Health Advice

for Travellers

Swiss Expert Committee for Travel Medicine
Ukraine

Ukraine

Latest news

Das ukrainische Gesundheitsministerium meldet einen Fall von akuter schlaffer Lähmung verursacht durch das Poliovirus. Es handelt sich dabei um ein ungeimpftes 18 Monate altes Mädchen aus der Oblast Rivne im Nordwesten des Landes. Die Eltern hatten die Impfung aufgrund religiöser Überzeugungen abgelehnt. Auch bei 6 Kontaktpersonen wurde das Virus gefunden. Die Durchimpfungsrate gegen Polio ist in der Bevölkerung sehr gering.

Polio wird durch Wasser oder verunreinigte Nahrungsmittel übertragen und kann bleibende, invalidisierende Lähmungen verursachen. Es gibt keine Behandlung, aber die Impfung ist ein wirksames Mittel zur Vorbeugung der Krankheit.

 

Folgen für den Reisenden

Personen, die sich > 4 Wochen im Land aufhalten, wird dringend empfohlen, bei Ausreise aus der Ukraine eine mind. 4 Wochen und max. 12 Monate zurückliegende Polio-Auffrischimpfung mit Dokumentation im internationalen Impfausweis zu haben.  Bei Aufenthalten < 4 Wochen: Grundimmunisierung und Auffrischimpfung alle 10 Jahre.

 

Links

ECDC CDTR, 8.10.2021

Polioeradication (accessed 14.10.2021)

General Information

  • Avoid all non-essential travel
  • If travel is unavoidable: get full COVID-19 vaccination protection before travel and adhere strictly to the recommendations and regulations of your host country
  • Check entry requirements of destination country (see regulary updated COVID-19 Travel Regulations Map of IATA: LINK)
  • Check the Federal Office of Public Health (FOPH) requirements for return to Switzerland from your travel destination (see LINK)

Detailed information by diseases (key aspects | maps | fact sheets etc.) are primary included in the section 'important health risks' otherwise to be found under the respective vaccination.

Important health risks

  • Covid-19 is a disease that affects the whole body, but mainly shows with respiratory symptoms such as cough and difficulty in breathing. It is caused by the SARS-CoV-2 virus.
  • The infection is mainly spread through respiratory droplets and possibly aerosols when infected persons cough, sneeze, speak or sing without wearing a mask.
  • The infection can be prevented very effectively by vaccination and an increasing number of vaccines are now approved and available for protection.
  • Furthermore, prevention relies heavily on people wearing face masks, on hand hygiene and on physical distancing (min. 1.5 m) if masks are not worn and people are not vaccinated.

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There is a risk of arthropod-borne diseases other than malaria, dengue, chikungunya or zika in sub-/tropical regions, and some areas of Southern Europe. These include the following diseases [and their vectors]:

  • in Europe
    • Borreliosis, FSME (= tick-borne encephalitis), rickettsiosis [ticks]
    • Leishmaniasis [sand flies]
    • West-Nile fever [mosquitoes]
  • in Africa
    • Rickettsiosis, in particular African tick bite fever [ticks]
    • Leishmaniasis [sand flies]
    • African trypanosomiasis =sleeping sickness [tsetse flies]
    • West-Nile fever [mosquitoes]
  • in Asia 
    • Scrub typhus [mites]
    • Rickettsiosis [fleas or ticks]
    • Leishmaniasis [sand flies]
    • West-Nile fever [mosquitoes]
    • Crimea-Congo-hemorrhagic fever [ticks]
  • in North and Latin America  
    • Rickettsioses and in particular Rocky Mountain spotted fever [ticks]
    • Leishmaniasis and Carrion's disease [sand flies]
    • American trypanosomiasis = Chagas disease [triatomine bugs]
    • West Nile fever [mosquitoes)]

Read the following factsheet for more information.

  • Rabies is mainly transmitted through the saliva or other body fluids of dogs (and bats), but any mammal can be infectious.
  • Rabies is invariably fatal once symptoms occur.
  • The only way to prevent death is pre-travel vaccination or immediate wound cleaning and immunizing after exposure.
  • In many countries vaccines and immunoglobulins are often unavailable.
  • Rabies is best prevented by pre-exposure vaccination that is highly recommended for
    • long-term stay in endemic countries,
    • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
    • professionals working with animals, or cave explorers (bats!).
  • For optimal travel preparation, we recommend that you read the below mentioned information carefully and take the fact sheet on your trip!

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This fact sheet contains important information about rabies. For optimal travel preparation, we recommend that you read this information carefully and take the fact sheet on your trip!

  • Rabies is mainly transmitted through the saliva or other body fluids of dogs (and bats), but any mammal can be infectious.
  • Rabies is invariably fatal once symptoms occur.
  • The only way to prevent death is pre-travel vaccination or immediate wound cleaning and immunizing after exposure.
  • In many countries vaccines and immunoglobulins are often unavailable.
  • Rabies is best prevented by pre-exposure vaccination that is highly recommended for
    • long-term stay in endemic countries,
    • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
    • professionals working with animals, or cave explorers (bats!).

Dogs are responsible for more than 95% of human cases. Bats (Latin America), cats, and (rarely) monkeys, predators, and other mammals can transmit rabies. The highest risk areas are Asia, Sub-Saharan Africa, and some Latin American countries (e.g. Bolivia). Rabies may occur anywhere in the world, except in countries where successful eradication has been achieved.

Bleeding scratch injuries, licks over injured skin, bites by infected animals: when saliva or other body fluids of infected animals enter the human body, the rabies virus multiplies at the site of entry and later spreads to the peripheral nerves and eventually moves to the central nervous system. Once it has reached the brain, the infection is invariably fatal.

When symptoms such as abnormal skin sensation, paralysis, or hydrophobia (fear of water) appear at 2-12 weeks after contact (range: 4 days-4 years!), the point of no return is reached, and the disease is fatal. Therefore, vaccination before exposure and immediate action after contact are crucial.

No reliable treatment of rabies disease exists!

Post-exposure measures:

  • Immediate cleaning of the wound with plenty of water and soap for 10-15 minutes, followed by disinfection (e.g. Betadine, Merfen) and emergency post-exposure vaccination at the nearest health institution within 24 hours.
  • Tetanus booster vaccination is also required.
  • For those having received full pre-exposure rabies vaccination before travel: two additional vaccine shots (any available brand) at an interval of 3 days suffice.
  • If full pre-exposure vaccination has not been given, in addition to vaccination, passive immunization is required with immunoglobulins.
  • It should be noted that immunoglobins (and sometimes vaccines) are often unavailable in low-resource settings, causing stress and uncertainty.

Stroking cute pets is not a good idea; refrain from touching wild or unfamiliar or dead animals.
All travellers to places where rabies may occur and who are likely to take repeated trips to areas where rabies occurs should have a pre-exposure vaccination. In addition, pre-exposure vaccination is highly recommended for travellers at particular risk:

  • long-term stay in endemic countries,
  • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
  • professionals working with animals, or cave explorers (bats!).

The shortened vaccination schedule can be proposed to most travellers: 2 shots, the first one at one month before departure if possible (minimum: 8 days before departure). A single third rabies booster vaccination is recommended before the next trip, at least after one year.

  • Obtain information about prevention of rabies in time before travelling.
  • In case of trips planned for longer than a few weeks, schedule a visit at the travel clinic 4 weeks before departure at the latest.
  • After possible exposure (bite, scratch injury) wound treatment and additional vaccinations are necessary even for those with a completed series of basic vaccinations.
  • This information leaflet should be printed and kept handy during the trip!

  • Sexually transmitted infections (STIs) are a group of viral, bacterial and parasitic infections; while many are treatable, some can lead to complications, serious illness or chronic infection.
  • STIs are increasing worldwide.
  • Read the following fact sheet for more information.

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  • There are other important travel related health risks such as diarrhoea, road traffic accidents, air pollution and more.
  • For more information, see the section "Healthy Travelling".

Vaccinations

All travellers should have completed a primary vaccination course and boosters according to the Swiss vaccination schedule to prevent the following conditions:

  • Tetanus-diphtheria-pertussis-polio
  • Measles-mumps-rubella

Travellers should be immune to chickenpox. Persons between 11 and 40 years of age who have not had chickenpox should be vaccinated (2 doses with minimum interval of 4-6 weeks)

Vaccination recommended according to Swiss recommendations.

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  • Hepatitis A vaccination is recommended for all travellers going to tropical or subtropical countries.

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  • Polio is a vaccine-preventable viral disease of the nervous system that is acquired mainly through the consumption of food or water contaminated by feces.
  • The infection with the poliovirus can affect children and adults and may lead to permanent limb or respiratory muscle paralysis and death.
  • An effective, well-tolerated vaccine is available! Check if booster doses are recommended (on top of completed basic vaccination schedule).

  • On departure from Ukraine, persons with residence in the country for >4 weeks are strongly recommended to have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their ‘International Certificate for Vaccination’.
  • Stays < 4 weeks: in addition to the basic immunisation against polio, a booster vaccination is recommended every 10 years (recommendation of the Swiss Expert Committee for Travel Medicine (ECTM).

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  • Polio is a vaccine-preventable viral disease of the nervous system that is acquired mainly through the consumption of food or water contaminated by feces.
  • The infection with the polio virus can affect children and adults and may lead to permanent limb or respiratory muscle paralysis and death.
  • An effective, well- tolerated vaccine is available! Check if booster doses are recommended for the travel destination (on top of completed basic vaccination schedule).

Poliomyelitis, or polio, is a highly infectious viral disease that affects the nervous system and can cause total limb paralysis within a very short time period. People of all ages can be infected through consumption of contaminated food or water. Humans are the only known reservoir of the polio virus.  Infection may be mild or even without symptoms. If symptoms of muscular or nervous system complications appear, sequelae (long-term complications) almost always occur. There is no medication to cure polio but the vaccine against polio is highly efficacious.

Polio due to wild types of viruses has been eradicated from most countries. In Afghanistan and Pakistan, however, new infections still occur. In some countries, polio viruses derived from live, oral vaccines are circulating and cause outbreaks of polio disease, especially in countries where vaccination coverage against polio is low in the population.

Polio virus is mainly transmitted through the consumption of food or water contaminated by feces. The virus can also be acquired through secretions or saliva of an infected person. In the tropics, transmission occurs year round, whereas in temperate zones, a peak can be seen in summer.

Symptoms most commonly appear 3 to 21 days following exposure. Initial symptoms may include fever, fatigue, headache, vomiting, and diarrhea. Those with mild cases may recover within a week. More serious cases result in stiffness of the neck and pain in the limbs. 1 in 200 infections leads to irreversible limb or respiratory muscle paralysis.

There is no cure for polio. Treatment targets symptom alleviation only.

Regular hand washing after using the bathroom and before eating or preparing food. Avoidance of undercooked or raw food that is potentially contaminated with fecal material.

The most important prevention is vaccination. A very effective and well-tolerated vaccine against polio is available (inactivated (killed) polio vaccine (IPV)), which is part of the basic vaccination schedule during childhood. Combination vaccines (e.g. with diphtheria and tetanus) are also available. After basic vaccination, a booster dose is recommended every 10 years for travel to certain countries (see country page recommendations). WHO recommends a yearly vaccination for residents or long-stay visitors (minimum 4 weeks) in a country with ongoing polio infections or circulating vaccine-derived polio viruses. This recommendation not only targets individual protection, but aims to prevent the international spread of the virus.

Check the risk for polio in the region of travel, and ensure vaccination if recommended (see country page recommendations).

In special situations, additional vaccinations are recommended or mandatory. Discuss with your doctor whether one of the following vaccinations is recommended for you:

  • Hepatitis B is a viral liver infection that is transmitted via contaminated blood or via sexual contact.
  • A safe and very effective vaccine is available that affords life-long protection.
  • Hepatitis B vaccination is recommended for all young people and at-risk travellers, especially if:
    • You travel regularly or spend long periods of time abroad.
    • You are at risk of practicing unsafe sex.
    • You might undergo medical or dental treatment abroad, or undertake activities that may put you at risk of acquiring hepatitis B (tattoos, piercing, acupuncture in unsafe conditions).

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  • Tick-borne encephalitis is a viral infection that is transmitted by ticks. It is often referred to by the German name and abbreviation ’Frühsommer meningoenzephalitis’ (FSME).
  • Tick-borne encephalitis occurs in certain forested areas in Europe through to the Far East.
  • A safe and effective vaccine is available that is recommended for all stays in endemic areas.

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  • Rabies is a viral infection that is mainly transmitted by dogs (and bats), but any mammal can be infectious. Infection occurs via contact with the saliva of an infected mammal.
  • It is invariably fatal at the time when symptoms occur.
  • The only way to prevent death is pre-travel vaccination or immediate wound cleaning and immunizing after a contact in countries where vaccines and immunoglobulins are often difficult to get.
  • Rabies is best prevented by pre-exposure vaccination. This is highly recommended for
    • long-term stay in endemic countries,
    • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas  or travel with toddlers and children up to 8 years,
    • professional work with animals or cave explorers (bats!).

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This fact sheet contains important information about rabies. For optimal travel preparation, we recommend that you read this information carefully and take the fact sheet on your trip!

  • Rabies is mainly transmitted through the saliva or other body fluids of dogs (and bats), but any mammal can be infectious.
  • Rabies is invariably fatal once symptoms occur.
  • The only way to prevent death is pre-travel vaccination or immediate wound cleaning and immunizing after exposure.
  • In many countries vaccines and immunoglobulins are often unavailable.
  • Rabies is best prevented by pre-exposure vaccination that is highly recommended for
    • long-term stay in endemic countries,
    • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
    • professionals working with animals, or cave explorers (bats!).

Dogs are responsible for more than 95% of human cases. Bats (Latin America), cats, and (rarely) monkeys, predators, and other mammals can transmit rabies. The highest risk areas are Asia, Sub-Saharan Africa, and some Latin American countries (e.g. Bolivia). Rabies may occur anywhere in the world, except in countries where successful eradication has been achieved.

Bleeding scratch injuries, licks over injured skin, bites by infected animals: when saliva or other body fluids of infected animals enter the human body, the rabies virus multiplies at the site of entry and later spreads to the peripheral nerves and eventually moves to the central nervous system. Once it has reached the brain, the infection is invariably fatal.

When symptoms such as abnormal skin sensation, paralysis, or hydrophobia (fear of water) appear at 2-12 weeks after contact (range: 4 days-4 years!), the point of no return is reached, and the disease is fatal. Therefore, vaccination before exposure and immediate action after contact are crucial.

No reliable treatment of rabies disease exists!

Post-exposure measures:

  • Immediate cleaning of the wound with plenty of water and soap for 10-15 minutes, followed by disinfection (e.g. Betadine, Merfen) and emergency post-exposure vaccination at the nearest health institution within 24 hours.
  • Tetanus booster vaccination is also required.
  • For those having received full pre-exposure rabies vaccination before travel: two additional vaccine shots (any available brand) at an interval of 3 days suffice.
  • If full pre-exposure vaccination has not been given, in addition to vaccination, passive immunization is required with immunoglobulins.
  • It should be noted that immunoglobins (and sometimes vaccines) are often unavailable in low-resource settings, causing stress and uncertainty.

Stroking cute pets is not a good idea; refrain from touching wild or unfamiliar or dead animals.
All travellers to places where rabies may occur and who are likely to take repeated trips to areas where rabies occurs should have a pre-exposure vaccination. In addition, pre-exposure vaccination is highly recommended for travellers at particular risk:

  • long-term stay in endemic countries,
  • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
  • professionals working with animals, or cave explorers (bats!).

The shortened vaccination schedule can be proposed to most travellers: 2 shots, the first one at one month before departure if possible (minimum: 8 days before departure). A single third rabies booster vaccination is recommended before the next trip, at least after one year.

  • Obtain information about prevention of rabies in time before travelling.
  • In case of trips planned for longer than a few weeks, schedule a visit at the travel clinic 4 weeks before departure at the latest.
  • After possible exposure (bite, scratch injury) wound treatment and additional vaccinations are necessary even for those with a completed series of basic vaccinations.
  • This information leaflet should be printed and kept handy during the trip!

  • Influenza is common all over the world including sub-tropical and tropical countries.
  • Vaccination offers the best protection. 
  • Vaccination against flu is recommended for all travellers who belong to an “at risk” group such as pregnant travellers, travellers with comorbidities, elderly people (>65 years), or who plan a a high-risk trip (e.g. cruise-ship, pilgrimage).
  • The influenza vaccine does not offer protection against avian flu.

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