has seen 2,700 so far. Diphtheria is also on the rise, with eight cases so far this year, compared to seven for the whole of last year.
Legionellosis is also significantly higher at the beginning of this year than last year. Unlike other infections, it is not transmitted between humans, but is caused by infected water that remains in pipes unless the water is heated to more than 70 degrees Celsius. The infection can cause severe pneumonia. Last year there were 340 cases of it, whereas this year 104 cases have been recorded so far.
There is no single reason for the increase, SZU said previously. For example, for diseases against which there are vaccinations, experts talk about a lower willingness to have children vaccinated or a different composition of vaccines. For some diseases, the fact that the population and doctors do not encounter them often and sometimes take time to detect them also has an impact. The decline in the previous three years was in large part due to anti-COVID measures.
Numbers of infectious diseases in previous years:
| Year | 2019 | 2020 | 2021 | 2022 | 2023 | 2024* |
| Whooping cough | 1347 | 696 | 51 | 96 | 494 (20*) | 5,293 (6,397)** |
| Diphtheria | 0 | 0 | 0 | 5 | 7 | 8 |
| Legionellosis | 280 | 216 | 239 | 287 | 340 (53*) | 104 |
| Scabies | 3,570 | 2,382 | 3,306 | 5,276 | 9,167 (2602*) | 2,702 |
| Malaria | 34 | 9 | 10 | 30 | 42 (11*) | 12 |
| Dengue | 81 | 38 | 4 | 22 | 79 (12*) | 28 |
| Measles | 590 | 4 | 0 | 0 | 1 (0*) | 14 |
| Hepatitis A | 240 | 183 | 210 | 70 | 66 (4*) | 24 |
| Acute hepatitis B | 41 | 26 | 17 | 48 | 37 (10*) | 9 |
| Chronic hepatitis B | 276 | 144 | 127 | 244 | 378 (85*) | 128 |
| Hepatitis C | 1,138 | 770 | 662 | 921 | 1,300 (372*) | 580 |
| Hepatitis E | 268 | 223 | 200 | 319 | 684 (137*) | 170 |
| Mpox (monkeypox) | 0 | 0 | 0 | 71 | 0 | 9 |
Source: the National Institute of Public Health – Infectious Diseases Information System (ISIN)
*for the first quarter
**until April 7, 2024
