Many once-threatening infectious diseases have been reduced or nearly “eradicated” in industrialized countries thanks to consistent vaccination programs. Smallpox has even been made to disappear completely. Infectious diseases that must be taken seriously also include the so-called childhood diseases: They are highly contagious and therefore usually occur in childhood. However, adults can also become infected – possibly with serious complications for themselves and others.
Classic childhood diseases
Almost everyone knows them, the classic childhood diseases such as:
- Measles
- Mumps
- Rubella
- Whooping cough
- Chickenpox
Either because you have “suffered through” them yourself or because they have occurred in the circle of acquaintances; in some circumstances only from stories of the parents’ generation. For most of these diseases, once you have had them, you are immune for life. They are called childhood diseases only because most adults are protected by childhood infection or vaccination.
Vaccination fatigue and its consequences
Nevertheless, it can currently be observed that more and more adolescents and adults are getting childhood diseases. This is due, on the one hand, to the fact that many parents no longer consistently vaccinate themselves and their children or have the vaccination refreshed; one speaks of vaccination fatigue in a trivializing way. Another reason is that unvaccinated children are not so easily infected today because they grow up in ever smaller families or without any siblings at all. Thus, the time of infection is postponed further and further back.
How can an adult become infected?
An adult can usually get a childhood disease only if he or she did not go through it as a child and does not have vaccine protection. But even vaccinated people can get sick under certain circumstances: namely, if not enough antibodies against the disease have formed after vaccination. This is called a vaccination gap – in relation to all vaccinated persons. In the case of the measles–mumps–rubella vaccination, a second vaccination is therefore given after the first. This second vaccination is not a booster vaccination, but is intended to give a second chance to those for whom the first vaccination did not “hit” properly. Since July 2001, this second vaccination is recommended by the Permanent Vaccination Commission of the Robert Koch Institute (STIKO) already at the age of 15-23 months and at the earliest 4 weeks after the first vaccination. In addition, since March 1, 2020, vaccination against measles has been mandatory in Germany. This applies to all children and adolescents attending kindergarten or school, as well as to all persons working in community or medical settings who were born after 1970.
What complications can occur?
If a young person or adult contracts pediatric disease, the course is more likely to be serious than for a young child. In addition, ill adults may endanger their unborn or newborn children. Typical examples include infection of an early pregnant woman with rubella or infection of an infant with pertussis.
Typical childhood diseases in adults
In the following, we present the different childhood diseases and explain what the consequences of infection in the with each disease can be.
Whooping cough (pertussis)
In this highly contagious and especially protracted infectious disease, transmission occurs through inhalation of infectious droplets when speaking, coughing, sneezing (therefore called droplet infection). In most cases, the disease begins like a harmless cold with a cold and cough. In the further course, the typical, choppy coughing fits (staccato cough) occur – mostly at night – which can lead to respiratory distress, especially in infants. The disease or vaccination leaves a long-lasting but not lifelong immunity. When immunity wanes (if the disease has been passed through: after about 15-20 years; if fully vaccinated: after about 10 years), whooping cough disease in adolescents and adults is usually atypical; therefore, they are often contagious without even realizing it. Thus, they can infect an unprotected infant, for whom vaccination is possible only after the third month. For this age group, the disease is particularly dangerous, because breathing can stop in them.To prevent young adults from becoming a danger to their infant, the STIKO advocates booster vaccination for all 9-16 year-olds and booster vaccination for adults. Women of childbearing potential or those who have frequent contact with babies should ensure that their last pertussis vaccination is no more than ten years old. Rare complications of the disease include pneumonia and neurological disorders. However, the older the person with the disease, the higher the likelihood of a serious course. Important: Vaccination in infancy offers the best protection.
Measles (Morbilli)
Measles is a far from harmless, highly contagious infectious disease. They are transmitted by droplet infection and leave lifelong immunity. Thanks to consistent vaccination practice, the incidence of measles disease has declined significantly in recent decades. However, widespread outbreaks still occur. The disease starts with flu-like symptoms, after about 3-5 days the typical measles rash appears all over the body. Rare but severe complications of the disease are, for example, pneumonia and middle ear infections, as well as the particularly feared brain/brain meningitis, from which the sufferers not infrequently die or at least retain permanent damage. Here, too, the probability of complications increases with age. While there is one case of encephalitis for every 10,000 measles cases in infants, it occurs in one in 500 measles-infected children, adolescents and adults. Important: Preventive vaccination can be given in infancy (measles-mumps–rubella vaccination at the age of 11-23 months, in short: MMR vaccination), twice, to avoid vaccination gaps. Vaccination against measles has been mandatory in Germany since March 1, 2020, and is regulated by the Measles Protection Act. Unvaccinated people who work in children’s facilities, for example, must also be vaccinated if they were born after 1970.
Mumps (goat’s peter, parotitis epidemica).
Mumps is an infectious disease transmitted by droplet infection that leads to lifelong immunity. Painful inflammation of the parotid glands (parotitis) occurs, with swelling, pain, and fever. More often than in young children, mumps in adults progresses with complications. The disease spreads to other organs, infecting mainly the pancreas, brain or meninges. A rare but nevertheless typical consequence of the disease is usually unilateral, sometimes bilateral hearing impairment. A frequent and particularly unpleasant complication affects sexually mature boys and adult men: a good quarter of male patients suffer from testicular inflammation (so-called mumps orchitis), which can lead to infertility. In pregnancy, the disease – especially if it occurs during the first three months – can trigger a miscarriage. Important: Vaccination recommendations are the same as for measles.
Rubella (rubeola)
Transmission of this disease, which is usually harmless to children, occurs through droplet infection. Typical symptoms are fever (rarely above 39 degrees Celsius), joint pain, swelling of the lymph nodes (in the neck), and the bright red, fine-spotted rash all over the body. Rare, but with increasing age more frequent complications are for example ear, brain and joint inflammations. Rubella is particularly feared during pregnancy: then there is a risk that the infection is transmitted to the child in the womb. This can cause severe damage to the unborn child, especially during the first three months of pregnancy (rubella embryopathy). Malformations of the heart and brain, blindness and deafness can occur. Important: Effective protection is provided by the measles-mumps-rubella vaccination in infancy, for both girls and boys (!). Women who wish to have children should have a blood test for antibodies against rubella virus done by their doctor and be vaccinated if they are not protected. In addition, MMR vaccination is recommended in antenatal and postnatal care facilities, as well as infant and child care facilities. Because there is no age limit, vaccination can be given at any age.
Chickenpox (varicella, water pox).
Chickenpox is a very contagious infectious disease that is transmitted by droplet infection, but also through the air (or with the wind).As with most infectious diseases, there is initially an uncharacteristic stage of illness with a general feeling of sickness. This is followed by fever and the typical skin rash with lentil-sized reddish spots that turn into watery vesicles. The rash itches intensely and can leave scars if scratched open. As a rule, people contract chickenpox only once in their lifetime. In some cases, however, the viruses survive in the nerve nodes and can – newly activated (for example, in immunocompromised but also completely healthy people) – trigger a painful shingles. Rare complications include inflammation:
- Of the brain
- Of the lungs
- Of the middle ear
- Of the heart muscle
If an illness occurs in a pregnant woman, it can lead to skin scars, eye deformities and pathological changes in the brain in the child. It has particularly severe consequences if a pregnant woman 5 days before birth or up to 48 hours after: 30% of infected newborns at this time die. Important: There is a vaccination against chickenpox that is especially important for people at risk, for example patients before an organ transplant or before treatment that weakens the immune system. The chickenpox vaccination is also recommended by the STIKO for all children and adolescents. The first vaccination should be given at 11-14 months of age, but can be given at any time after that. The second vaccination should be given at 15-23 months of age. Still unvaccinated 9-17 year olds should be vaccinated as soon as possible, as the disease is associated with a higher rate of complications in them.
