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Table 2 Summary of 12 articles describing outbreaks associated with anthroposophic medicine/Waldorf schools

From: Understanding and explaining the link between anthroposophy and vaccine hesitancy: a systematic review

Paper

Country

Year

Disease and Cases

Study aim

Population

Braeye, T., Sabbe, M., Hutse, V., Flipse, W., Godderis, L. and Top, G., 2013. Obstacles in measles elimination: an in-depth description of a measles outbreak in Ghent, Belgium, spring 2011. Archives of Public Health, 71(1), pp.1–7

Belgium

2011

65 measles cases

This report describes a measles outbreak and evaluates control measures and interventions

The outbreak was in Flanders. It started in a day care center, infecting children too young to be vaccinated, spread to anthroposophic schools with a low vaccination coverage

Ernst, E., 2011. Anthroposophic medicine causes measles outbreaks. Deutsche Medizinische Wochenschrift (1946), 136(44), pp.2271–2272

Germany

2011

Describes 7 measles outbreaks in Europe

Summarizes measles outbreaks

Waldorf school

Ernst, E., 2011. Anthroposophy: a risk factor for noncompliance with measles immunization. The Pediatric infectious disease journal, 30(3), pp.187–189

In several European countries: Germany, Austria, Netherlands, and Great Briain

2011

Describes 5 measles outbreaks in Europe

Review of outbreaks

Waldorf schools

Lassen, S.G., Schuster, M., Stemmler, M., Steinmüller, A., Matysiak-Klose, D., Mankertz, A., Santibanez, S., Wichmann, O. and Falkenhorst, G., 2014. Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011. Epidemiology & Infection, 142(4), pp.789–796

Berlin

2011

73 measles cases

Measles outbreak investigation in Berlin 2011:

Berlin community and among students of an anthroposophic school

Muscat, M., 2011. Who gets measles in Europe?. The Journal of Infectious Diseases, 204(suppl_1), pp.S353-S365

Several European countries

2011

Describes 4 measles outbreaks linked to anthropsophic communities

 

Individuals susceptible to measles

Roggendorf, H., Mankertz, A., Kundt, R. and Roggendorf, M., 2010. Spotlight on measles 2010: Measles outbreak in a mainly unvaccinated community in Essen, Germany, March–June 2010. Eurosurveillance, 15(26), p.19605

Germany

2010

71 measles cases

Describes measles outbreak in 2010 in Germany and lists public health interventions used to stop this outbreak

Unvaccinated community in Essen

Cases identified in members of the Waldorf school or kindergarten, siblings of those members and visiting doctors who do not recommend vaccination

Kasper, S., Holzmann, H., Aberle, S.W., Wassermann-Neuhold, M., Gschiel, H., Feenstra, O., Allerberger, F. and Schmid, D., 2009. Measles outbreak in Styria, Austria, march–may 2009. Eurosurveillance, 14(40), p.19347

Austria

2009

37 cases in 2009,

397 cases in 2008

Outbreak investigation: to describe the measles outbreak by person, place and time and to identify the proportion of cases who were vaccinated

General population and the anthroposophic community in the Austrian province of Styria

Schmid, D., Holzmann, H., Abele, S., Kasper, S., König, S., Meusburger, S., Hrabcik, H., Luckner-Hornischer, A., Bechter, E., DeMartin, A. and Stirling, J., 2008. An ongoing multi-state outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and Norway, March–April 2008. Eurosurveillance, 13(16), p.18838

Austria, Germany, Norway

2008

202 measles cases in Austria, 53 in Germany, and four in Norway, total number of measles cases 259

Outbreak investigation

Non-immune anthroposophic communities in Austria, Germany, and Norway

Schmid, D., Holzmann, H., Schwarz, K., Kasper, S., Kuo, H.W., Aberle, S.W., Redlberger-Fritz, M., Hautmann, W., Santibanez, S., Mankertz, A. and König, C., 2010. Measles outbreak linked to a minority group in Austria, 2008. Epidemiology & Infection, 138(3), pp.415–425

Austria

2008

A total of 394 (cases fulfilled the outbreak case definition} including 168 (affiliated to the anthroposophic community)

Described measles outbreak

Anthroposophic school in Salzburg city (Austria)

Wadl, M., Siedler, A., Krämer, W., Haindl, M.E., Gebrande, S., Krenn-Lanzl, I., Mankertz, A. and Hautmann, W., 2011. Measles transmission from an anthroposophic community to the general population, Germany 2008. BMC Public Health, 11(1), pp.1–8

Germany

2008

(217 Bavarian cases identified)

(28 cases were attendees of the anthroposophic school in Austria)

Measles Outbreak investigation and its transmission to the general population which will guide the future public health action

Two neighbouring Bavarian counties with students attended an Austrian anthroposophic school

Hanratty, B., Holt, T., Duffell, E., Patterson, W., Ramsay, M., White, J.M., Jin, L. and Litton, P., 2000. UK measles outbreak in non-immune anthroposophic communities: the implications for the elimination of measles from Europe. Epidemiology & Infection, 125(2), pp.377–383

UK

2000

293 measles cases

Describes the epidemiology of this UK measles outbreak

Non-immune anthroposophic communities, and unvaccinated groups

Ströhle, A., Eggenberger, K., Steiner, C.A., Matter, L. and Germann, D., 1997. Mumps epidemic in vaccinated children in West Switzerland. Schweizerische Medizinische Wochenschrift, 127(26), pp.1124–1133

Switzerland

1997

Exact number of cases not present but describes Mumps outbreaks throughout Switzerland

Describing the epidemic of Mumps in Switzerland and the main interacting factors that led to the epidemic

Vaccinated and unvaccinated children in Switzerland