The Swiss Expert Committee for Travel Medicine (ECTM) - a body of the Swiss Society for Tropical and Travel Medicine (FMH) - has revamped the Safetravel® website and renamed it to HealthyTravel.ch. The website continues to offer basic travel medicine recommendations for laypersons free of charge. Professionals can also subscribe to additional travel medicine information and recommendations such as in-depth country-specific information, vaccination recommendations with expert opinions, detailed maps (including malaria recommendations), fact sheets (including e.g. dosage information for malaria prophylaxis) and other important travel medicine content. These can be used during travel medicine consultation of patients and clients and can be individually compiled for the traveller, printed out or sent electronically.  The recommendations and content on HealthyTravel.ch reflect the recommendations of the Swiss Expert Committee for Travel Medicine. They are developed in cooperation with the Federal Office of Public Health (FOPH). The website is under construction and will be continuously expanded with additional content and updates. Please note that all content available on the website HealthyTravel.ch is protected by copyright and may not be passed on to third parties. Further information can be found in the flyer (LINK). The Swiss Expert Committee for Travel Medicine will be happy to answer any questions at info@healthytravel.ch !

A Zika infection was diagnosed in 5 tourists from Germany, Israel, and the United Kingdom who had recently returned from Thailand. They visited the following areas: Phuket, Phi Phi Island, Koh Samui, Khao Lak, Bangkok, and Chang Mai. The country is not classified as an area with a current outbreak at this time (see CDC map).

Since the beginning of the year, the Costa Rican Ministry of Health has reported 256 cases of malaria. The trend has been increasing for 5 years. The three regions with the most cases are Huetar Norte with 226 cases, Huetar Caribe with 22 cases and Central Pacific with 8 cases.

Preliminary analysis of samples revealed two positive Marburg virus cases. The two patients from the southern Ashanti region - both deceased and unrelated - presented symptoms of diarrhea, fever, nausea and vomiting. Preparations for a possible outbreak response are being made rapidly as further investigations are in progress.Marburg is transmitted to humans by bats (fruit bats) and spreads in humans through direct contact with bodily fluids of infected persons, surfaces, and materials. The disease begins abruptly with high fever, severe headache and discomfort. Many patients develop severe hemorrhagic symptoms within seven days. Mortality rates have varied from 24% to 88% in previous outbreaks, depending on the strain of virus and case management.

Most of the laboratory-confirmed cases (2933/3413; 86%) were reported from the WHO European Region. In Switzerland, there have been 81 confirmed cases since May 21 and up to June 29.Clinical presentation: The cases so far have been mild, there have been no deaths yet. Hospitalised patients have mostly been admitted for local isolation orders. The clinical picture is characterised by lesions that are atypical of the clinical picture in endemic countries. Currently, there are mainly very few, non-grouped, painless pustular lesions on the genitals, perianally and orally. Whether transmission occurs through genital secretions or primarily only through close skin-to-skin contact is not yet clear. The draining lymph nodes are sometimes massively swollen, and fever usually occurs for a few days. The general condition is often only slightly reduced. Transmission: The virus can be transmitted from person to person via the respiratory tract, through direct contact with body fluids of an infected person or with virus-contaminated objects. The incubation period is 5-21 days, usually about 7-17 days. Monkeypox is transmitted from infected animals through a bite or through direct contact with blood, body fluids or lesions of the infected animal. They can be transmitted to people who eat infected animals via abrasions in the mouth, source, NCDC. Symptoms: Symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills. 1- 3 days after the onset of symptoms, a rash develops that may look like chickenpox or syphilis and spreads from the face to other parts of the body, including the genitals. The disease is usually mild. In immunocompromised individuals, the disease can be severe. The mortality rate is about 1% for the West African type and up to 10% for the Central African type.

As of June 24, 2022, the Florida Department of Health confirmed 13 cases (2 deaths) of Vibrio vulnificus infection. In 2021, Florida reported 34 cases and 10 deaths. Vibrio vulnificus is a bacterium that normally lives in warm seawater. Infections with Vibrio vulnificus are rare. If saltwater is swallowed or shellfish or mussels are eaten, the bacteria can be ingested and lead to gastroenteritis. If the bacteria enter the body through small skin lesions (e.g., injuries to coral or fish spines), there is a risk of fulminant sepsis, especially in immunocompromised individuals or those with chronic liver or kidney disease, diabetes, or iron storage disease. The bacterium is inactivated by cooking or freezing.

An outbreak of meningococcal serogroup C disease in gay and bisexual men is reported in Florida, USA. So far, 24 cases and 7 deaths have been reported.

Since the beginning of 2022, there have been 1'715 cases and 73 deaths of monkeypox reported from eight endemic and two non-endemic countries in the African Union. According to WHO, these countries are Benin, Cameroon, Central African Republic, Republic of Congo, D.R. Congo, Ghana, Nigeria, and South Africa. From February 2020 until today, 12'141 cases and 363 deaths of monkeypox have been documented in Africa. The number of cases continues to increase in Africa.

Heat waves can have significant impacts, including an increase in heat-related deaths. They are among the most dangerous natural events, but rarely receive proper attention because resulting deaths and damage are not always immediately visible. From 1998 to 2017, more than 166'000 people died as a result of heat waves, including more than 70'000 during the 2003 heat wave in Europe.Globally, extreme temperature events are observed to be increasing in frequency, duration, and magnitude. Between 2000 and 2016, the number of people exposed to heat waves increased by about 125 million.Heat waves can strain health care and emergency services and increase stress on water, energy, and transportation supplies, which can lead to power shortages or even blackouts. Food and nutrition security can also be affected if crops or livestock are destroyed by extreme heat.Direct impacts: Heat illness (dehydration, heat cramps, heat stroke), accelerated death from respiratory illness, cardiovascular disease, kidney disease, and other chronic diseases), stroke, diabetes, etc. Indirect effects: Impacts on health services, increased risk of accidents (drowning, workplace accidents, etc.). Disruption of infrastructure (electricity, water, etc.). Increased transmission of foot and water borne diseases, algal blooms.

The "Pride Season" begins and events will take place all over the world. Participants will be primarily lesbian, gay (MSM), bisexual, transgender and queer (LGBTQ) people. It is important to take protective measures against sexually transmitted infections (STIs), including COVID-19 and other infections transmitted through close human-to-human contact, such as monkeypox, HIV, gonorrhea, etc.

Since the end of December 2019, there have been 535'143'050 reported cases of COVID-19 worldwide, including 6'328'694 deaths. In the EU/EEA, 1'112'088 deaths have been recorded. As of mid-June 2022, the total number of weekly reported cases in the EU/EEA increased by 9.2% compared to the previous week. The countries with the highest 14-day reporting rates per 100'000 inhabitants are: Portugal, Luxembourg, Iceland, Germany and France. 

The Yogyakarta Health Department reported 22 cases of leptospirosis this year, 4 of which were fatal. Indonesia has a relatively high risk of leptospirosis due to recurrent flooding and the presence of standing water and poor sewerage and sanitation in some residential areas.Leptospirosis is a bacterial disease that occurs worldwide and is particularly common in tropical countries during the rainy or flood season. It is caused by a bacterium and transmitted through skin contact (minor injuries) with water contaminated by urine (mainly from infected rats, dogs, pigs, cows, etc.). The risk increases when camping or engaging in water-related activities (swimming, kayaking, wading through streams). The disease can be treated with antibiotics if diagnosed in time.

Since the beginning of the year, 755'014 suspected cases of typhoid fever, including 376 deaths, have been reported in the Democratic Republic of Congo.

Since the beginning of the year, 555 clinical cases of yellow fever have been reported from all ten regions of Cameroon. In Uganda, 199 clinical cases were registered during the same period.

Since the beginning of the year, 17'497 dengue cases have been registered in Malaysia (10 deaths). This is an increase of more than 57% compared to the reported cases in the same period in 2021.

More than 100 cases of anisakiasis have been reported in Japan, caused by fish contaminated with parasites. Mackerel, bonito and sashimi are most likely the source. People experience reactions such as severe abdominal pain and vomiting after eating contaminated fish. Several supermarkets have stopped selling fish products and closed the markets for fresh fish.

So far this year, more than 13'000 cases of dengue fever have been reported in Singapore. The weekly number of dengue cases is expected to increase and reach another historic high. The start of the traditional peak of the dengue season is June.

Malaria cases in the north-eastern Kavango East region of Namibia continue to increase. By the end of April 2022, the most affected district was Andara with 249 cases, followed by Rundu (146) and Nyangana (104). With the emergence of COVID-19, an increase in malaria cases has been observed worldwide.

Since the beginning of the year, a total of 7,394 Zika cases have been reported in the Americas region. The countries particularly affected are Guatemala, Paraguay, Brazil, El Salvador and Bolivia. Currently, none of the above countries is classified as an area where an epidemic is taking place (CDC map).

According to the ECDC (as of June 8, 2022), a total of 1'177 cases have been confirmed worldwide (including EU/EEA). Cases occurred mainly in gay, bisexual and other men who have sex with men (GBMSM), though not exclusively. Most of the cases outside the UK, Canada and US are reported to be linked to travel. However, cases with no known travel history, contact with other cases, animals or specific events are also reported.Clinical presentation: The cases so far have been mild, there have been no deaths yet. Hospitalised patients have mostly been admitted for local isolation orders. The clinical picture is characterised by lesions that are atypical of the clinical picture in endemic countries. Currently, there are mainly very few, non-grouped, painless pustular lesions on the genitals, perianally and orally. Whether transmission occurs through genital secretions or primarily only through close skin-to-skin contact is not yet clear. The draining lymph nodes are sometimes massively swollen, and fever usually occurs for a few days. The general condition is often only slightly reduced.Transmission: The virus can be transmitted from person to person via the respiratory tract, through direct contact with body fluids of an infected person or with virus-contaminated objects. The incubation period is 5-21 days, usually about 7-17 days. Monkeypox is transmitted from infected animals through a bite or through direct contact with blood, body fluids or lesions of the infected animal. They can be transmitted to people who eat infected animals via abrasions in the mouth, source, NCDC.Symptoms: Symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills. 1- 3 days after the onset of symptoms, a rash develops that may look like chickenpox or syphilis and spreads from the face to other parts of the body, including the genitals. The disease is usually mild. In immunocompromised individuals, the disease can be severe. The mortality rate is about 1% for the West African type and up to 10% for the Central African type.

Besides an increase in syphilis infections among men who have sex with men (MSM), the continuous rise since 2014 is attributed rather to heterosexual transmissions.

An Israeli traveler contracted the Zika virus during a stay in northern Thailand. An English couple who had travelled to Thailand in March 2022 also contracted Zika. They had visited Phuket, some islands and an elephant sanctuary.The spread of Zika is known in Thailand.

In the beginning of May 2022, one case of monkeypox was detected in England, which had occurred after travel to Nigeria. In the course of this, 6 further cases of monkeypox were diagnosed in England in people with no previous travel and no contact with known travel-associated cases. These are two cases in one family and four cases in men who have sex with men (MSM). The latter apparently got infected in London. Apart from the family and two of the MSM cases, there are no known links between the cases. Further 2 cases have been reported in the meantime. Investigations into the sources of infection and other suspected cases are in progress.Additional cases are reported by GeoSentinel and various media reports from the following countries:France: 1 suspected case (Île-de-France region).Italy: 3 cases, one confirmed, 1 case with travel history Canary Islands (link)Canary Islands: 1 suspected casePortugal: 14 confirmed cases, another 6 suspected cases (link), Lisbon Region and Tagus Valley RegionSpain: 7 confirmed, 23 suspected cases, (link)Sweden: 1 confirmed case, 1 suspected caseCanada: 17 suspected cases (link)USA: 1 confirmed case with travel history to Canada (link) Description: Monkeypox is a zoonosis caused by an orthopoxvirus, a DNA virus genetically related to the variola and vaccinia viruses. Monkeypox is endemic in West and Central Africa. Increased cases have been recorded in Nigeria since September 2017, and imports by returning travellers to England and the USA have also been recorded more frequently in recent years. There are two types of monkeypox virus: the West African type and the Central African type (Congo Basin).Transmission: Monkeypox is transmitted from infected animals by a bite or by direct contact with blood, body fluids or lesions of the infected animal. It can be transmitted via abrasions in the mouth to people who eat infected animals. It can also be transmitted from person to person via the respiratory tract, through direct contact with body fluids of an infected person or with virus-contaminated objects. The incubation period is 5-21 days, usually about 7 to 17 days.Symptoms: Symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills. 1- 3 days after the onset of symptoms, a rash develops that may look like chickenpox or syphilis and spreads from the face to other parts of the body, including the genitals. The disease is usually mild. In immunocompromised individuals, the disease can be severe. The mortality rate is about 1% for the West African type and up to 10% for the Central African type. For further details, see WHO factsheet, ECDC and CDC.

In der Nordöstlichen Provinz Tete wurde bei einem Kind mit akuter schlaffer Lähmung eine Infektion mit dem Wildpoliovirus Typ 1 (WPV1) diagnostiziert. Der letzte WPV Fall in Mozambique war 1992.Die Sequenzierung deutet darauf hin, dass der Fall in Mosambik mit einem Polio-Stamm in Verbindung steht, der sich 2019 in Pakistan ausbreitet und dem Fall ähnelt, der Anfang des Jahres in Malawi gemeldet wurde [2022]. Tete liegt in der Nähe der Grenze zu Malawi, was die Befürchtung nährt, dass das Virus in dieser Region beider Länder zirkulieren könnte.

Since the beginning of the year, more than 7'300 dengue cases have been registered in Singapore, including 1'005 in the last week of April alone. Dengue is mainly transmitted by Aedes aegypti mosquitoes. In March 2022, the incidence of these mosquitoes in Singapore was about 48% higher than in the same period last year.