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EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
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- Altitude sickness can be life-threatening and may be experienced by any traveler.
- The danger begins at around 2500m and rises with increasing altitude.
- People differ in their susceptibility to altitude sickness; this is not related to their physical fitness.
- Severe altitude sickness with fluid accumulation in the brain or lungs can rapidly result in death.
- If you are planning a stay in high altitudes, we strongly recommend you to consult your doctor for detailed recommendations and instructions.
- Eine Höhenkrankheit kann lebensgefährlich sein und bei jedem Reisenden auftreten.
- Die Gefahr beginnt bei ca. 2500m und nimmt mit zunehmender Höhe zu.
- Wenn Sie einen Höhenaufenthalt planen, lesen sie bitte dieses Merkblatt aufmerksam durch!
- Je nach Reiseart und / oder Vorerkrankungen wird die Beratung durch eine Fachperson dringend angeraten.
Reisen in die Anden, den Himalaya oder Ostafrika (z.B. Kilimanjaro) können in ungewohnte Höhen führen. In vielen Reiseangeboten werden für diese Höhentreks nur wenige Tage vorgesehen, was eine ungewöhnliche Anforderung und zum Teil eine Überforderung für den Organismus bedeutet. Reisen in grosse Höhen sind nicht risikolos, auch nicht für gesund befundene Personen. Personen, die schon zu Hause an Atem- oder Herzbeschwerden leiden, sollten sich bei ihrem Hausarzt beraten lassen.
Die Gefahr einer akuten Bergkrankheit besteht bei allen Personen. Das Risiko eine akute Bergkrankheit zu erleiden, ist weitestgehend unabhängig von Alter und Trainingszustand und wird in erster Linie von der Aufstiegsgeschwindigkeit und der Schlafhöhe bestimmt. Die Gefahr beginnt ungefähr bei 2500m und nimmt mit zunehmender Höhe zu. Die akute Höhenkrankheit äussert sind durch Kopfschmerzen, Übelkeit, Appetitverlust und Schlafstörungen.
Nehmen die obigen Symptome zu, z.B. keine Reaktion der Kopfschmerzen mehr auf Kopfwehtabletten, und werden zusätzlich von Schwindel, Erbrechen, Teilnahmslosigkeit, Gangunsicherheit und ev. Atemnot begleitet, dann soll schnellstmöglich abgestiegen werden bzw. der Erkrankte in tiefere Lagen abtransportiert werden. Beim Nichtabsteigen besteht die Gefahr, dass es zu lebensbedrohlichen Zuständen wie Höhenhirnödem und/oder Höhenlungenödem kommt.
- Langsamer Aufstieg. Aufstiegsregeln: oberhalb von 2500m sollte die Schlafhöhe um nicht mehr als 300-500m pro Tag gesteigert werden und pro 1000m Schlafhöhengewinn sollte ein zusätzlicher Ruhetag eingelegt werden.
- Treten Beschwerden auf, die auf eine Bergkrankheit hinweisen (siehe oben), muss der Anstieg pausiert werden und er darf erst wieder bei Beschwerdefreiheit fortgesetzt werden. Bei Zunahme der Beschwerden muss abgestiegen werden bzw. Patient:innen in tiefere Lagen abtransportiert werden. Bei Ignorieren zunehmender Beschwerden können sich die lebensbedrohlichen Formen der Höhenkrankheit, das Höhenhirnödem und/oder das Höhenlungenödem entwickeln.
- Ist das Einhalten der oben genannten Aufstiegsregeln situativ oder geländebedingt nicht möglich, kann die Einnahme von Acetazolamid (DIAMOX®) das Risiko eine akute Höhenkrankheit zu entwickeln, vermindern. Die Verschreibung des Medikaments bedingt eine ärztliche Indikationsstellung sowie eine Aufklärung über allfällige Nebenwirkungen!
- Kopfschmerzen: Paracetamol (z.B. PANADOL®, DAFALGAN®). Keine Schlafmittel verwenden!
- Höhenhirnödem: sofortiger Abstieg. Falls verfügbar: Sauerstoffgabe, medikamentöse Notfalltherapie.
- Höhenlungenödem (Atemnot auch in Ruhe, rasselndes Atemgeräusch, Reizhusten) Sofortiger Abstieg. Falls verfügbar: Sauerstoffgabe, medikamentöse Notfalltherapie.
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- 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.
Chikungunya is caused by the chikungunya virus, which was first described in 1952 in Tanzania. The name is believed to come from a local African language, meaning ‘to become bent over’, and refers to the posture of affected persons who lean on walking sticks due to severe joint pain.
Indian subcontinent, South-East Asia and Pacific islands, Central and South America, Caribbean islands, Sub-Sahara Africa, Arabian peninsula. In Europe, cases are mainly imported from endemic countries. However, local transmission has occurred in 2007, in 2014, and in 2017 (Italy and France).
The chikungunya virus is transmitted through the bite of Aedes mosquitoes, which predominantly bite humans during daytime.
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.
Diagnosis can be confirmed by blood tests: PCR in the first week of symptoms or serology (antibody measurement) from the second week of illness.
There is no treatment against the virus itself, only symptomatic treatment for the joint pains (anti-inflammatory drugs).
Mosquito bite prevention during the daytime (when Aedes mosquitoes are active): repellants on uncovered skin, wearing long clothes, treating clothes with insecticide. A further very important protective factor is ‘environmental hygiene’, meaning preventing the occurrence of breeding sites for mosquitoes within close proximity of human housing by eliminating all forms of recipients containing water.
- 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
- 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!
- Note on vaccination against dengue:
- In December 2022, the European Union authorised the dengue vaccine Qdenga®; however Swissmedic has not yet approved this vaccine for Switzerland.
- Based on the data available, the Swiss Expert Committee for Travel Medicine (EKRM) currently only recommends vaccination with Qdenga® for travellers who have already had a dengue infection and who are staying in areas with dengue high transmission.
- 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.
- 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.
Dengue fever occurs in all tropical and subtropical regions between latitudes 35°N and 35°S (see also CDC map: https://www.cdc.gov/dengue/areaswithrisk/around-the-world.html).
Dengue virus is transmitted mainly by day- and dusk-active mosquitoes, namely Stegomyia (Aedes) aegypti and Stegomyia (Aedes) albopictus. These mosquitoes breed in small water puddles, as they are often found around residential buildings or at industrial zones / waste dumps of human settlements. The main transmission season is the rainy season.
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-covering, long-sleeved clothing and long pants and spray 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.
Note on dengue vaccines:
two vaccines against dengue are on the market: Qdenga®and Dengvaxia®. The Qdenga® vaccine was approved by the European Union in December 2022.
However, due to the data available, many European countries, as well as the Swiss Expert Committee for Travel Medicine (ECTM), currently recommend vaccination with Qdenga® only for certain travelers and in special situations. Consultation with a specialist in tropical and travel medicine is therefore recommended.
Of note:
- Qdenga® is not yet licensed in Switzerland and the recommendations for travelers will be limited once Qdenga® is licensed in Switzerland.
- The vaccine Dengvaxia® is not a vaccine for travelers.
Consistent mosquito protection during the day (see above) is still considered the most important preventive measure against dengue!
Do not take any products containing the active ingredient acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®) if you have symptoms, as they may increase the risk of bleeding in the event of a severe dengue infection!
Dengue Map (Center for Disease Control and Prevention – CDC): https://www.cdc.gov/dengue/areaswithrisk/around-the-world.html
- Common, usually harmless and self-limiting disease that does not require therapy.
- Pay attention to good food and hand hygiene, drink water only from correctly closed bottles.
- In case of bloody/mucous diarrhea with abdominal pain +/- fever, a doctor must be consulted.
- Common, usually harmless and self-limiting disease that does not require therapy.
- Pay attention to good food and hand hygiene, drink water only from correctly closed bottles.
- In case of bloody/mucous diarrhea with abdominal pain +/- fever, a doctor must be consulted.
Diarrheal disease that occurs in chronological relation to a trip. Acute travelers’ diarrhea is mostly caused by bacteria and viruses, protozoal pathogens are more common in persistent or chronic diarrhea.
10-40% of all travelers develop travelers’ diarrhea.
Mainly fecal-oral through contaminated food or water.
Normal travelers’ diarrhea: 3 or more loose and liquid stools per 24 hours.
Dysentery: bloody and/or mucous diarrhea with abdominal pain +/- fever.
Dysentery: bloody and/or mucous diarrhea with abdominal pain +/- fever.
Ensure sufficient fluid intake. In case of watery diarrhea without fever or blood in the stool, loperamide (e.g. Immodium®) may be taken (CAVE: max. 12mg/day).
In case of additional occurrence of fever, severe abdominal pain and/or blood in the stool, a doctor must be consulted. This also applies if sufficient fluid intake is not possible due to repeated vomiting.
Self-treatment with antibiotics should only be carried out in exceptional cases and must be discussed with a doctor before the trip.
In case of additional occurrence of fever, severe abdominal pain and/or blood in the stool, a doctor must be consulted. This also applies if sufficient fluid intake is not possible due to repeated vomiting.
Self-treatment with antibiotics should only be carried out in exceptional cases and must be discussed with a doctor before the trip.
- Ensure good hand hygiene: wash your hands with soap and water or a disinfectant alcohol gel before cooking or eating and after using the toilet.
- Consume only well-cooked/fried foods that are served hot. Avoid salads, unpeeled fruits, foods with raw eggs, soft ice cream and similar products.
- Drink water only from bottles that have been properly sealed. Ice cubes should be avoided.
Incidence Rates of Traveler’s Diarrhea in the Initial 2 Weeks of Stay in Various Regions of the World Among Visitors Residing in Industrialized Countries, 1996-2008, JAMA, 2015; doi:10.1001/jama.2014.17006
- 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 is caused by a highly contagious virus that affects the liver. It is also known as infectious jaundice. Hepatitis A is very common in unvaccinated travelers.
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.
Transmission occurs mainly through drinking water or food contaminated by faeces. Other transmission routes are close personal contacts, especially sexual contacts (anal-oral sex) or insufficient hand hygiene.
Several weeks after the infection symptoms such as fever, fatigue, nausea, lack of appetite, abdominal discomfort and diarrhea may occur. Within a few days yellow skin and eyes (jaundice) may follow. Most symptoms disappear after a few weeks, but fatigue can often last for months. Young children usually have few or no symptoms, but in older people, the disease can be severe and prolonged.
No specific treatment is available. Recovery from an acute hepatitis A infection can take several weeks or months and requires physical rest and diet.
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
- 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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- Japanese encephalitis is a viral infection that is endemic in South and Southeast Asia and in Australia.
- The virus causes an infection of the brain.
- The risk of Japanese encephalitis is very low for travellers.
- Follow diligent mosquito bite prevention measures in the evening and night.
- A safe and effective vaccine is available that is recommended for high-risk travellers such as
- Work / extensive outdoor activities in rural areas
- Long-term stays (>4 weeks) or during an ongoing outbreak
- For details, see SOP vaccination japanese encephalitis (only available in HealthyTravel PRO)
EKRM_Factsheet_Layperson_EN_Japanese-Encephalitis.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
EKRM_Factsheet_Layperson_IT_Japanese_Encephalitis.pdf
- Viral disease transmitted by night-biting mosquitoes in rural/suburban areas.
- Very rare in travelers.
- Mostly mild or without symptoms; severe illness is rare but has a high mortality.
- Vaccine available for those at increased risk, such as long-term travelers to endemic areas.
Japanese encephalitis is caused by the Japanese encephalitis virus (JEV), a flavivirus, which is spread by mosquitoes. Epidemics of Japanese encephalitis were first described in Japan from the 1870s onward. It is the main cause of viral encephalitis in the Asia-Pacific region.
JEV is endemic in tropical regions of Eastern and Southern Asia and the Western Pacific regions. Epidemics are reported in these regions in subtropical and temperate climate zones. In 2016, a first autochthonous human case was reported in Angola, Africa. The virus exists naturally in a transmission cycle between mosquitoes, pigs and water birds. Birds may be responsible for the spread of JEV to new geographical areas. Humans mainly become infected in rural or suburban areas, when staying in close proximity to pigs.
JEV is transmitted through the bite of female Culex mosquitoes (mainly Culex tritaeniorrhynchus), which are active throughout the night, indoors and outdoors. For most travelers to Asia, the risk is very low but varies based on destination, season, length of travel and activities.
Most people infected are asymptomatic or experience only mild symptoms with fever and headache. About 1/250 people develop severe symptoms after 4-14 days of getting infected, as the infection spreads to the brain, characterized by an abrupt onset of high fever, headache, neck stiffness, disorientation, coma, seizures and paralysis. Up to 1 in every 3 persons developing severe symptoms consequently die. Permanent sequelae, such as behavioural changes, muscle weakness, or recurrent seizures occur in 30%–50% of those with encephalitis.
The diagnosis can be confirmed by serology in cerebrospinal fluid and serum, IgM antibodies usually become detectable 3-8 days after onset of symptoms.
There is no directed antiviral treatment available. Treatment consists of supportive care to relieve symptoms.
Mosquito bite prevention from dusk to dawn (Culex are active during the night) – sleeping under a mosquito net or in an air-conditioned room; repellants on exposed skin; wearing long clothes; treating clothes with insecticide. Vaccination is recommended in travelers at increased risk of infection (longer periods of travel in endemic regions, travel during the JEV transmission season, staying in rural areas especially near rice paddies or pig farms and participating in outdoor activities). The inactivated vaccine IXIARO® is given in two doses (ideally spaced 28 days apart, though the second dose can be given as early as 7 days after the first dose) before travel. In case of continuous risk or re-exposure, a booster dose can be given after 12 months, and then every 10 years. For children 12 months to 18 years, the use is "off-label". Reactions to the vaccine are generally mild and may include pain and tenderness at the injection site, headache, muscle aches, and low-grade fever.
- WHO Factsheet Japanese Encephalitis: https://www.who.int/news-room/fact-sheets/detail/japanese-encephalitis
- Solomon et al., Japanese Encephalitis, BMJ 2000: https://jnnp.bmj.com/content/jnnp/68/4/405.full.pdf
- CDC Japanese Encephalitis: https://www.cdc.gov/japaneseencephalitis/index.html
- 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
For personal safety, we strongly recommend getting informed in detail about malaria and taking this factsheet with you on your trip.
- 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!
Malaria is a life-threatening acute febrile illness caused by parasites called Plasmodia, which are transmitted by mosquitoes at night (between dusk and dawn). Rapid diagnosis and treatment are crucial to prevent complications and death, and to cure the disease. To prevent malaria, diligent mosquito-bite protection is important, as well as taking additional prophylactic (preventive) medication when staying in high-risk areas. Risk groups such as pregnant women, small children, elderly persons or travellers with complex chronic conditions should seek specialized advice.
Malaria occurs widely in tropical and subtropical areas of Africa, Asia, South and Central America (see also malaria map).
Plasmodia are transmitted to humans by Anopheles mosquitoes, which only bite between dusk and dawn. They sometimes go unnoticed, because they are small and make almost no noise.
After visiting a malaria endemic area, the symptoms usually appear seven days to one month after infection, but sometimes after several months or more than a year. Symptoms begin with fever and may appear very similar to flu. Other symptoms may include headache, muscle pain, nausea, and sometimes diarrhea or cough. The diagnosis can only be confirmed with a blood test.
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.
For information, see LINK of Infovac
- 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.
- 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 disease is a very severe, life threatening infection caused by bacteria called Neisseria meningitidis. Patients with meningococcal infection typically have sudden onset of fever, chills and headache rapidly followed by other symptoms like skin rash, nausea, vomiting, tiredness or confusion. Immediate medical attention and antibiotic treatment is needed.
Meningococcal infections occur worldwide. The highest incidence is observed during seasonal epidemics in the dry season (December – June) in the so-called "meningitis-belt" in sub-Saharan Africa. There is also a higher risk of infection in situations with overcrowding or close contacts to many people, especially participants in the Hajj or Umrah pilgrimages in Saudi Arabia. Everyone can be infected, but young children and persons with certain medical conditions or treatments (e.g. non-functional spleen) are at higher risk for meningococcal infection.
The bacteria are transmitted from person to person by droplets, mostly through close personal contact such as living together or kissing.
Meningococcal disease typically presents as meningitis or septicemia. Patients have sudden onset of fever, headache and malaise rapidly followed by other symptoms such as stiff neck, limb pain, rash, confusion, diarrhea and vomiting. Meningococcal infections are very serious and can be deadly within a few hours.
Patients with meningococcal disease need immediate medical attention and rapid intravenous antibiotic treatment. Severe complications such as breathing problems, low blood pressure, seizures or tissue necrosis can occur and need specific treatment.
For travelers to epidemic areas and persons with risk factors, vaccination is the best way to prevent meningococcal disease. One dose of a four-valent meningococcal conjugate vaccine (e.g. Menveo®) protects against the majority of meningococcal infections from 7-10 days after vaccination. The protection lasts for at least 5 years and the vaccine is licensed from the age of two years. Younger children can be vaccinated off label (i.e. not within the official recommendations); under the age of 12 months, a three-dose schedule is indicated. In case of recurrent exposure or continued risk, a booster dose is recommended every 5 years. For pilgrimages to Saudi Arabia (Hajj / Umrah), meningococcal vaccine (booster dose every 3-5 years, depending on vaccine) is mandatory. The vaccine is well tolerated, transient side effects such as fever, injection site pain, headache or tiredness can occur, but disappear by their own within a few days after vaccination.
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
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- Monkeypox are caused by a virus and are very similar to the smallpox virus.
- The virus circulates primarily among rodents and humans and monkeys are accidental false hosts.
- Monkeypox is endemic in West and Central Africa. However, since May 2022, several cases have also occurred in European and American countries.
- The disease generally follows a mild course. In immunosuppressed persons, the disease can be severe.
- Monkeypox is transmitted from infected animals through a bite or through direct contact with blood, body fluids or lesions of the infected animal.
- Therefore, maintain good personal hygiene and avoid contact with infected persons and animals at all costs. During stays in West and Central Africa: Do not consume bushmeat.
CDC Map: 2022 Monkeypox Outbreak Global Map
For information, see LINK of Infovac
- 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).
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).
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).
- 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!
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 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!
Rabies disease is invariably fatal, transmitted through the saliva or other body fluids of infected warm-blooded animals (i.e. mammals).
Dogs are responsible for more than 95 % of human cases. Bats, cats and (rarely) monkeys and other mammals can transmit rabies as well. The highest risk areas are Asia, 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.
Saliva from infected animals enters the human body through injured skin, either via bites and scratches or by licking already wounded skin. Once it has entered the body through the skin lesion, the rabies virus migrates along nerve pathways towards the brain. In most cases, this migration takes several weeks to months and proceeds without accompanying symptoms.
Symptoms usually only appear when the virus has reached the brain. In most cases, this is the case after 2-12 weeks (range: 4 days - several years!) and manifests itself as encephalitis (inflammation of the brain), which in 99.99% of cases is fatal within a few weeks. As soon as symptoms of encephalitis appear, a fatal course can no longer be prevented.
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
For information, see LINK of the Federal Office of Public Health
- 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.
Schistosomes are parasitic worms that infect humans while bathing or walking in fresh water ponds, lakes, or slow-flowing rivers. The larvae of the worm penetrate the skin and migrate in the body until they settle as adults in the veins surrounding the intestines or the genital and urinary tracts, depending on the parasite type. Chronic complications are due to the worms’ eggs, which trigger inflammation and fibrosis (scar tissue) in affected organs.
Schistosomiasis occurs in Sub-Saharan Africa and the Arabian Peninsula, Asia (China, the Philippines, South-East Asia), north-eastern South America, and some Caribbean islands.
The larvae of schistosomes are shed by fresh water snails and penetrate the skin of humans when they bath or swim in the water. The worms develop in various organs of the human body, producing eggs that later migrate through the walls of the intestines and the urinary bladder where they trigger an inflammation and can impair the function of the respective organ systems over the course of months or years. The eggs are deposited in fresh water bodies when humans defecate or urinate into them. Larvae hatch from these eggs and infect water snails, thus completing the parasitic cycle.
Many infections do not cause any signs or symptoms. These depend on the stage of infection: soon after the larvae penetrate the human skin in fresh water, an itching rash may appear (‘swimmer’s itch’). An immunological reaction after 4-8 weeks sometimes occurs with fever and feeling sick, the so-called ‘Katayama fever’. Chronic symptoms such as bloody urine, pain in passing urine, (bloody) diarrhea, and abdominal pain eventually occur after months or years. If those symptoms occur and treatment is not given, damage to the urinary and gastrointestinal tract can lead to dysfunction of the organs.
Consult a tropical disease specialist for diagnosis and management. Specific drugs are effective and prescribed when eggs are detected in the urine or stool, or when the blood test shows antibodies against the worms (see below).
Avoid bathing, washing, or walking in fresh water ponds or slow-flowing rivers in endemic areas. Correctly treated swimming pools and sea water are safe! There is not enough evidence for post-exposure treatment.
If any suspicious fresh water contacts occurs during a trip, a tropical medicine specialist or general practitioner should be consulted for a blood test, approximately 2 months after exposure.
- 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.
Reisende, die Gelegenheitssex haben, sind einem erhöhten Risiko ausgesetzt, sich mit sexuell übertragbaren Infektionen, sogenannten Sexually Transmitted Infections (STIs), einschliesslich HIV, anzustecken. Ein Auslandaufenthalt, wobei man auch neue Menschen kennen lernt, kann damit verbunden sein, sich anders zu verhalten und mehr Risiken einzugehen, als man dies zu Hause tun würde. Es ist wichtig daran zu denken, dass ungeschützter Sex und mehrere neue Sexualpartner ein Risiko für Geschlechtskrankheiten darstellen. Geschlechtskrankheiten können unter Umständen schwere Komplikationen verursachen und zudem auf weitere Partner*innen übertragen werden, sofern diese nicht rechtzeitig bemerkt und behandelt werden. Sind Sie nicht sicher, ob es sich um eine Risikosituation handelt, dann hilft der 'Risk-Check' von Love Live weiter.
Geschlechtskrankheiten sind Infektionen, die durch sexuellen Kontakt (vaginaler, analer oder oraler Sex) übertragen werden. Sie werden durch mehr als 30 verschiedene Bakterien, Viren oder Parasiten verursacht, die in oder auf Ihrem Körper vorkommen. Es ist auch möglich, dass gleichzeitig mehr als eine STI gleichzeitig übertragen wird. Einige bedeutendsten STIs sind HIV (Informationsblatt HIV-AIDS), Hepatitis B, das humane Papillomavirus (HPV), Herpes simplex (HSV), Syphilis, Chlamydien und Gonorrhö.
Geschlechtskrankheiten treten weltweit auf und können jeden und jede treffen, unabhängig von Alter, Geschlecht oder auch der sexuellen Orientierung. STIs kommen in vielen Ländern mit schwächerem Gesundheitssystem häufiger vor.
Geschlechtskrankheiten werden in der Regel durch ungeschützten vaginalen, oralen oder analen Geschlechtsverkehr übertragen. Sie können aber auch durch andere intime Kontakte weitergegeben werden, wie z. B. Herpes und HPV, die durch Hautkontakt/Küssen übertragen werden. Andere können auch auf nicht sexuellem Wege übertragen werden, z.B. über Blut. Viele Geschlechtskrankheiten - darunter Syphilis, Hepatitis B, HIV, Chlamydien, Tripper, Herpes und HPV - können auch während der Schwangerschaft und bei der Geburt von der Mutter auf das Kind übertragen werden.
- 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.
Geschlechtskrankheiten können bei einer körperlichen Untersuchung oder durch die Untersuchung von Urin, einer Wunde, eines Bläschens oder eines Abstrichs aus der Vagina, dem Penis oder dem Anus diagnostiziert werden. Bluttests können bei der Diagnose helfen. Auch wenn Sie keine Symptome haben, sollten Sie mit ihrer Ärztin, ihrem Arzt sprechen, wenn Sie im Ausland ungeschützten Geschlechtsverkehr hatten. Denn eine frühzeitige Erkennung und Behandlung ist wichtig, um eine Errergerübertragung und Komplikationen durch unbehandelte STIs zu verhindern.
Viele Geschlechtskrankheiten sind heilbar, andere wie z.B. HIV jedoch nicht und bedeuten, dass lebenslang Medikamente eingenommen werden müssen, damit es nicht zu Komplikationen kommt. Beispielsweise können mit Antibiotika bakteriell verursachte STIs geheilt werden. Eine frühzeitige Behandlung verringert zudem das Risiko von Komplikationen. Denn unbehandelt können einige STIs langfristig unter Umständen zu Gesundheitsproblemen führen, wie z.B. zu Unfruchtbarkeit, Geburtskomplikationen und einigen Arten von Krebs. Wenn eine schwangere Frau eine STI hat, kann dies zu Gesundheitsproblemen beim Baby führen. Auch Sexualpartner sollten gleichzeitig behandelt werden, um eine erneute Infektion zu verhindern (Ping-Pong-Übertragung).
- 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
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
If you are planning or have had a trip with very basic accommodations or a long-term stay in rural areas, inform yourself about Chagas disease.
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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.
EKRM_Factsheet_Layperson_DE_TBE.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
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- 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.
Typhoid fever is a bacterial disease that affects the whole body and mainly presents with high fever, often accompanied by drowsiness (“typhos” in Greek stands for delirium) and severe headaches. If the infection is treated with appropriate antibiotics, mortality is very low. If left untreated however, complications may follow, which can lead to significant mortality. Typhoid fever must be clearly distinguished from salmonellosis, caused by a large range of non-typhoidal salmonella species that mainly cause benign diarrheal symptoms worldwide.
The highest occurrence of typhoid fever is on the Indian subcontinent (Afghanistan, Pakistan, Nepal, Bhutan, India and Bangladesh). This is also the region with a steady increase in antibiotic resistance. The disease also occurs in the whole sub-/tropical region, but with lower frequency. It used to occur also in Europe and North America, but the disease has disappeared thanks to improved water and sanitation standards.
Typhoid fever is transmitted via the fecal-oral route: bacteria are shed in the feces of infected persons and – if insufficient hand hygiene is practiced – infected persons may contaminate the food and drinking water supply of their families. In regions with low sanitation standards, contaminated feces may also contaminate the public drinking water supply.
The incubation period – time between infection and first symptoms – can vary between 3 days to 3 weeks. The principle symptom of typhoid fever is high-grade fever (39° - 41° C) accompanied by strong headache and drowsiness. In the initial phase of the disease, patients often complain of constipation. In later stages, this may turn into diarrhea. In later stages of the disease - and in the absence of correct treatment - complications such as septicemia, intestinal hemorrhage or perforation can follow, which may lead to considerable mortality.
Appropriate antibiotic treatment cures typhoid fever. Treatment should be adapted according to the resistance profile of the bacteria. On the Indian subcontinent, some strains may be multi-resistant, necessitating broad-spectrum intravenous antibiotic treatment. In severe typhoid fever with reduced consciousness (delirium) or coma, treatment with corticosteroids may need to be added.
“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.
Vaccination against typhoid fever is advised for long-term travelers and for travelers visiting areas where the risk of transmission is particularly high and/or the disease more difficult to treat due to severe antibiotic resistance.
Federal Office of Public Health Switzerland: https://www.bag.admin.ch/bag/de/home/krankheiten/krankheiten-im-ueberblick/typhus-abdominalis-paratyphus.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
CDC Map: Distribution of Zika
- 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.
Zika is a viral disease transmitted by mosquitoes that bite during the day. In general, the disease is mild and heals spontaneously. About one in five people develop symptoms such as fever, skin rash, conjunctivitis, joint pain, muscle pain, and sometimes headaches. Rarely, immunological and neurological complications occur. Infection during pregnancy can have serious consequences for the fetus. Pregnant women are advised against travelling to countries with increased risk (current epidemic).
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.
Zika virus is transmitted by the bites of infected mosquitoes (Aedes spp. including ‘tiger mosquito’), which bite during the day, with maximum activity at dawn and around sunset. These mosquitoes are common in cities in tropical and subtropical regions. The virus can be transmitted from person to person, during pregnancy by an infected mother to the fetus, or during unprotected sex with an infected person (with or without symptoms). Transmission by blood transfusion is also possible.
About 80% of infected people have no symptoms. Clinical signs begin within 2 weeks after the bite of an infected mosquito and are generally mild: moderate fever, rash often with itching, conjunctivitis, joint pain, headache, muscle pain, and digestive disorders. In general, the patient heals spontaneously after 5-7 days. Neurological (Guillain-Barré syndrome) and immunological complications can occur, but are rare. Zika virus infection during pregnancy (any trimester) can cause fetal malformation.
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
Swiss TPH - Information on the Zika Virus: https://www.swisstph.ch/en/travelclinic/zika-info/
- 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".