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According to WHO, between 2 to 29 September 2024 (week 36 to 36), 17 countries shared their meningitis epidemiological data.
Epidemic:
- Benin: Zoe region (Abdomey health district, crossed epidemic threshold on weeks 33 and 34), remaining in epidemic phase on week 36
Alert:
- Benin: Alibori region, Atacora region, Bargou region, Collines region
- Mali: Bamako region
For previous epidemics and alerts, see EpiNews or news at www.healthytravel.ch.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended:
- During epidemics or alerts, vaccination is recommended for stays > 7 days or in the case of close contact with the population.
If no alert or epidemic is reported, vaccination is recommended for travel to the ‘meningitis belt’ during the dry season (typically occurring from December to June) across sub-Saharan Africa if
- Travelling for >30 days or
- For shorter stays, depending on the individual risk (e.g. close personal contacts, work in health care facilities, stay in heavily occupied accommodation, risk of epidemics).
In 2024, as of 06 October 2024, 16 countries have reported 7’524 confirmed cases (+770 new confirmed cases within 1 week), including 32 deaths. The three countries with the majority of the cases in 2024 (all clades) are Democratic Republic of the Congo (6’169), Burundi, (n = 987), and Nigeria, (n = 84).
(Note: A significant number of suspected mpox cases that are clinically compatible with mpox remain untested due to limited diagnostic capacity in some African countries and therefore never got confirmed.)
In 2024, 15 countries have reported both 31’527 suspected and laboratory tested cases (+5’160 within 1 week, all clades), including 998 suspected and confirmed deaths (+2 within 1 week).
According to WHO, in 2024 as of 29 Sept 2024 the cumulative confirmed mpox cases (+ cases since last update 29 Sep 2024) were reported in the below mentioned countries (for updates, details, suspected cases, epidemic curves, see WHO LINK):
Clade Ia and b:
- D.R. Congo: according to WHO: 5’610 (+559 cases since 29 Sept 2024; note OV: in the week before the reported number was not conclusive)
Clade Ib
- Burundi: 987 confirmed cases (+134 cases since 29 Sept 2024, stable increase of confirmed cases) (plus hundreds of suspected cases)
- Uganda: 69 cases (+47 cases since 29 Sept 2024)
- Kenya: 12 cases (+4 since 29 Sept 2024)
- Rwanda: 6 cases (+0 cases since 29 Sept 2024)
- Outside Africa: Sweden (1 case, imported from Burundi), Thailand (1 case, imported from DRC), India (1 imported case)
Clade Ia:
- Republic of the Congo: 21 confirmed cases (+0)
- Central African Republic: 57 confirmed cases (+2)
- Cameroon: 6 cases (+0), including unknown number of cases with clade IIa and IIb
Clade II (a and/or b):
- Côte d’Ivoire: 67 cases (+15)
- Cameroon: 6 cases including unknown number of cases with clade 1a
- Ghana: 1 case
- Guinea: 1 case (+0)
- Morocco: 3 case (+1)
- Nigeria: 84 cases (+6)
- South Africa: 25 cases (+0)
In addition, mpox cases have been reported in Africa in 2024 without specification of the clade:
- Gabon: 2 cases (+0)
- Liberia: 14 cases (+1)
Epicurve for Ib clade cases as 6 October 2024:
Follow local media and local health authority advice. The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet Mpox).
General precautions
- Worldwide:
- Avoid close, skin-to-skin contact with people who have or may have mpox or people who have a rash (e.g., pimples, blisters, scabs).
- Wash your hands often with soap + water or an alcohol-based hand sanitizer containing at least 60% alcohol.
- Avoid touching potentially contaminated personal items such as bedding/clothing, towels or sharing eating utensils/cups, food or drink with a person who has, or may have mpox.
- Avoid sex with sick persons; use of condoms for up to 12 weeks if you sexual partner have had mpox.
- Follow advice of local authorities.
- Avoid close, skin-to-skin contact with people who have or may have mpox or people who have a rash (e.g., pimples, blisters, scabs).
- When travelling to endemic / epidemic areas in Africa, in addition to above mentioned general precautions:
- Avoid contact with and animals in areas where mpox regularly occurs.
- Avoid eating or preparing meat from wild animals (bushmeat) or using products (creams, lotions, powders) derived from wild animals.
Vaccination
A vaccination against mpox is available (Jynneos®, manufactured by Bavarian Nordic). The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, as of 3 October 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi in case of:
- Clinical, research or laboratory work
- Working with animals
(a broader indication is still under discussion)
2. People staying outside of Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi (worldwide) in case of:
- Increased risk (e.g. laboratory workers handling mpox virus, men who have sex with men, trans-persons with multiple sexual partners), see Swiss recommendations: see Link.
At the present time, it is assumed that the available vaccine against mpox (e.g. Jynneos®) is also effective against clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms
- Seek medical attention immediately
If you are diagnosed with mpox:
- Please stay at home (isolate yourself) until your mpox rash has healed and a new layer of skin has formed. Staying away from other people and not sharing things you have touched with others will help prevent the spread of mpox.
- People with mpox should regularly clean and disinfect the spaces they use to limit household contamination.
Wash your hands often with soap /water or an alcohol-based hand sanitizer containing at least 60% alcohol. - You should not have sex while symptomatic and while you have lesions or symptoms. Use condoms for 12 weeks after infection. This is a precaution to reduce the risk of spreading the virus to a partner.
- For more information on what do if you are sick, see CDC LINK.
For clinicians:
- Consider mpox as a possible diagnosis in patients with epidemiologic characteristics and lesions or other clinical signs and symptoms consistent with mpox. This includes persons who have been in DRC or, due to the demonstrated risks of regional spread, any of its neighboring countries in the previous 21 days.
- Further information on evaluation and diagnosis: see CDC LINK.
According to WHO, between 29 to 1 September 2024 (week 31 to 35), 19 countries shared their meningitis epidemiological data.
Epidemic:
- Benin: Zoe region (Abdomey health district, crossed epidemic threshold on weeks 33 and 34)
- D.R. Congo: Province Sud-Ubangui and province Sankuru
Alert:
- Benin: Bargou region, Collines region
- D.R. Congo: Haut – Lomami province, Ituri province, Lomami province, Maindombe province
- Ghana: Savannah region
- Mali: Bamako region
For previous epidemics and alerts, see EpiNews or news at www.healthytravel.ch.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended:
- During epidemics or alerts, vaccination is recommended for stays > 7 days or in the case of close contact with the population.
If no alert or epidemic is reported, vaccination is recommended for travel to the ‘meningitis belt’ during the dry season (typically occurring from December to June) across sub-Saharan Africa if
- Travelling for >30 days or
- For shorter stays, depending on the individual risk (e.g. close personal contacts, work in health care facilities, stay in heavily occupied accommodation, risk of epidemics).
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
- The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
According to the WHO, 18 countries shared their epidemiological data on meningitis between March 4 and 10, 2024.
Epidemics:
- Niger: Niamey region
- Nigeria: Bauchi state
- D.R. Congo: North Kivu province
Warnings:
- Benin: Collines region and Dinga region
- Central African Republic: Region 3 and Region 6
- Chad: Mandoul region
- D.R. Congo: Haut-Uelé Province and Bas-Uelé Province and North Ubangui Province
- Ghana: Upper West Region and Ahafo Region and North East Region
- Guinea: Conakry region (Ratoma district)
- Nigeria: Gombe State
- South Sudan: Northern region of Bahr El Ghazal
- Togo: Kara region
Previous epidemics and warnings can be found under News at www.healthytravel.ch.
Seasonal meningitis epidemics occur in sub-Saharan Africa mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. Vaccination against the most important strains of meningitis is available as prophylaxis for adults and children over 1 year of age.
According to the WHO, 18 countries submitted their epidemiological data on meningitis between February 18 and March 3, 2024 (week 7 to 9).
Epidemics:
- Nigeria: Gombe State
- D.R. Congo: North Kivu province
Warnings:
- D.R. Congo: Province of Haut-Uele
- Ghana: Upper West Region and Savannah Region
- Guinea: Conakry region (Ratoma district)
- Niger: Niamey region
- Senegal: Dakar region (Dakar Centre district)
- Nigeria: Bauchi State, Gombe State
- Togo: Kara region (Doufelgou district)
Further information:
- Nigeria: according to media reports, an outbreak of meningitis in Yobe state has resulted in 636 cases.
Previous epidemics and warnings can be found under News on www.healthytravel.ch
Seasonal meningitis epidemics in sub-Saharan Africa occur mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. Vaccination against the most important strains of meningitis is available as a prophylaxis for adults and children over 1 year of age.
Seasonal meningitis epidemics occur in sub-Saharan Africa primarily during the dry season, usually from December to June. They decline rapidly with the onset of rains. Generally, meningococcal serogroups A, C, W, and X are responsible for these outbreaks. The disease spreads through droplets from person to person. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. As prophylaxis, vaccination against the main meningitis strains is available for adults and children over 1 year of age.
Seasonal meningitis epidemics occur in sub-Saharan Africa primarily during the dry season, usually from December to June. They decline rapidly with the beginning of rains. Generally, meningococcal serogroups A, C, W, and X are responsible for these outbreaks. The disease spreads by droplets from person to person. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. As prophylaxis, vaccination against the main meningitis strains is available for adults and children over 1 year of age.
In 2021, nine countries in the WHO African Region (Cameroon, Chad, Central African Republic (CAR), Côte d'Ivoire, Democratic Republic of Congo (DRC), Ghana, Niger, Nigeria, and Republic of Congo) reported human yellow fever cases that were confirmed in the laboratory. The number of cases in these outbreaks is increasing compared to previous years. Yellow fever cases classified as probable have also been reported in Benin, Burkina Faso, Gabon, Mali, Togo, and Uganda.
Some of the affected countries are classified as fragile, conflict-affected, or vulnerable, where population immunity to yellow fever is low.
Consequences for travelers
Yellow fever vaccination is strongly recommended when traveling to yellow fever endemic areas, see country pages www.healthytravel.ch/countries/ or 'Reisemedizinischen Tabellen' of the FOPH: LINK.
References
WHO DON, 23.12.2021
Masernausbrüche werden aus mindestens 14 Ländern Afrikas berichtet mit einigen Hundert bis mehreren Tausend Fällen seit Jahresbeginn 2021.
Masern sind eine hoch ansteckende Viruserkrankung, die über die Atemwege übertragen wird. Sie ist in der ganzen Welt verbreitet. Mit einem Impfstoff lässt sich die Krankheit sehr wirksam verhindern.
Folgen für Reisende
Eine Reise bietet eine ideale Gelegenheit, den Schutz vor Masern zu kontrollieren (2x geimpft oder durchgemachte Masern) und wenn nötig den Impfschutz zu aktualisieren.
Referenzen
General Information
- Although the public health emergency of international concern for COVID-19 was declared over on 5 May 2023, COVID-19 remains a health threat
- Adhere 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)
Vaccinations for all travellers
For medical reasons, the following vaccination recommendation is valid for all travelers (unless there is a contraindication):
- Vaccination recommended for all travel to areas south of the Sahara Desert.
- Vaccination not recommended for travellers whose itineraries are limited to areas within the Sahara Desert.
For administrative reasons, there is the following entry regulation of the country:
- Vaccination against yellow fever is required.
Exempt from this entry requirement:
- Children under 1 year of age.
- Passengers transiting countries with risk of yellow fever transmission if not leaving the transit areas.
- Yellow fever is a life-threatening viral infection. A highly effective vaccine is available.
- Vaccination is strongly recommended for all travellers to regions where yellow fever occurs, even if it is not a mandatory entry requirement of the country.
- A booster single booster dose is recommended for immuncompetent persons after 10 years.
- The yellow fever vaccination must be administered by an authorized doctor or center at least ten days before your arrival in the destination country with record in the yellow vaccination booklet ('International Certificate for Vaccination').
- For travellers who are pregnant, breastfeeding, or who have a condition that leads to immunosuppression, please consult a travel health advisor.
EKRM_Factsheet_Layperson_EN_Yellow-fever.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
For medical reasons, the following vaccination recommendation is valid for all travelers (unless there is a contraindication):
- Vaccination recommended for all travel to areas south of the Sahara Desert.
- Vaccination not recommended for travellers whose itineraries are limited to areas within the Sahara Desert.
For administrative reasons, there is the following entry regulation of the country:
- Vaccination against yellow fever is required.
Exempt from this entry requirement:
- Children under 1 year of age.
- Passengers transiting countries with risk of yellow fever transmission if not leaving the transit areas.
CDC Map: Yellow fever vaccine recommendations for the Americas
Footnotes
- Current as of November 2022. This map is an updated version of the 2010 map created by the Informal WHO Working Group on the Geographic Risk of Yellow Fever.
- In 2017, the Centers for Disease Control and Prevention (CDC) expanded its yellow fever vaccine recommendations for travelers going to Brazil because of a large outbreak in multiple states in that country. For more information and updated recommendations, refer to the CDC Travelers’ Health website.
- Yellow fever (YF) vaccination is generally not recommended for travel to areas where the potential for YF virus exposure is low. Vaccination might be considered, however, for a small subset of travelers going to these areas who are at increased risk for exposure to YF virus due to prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites. Factors to consider when deciding whether to vaccinate a traveler include destination-specific and travel-associated risks for YF virus infection; individual, underlying risk factors for having a serious YF vaccine-associated adverse event; and country entry requirements.
- Yellow fever occurs in sub-Saharan Africa and South America and is transmitted by mosquitoes.
- Disease may be severe in unvaccinated travelers and death may occur in over 50%.
- A highly effective vaccine is available.
- Due to potentially severe side effects the vaccine is used with caution in immunocompromised or elderly individuals, as well as in pregnant women.
As against all mosquito-borne diseases, prevention from mosquito bites is during day and night (see “Insect and tick bite protection” factsheet). The available vaccine is highly efficacious and provides a long-term protection. It is recommended for people aged 9 months or older who are travelling to yellow fever endemic areas. In addition, providing proof of vaccination may be mandatory for entry into certain countries.
The vaccine is a live-attenuated form of the virus. In immunocompetent persons, protection starts about 10 days after the first vaccination. Reactions to yellow fever vaccine are generally mild and include headache, muscle aches, and low-grade fevers. Side effects can be treated with paracetamol but aspirin and other nonsteroidal anti-inflammatory drugs, for example ibuprofen or naproxen, should be avoided. On extremely rare occasions, people may develop severe, sometimes life-threatening reactions to the yellow fever vaccine – which is why this vaccine is used with caution in immunocompromised individuals, pregnant women and the elderly for safety reasons. Talk to your travel health advisor if you belong to this group.
Yellow Fever Info - Centers for Disease Control and Prevention: https://www.cdc.gov/yellowfever/index.html
Yellow Fever Info - European Centre for Disease Prevention and Control: https://www.ecdc.europa.eu/en/yellow-fever/facts
- Hepatitis A vaccination is recommended for all travellers going to tropical or subtropical countries.
- Hepatitis A is a liver infection caused by a virus. It is also known as infectious jaundice.
- The virus is easily transmitted by contaminated food or water but can also be transmitted through sexual contact.
- A safe and very effective vaccine is available that affords long-lasting protection.
- Hepatitis A vaccination is recommended for all travelers going to tropical or subtropical countries, and for risk groups.
- Hepatitis A is a liver infection caused by a virus.
- The virus is easily transmitted by contaminated food or water but can also be transmitted through sexual contact.
- A safe and very effective vaccine is available that affords long-lasting protection.
- Hepatitis A vaccination is recommended for all travelers going to tropical or subtropical countries, and for risk groups.
Hepatitis A occurs all over the world, but the risk of infection is higher in countries with poor hygiene standards. There is an increased risk in most tropical and subtropical countries, as well as in some countries in Eastern Europe and around the Mediterranean.
In recent years, there have also been increasing cases in North America and Europe, including Switzerland, especially among men who have sex with men (MSM). Outbreaks in northern European countries can also occur when unvaccinated children become infected during family visits to tropical and subtropical countries. Upon return, they may transmit the virus within their care facilities.
There is a safe and very effective vaccine that consists of two injections at least 6 months apart. It provides lifelong protection after the second dose. Hepatitis A vaccination can also be given in combination with hepatitis B vaccination (3 doses required).
Vaccination against hepatitis A is recommended for all travellers to risk areas, as well as for persons at increased personal risk: persons with chronic liver disease, men who have sex with men, people who use or inject drug, persons with increased occupational contact with persons from high-risk areas or populations, and others.
- Federal Office of Public Health (FOPH). Hepatitis A. https://www.bag.admin.ch/bag/en/home/krankheiten/krankheiten-im-ueberblick/hepatitis-a.html
- Swiss Hepatitis: https://en.hepatitis-schweiz.ch/all-about-hepatitis/hepatitis-a
After completion of basic immunization against polio:
- Duration of stay > 4 weeks:
- according to International Health Regulation (IHR), it is recommended to have received a polio booster vaccination (IPV) no more than 12 months prior to departure from Niger (documentation of the vaccination in the international yellow vaccination card).
- according to International Health Regulation (IHR), it is recommended to have received a polio booster vaccination (IPV) no more than 12 months prior to departure from Niger (documentation of the vaccination in the international yellow vaccination card).
- Duration of stay < 4 weeks: a booster vaccination against polio is recommended for:
- immunocompetent travellers <65 years: every 20 years
- immunocompetent travellers ≥65 years: every 10 years
- travellers with immunodeficiency: every 10 years
- 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).
After completion of basic immunization against polio:
- Duration of stay > 4 weeks:
- according to International Health Regulation (IHR), it is recommended to have received a polio booster vaccination (IPV) no more than 12 months prior to departure from Niger (documentation of the vaccination in the international yellow vaccination card).
- according to International Health Regulation (IHR), it is recommended to have received a polio booster vaccination (IPV) no more than 12 months prior to departure from Niger (documentation of the vaccination in the international yellow vaccination card).
- Duration of stay < 4 weeks: a booster vaccination against polio is recommended for:
- immunocompetent travellers <65 years: every 20 years
- immunocompetent travellers ≥65 years: every 10 years
- travellers with immunodeficiency: every 10 years
EKRM_Factsheet_Layperson_EN_Polio.pdf
- 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).
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.
All travellers should have completed a basic immunisation and boosters according to the Swiss vaccination schedule, LINK.
All travellers should have completed a basic immunisation and boosters according to the Swiss vaccination schedule, LINK.
Travellers should be immune to chickenpox. Persons between 13 months and 39 years of age who have not had chickenpox and who have not received 2 doses of chickenpox vaccine should receive a booster vaccination (2 doses with minimum interval of 4 weeks), see Swiss vaccination schedule, LINK.
Vaccinations for some travellers
- 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).
- Rabies is mainly transmitted by dogs (and bats), but any mammal can be infectious.
- It is invariably fatal at the time when symptoms occur.
- Rabies is best prevented by a pre-travel vaccination and appropriate behavior towards mammals.
- Pre-travel vaccination is also recommended because vaccines and immunoglobulins are often not available in many travel countries. Vaccination before travel is highly recommended in particular 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!),
- for details, see SOP vaccination rabies (only available in HealthyTravel PRO).
- Attention: a bite or scratch wound as well as contact with mammal saliva is an emergency! Find out about the necessary actions below!
- Rabies is mainly transmitted by dogs (and bats), but any mammal can be infectious.
- It is invariably fatal at the time when symptoms occur.
- Rabies is best prevented by a pre-travel vaccination and appropriate behavior towards mammals.
- Pre-travel vaccination is also recommended because vaccines and immunoglobulins are often not available in many travel countries. Vaccination before travel is highly recommended in particular 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!).
- long-term stay in endemic countries,
- Attention: a bite or scratch wound as well as contact with mammal saliva is an emergency! Find out about the necessary actions below!
No treatment against 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!
- FOPH Switzerland (German): https://www.bag.admin.ch/dam/bag/de/dokumente/mt/infektionskrankheiten/tollwut/bag-bulletin-15-2021-tollwut-prep-und-pep.pdf.download.pdf/210412_BAG_Bulletin_15_2021_Tollwut%20PrEP%20und%20PEP_d.pdf
- FOPH Switzerland (French): https://www.bundespublikationen.admin.ch/cshop_mimes_bbl/14/1402EC7524F81EDBA5D6C3EBC18BA9FB.pdf
- Typhoid fever is a serious disease that is caused by bacteria and transmitted through contaminated food or water.
- The risk is very low for travellers who have access to safe food and drinks.
- The best protection against typhoid fever is to follow optimal basic hygiene.
- A vaccination against typhoid is available that is recommended in following circumstances
- Visit to an area with poor hygienic conditions (e.g. travelling to rural areas)
- Short stay (>1 week) in a high-risk (hyper-endemic) country (see country page)
- Long-term stays (> 4 weeks) in an endemic country
- Presence of individual risk factors or pre-existing health conditions. In that case, please talk to your health advisor.
- Typhoid fever, also called enteric fever, is caused by the bacteria Salmonella Typhi and Salmonella Paratyphi.
- Infected persons shed the bacteria in their feces. In countries with low sanitation standards, the bacteria can then enter the drinking water system and lead to infections in other people.
- Frequent sources of infection are contaminated food and beverages.
- The main preventive measure therefore is “cook it, peel it, boil it or forget it” – meaning: avoid drinking uncooked water or water from unsealed bottles; avoid cooled/frozen products (e.g. ice cubes in drinks, ice cream) unless from a known safe source; avoid uncooked vegetables, peel and clean fruit and vegetables yourself and only with known safe drinking water.
- A vaccine is available and recommended: a) for travelers to the Indian subcontinent or to West Africa, b) for travelers visiting friends and relatives or for long-term travelers also to other sub-/tropical areas.
“Cook it, boil it, peel it or forget it” – this simple slogan would be sufficient to prevent typhoid fever nearly entirely. However, only few travelers fully adhere to this advice. Nevertheless, the value of food and water hygiene cannot be stressed enough: avoid buying water bottles without proper sealing, avoid drinking tap water from unknown sources, avoid eating cooled / frozen foods (i.e. ice cubes in water or ice cream) and avoid eating raw fruits and vegetables that you yourself have not peeled and washed with clean drinking water.
Two types of vaccines are available:
- Oral (live) vaccine consisting of three capsules to be taken on alternate days on empty stomach. These capsules require refrigeration before use. Protection from this vaccine is approximately 70% and starts 10 days after the third dose. After 1 to 3 years, the vaccine needs to be taken again before a new travel into at-risk areas. This vaccine cannot be given to patients with a severe chronic gastrointestinal disease (such as Crohn’s disease or ulcerative colitis) or with severe immunosuppression.
- The single-dose vaccine is an inactivated vaccine and is injected intramuscularly. Protection also reaches around 70% and starts 14 days after the injection. This vaccine can be given to patients who should not take the oral vaccine. However, it is not registered in Switzerland, but most doctors with specialization in tropical and travel medicine and all travel health centres have the vaccine on stock. Duration of protection is around 3 years.
- 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.
- Vaccination is recommended according to the Swiss recommendations of the Federal Office of Public Health (FOPH), see LINK.
- 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.
- 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.
- Meningococcal disease is a very severe, life threatening bacterial infection that can lead to death within a few hours if untreated.
- Transmission occurs from person to person by droplets.
- The risk is higher for travelers to regions with seasonal epidemics (Meningitis Belt in Sub-Saharan Africa: outbreaks occur each year during the dry season, mainly between December and the end of June).
- The disease can be prevented by one dose of four-valent meningococcal vaccine and protection lasts for at least 5 years.
- Vaccination is compulsory for everyone over the age of two years going on a pilgrimage in Saudi Arabia.
Vaccination is recommended for stays in the meningitis belt:
- During an alert or epidemic (typically occurring during dry season from December to June → check News)
- for those travelling more than 7 days OR
- for those who will be in close contact with the local population or living/travelling in crowded conditions
- For those who will be staying for more than four weeks
- For those who will be working in a medical setting
- For those with predisposing factors or who have ever had an invasive meningococcal infection
- For those with a condition affecting the spleen or who have a poorly functioning spleen
For details, see SOP vaccination meningococcal meningitis (only available in HealthyTravel PRO).
- Meningococcal disease is a very severe, life threatening bacterial infection that can lead to death within a few hours if untreated.
- Transmission occurs from person to person by droplets. The risk is higher for travelers to regions with seasonal epidemics (meningitis belt in sub-Saharan Africa).
- The disease can be prevented by one dose of four-valent meningococcal vaccine and protection lasts for at least 5 years.
Meningococcal vaccination is recommended in Switzerland as a complementary vaccination for children between 2 – 4 years and for adolescents between 11 – 15 years. Furthermore, it is recommended as a risk group vaccination for persons with certain medical conditions, for persons with close contact to a patient with meningococcal disease and for travelers to endemic areas.
For more detailed information on the disease and Swiss national recommendations (in German, French, Italian) see: https://www.bag.admin.ch/bag/de/home/krankheiten/krankheiten-im-ueberblick/meningokokken-erkrankungen.html
Malaria
- All year around: southern third of the country (see map), cities Tahoua, Niamey.
Prevention: Mosquito bite prevention and chemoprophylaxis.
Discuss with your travel health advisor which prophylactic medication is suitable for you. The travel health advisor will prescribe the appropriate medication and dosage.
There is a seasonal risk in the following regions:
- belt between Sahara desert and tropical regions of the country (see map), including city Agadez.
- From June to December: the malaria risk is high.
Prevention: Mosquito bite prevention and chemoprophylaxis. - From January to May: the malaria risk is moderate.
Prevention: Mosquito bite prevention.
Discuss with a travel health advisor whether carrying a stand-by emergency self-treatment against malaria is necessary.
- From June to December: the malaria risk is high.
- All year around: travel only to / in the Sahara desert.
Prevention: Mosquito bite prevention.
Discuss with a travel health advisor whether carrying a stand-by emergency self-treatment against malaria is necessary.
- Malaria is a life-threatening parasitic infection, which is transmitted by mosquitoes at night.
- Great care should be given to preventive mosquito protection from dusk to dawn in all malaria risk areas.
- In high-risk areas, taking regular prophylactic medication is strongly advised.
- For stays in low risk areas: discuss with a travel health advisor whether carrying stand-by emergency self-treatment against malaria is recommended.
- If you belong to a special risk group (pregnant women, small children, senior citizens, persons with pre-existing conditions and/or with immune deficiency): seek medical advice before the trip as malaria can quickly become very severe.
- If you have a fever >37.5°C on measuring under your arm or in your ear (a functioning thermometer is indispensable!) during or after the trip, see a doctor / hospital immediately and have a blood test done for malaria! This applies regardless of whether you used prophylactic medication or not!
- For personal safety, we strongly recommend getting informed in detail about malaria and reading the following information.
EKRM_Factsheet_Layperson_EN_Malaria.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
- All year around: southern third of the country (see map), cities Tahoua, Niamey.
Prevention: Mosquito bite prevention and chemoprophylaxis.
Discuss with your travel health advisor which prophylactic medication is suitable for you. The travel health advisor will prescribe the appropriate medication and dosage.
There is a seasonal risk in the following regions:
- belt between Sahara desert and tropical regions of the country (see map), including city Agadez.
- From June to December: the malaria risk is high.
Prevention: Mosquito bite prevention and chemoprophylaxis. - From January to May: the malaria risk is moderate.
Prevention: Mosquito bite prevention.
Discuss with a travel health advisor whether carrying a stand-by emergency self-treatment against malaria is necessary.
- From June to December: the malaria risk is high.
- All year around: travel only to / in the Sahara desert.
Prevention: Mosquito bite prevention.
Discuss with a travel health advisor whether carrying a stand-by emergency self-treatment against malaria is necessary.
- Malaria is a life-threatening parasitic infection, which is transmitted by mosquitoes at night.
- Great care should be given to preventive mosquito protection from dusk to dawn in all malaria risk areas.
- In high-risk areas, the intake of prophylactic medication is strongly advised.
- For stays in low risk areas: discuss with a travel health advisor whether carrying an emergency self-treatment against malaria is necessary.
- If you belong to a special risk group (pregnant women, small children, senior citizens, persons with pre-existing conditions and/or with immune deficiency): seek medical advice before the trip as malaria can quickly become very severe.
- If you have a fever >37.5°C on axillary or tympanic measurement (a functioning thermometer is indispensable!) during or after the trip, see a doctor / hospital immediately and have a blood test done for malaria! This applies regardless of whether you have used prophylactic medication or not!
Fever during or after a stay in a malaria-endemic area is an emergency! Prompt diagnosis and treatment are required as the health of people with malaria can deteriorate very quickly. That means: if you have fever >37.5° (use a thermometer!) you need to test for malaria within a maximum time-frame of 24 hours, regardless of whether or not you have used prophylactic medication (malaria chemoprophylaxis). Try to reach a doctor or hospital where you can reliably receive such a test. If the first test is negative, it should be repeated on the following day if the fever persists.
Prevention of malaria requires a combination of approaches:
- Diligent mosquito-bite protection at dusk and at night until dawn is of key importance. Use it for all regions where malaria is present, including areas where the risk is minimal. Bite protection is also effective against other insect-borne diseases that often occur in the same region. It consists of the following measures:
- Clothing: Wear long-sleeved clothes and long trousers. For additional protection, impregnate the clothes beforehand with insecticides containing the active ingredient permethrin (e.g. Nobite® Textile).
- Mosquito repellents: Apply a mosquito repellent to uncovered skin.
- Sleeping room: Sleep in an air-conditioned room or under an impregnated mosquito net. Cautiously use ‘knockdown’ sprays indoors or burn mosquito coils strictly outside, e.g. under a table in the evening.
- Chemoprophylaxis: Depending on the region and season, it may be necessary to take a prophylactic medication. This is recommended for all destinations with a high risk of malaria (marked as red on our maps). It needs to be taken with food before, during, and after your stay. Discuss with your travel health advisor to ascertain if you need to take chemoprophylaxis for your trip. The appropriate medication and the right dosage will be prescribed.
- Taking standby emergency self-treatment (SBET, drugs used to self-treat malaria) with you is recommended for special risk situations (stay in regions with low malaria risk and if there is no or uncertain medical care available). Following such a course of SBET, please consult a doctor as soon as possible. Talk to your travel health advisor to determine whether carrying SBET is necessary, especially if you plan a trip where reliable medical infrastructure is not assured.
- For some risk groups, malaria can quickly develop to a dangerous disease. If you are pregnant, if you are travelling with small children, or if you are a senior citizen and / or if you have other illnesses /pre-existing conditions and / or you are immunocompromised, you should seek advice from a specialist in travel medicine to determine whether chemoprophylaxis is recommended for your trip – even if the area is marked as low risk malaria zone.
For travellers, there is currently no malaria vaccination available.
- Take a functioning clinical thermometer with you!
- Malaria symptoms develop at the earliest 7 days after entering the malaria area. A fever > 37.5° always means suspicion of malaria!
- In case you have fever during or even months after a stay in a malaria area:
- Immediately consult a health care facility to rule out malaria through a blood test.
- This should be done within a maximum of 24 hours and applies regardless of whether you have used prophylactic medication or not!
- The blood tests should be repeated if the result is negative or doubtful and fever persists or recurs.
- For persons having visited a malaria area with low risk and for whom SBET was prescribed:
- If you have fever: immediately try to get tested for malaria.
- If this is not possible, and fever persists for longer than 24 hours or recurs: start taking the standby emergency-self-treatment as it was prescribed by your travel health advisor.
- Even if you have started your self-treatment against malaria: seek medical advice as quickly as possible to get the cause of your fever diagnosed.
Other health risks
- Dengue fever is a viral disease that is disease that bite during daytime.
- The best way to prevent these diseases is to protect yourself from mosquito bites, see LINK!
- A vaccination (Qdenga®) against dengue is available.
- However, based on the data available, the Swiss Expert Committee for Travel Medicine (ECTM) currently recommends vaccination with Qdenga® only for travellers who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission, for details see LINK.
- In case of fever: do not use any medication containing acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®), as this can worsen bleeding in case of dengue infection.
- Read the following information for optimal travel preparation.
EKRM_Factsheet_Layperson_EN_Dengue.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
CDC Map: Distribution of dengue
- Dengue fever is the world's most common insect-borne infectious disease.
- Great attention should be paid to mosquito protection during the day!
- The disease can cause high fever, muscle and joint pain, and skin rashes. In rare cases, bleeding may occur. There is no specific treatment. Vaccination is recommended only for people with evidence of previous dengue infection.
- For personal safety, we strongly recommend that you inform yourself in detail about dengue.
Dengue fever is the most common insect-borne infectious disease worldwide. There are 4 known serotypes of dengue virus, so it is possible to be infected with dengue more than once. Approximately 1 in 4 infected individuals develop symptoms of dengue, resulting in high fever, muscle and joint pain, and skin rash. In rare cases, most often after a second infection, life-threatening bleeding and shock (severe drop of blood pressure) may occur.
In 3 out of 4 cases, an infection with the virus remains asymptomatic. After a short incubation period (5-8 days), 1 out of 4 infected people present an abrupt onset of fever, headache, joint, limb and muscle pain, as well as nausea and vomiting. Eye movement pain is also typical. A rash usually appears on the 3rd or 4th day of illness. After 4 to 7 days, the fever finally subsides but fatigue may persist for several days or weeks.
In rare cases, severe dengue can occur. Particularly susceptible are local children and seniors as well as people who have experienced a prior dengue infection. Tourists extremely rarely present with severe dengue. In the first days, the disease resembles the course of classic dengue fever, but on the 4th/5th day, and usually after the fever has subsided, the condition worsens. Blood pressure drops, and patients complain of shortness of breath, abdominal discomfort, nosebleeds, and mild skin or mucosal hemorrhages. In the most severe cases, life-threatening shock may occur.
There is no specific treatment for dengue virus infection. Treatment is limited to mitigation and monitoring of symptoms: fever reduction, relief of eye, back, muscle and joint pain, and monitoring of blood clotting and blood volume. Patients with severe symptoms must be hospitalised.
For treatment of fever or pain, paracetamol or acetaminophen are recommended (e.g. Acetalgin® Dafalgan®). Drugs containing the active ingredient acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®) must be avoided.
Effective mosquito protection during the day and especially during twilight hours (i.e. sunset) is the best preventive measure:
- Clothing: Wear well-covered, long-sleeved clothing and long pants and treat clothing with insecticide beforehand (see factsheet “prevention of arthropod bites”).
- Mosquito repellent: Apply a mosquito repellent to uncovered skin several times a day (see factsheet “prevention of arthropod bites”).
- Environmental hygiene: Do not leave containers with standing water (coasters for flower pots, etc.) in your environment to avoid mosquito breeding sites.
For further information, please refer to the factsheet on "Mosquito and tick bite protection".
Note on the dengue vaccine Qdenga®:
- Based on the data available, many European countries, as well as the Swiss Expert Committee for Travel Medicine (ECTM), currently recommend vaccination with Qdenga® only for travelers who have evidence of a previous dengue infection and who will be exposed in a region with significant dengue transmission. This is a precautionary decision, since the current data also include the possibility that people who are vaccinated with Qdenga® before a first dengue infection may experience a more severe course of the disease. A consultation with a specialist in tropical and travel medicine is recommended.
Consistent mosquito protection during the day (see above) is still considered the most important preventive measure against dengue!
Of note
- Do not take any products containing the active ingredient acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®) if you have symptoms, as they increase the risk of bleeding in the event of a dengue infection!
- However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
- Do not take any products containing the active ingredient acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®) if you have symptoms, as they increase the risk of bleeding in the event of a dengue infection!
- However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
- Chikungunya is a viral disease transmitted by mosquitoes that bite during daytime.
- As a prevention measure, great attention should be given to protection from mosquito bites.
- There is neither a vaccination nor a specific medication against chikungunya for travellers.
- In case of fever: do not use acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®) as this can worsen bleeding in case of dengue infection.
- Read the following information for optimal travel preparation.
EKRM_Factsheet_Layperson_EN_Chikungunya.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
CDC Map: Distribution for Chikungunya
- Chikungunya is a viral disease transmitted by Aedes mosquitoes.
- Chikungunya can be prevented by protection against mosquito bites.
- It typically presents with severe joint pain of the hands and feet. In a few patients, these may persist for weeks or months.
The infection may present with some or all of the following symptoms: sudden onset of high-grade fever, chills, headache, redness of eyes, muscle and joint pain, and rash. The rash usually occurs after the onset of fever and typically involves the trunk and extremities, but can also include the palms, soles of the feet, and the face.
Often fever occurs in two phases of up to one week duration, with an interval of one to two fever-free days in between. The second phase may present with much more intense muscle and joint pain, which can be severe and debilitating. These symptoms are typically bilateral and symmetric and mainly involve hands and feet, but may also involve the larger joints, such as the knees or shoulders.
About 5-10% of infected people continue to experience severe joint pain even after the fever has subsided, in some cases lasting up to several months or, albeit rare, even years.
- FOPH Switzerland: https://www.bag.admin.ch/bag/de/home/krankheiten/krankheiten-im-ueberblick/chikungunya.html
- WHO - Chikungunya fact sheet: https://www.who.int/news-room/fact-sheets/detail/chikungunya
- Center for Disease Control and Prevention (CDC): https://www.cdc.gov/chikungunya/index.html
- Zika is a viral disease transmitted by mosquitoes that bite during the day.
- Zika virus infection during pregnancy (any trimester) can cause fetal malformation.
- In areas at increased risk of transmission (epidemic), specific recommendations must be given to women who are – or wish to become – pregnant.
- If you or your partner is pregnant or if you are planning a family, we strongly recommend that you inform yourself in detail about zika.
EKRM_Factsheet_Layperson_EN_Zika.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
- The fact sheet contains important information on zika and prevention measures.
- If you or your partner is pregnant or if you are planning a family, we strongly recommend that you inform yourself in detail about zika.
- Zika is a viral disease transmitted by mosquitoes that bite during the day.
- Zika virus infection during pregnancy (any trimester) can cause fetal malformation.
- In areas at increased risk of transmission (epidemic), specific recommendations must be given to women who are – or wish to become – pregnant.
The Zika virus was identified in 1947 in monkeys from the Zika forest in Uganda. Virus circulation has long been limited (a few cases each year) in Africa and South-East Asia. In May 2015, the American continent was affected for the first time, with an epidemic in Brazil that rapidly spread to South America, Central America, and the Caribbean. Since then, the disease has been reported in most tropical and subtropical regions.
The risk of infection is currently low in most regions and does not require specific measures. However, epidemics may occasionally reappear. During epidemics, the risk of transmission is high, and specific recommendations for the traveller are necessary.
In case of fever, it is recommended to consult a doctor. The symptoms of a Zika virus infection may seem similar to those of malaria, for which urgent treatment is necessary, or dengue fever. Treatment for Zika aims for reduction of fever and joint pain (paracetamol). Avoid aspirin and anti-inflammatory drugs (e.g. ibuprofen) as long as dengue fever is not excluded. There is no vaccine available.
In case of pregnancy and fever during or upon return from a Zika virus transmission area, blood and/or urine tests are indicated. In case of confirmed infection, the medical management should be discussed with the gynecologist and infectious/travel medicine specialists.
The risk of infection can be reduced by effective protection from mosquito bites during the day and in the early evening (long clothing, mosquito repellents, mosquito net).
When travelling in an area of increased risk (= declared epidemic) and in order to prevent possible sexual transmission of the virus, it is recommended to use a condom / Femidom during the trip and at least 2 months after return.
Due to the risk of fetal malformation, pregnant women are advised against travelling to areas at increased risk (= declared as epidemic) of Zika transmission at any time during pregnancy (in case of essential travel, a consultation with a travel medicine specialist is advised before departure). Women who wish to become pregnant should wait at least 2 months after their return (or that of their partner) from an area at increased risk of Zika transmission.
- Zika virus infection during pregnancy (any trimester) can cause fetal malformation.
- For most up-to-date information on Zika distribution and / or Zika outbreaks, please consult CDC Zika Travel Information: https://wwwnc.cdc.gov/travel/page/zika-information
- 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.
- Geschlechtskrankheiten sind ein weltweit verbreitetes Gesundheitsproblem und können durch Prävention, regelmässiges Testen und Behandlung in den Griff bekommen werden.
- Das Wissen um Risiken sowie Safer-Sex-Praktiken inklusive Kondomgebrauch sind wichtig. Falls Sie mehr dazu erfahren wollen, wie Sie sich während der Reise optimal schützen können, besprechen Sie dies mit einer Fachperson.
- Hatten Sie eine Risikosituation, ist es wichtig mit einer Fachperson so rasch wie möglich Rücksprache zu halten, um zu erörtern, ob eine HIV-Post-Expositions-Prophylaxe (PEP) durchgeführt werden soll, um eine Ansteckung mit HIV zu verhindern.
- Im Nachgang einer Risikosituation ist es wichtig sich auf Geschlechtskrankheiten testen zu lassen. Auch dann, wenn Sie keine Symptome haben.
- Brennen oder Juckreiz im Genitalbereich
- Schmerzhaftes oder häufiges Wasserlösen oder auch Schmerzen im Unterleib
- Ungewöhnlicher Ausfluss aus dem Penis oder der Vagina
- Wunden, Rötungen, Bläschen im Mund/Lippen oder Genitalbereich sowie Warzen im Intimbereich
- Manchmal auch Fieber (eher selten)
Wichtig: Eine STI kann auch ohne oder mit nur leichten Symptomen auftreten. Auch wenn Sie sich dessen nicht bewusst sind, können Sie andere anstecken. Deshalb ist es wichtig sich testen zu lassen.
- Beachten Sie die Safer Sex Regeln von Love Live. Dazu gehört auch bei jedem Anal- oder Vaginalverkehr Kondome zu verwenden.
- Denken Sie daran, dass es bei Oralverkehr auch zu Übertragungen von STIs kommen kann.
- Lassen Sie sich impfen! Es gibt Impfstoffe zum Schutz vor HPV, Hepatitis A und Hepatitis B.
- Hatten Sie eine Risikosituation, ist es wichtig mit einer Fachperson so rasch wie möglich Rücksprache zu halten, um zu erörtern, ob eine HIV-Post-Expositions-Prophylaxe (PEP) durchgeführt werden soll, um eine HIV-Infektion zu verhindern. Am wirksamsten ist eine HIV-PEP innerhalb weniger Stunden danach.
- Es gibt auch weitere Präventionsmassnahmen für spezielle Situationen (Präexpositionsprophylaxe HIV-PrEP). Sprechen Sie mit einer damit erfahrenen Fachperson vor Abreise darüber.
- Denken Sie daran, dass Alkohol oder Drogen zu erhöhtem Risikoverhalten führen.
- Denken Sie daran, dass Sie eine weitere Person/bekannter Partner*in bei ungeschütztem Sex anstecken können, sofern bei Ihnen eine unbehandelte STI vorliegt.
- Menschen mit einer neu diagnostizierten STI sind angehalten ihre früheren Sexualpartner*innen zu informieren, damit auch sie behandelt werden können.
Durch Bakterien oder Parasiten hervorgerufen
Alle diese Krankheiten können geheilt werden. Wichtig ist dabei, frühzeitig zu testen und umgehend zu therapieren, um Komplikationen und v.a. weitere Übertragungen zu vermeiden.
- Syphilis
Auch bekannt als Lues. Sie wird durch das Bakterium Treponema pallidum verursacht. Das erste Anzeichen ist eine schmerzlose Wunde an den Genitalien, im Mund, auf der Haut oder im Rektum, die hochgradig ansteckend ist und nach 3 bis 6 Wochen spontan abklingt. Da diese schmerzlos ist, nehmen nicht alle Patienten*innen diese Läsion wahr. Oft heilt diese Infektion jedoch nicht von selbst aus. In der zweiten Phase können Hautausschlag, Halsschmerzen und Muskelschmerzen auftreten. Unbehandelt kann die Krankheit im Verborgenen (latent) bleiben, ohne dass Symptome auftreten. Etwa ein Drittel der Infizierten mit unbehandelter Syphilis entwickelt im Verlauf Komplikationen. Diese Spätform wird als sogenannt tertiäre Syphilis bezeichnet . In diesem Stadium kann die Krankheit alle Organe befallen: am häufigsten das Gehirn, die Nerven und die Augen. Die Infektion kann während der Schwangerschaft auf den Fötus und bei der Geburt auf das Kind übertragen werden. - Chlamydia trachomatis
Chlamydien können ungewöhnlichen Ausfluss aus dem Penis oder der Vagina, Unbehagen beim Wasserlösen und Unterleibsschmerzen verursachen. Oft treten keine Symptome auf. Unbehandelt können sie zu Unfruchtbarkeit führen und die Krankheit kann auf Sexualpartner*innen übertragen werden. Die Bakterien können auch während der Schwangerschaft auf den Fötus, oder während der Geburt auf das Kind übertragen werden und Augeninfektionen oder Lungenentzündungen verursachen. - Gonorrhoe
Auch bekannt als Tripper. Zu den häufigsten Symptomen gehören Ausfluss aus der Vagina oder dem Penis und schmerzhaftes Wasserlassen. Symptome müssen aber nicht immer auftreten. Sowohl bei Männern als auch bei Frauen kann Gonorrhoe auch den Mund, den Rachen, die Augen und den Anus infizieren und sich auf das Blut und die Gelenke ausbreiten, wo sie in eine schwere Krankheit übergehen kann. Bleibt sie unbehandelt, kann sie eine Beckenentzündung verursachen, die zu chronischen Beckenschmerzen und Unfruchtbarkeit führen kann. Die Krankheit kann während der Schwangerschaft auf den Fötus übertragen werden. - Weitere bakterielle STIs: Mykoplasmen und Ureaplasmen. Diese können ebenfalls behandelt werden.
- Trichomoniasis
Sie wird durch einen Parasiten verursacht, der mit einer einzigen Dosis eines Antibiotikums behandelt werden kann. Trichomoniasis kann bei Frauen einen übel riechenden Scheidenausfluss, Juckreiz im Genitalbereich und schmerzhaftes Wasserlassen verursachen. Bei Männern treten in der Regel weniger oder keine Symptome auf. Zu den Komplikationen gehört das Risiko einer vorzeitigen Entbindung bei schwangeren Frauen. Um eine Reinfektion zu verhindern, sollten beide Sexualpartner behandelt werden.
Durch Viren hervorgerufen
- HIV/AIDS - siehe Informationsblatt HIV-AIDS
- Herpes simplex Virus
Im Lippen-Mundbereich, auch bekannt als Fieberbläschen, ist nicht heilbar. Herpes kann aber mit Medikamenten bei akuten Beschwerden kontrolliert werden. Die Symptome sind in der Regel schmerzhafte, wässrige Hautbläschen und finden sich an oder um die Genitalien, den Anus oder den Mund. Nach der Erstinfektion ruht das Virus im Körper und die Symptome können über Jahre hinweg wieder auftreten. Schwangere Frauen können die Infektion an ihre Neugeborenen weitergeben, was zu einer bedrohlichen Infektion führen kann. - Virale Hepatitis (siehe auch Hepatitis Schweiz)
- Hepatitis A (HAV)
Hepatitis A ist eine durch Impfung vermeidbare Leberinfektion, die durch das Hepatitis-A-Virus verursacht wird. Das Hepatitis-A-Virus findet sich im Stuhl und im Blut infizierter Personen. Hepatitis A kann durch verunreinigtes Wasser und Lebensmittel sowie bei anal-oralen sexuellen Aktivitäten übertragen werden. Die Patienten*innen leiden an einer akuten und oft schweren Erkrankung, erholen sich aber allermeist spontan. - Hepatitis B (HBV)
Das Hepatitis-B-Virus wird durch sexuelle Kontakte sowie durch den Kontakt mit anderen Körperflüssigkeiten, wie z.B. Blut, übertragen. Zur Übertragung kann es z.B. auch bei medizinischen Eingriffen oder Brennen eines Tatoos unter nicht optimalen hygienischen Bedingungen kommen. Hepatitis B kann eine schwere Leberinfektion verursachen, die sowohl zu einer sofortigen Erkrankung, als auch zu einer lebenslang andauernden Infektion führen kann mit möglicher Folge einer dauerhaften Lebervernarbung (Zirrhose) und Krebs. Schwangere Frauen mit Hepatitis B können das Virus während der Geburt auf ihr Kind übertragen. Zu Beginn der Infektion haben Sie möglicherweise keine Symptome. Das Virus kann auf Sexualpartner*innen übertragen werden. Hepatitis B kann mit antiviralen Medikamenten behandelt werden, ist aber nur selten heilbar. Eine Impfung kann eine Hepatitis-B-Infektion verhindern. - Hepatitis C (HCV)
In den meisten Fällen wird Hepatitis C durch den Kontakt mit infiziertem Blut übertragen. Seltener kann es durch analen Sexualkontakt oder von der Mutter auf das Kind während der Schwangerschaft und Geburt übertragen werden. Die meisten Infizierten sind sich ihrer Infektion nicht bewusst, weil sie keine Symptome entwickeln, aber diese chronische Infektion kann zu Leberzirrhose und Krebs führen. Hepatitis C kann behandelt werden, eine Impfung gibt es nicht.
- Hepatitis A (HAV)
- Humanes Papillomavirus (HPV)
HPV ist die häufigste Geschlechtskrankheit. Es gibt eine Vielzahl verschiedener HPV-Typen, und einige von ihnen können Genital-, Anal- und Mundwarzen sowie Gebärmutterhals-, Penis- oder Rachenkrebs verursachen. Die Symptome können auch noch Jahre nach dem Sex mit einer infizierten Person auftreten. Zwei verfügbare Impfstoffe schützen gegen die wichtigsten HPV-Typen, die Gebärmutterhals-, Penis- oder Analkrebs verursachen. - Zika - siehe Informationsblatt Zika
In den meisten Fällen wird es vor allem durch Stechmücken übertragen. Es kann aber auch sexuell übertragen werden. Eine Ansteckung mit Zika während der Schwangerschaft kann bei dem sich entwickelnden Fötus Geburtsfehler wie Mikrozephalie (kleiner Kopf mit neurologischen Ausfällen) verursachen. Die einzige Möglichkeit, eine sexuelle Übertragung des Virus während der Schwangerschaft zu verhindern, besteht darin, Vorsichtsmassnahmen (Kondome) zu treffen oder Sex (mindestens 2 Monate nach der Rückkehr) mit jemandem zu vermeiden, der kürzlich in ein Risikogebiet gereist ist, auch wenn der Reisende keine Symptome hat.
- Love Life: www.lovelife.ch
- Sexuelle Gesundheit Schweiz: www.sexuelle-gesundheit.ch
- Hepatitis Schweiz: https://hepatitis-schweiz.ch/formen/was-ist-hepatitis
- World Health Organization (WHO). Factsheets. Sexually transmitted infections (STIs). 14 June 2019: www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
- Centers for Disease Control and Prevention (CDC). Factsheet: Information for Teens and Young Adults: Staying Healthy and Preventing STDs (2017): www.cdc.gov/std/life-stages-populations/stdfact-teens.htm
- Centers for Disease Control and Prevention (CDC). How You Can Prevent Sexually Transmitted Diseases: www.cdc.gov/std/prevention/
- Centers for Disease Control and Prevention (CDC) Sexual Transmission and Prevention. Zika Virus: www.cdc.gov/zika/prevention/protect-yourself-during-sex.html
- Centers for Disease Control and Prevention (CDC) Zika and Pregnancy; Pregnant Women and Zika (March 2021): www.cdc.gov/pregnancy/zika/protect-yourself.html
- Schistosomes are parasitic worms that infect humans while bathing or walking in fresh water ponds, lakes, or slow-flowing rivers.
- Avoid bathing, washing, or walking in fresh water in areas endemic for schistosomiasis, also called bilharzia.
- Consult a general practitioner or a specialist in travel and tropical medicine after suspected skin contact with fresh water during a trip.
- Specific diagnostic tests and an effective treatment are available, which can prevent long-term complications.
- Schistosomes are parasitic worms that infect humans while bathing or walking in fresh water ponds, lakes, or slow-flowing rivers.
- Avoid bathing, washing, or walking in fresh water in areas endemic for schistosomiasis, also called bilharzia.
- Consult a general practitioner or a specialist in travel and tropical medicine after suspected skin contact with fresh water during a trip.
- Specific diagnostic tests and an effective treatment are available, which can prevent long-term complications.
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]
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
- Marburg virus disease is a rare but severe hemorrhagic fever.
- The disease spreads through contact with infected animals or people.
- Symptoms can be similar to other tropical diseases
- There is no licensed treatment or vaccine for Marburg disease, and
- Please have a look to the factsheet below.
- Marburg virus disease is a rare but severe hemorrhagic fever.
- The disease spreads through contact with infected animals or people.
- Symptoms can be similar to other tropical diseases
- There is no licensed treatment or vaccine for Marburg disease, and
- Prevention measures are important to follow, see below.
The incubation period (time between infection and onset of symptoms) ranges from a 2 to 21 days (usually 5 to 10 days). The onset of MVD is usually abrupt, with initially non-specific, flu-like symptoms such as a high fever, severe headache, chills and malaise. Rapid worsening occurs within 2–5 days for more than half of patients, marked by gastrointestinal symptoms such as anorexia, abdominal discomfort, severe nausea, vomiting, and diarrhoea. As the disease advances, clinical manifestations can become more severe and include liver failure, delirium, shock, bleeding (hemorrhaging), multi-organ dysfunction and death.
In case of symptoms
If think that you have had an exposure at risk and develop fever with nonspecific symptoms such as chills, headache, muscle pain, malaise or abdominal pain:
- you should separate yourself from others (isolate) immediately and
- immediately seek medical advice by contacting the in-country hotline by phone or contact a tropical institute or university hospital infectious disease unit.
- alert the healthcare providers of your recent travel to an area with a Marburg outbreak.
The risk for travellers is very low if the below precautions are followed, but it is high for family members and caregivers who have contact with sick people.
General precautions during travel to affected areas:
- Wash your hands regularly and carefully using soap and water (or alcohol gel if soap is unavailable).
- Avoid contact with sick people who have symptoms, such as fever, muscle pain, and rash.
- Avoid contact with blood and other body fluids
- Avoid visiting healthcare facilities in the MVD-affected areas for nonurgent medical care or non-medical reasons.
- Avoid contact with dead bodies or items that have been in contact with dead bodies, participating in funeral or burial rituals, or attending a funeral or burial.
- Avoid handling, cooking, or eating bush/wild meat (meat of wild/feral mammals killed for food).
- Wash and peel fruit and vegetables before consumption.
- Avoid visiting mines or bat caves and contact with all wild animals; alive or dead, particularly bats.
- If you decide to visit mines or caves inhabited by fruit bat colonies, wear gloves and other appropriate protective clothing, including masks and eye protection.
- Practice safer sex.
- Swiss Federal Office of Public Health: LINK
- European Center for Disease Control and Prevention (ECDC): Marburg virus disease
- US Center for Disease Control and Prevention (CDC): About Marburg Disease
- World Health Organization: Marburg Virus Disease
- Mpox is a viral disease that typically causes a rash, swollen lymph nodes and fever.
- An emerging variant is spreading rapidly in eastern D.R. Congo and neighbouring countries, leading the WHO to declare a new Public Health Emergency International (PHEIC) in August 2024.
- Close physical contact (sexual or non-sexual) is the main route of transmission.
- The disease is usually mild. Children, pregnant women and people with weakened immune systems are most at risk of complications.
- Take general precautions (see factsheet) to prevent the disease.
- There is a vaccination against Mpox, but it is currently only available for people at high risk.
- Mpox is a viral disease that typically causes a rash, swollen lymph nodes and fever.
- An emerging variant is spreading rapidly in eastern D.R. Congo and neighboring countries prompting a new WHO declaration of a public health emergency of international concern (PHEIC), as of August 14th 2024.
- Close physical contact (sexual or non-sexual) is the main mode of transmission.
- The disease generally follows a mild course. Children, pregnant women, and people with weak immune systems are the most at risk of complications.
- Vaccination against mpox is available, but limited to groups at high risk of exposure.
Mpox has been commonly found in West and Central Africa for many years where the suspected reservoir - small mammals - is endemic. There are two types of Monkeypox virus called ‘clades’ that cause the disease mpox - clade I in Central Africa and clade II in West Africa. Since the end of smallpox vaccination campaigns in the early 1980’s, cases of mpox have increased, slowly at first and significantly in the last 5-10 years, especially in the Democratic Republic of Congo (DRC).
In 2022, a new emerging subclade of clade II was responsible for a global epidemic that spread mainly through sexual contact among men who have sex with men. It resulted in the first public health emergency of international concern (PHEIC) declared by the WHO until 2023. Although the clade II epidemic is now under control, this virus variant continues to circulate worldwide.
In 2024, the continued spread of mpox clade I in endemic regions of Central Africa, particularly in the DRC, and the emergence of a new subclade Ib in Eastern DRC and neighboring countries have raised global concern and prompted the WHO to declare a PHEIC for the second time in two years. The current geographical spread of the mpox clade Ib variant occurs via commercial routes through sexual contact (e.g. sex workers), followed by local transmission in households and other settings (which is becoming increasingly important).
Animal to human transmission
Mpox can spread from animal to human when they come into direct contact with an infected animal (rodents or primates).
Human to human transmission
Mpox can be spread from person to person through close physical contact (sexual and non-sexual contact) with someone who has symptoms of mpox. Skin and mucous membrane lesions, body fluids, and scabs are particularly infectious. A person can also become infected by touching or handling clothing, bedding, towels, or objects such as eating utensils/dishes that have been contaminated by contact with a person with symptoms. Household members, family caretakers, and sexual partners of a confirmed case of mpox are at higher risk for infection as are health care workers who treat a case without adequate personal protection.
The incubation period (time between infection and onset of symptoms) ranges from a few days up to 3 weeks. Mpox causes a rash / skin eruption that can be painful associated with swollen lymph nodes and fever. Fever may start already before the rash phase. Other symptoms include muscle aches, back pain, and fatigue. The rash may be localized or generalized, with few or hundreds of skin lesions. It mainly affects the face, the trunk and the palms of hand and soles of the feet. It can also be present in genital areas and on mucous membranes such as in the mouth and throat. Symptoms usually last 2 to 4 weeks and the person remains contagious until all lesions have healed (once the cabs have fallen off).
Complications include secondary bacterial infections, infections of the lung and brain and involvement of other organs, still birth and others. Children, pregnant women, and people with weak immune systems are at higher risk to develop a severe form of mpox.
The majority of person with mpox recovers spontaneously and do not need specific antiviral treatment. Care management consists of relieving pain and other symptoms and preventing complications (e.g., superinfection). Several antiviral treatments are studied in various countries and may be used in trials or in clinical situations according to the recommendations of national medical societies.
In case of symptoms:
- Seek medical attention immediately
- If you are diagnosed with mpox
- Please stay at home (isolate yourself) until your mpox rash has healed and a new layer of skin has formed. Staying away from other people and not sharing things you have touched with others will help prevent the spread of mpox. People with mpox should regularly clean and disinfect the spaces they use to limit household contamination.
- Wash your hands often with soap and water or an alcohol-based hand sanitiser containing at least 60% alcohol.
- You should not have sex while symptomatic and while you have lesions or symptoms. Use condoms for 12 weeks after infection. This is a precaution to reduce the risk of spreading the virus to a partner.
- For more information on what do if you are sick, see CDC LINK.
General precautions:
- Worldwide:
- avoid close, skin-to-skin contact with people who have or may have mpox or people who have a rash (e.g., pimples, blisters, scabs).
- Wash your hands often with soap and water or an alcohol-based hand sanitiser containing at least 60% alcohol.
- Avoid touching potentially contaminated personal items such as cups, bedding/clothing, towels or sharing eating utensils/cups, food or drink with a person who has, or may have mpox.
- Avoid sex with sick persons; use of condoms for up to 12 weeks if you sexual partner have had mpox.
- Follow advice of local authorities.
- When travelling to endemic / epidemic areas in Africa, in addition to above mentioned general precautions:
- Avoid contact with and animals in areas where mpox regularly occurs.
- Avoid eating or preparing meat from wild animals (bushmeat) or using products (creams, lotions, powders) derived from wild animals.
Vaccination:
There are several vaccines against mpox (e.g. Jynneos®, manufacture Bavarian Nordic). The Bavarian Nordic vaccine was originally developed to fight against smallpox, but offers a cross-protection against mpox. In Switzerland, the Jynneos® vaccine has been licensed by Swissmedic since 2024. Groups at risk (e.g., men who have sex with men or transgender people with multiple sex partners) are eligible for vaccination since 2022 and this recommendation remains unchanged (see FOPH recommendations). In light of the epidemiological situation in Africa in 2024, the Swiss Expert Committee for Travel Medicine recommends vaccination against mpox for professionals who are / will be in contact with suspect mpox patients or animals in endemic/epidemic regions or who work in a laboratory with the virus (for updates, see news).
The risk to the general population and travelers (tourists) is considered extremely low if the above-mentioned general precautions are followed and vaccination is not recommended.
- Seek medical attention immediately.
- Mpox is not a sexual transmitted disease in the strict sense, physical contact with a person with symptoms of mpox (rash at any stage) is sufficient to transmit the disease. Condoms do not protect you from getting mpox!
- 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".