Stati Uniti d'America
Ultime notizie
As of 26 May 2026:
D.R. Congo:
- Cases: More than 1’100 cases (>1000 suspected, >120 confirmed cases). Confirmed cases have been reported from Ituri (110 confirmed cases), North Kivu (11 confirmed cases) and South Kivu provinces (one confirmed death).
- Deaths: 246 suspected and 17 confirmed deaths. Of the confirmed deaths, 14 deaths were individuals over 15 years of age, while three were under 15.
- Location: Cases have been reported in three provinces: Ituri (16 health zones), North Kivu (2 health zones), and South Kivu (1 health zone).
- Contacts: As of 25 May, more than 2’231 contacts have been identified, with approximately 20% under follow-up. The laboratory test positivity rate in DRC is currently 30.0%.
- Operational update: Bunia airport, DRC, has been temporarily closed.
- Operational challenges:
- Information regarding transmission chains and affected population groups is currently limited, partly due to the complex context of ongoing insecurity and humanitarian challenges in the affected areas.
- Several sources have reported local protests and arson attacks targeting treatment centres with escape of at least 25 suspected cases. Citizens burned two tents in a hospital section treating Ebola patients. Volunteers have also faced intimidation and threats from armed groups in Bunia.
- Information regarding transmission chains and affected population groups is currently limited, partly due to the complex context of ongoing insecurity and humanitarian challenges in the affected areas.
WHO expects those numbers to keep increasing, given the amount of time the virus was circulating before the outbreak was detected.
Uganda:
- Cases, deaths: a total of seven confirmed cases, including one death have been reported. Three of the cases have travel links to DRC and five are contacts linked to the first two cases, including 3 healthcare workers.
- Location: Cases have been diagnosed and are hospitalized in Kampala.
- Contacts: As of 24 May, 311 contacts linked to the confirmed cases have been identified and are being closely monitored and followed up.
Further cases:
- One confirmed BVD case involving a US surgeon who had worked in the affected area in DRC was transferred to Germany and is hospitalised in Berlin alongside six high-risk contacts. One additional contact was transferred to the Czech Republic.
- On 27 May, an asymptomatic Italian doctor returning from Ituri (DRC) after exposure to confirmed cases was placed in quarantine in Rome.
- South Sudan is investigating a suspected Bundibugyo virus disease case in West Equatoria State after a preliminary positive result in a patient from South Yambio County.
Exit screening and control measures:
- Regional: Exit screening and health control measures have been implemented for travellers from DRC, Uganda, and South Sudan.
- Uganda has ceased air travel to DRC, closed multiple border crossings, and increased border crossing screenings (LINK).
- Rwanda: Reinforced health screening at land border crossings with DRC and enhanced entry screening at Kigali International Airport for inbound travellers to Rwanda.
- United States: Introduced enhanced entry screening measures and established a regional Ebola quarantine and treatment facility in Kenya for exposed or infected US citizens.
- Canada: Temporary entry restrictions for residents of DRC, Uganda, and South Sudan effective from 27 May for 90 days. From 30 May, asymptomatic Canadian citizens and residents returning from high-risk areas will be subject to a 21-day quarantine.
- For other countries, see IATA LINK which will be constantly updated.
Authorities are concerned about the risk of further spread due to population high mobility, insecurity, and the proximity of affected areas to Uganda and South Sudan through a porous border.
Distribution of suspected and confirmed Bundibugyo virus disease cases in the Democratic Republic of the Congo and Uganda, as of 24 May 2026:
WHO assesses the risk of the epidemic as very high at the national level, high at regional levels, and low at the global level (including Switzerland and the EU/EEW). For details, see LINK.
ECDC: Due to the very recent declaration of the outbreak and the uncertainties related to the
epidemiological information, it is probable that the outbreak is much larger than what is currently
being reported – not only in regard to the number of affected cases, but also to its geographical
extent.
ECDC assesses the risk for EU/EEA travellers in affected areas as low if precautions (see below) are followed but emphasizes uncertainties and rapid evolution.
ECDC considers that screening of returning travellers from affected areas (DRC, Uganda) would not be an effective measure to prevent introduction to Europe. This consideration is based on the lessons learned and results of the large EVD outbreak in West Africa between 2013 and 2016, where tens of thousands of cases were reported, transmission was ongoing in large urban centres, and hundreds of EU/EEA humanitarian and military personnel were deployed to the affected areas. Screening incoming travellers is time- and resource-consuming and will not effectively identify infected cases.
Priority should instead be given to providing travellers with clear information on symptoms, routes of transmission, and what to do if symptoms develop after arrival in the EU/EEA. For details, see ECDC Threat Assessment, 21 May 2026.
The situation is evolving rapidly. Avoid non-essential travel to affected areas in DRC, Uganda and South Sudan. In case travel cannot be avoided, see precautions below:
General preventive measures:
- Wash hands regularly and carefully using soap and water (or alcohol gel if soap is unavailable).
- Avoid contact with sick people who have symptoms, such as fever, muscle pain, and rash.
- Avoid contact with blood and other body fluids.
- Avoid visiting healthcare facilities in the filovirus-affected areas for nonurgent medical care or non-medical reasons.
- Avoid contact with dead bodies or items that have been in contact with dead bodies, participating in funeral or burial rituals, or attending a funeral or burial.
- Avoid handling, cooking, or eating bush/wild meat (meat of wild/feral mammals killed for food).
- Wash and peel fruit and vegetables before consumption.
- Avoid visiting mines or bat caves and contact with all wild animals; alive or dead, particularly bats.
- If visiting mines or caves inhabited by fruit bat colonies, wear gloves and other appropriate protective clothing, including masks and eye protection.
- Practice safer sex.
Of note: there is currently no licensed vaccine or specific treatment against Ebola diseased caused by Bundibugyo virus. For humanitarian missions, consultation with a travel medicine specialist is recommended.
While in the outbreak area and for 21 days after leaving:
- Watch for symptoms.
- Follow quarantine measures established by your local health authorities.
! In case of symptoms such as fever or feeling feverish during your stay in and for 21 days after leaving north-eastern D.R. Congo (province of Ituri, North Kivu, South Kivu) and /or Uganda, especially the affected areas:
- Separate yourself from others (isolate) immediately.
- Do not travel.
- By phone: contact local health authorities or a healthcare facility for a thorough evaluation of your risk (e.g. tropical institute or travel clinic or university hospital infectious disease unit).
- Always state that you were in the affected areas and you may have had a possible exposure to Ebola (incubation period: 2-21 days).
- While under investigation as a suspected case, please also raise the issue of a malaria test and other investigations as necessary based on the exposure region.
- Details for Ebola disease: see BAG and RKI (in German) or ECDC (in English).
Swiss ECTM recommendations (as of 28 May 2026, subject to change according to the evolving situation):
A suspected case is:
- A symptomatic person (see FOPH case definition) with a history of stay within the last 21 days in north-eastern D.R. Congo (province of Ituri, North Kivu, South Kivu) and/or Uganda.
AND - Having had a high-risk exposure* - evaluated by a specialist in infectious diseases or tropical medicine (in case of doubt, contact the Geneva Reference Centre for Emerging Virus Diseases).
Such cases should be isolated, tested, and reported to the Cantonal Physician and the Swiss Federal Office of Public Health within 2 hours.
*High-risk exposure includes:
- Participation in local funerals; or
- Contact with a sick patient at home, during transport, or in a healthcare facility; or
- Attendance at a local healthcare facility.
On 5 May 2026, WHO was alerted of a cluster of unknown febrile illnesses with a high mortality rate in Mongbwalu and Rwampara Health Zones, Ituri Province. Following investigation by rapid response teams, the cause was confirmed to be Bundibugyo virus disease (BVD) due to Bundibugyo virus (Orthoebolavirus bundibugyoense) - a species of Ebola virus - on 15 May with 8/13 positive samples from Rwampara.
On 15 May 2026, the DRC declared its 17th Ebola outbreak, affecting Rwampara, Mongbwalu, and Bunia Health Zones. Uganda subsequently confirmed two imported cases. On 16 May 2026, WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC).
As of 20 May 2026 (WHO press releaset):
- More than 600 suspected cases (>500 in DRC, 12 in Uganda) and 139 suspected deaths (131 in DRC, 1 in Uganda. Most suspected cases were reported in Mongbwalu (302 cases, 74 deaths) and Rwampara (136 cases, 74 deaths), Ituri Province.
- 35 confirmed cases (33 in DRC, 2 in Uganda), including 5 deaths (4 in DRC, 1 in Uganda), corresponding to a CFR of 14.3% (5/35). In DRC, confirmed cases were reported in four health zones in Ituri Province — Rwampara (19), Bunia (6), Nyankunde (4), and Mongbwalu (1) — and three health zones in North Kivu: Butembo (1), Goma (1), and Katwa (1).
WHO expects those numbers to keep increasing, given the amount of time the virus was circulating before the outbreak was detected.
Further cases:
- The US citizen who has tested positive has been transferred to Germany (with six high risk contacts). One other contact will be transferred to Czechia.
- South Sudan is investigating a suspected Bundibugyo virus disease case in West Equatoria State after a preliminary positive result in a patient from South Yambio County.
- Information regarding transmission chains and affected population groups is currently limited, partly due to the complex context of ongoing insecurity and humanitarian challenges in the affected areas.
- Genomes from DRC and Uganda have been published and preliminary analysis shows distinct
sequences from the previous outbreaks (Virological Ebolavirus/Bundibugyo ebolavirus, 18 May 2026).
Authorities are concerned about the risk of further spread due to population high mobility, insecurity, and the proximity of affected areas to Uganda and South Sudan through a porous border.
The D.R. Congo has experienced several Ebola outbreaks in recent years. The most recent outbreak, in the Kasai provinces (species Orthoebolavirus zairense), was declared over in December 2025. In Ituri Province specifically, Ebola disease due to Ebola virus (Orthoebolavirus zairense) was last documented during the 2018-2020 outbreak. Bundibugyo virus was first reported in 2007 in Bundibugyo district in Uganda during an outbreak. The most recent outbreak due to Bundibugyo virus was in 2012 in DRC.
WHO assesses the risk of the epidemic as high at the national and regional levels, and low at the global level (including Switzerland and EU/EEW).
The outbreak was first detected in a remote and conflict-affected area of the Democratic Republic of Congo. There are significant uncertainties to the true number of infected persons and geographic spread associated with this event at the present time. In addition, there is limited understanding of the epidemiological links with known or suspected cases.
People visiting affected areas in D.R. Congo and Uganda should follow these precautions:
General preventive measures:
- Wash hands regularly and carefully using soap and water (or alcohol gel if soap is unavailable).
- Avoid contact with sick people who have symptoms, such as fever, muscle pain, and rash.
- Avoid contact with blood and other body fluids.
- Avoid visiting healthcare facilities in the filovirus-affected areas for nonurgent medical care or non-medical reasons.
- Avoid contact with dead bodies or items that have been in contact with dead bodies, participating in funeral or burial rituals, or attending a funeral or burial.
- Avoid handling, cooking, or eating bush/wild meat (meat of wild/feral mammals killed for food).
- Wash and peel fruit and vegetables before consumption.
- Avoid visiting mines or bat caves and contact with all wild animals; alive or dead, particularly bats.
- If visiting mines or caves inhabited by fruit bat colonies, wear gloves and other appropriate protective clothing, including masks and eye protection.
- Practice safer sex.
Of note: there is currently no licensed vaccine or specific treatment against Ebola diseased caused by Bundibugyo virus. For humanitarian missions, consultation with a travel medicine specialist is recommended.
While in the outbreak area and for 21 days after leaving:
- Watch for symptoms.
- Follow quarantine measures by your local health authorities if applicable.
! In case of symptoms (during your stay in North-eastern D.R. Congo (province of Ituri, North Kivu, South Kivu) and /or Uganda, especially the affected area, or until 21 days after leaving) such as fever >38° C:
- Separate yourself from others (isolate) immediately.
- Do not travel.
- Contact by phone local health authorities or a healthcare facility for advice (e.g. tropical institute or travel clinic or university hospital infectious disease unit).
- Always state that you may have had a possible exposure to Ebola (incubation period: 2-21 days).
- As soon as you know that you are NOT a suspected case, go to a tropical / travel clinic, or to the hospital if severe, to get a malaria test (and other investigations If necessary).
Swiss ECTM recommendations (as of 28 May 2026, subject to change according to the evolving situation):
A suspected case is:
- A symptomatic person (see FOPH case definition) with a history of stay within the last 21 days in north-eastern D.R. Congo (province of Ituri, North Kivu, South Kivu) and/or Uganda.
AND - Having had a high-risk exposure* - evaluated by a specialist in infectious diseases or tropical medicine (in case of doubt, contact the Geneva Reference Centre for Emerging Virus Diseases).
Such cases should be isolated, tested, and reported to the Cantonal Physician and the Swiss Federal Office of Public Health within 2 hours.
*High-risk exposure includes:
- Participation in local funerals; or
- Contact with a sick patient at home, during transport, or in a healthcare facility; or
- Attendance at a local healthcare facility.
A cluster of Andes hantavirus infections linked to the Dutch-flagged cruise ship MV Hondius in the South Atlantic has resulted in multiple cases among passengers and crew from several countries. The outbreak involves Andes virus (ANDV), the only hantavirus known to cause limited person-to-person transmission, typically through close and prolonged contact.
Updates on new reported cases between 8 and 15 May 2026:
New cases - three new cases after the after evacuation from the cruise ship:
- One confirmed case in France – who became symptomatic during repatriation.
- One confirmed case in Spain.
- One of the passengers who was evacuated from the ship had a positive result for hantavirus by PCR on 12 May 2026. The person was asymptomatic at the time of testing but successively developed respiratory symptoms. The individual currently remains in isolation.
- One inconclusive case was reported in the United States involving an asymptomatic passenger repatriated on 10 May, with conflicting laboratory results (one positive and one negative from separate laboratories). A second US citizen reportedly developed mild symptoms during evacuation, although details remain unclear based on currently available information.
Total cases:
- 11 cases (8 confirmed, 2 probable, 1 inconclusive case), including 3 deaths.
Other news:
- The cruise ship MV Hondius arrived at the port of Granadilla, Tenerife on Sunday 10 May.
- Disembarkation of guests and part of the crew was carried out and completed on 11 May. Disembarked guests and crew members were transported to the airport and repatriated via evacuation flights throughout 10 and 11 May.
- Evacuation was carried out from Tenerife to the following countries: Spain (14), France (5), Canada (4), the Netherlands (26), UK (22), Ireland (2), Turkey (3), US (17).
- The ship departed Tenerife on 11 May and is expected to arrive in the Netherlands on 17–18 May.
- Preliminary genome sequencing analysis showed high genetic similarities between isolates of Andes virus, likely indicating an initial zoonotic spillover event followed by human-to-human transmission.
- Investigations into the travel history and potential exposures of the first case in the Southern Cone are ongoing and suggest possible exposure to rodents during bird watching activities.
- For details, see ECDC and WHO reports, or on BEACON.
- For contact management: see WHO LINK.
Additional cases among cruise ship passengers remain possible due to the long incubation period of hantavirus infection, which can last up to 6–8 weeks. However, current response measures — including quarantine of disembarked passengers, rapid isolation of suspected cases, and contact monitoring — are expected to reduce the risk of further transmission.
Hantaviruses are rodent-borne zoonotic viruses transmitted to humans primarily through contact with contaminated rodent urine, droppings, or saliva. Human infections are rare but can cause severe and sometimes fatal disease.
Two main clinical syndromes are associated with hantavirus infection:
- Hantavirus cardiopulmonary syndrome (HCPS) occurs mainly in the Americas; it can rapidly progress from fever and flu-like symptoms to respiratory failure, pulmonary oedema, shock, and death. Case fatality is high, typically ranging from 20–40% and may reach up to 50%, particularly among older adults and people with comorbidities.
- Hemorrhagic fever with renal syndrome (HFRS) occurs mainly in Europe and Asia. It primarily affects the kidneys and blood vessels, potentially causing hypotension, bleeding disorders, and renal failure. Case fatality is generally lower, ranging from less than 1% to 15%, depending on the virus and setting.
Transmission: Most hantaviruses are associated with specific rodent reservoir species that carry the virus without apparent illness. Human-to-human transmission is not typically and has only been documented with Andes virus in South America, primarily among close and prolonged contacts. Exposure risk increases during activities that disturb rodent-contaminated environments, such as cleaning enclosed spaces, farming, forestry work, or sleeping in rodent-infested dwellings.
Symptoms usually begin 1–8 weeks after exposure and include fever, headache, myalgia, abdominal pain, nausea, and vomiting.
Diagnosis can be difficult in the early stages because symptoms overlap with influenza, COVID-19, leptospirosis, dengue, viral pneumonia, and sepsis Confirmation relies on serology, especially IgM or rising IgG titres, and RT-PCR during acute illness.
Treatment: There is no licensed specific antiviral treatment or vaccine. Management is supportive, with close monitoring and treatment of respiratory, cardiac, and renal complications. Early recognition and access to intensive care when needed are essential to improve survival.
The risk to the general population is considered very low, while the risk for cruise ship passengers is assessed as moderate. Of note: Even if transmission from evacuated passengers occurs, widespread community spread is unlikely, as Andes virus (ANDV) does not transmit easily and infection prevention measures are in place.
Travel in areas where hanta virus is: Very low risk for travellers.
- Avoid contact with rodents and their feces (wear a mask and gloves when handling a dead/sick animal or cleaning contaminated surfaces). When camping/ecotourism, close tents and cabins to prevent rodents from entering and protect your food from contamination in airtight boxes.
Mass events may favor respiratory and gastrointestinal infections. The following precautions are recommended:
General precautions:
- Wash hands frequently and avoid close contact with sick individuals.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Cover coughs and sneezes, dispose of tissues properly, and wash hands afterward.
- Follow food and water hygiene measures; avoid raw or undercooked poultry, eggs, and unpasteurized dairy products.
- Be aware of increased accident risks, particularly related to alcohol consumption.
- Practice safer sex to reduce the risk of sexually transmitted infections.
- Use mosquito protection at all times to prevent dengue, chikungunya, Zika, and other arboviral infections. For stays in Mexico: consult the malaria risk information on www.healthytravel.ch.
- Consult the official 2026 FIFA World Cup website for additional information and travel guidance.
Recommended vaccinations and other health risks:
- Be up to date with routine vaccinations, including measles-mumps-rubella (MMR) vaccination, due to ongoing outbreaks.
- Vaccination against meningococcal disease can be considered.
- Check country-specific vaccination recommendations on www.healthytravel.ch.
High transmission in Indonesia, the United States, Canada, Peru (Puno), Bangladesh, Japan (Tokyo), and Philippines.
Also continued high transmission in Mexico, Guatemala, Kazakhstan, Liberia, Yemen, UK (Birmingham) and Latvia.
Measles outbreaks are increasing worldwide.
Measles spread quickly and can be dangerous - protection is simple: get vaccinated!
Swiss recommendations: All persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine at one month interval. In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
In 2025, the Americas reported 14’891 confirmed measles cases and 29 deaths, a 32-fold increase from 2024 and the highest total since 2019, with most deaths occurring in Indigenous populations. For details, see LINK.
Measles spread quickly and can be dangerous - protection is simple: get vaccinated!
Swiss recommendations: All persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine at one month interval. In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a high-quality medical center for post-exposure vaccination as soon as possible!
Prevention: Avoid contact with animals and do not feed them! Travellers are advised to get a pre-exposure vaccination, especially those at higher risk, such as individuals working with animals, riding two-wheelers, visiting remote areas, young children, cave explorers, or anyone who may come into contact with bats.
A case of rabies has been reported in the U.S. in a traveler from India.
The circulation of counterfeit ABHAYRAB human rabies vaccine has recently been reported in major cities in India, including Delhi, Mumbai, Ahmedabad, and Lucknow. The fake vaccine mimics the registered product (Abhayrab; batch KA24014) but differs in formulation, packaging, labeling, manufacturer, and expiration date, posing a serious health risk.
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination and care as soon as possible!
Prevention: Avoid contact with animals and do not feed them! Travellers are advised to get a pre-exposure vaccination, especially those at higher risk, such as individuals working with animals, riding two-wheelers, visiting remote areas, young children, cave explorers, or anyone who may come into contact with bats.
Canada: Within one year, Canada reported 5’138 measles cases (4’777 confirmed, 361 probable). As a result, the WHO Region America has lost its measles elimination status according to World Health Organization (WHO).
USA: As of November 4, 2025, a total of 1’681 confirmed measles cases were reported in the United States, including 23 measles cases among international visitors. There have been 44 outbreaks, with 87% of cases linked to outbreaks, compared with 16 outbreaks and 69% outbreak-associated cases in 2024.
In addition, currently active measles outbreaks are ongoing in other countries of the WHO Region Americas such as Mexico, Bolivia, Brazil, Paraguay, Belize, as well as in Europe, Africa and Asia.
Measles spread quickly and can be dangerous - protection is simple: get vaccinated!
Swiss recommendations: All persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine at a one month interval. In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
Eine Impfung gegen Gelbfieber wird für die Amazonasregion Perus dringend empfohlen, siehe auch die Länderseite: www.healthytravel.ch.
Für immunkompetente Personen empfiehlt das Schweizerische Expertenkomittee für Reisemedizin eine einmalige Boosterimpfung zehn Jahre nach der Grundimmunisierung.
Optimal mosquito protection 24/7, also in cities (also against other mosquito-borne diseases). Vaccination against dengue is not recommended for stays in Florida.
Note on vaccination against dengue fever with Qdenga®:
- The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers older than 6 years who have had a previous dengue infection and who will be exposed in a region with significant dengue transmission (this is not the case in Florida/ USA).
- For details, see ECTM Statement.
In case of fever:
- Ensure adequate hydration and apply paracetamol products.
- Avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
On 22 August 2025, the US FDA’s Center for Biologics Evaluation and Research has suspended the biologics license for Valneva Austria GmbH’s live-attenuated IXCHIQ vaccine.
This vaccine was initially approved by the FDA under the accelerated approval pathway in November of 2023 for the prevention of disease caused by the chikungunya virus (CHIKV) in individuals 18 years of age and older who are at increased risk of exposure to CHIKV. CBER’s decision is based on serious safety concerns related to the vaccine, which appears to be causing chikungunya-like illness in vaccine recipients. There has been one death from encephalitis directly attributable to the vaccine (CSF PCR was + for the vaccine strain of the virus) and over 20 reported serious adverse events that were consistent with chikungunya-like illness. Reported serious adverse events have included 21 hospitalizations and 3 deaths. Furthermore, the clinical benefit of the vaccine has not yet been verified in confirmatory clinical studies. CBER’s benefit-risk analysis broadly shows the vaccine does not have benefits outweighing risks, under most plausible scenarios. For these reasons, CBER believes this vaccine is not safe and that continued administration to the public would pose a danger to health.
The FDA’s decision contrasts with that of the European Medicines Agency (EMA), which on 16 July 2025 lifted the temporary restriction on the Ixchiq® Chikungunya vaccine for individuals aged 65 years and older after reviewing reports of serious side effects.
Following its assessment, the EMA’s safety committee (PRAC) concluded that, for people of all ages, the Ixchiq® vaccine should only be given when there is a significant risk of chikungunya infection and after a careful consideration of the benefits and risks.
See also EpiNews as of 7 August 2025. The NYC Health Department is currently investigating a community cluster of Legionnaires' disease in Central Harlem (ZIP codes 10027, 10030, 10035, 10037, and 10039). As of August 19, there are: 108 confirmed cases, 5 deaths, 14 currently hospitalized.
Investigations are ongoing.
Legionella multiply especially in hot water systems, humidifiers, cooling towers, whirlpools and hydrotherapeutic facilities at water temperatures below 50°C.
Particularly at risk of severe illness are people older than 50, smokers, people with chronic lung disease diabetes, or weakened immune system such as transplant recipients and tumor patients.
NYC health authorities reported an outbreak of 58 cases (2 deaths) with Legionnaires’ disease in Central Harlem from 25 July to 4 August. Specific cooling towers are probably the source of transmission, but investigations of clinical and environmental isolates (including whole genome sequencing) are still ongoing. People >50, smokers, with chronic lung disease and/or weakened immune system are at high risk.
Outbreaks linked to cooling towers have occurred in NYC in the past with the largest (138 cases) occurring between July and September 2015. A cooling tower is a specialized heat exchanger that removes heat from a system by circulating water and exposing it to the atmosphere, primarily through evaporative cooling. This cooled water is then recirculated back into the system, while the heat is dissipated into the atmosphere.
Legionella multiply especially in hot water systems, humidifiers, cooling towers, whirlpools and hydrotherapeutic facilities at water temperatures below 50°C.
Particularly at risk of severe illness are people older than 50, smokers, people with chronic lung disease diabetes, or weakened immune system such as transplant recipients and tumor patients.
Following the significant increase in yellow fever cases in 2025 (see EpiNews 13 June 2025), the Swiss Expert Committee for Travel Medicine has adapted the risk areas where yellow fever vaccination is recommended. Notably, in addition to previously identified areas, the revised recommendations now include the following newly designated risk areas:
All countries:
- expansion of risk for stays up to 2’500m elevation in all countries
- vaccination may be considered for regions marked in green on the CDC map
Peru: Machu Picchu and all Inca trails
Colombia: islands of San Andrés and Providencia, stays in all national parcs (new entry requirement!)
For details, see yellow fever recommendations and countries’ entry requirements at the respective country page on www.healthytravel.ch and CDC map.
Canada (Manitoba, Ontario): Manitoba faces an increase in cases of measles with 42 new cases reported in May alone. Since February 2025, a total of 60 confirmed and 4 probable cases were reported by health officials. Outbreaks of cases with measles have been reported in Ontario with a total number of 655 cases in 2025.
US (multiple states): A total of 1’046 cases of measles have been confirmed as of 22 May 2025. Affected states are: Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, New Jersey, New Mexico, New York City and State, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia and Washington. In 2025, 92 % of the confirmed cases (961 of 1046) are associated to 14 outbreaks.
Tollwut ist in den USA endemisch.
Es ist keine gute Idee, auf Reisen irgendwelche Säugetiere zu streicheln, auch wenn sie noch so niedlich sind! Füttern Sie sie nicht! Berühren Sie keine wilden, unbekannten oder toten Tiere, siehe Factsheet Tollwut.
Eine Tollwutimpfung (vor der Exposition) wird dringend empfohlen bei:
- wiederholten Reisen oder Langzeitaufenthalten in Gebieten, in denen Tollwut vorkommt,
- Kurzreisen mit hohem individuellem Risiko, insbesondere bei Fahrrad- oder Motorradreisen, bei Wanderungen in abgelegene Gebiete, für Kleinkinder und Kinder,
- Personen, die mit Tieren arbeiten, oder Höhlenforscher (Fledermäuse!).
Besprechen Sie mit Ihrem Arzt*in, ob Sie eine Tollwutimpfung benötigen!
The Pan American Health Organization (PAHO) has issued an alert due to an increase in human cases of yellow fever (YF) in the last months of 2024 and beginning of 2025 in countries in the Region of Americas.
In the first 4 weeks of 2025:
- 17 confirmed human cases of YF have been reported in: Brazil (8 cases, incl. 4 deaths, all in state São Paulo), Colombia (8 cases, incl. 2 deaths), and Peru (1 death).
- Cumulatively in 2024:
61 human YF cases were confirmed the Americas Region. Out of them, at least 7 cases had history of vaccination. Cases were reported in Bolivia (8 cases incl. 4 death), Brazil (8 cases incl. 4 death), Colombia (23 cases incl. 13 deaths), Guyana (3 cases) and Peru (19 cases, incl. 9 deaths).
Yellow fever cases in humans in the Americas Region, between January 2020 and January 2025:
Given the risk of an increase in the circulation of dengue serotype DENV-3 in the southern hemisphere of the Americas Region during the peak dengue season, the Pan American Health Organization / World Health Organization (PAHO/WHO) urges Member States to prepare for a possible increase in cases and ensure early diagnosis and timely care dengue and other arbovirus cases, in order to prevent severe cases and deaths associated with these diseases.
The occurrence and magnitude of dengue outbreaks are usually associated with the introduction or increase in circulation of a serotype other than the one that previously predominated in an affected region.
For details, see PAHO publication.
Prevention: Optimal mosquito protection 24/7, also in cities (also against other mosquito-borne diseases such as Zika, chikungunya, oropouche, malaria).
In case of fever, ensure adequate hydration and apply paracetamol products. If you have a fever, avoid tak-ing medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop tak-ing medications containing acetylsalicylic acid if it is already part of your regular treatment for an underly-ing condition.
Note on vaccination against dengue fever with Qdenga®:
- The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evi-dence of previous dengue infection and who will be exposed in a region with significant dengue transmission.
- Studies have shown reduced seroprotection against dengue serotype DENV-3 in patient vac-cinated with Qdenga®, especially in dengue-naïve individuals.
For details, see ECTM Statement.
Both countries have reported an increase in measles cases since the beginning of the year 2025. In addition to children, adults are also affected.
Measles is not a benign disease, as the following facts show:
- Hospitalization: about 1 in 5 unvaccinated people in the United States who get measles are hospitalized.
- Pneumonia: as many as 1 out of every 20 children with measles will develop pneumonia, the leading cause of death from measles in young children.
- Encephalitis: about 1 in 1,000 children with measles will develop encephalitis, which can cause convulsions and leave the child deaf or intellectually disabled.
- Death: nearly 1 to 3 out of every 1000 children infected with measles will die from respiratory and neurological complications.
- Complications during pregnancy: measles can cause pregnant women who have not received the MMR vaccine to give birth prematurely or have a low-birth-weight baby.
All travelers should be immune against measles!
Swiss recommendations: all persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
According to WHO, as of 25 November 2024, a total of 11’ 634 confirmed Oropouche cases, including two deaths, have been reported in the Region of the Americas, across ten countries and one territory: Bolivia (356 cases), Brazil (9563 cases, including two deaths), Canada (two imported cases), Cayman Island (one imported case), Colombia (74 cases), Cuba (603 cases), Ecuador (two cases), Guyana (two cases), Panama (one case), Peru (936 cases), and the United States of America (94 imported cases). Additionally, imported Oropouche cases have been reported in countries in the European Region (30 cases).
In addition, As of 7 December 2024, two adult cases of Oropouche virus disease have been reported by health officials on Barbados.
Oropouche virus
- is spread primarily by the bite of infected midges (small flies) and mosquitoes (Culex quinquefasciatus).
- has been found in semen, but it is unknown if it can be spread through sex. No cases of sexual transmission of Oropouche virus have yet been reported.
- transmission to the unborn child has been reported. The extent of possible malformations or death in the unborn baby in the context of an OROV outbreak situation is currently still unclear and is being investigated.
- Illness can occur in people of any age and is often mistaken for dengue.
- There is no vaccine and not specific treatment available
Prevention: The best way to protect yourself from Oropouche is to prevent insect bites 24/7 (also against other mosquito-borne diseases such as Dengue, Zika, Chikungunya), see factsheet.
Pregnant women and women planning to be pregnant should be provided with comprehensive information during pre-travel consultation on the Oropouche virus outbreaks and the potential of miscarriage, fetal malformation or death.
In the event of increased OROV transmission (= declared as an OROV outbreak according CDC Level 2 Travel Health Notice for Oropouche), the Swiss Expert Commission for Travel Medicine recommends:
- Pregnant women should re-consider non-essential travel
- If travel is unavoidable, strictly adhere to insect prevention measures (see LINK) and talk to your health care provider.
- To avoid sexual transmission: males should consider using condoms during travel and up to 2 months after return.
The Fresno County Department of Public Health (FCDPH) is reporting a human rabies death, the first such case since 1992 in the county.
Officials say the Fresno County resident is suspected to have been bitten by a bat in Merced County in mid-October. The individual died on November 22 after one week of hospitalization.
Rabies can be transmitted by any mammals, including bats.
Prevention: Avoid contact with animals and do not feed them! Pre-exposure vaccination is particularly recommended for travellers with increased individual risk (working with animals, travel on two-wheelers, to remote areas, young children, cave explorers, possible contact with bats, etc.).
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination as soon as possible! For more information: see Flyer rabies.
On 28 October 2024, the US Center of Disease Control and Prevention reported a suspected imported case of Lassa fever in an Iowa resident. The case recently to West Africa (country unspecified) in early October 2024 and became ill upon return and was isolated in a hospital where he died end of October.
Lassa fever is endemic in West Africa with 100’000 to 300’000 cases reported each year.
Sporadic cases have been reported among returning travellers: In the past 10 years, EU/EEA countries have reported seven Lassa fever cases to ‘The European Surveillance System’ (TESSy). Two cases were reported by the UK (ex-Nigeria and ex-Mali) in 2009, one by Sweden (ex-Liberia) in 2016, two by Germany (ex-Togo and a secondary case infected in Germany) in 2016 and two by the Netherlands (ex-Sierra Leone) in 2019. In the USA, there have been nine imported Lassa fever cases since 1969.
Between epidemiological week (EW) 1 and EW 35 of 2024, 38 confirmed human cases including 19 deaths of yellow fever (YF) have been reported in 5 countries of the Americas Region: Bolivia (7 cases, including 4 with history of YF vaccination), Brazil (3 cases, including 1 case with history of YF vaccination in 2017), Colombia (8 cases, including 1 cases with history of YF vaccination), Guyana (2 cases), and Peru (18 cases). For details, see LINK.
Geographical distribution of municipalities with occurrence of yellow fever cases in humans in Bolivia, Brazil, Colombia, Guyana, and Peru, years 2022, 2023, and 2024 (as of EW 35):
The Los Angeles County Public Health Department has confirmed a case of locally acquired dengue from a resident who has no history of travel to areas where dengue fever is endemic. According to a release from the health department, the infected person resides in Baldwin Park.
It is the third case of locally acquired dengue in California and the first reported by the Los Angeles County Department of Public Health. Cases of locally acquired dengue were previously confirmed by Long Beach and Pasadena in fall 2023.
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
Murine typhus is caused by rickettsiae (organisms found worldwide and classified as bacteria), which are transmitted to humans by fleas. Symptoms include chills, headache, fever and rash. There is no vaccine; the disease can be treated with antibiotics.
- Do not eat raw oysters or other raw shellfish.
- Cook shellfish (oysters, clams and mussels) thoroughly.
- Consume seafood immediately after cooking and refrigerate leftovers.
- Avoid contact of open wounds or injured skin with warm salt or brackish water or with raw shellfish originating from such waters.
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 case
- Portugal: 14 confirmed cases, another 6 suspected cases (link), Lisbon Region and Tagus Valley Region
- Spain: 7 confirmed, 23 suspected cases, (link)
- Sweden: 1 confirmed case, 1 suspected case
- Canada: 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.
Further cases must be expected. Persons showing symptoms as described above should contact a doctor, ideally in advance by telephone. Persons who have several sexual partners or practice casual sex should be particularly vigilant!
Prevention: Good personal hygiene, avoid contact with infected persons and animals at all costs. During stays in West and Central Africa: No consumption of bushmeat. The individual risk of contact with a patient with monkeypox depends on the type and duration of contact. In the case of very close contact with a case (e.g. family members, aeroplane neighbours, medical personnel), the risk of infection has so far been classified as moderate; in the case of sexual / intimate contact, it is probably high.
Source image: NCDC
WHO 18.5.2022, RKI 19.5.2022, UK GOV, 16.5.2022, Outbreak News Today, 18.5.2022, CDC, Labor Spiez
In 2021, a total of 1,567 cases with West Nile virus (WNV) infection were recorded in the state of Arizona, with 110 cases being fatal. This is by far the highest number of reported cases in recent decades. As a possible cause for the huge increase in 2021, it could have been the extremely wet summer, which led to an increased mosquito population, as well as very warm temperatures still in November to early December, which could have extended the transmission season.
West Nile viruses belong to the flavivirus family and are transmitted by Culex mosquitoes. The main hosts are birds. Most cases are asymptomatic; clinically symptomatic cases present fever and flu-like symptoms. In severe cases, the disease can cause meningitis or encephalitis. Recovery from severe disease may take several weeks or months, and some of the neurological problems may be permanent. In rare cases, death may occur. Elderly people, pregnant women, and immunosuppressed individuals are at higher risk for severe disease progression.
Consequences for travelers
Optimal mosquito bite protection especially at dusk and dawn. Sick and dead birds should not be touched.
References
Five Americans died from rabies in 2021, the highest number in a decade. According to health officials, some of these people did not know they were at risk of infection or refused life-saving vaccinations.
- The first was an 80-year-old Illinois man who refused to receive the vaccines after a bat contact out of fear of vaccinations in general.
- The next were an Idaho man and a Texas boy who had refused vaccination because they mistakenly assumed they would not be injured after contact with a bat.
- The fourth was a Minnesota man who had been bitten by a bat.
- The last had been bitten by a rabid dog during a trip to the Philippines and died on his return to New York.
Consequences for travelers
Avoid contact with animals! Do not feed animals either! For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, small children, work with animals, cave explorers, etc.) a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is recommended.
Behavior after exposure:
After an animal bite/scratch: immediately wash the wound with running water and soap for 15 minutes, then disinfect and in any case visit a high-quality medical center for post-exposure vaccination as soon as possible!
For more information: see factsheet rabies
References
A person in Maryland, USA, has contracted monkeypox after a stay in Nigeria. Laboratory tests revealed that it is the same strain that has been circulating in Nigeria since 2017. The person is currently in isolation. Investigations regarding possible contacts have been initiated.
Monkeypox is endemic in Nigeria and other countries in West and Central Africa. An increase in cases in Nigeria has been recorded since September 2017. 88 cases have been reported in 2021 (through the end of October 2021).
Consequences for travelers
Prevention: Follow good personal hygiene, avoid contact with infected people and animals, do not consume bushmeat. The individual risk of contracting monkeypox from an infected patient depends on the type and duration of contact. If there is very close contact with a case (e.g., family members, airplane neighbors, medical personnel), the risk of infection is considered to be moderate, otherwise low.
References
Informazioni generali
Vaccinazioni per tutti i viaggiatori
- La poliomielite è una malattia virale del sistema nervoso prevenibile con il vaccino, che si acquisisce principalmente attraverso il consumo di cibo o acqua contaminati da feci.
- L'infezione da poliovirus può attaccare bambini e adulti e può provocare la paralisi permanente degli arti o dei muscoli respiratori e la morte.
- È disponibile un vaccino efficace e ben tollerato! Verificare se sono raccomandate dosi di richiamo (oltre al calendario di vaccinazione di base già completato).
EKRM_Factsheet_Layperson_IT_Polio.pdf
- La poliomielite ("paralisi infantile") è una malattia infettiva del sistema nervoso che può essere prevenuta con la vaccinazione.
- La poliomielite è causata principalmente dal consumo di cibo o acqua contaminati da feci.
- L'infezione da poliovirus può colpire sia i bambini che gli adulti e può portare alla paralisi permanente degli arti o dei muscoli respiratori, oltre che alla morte.
- Esiste un vaccino efficace e ben tollerato! Verificate se le vaccinazioni di richiamo (oltre all'immunizzazione di base completa) sono raccomandate per la vostra destinazione.
Lavarsi regolarmente le mani dopo aver usato la toilette e prima di mangiare o preparare il cibo. Evitare cibi poco cotti o crudi che potrebbero essere contaminati da feci.
La misura preventiva più importante è l'immunizzazione. Esiste una vaccinazione intramuscolare molto efficace e ben tollerata contro la poliomielite (vaccino antipolio inattivato ucciso, IPV), che fa parte del programma di immunizzazione di base durante l'infanzia. Esistono anche vaccini combinati (ad esempio con difterite e tetano). Dopo l'immunizzazione di base, si raccomanda una vaccinazione di richiamo ogni 10 anni quando si viaggia in alcuni Paesi (vedere le raccomandazioni nelle pagine dei Paesi). L'OMS raccomanda l'immunizzazione annuale per i residenti o i visitatori di lungo periodo (almeno 4 settimane) in un Paese dove sono ancora presenti infezioni da poliovirus selvaggio o dove circolano poliovirus derivati dal vaccino orale. Questa raccomandazione non è solo per la protezione personale, ma mira anche a prevenire la diffusione del virus a livello mondiale.
- Verificare il rischio di poliomielite nella regione in cui si viaggia e sottoporsi a una vaccinazione di richiamo se raccomandata (vedere le raccomandazioni nelle pagine dei Paesi).
- CHI: https://www.who.int/news-room/fact-sheets/detail/poliomyelitis
- BAG Svizzera: Piano di vaccinazione svizzero: https://www.bag.admin.ch/bag/it/home/gesund-leben/gesundheitsfoerderung-und-praevention/impfungen-prophylaxe/schweizerischer-impfplan.html
Informazioni generali su morbillo, parotite e rosolia (MOR)
Consultare i seguenti link dell' Ufficio federale della sanità pubblica UFSP:
Consultare il seguente link dell'UFSP:
Informazioni generali sulla varicella e sull’herpes zoster
Vaccinazioni per alcuni viaggiatori
- L'epatite B è un'infezione del fegato causata da un virus.
- Il virus si trasmette attraverso il contatto sessuale, ma può anche essere trasmesso attraverso il sangue o derivati ad esempio quando si condividono siringhe, aghi per tatuaggi, ecc.
- Esiste un vaccino sicuro e molto efficace che offre una protezione di lunga durata.
- La vaccinazione contro l'epatite B è raccomandata per tutti i neonati e gli adolescenti fino a 16 anni e per i gruppi a rischio indipendentemente dall'età.
- L'epatite B è un'infezione del fegato causata da un virus.
- Il virus si trasmette attraverso il contatto sessuale, ma può anche essere trasmesso attraverso il sangue o derivati ad esempio quando si condividono siringhe, aghi per tatuaggi, ecc.
- Esiste un vaccino sicuro e molto efficace che offre una protezione di lunga durata.
- La vaccinazione contro l'epatite B è raccomandata per tutti i neonati e gli adolescenti fino a 16 anni e per i gruppi a rischio indipendentemente dall'età.
- Ufficio federale della sanità pubblica (UFSP). Epatite B:
https://www.bag.admin.ch/bag/it/home/krankheiten/krankheiten-im-ueberblick/hepatitis-b.html - Epatite Svizzera: https://it.hepatitis-schweiz.ch/tutto-sull-epatite/epatite-b/
- La Covid-19 è una malattia che colpisce tutto il corpo, ma si presenta soprattutto con sintomi respiratori come tosse e difficoltà di respirazione. È causata dal virus SARS-CoV-2.
- L'infezione si trasmette principalmente attraverso goccioline respiratorie ed eventualmente aerosol quando le persone infette tossiscono, starnutiscono, parlano o cantano senza indossare una mascherina.
- L'infezione può essere prevenuta in modo molto efficace con la vaccinazione e un numero crescente di vaccini è approvato e disponibile per la protezione.
- La vaccinazione è raccomandata secondo le raccomandazioni svizzere dell'Ufficio federale della sanità pubblica (UFSP), vedi LINK.
- Inoltre, la prevenzione si basa molto sull'uso di mascherine, sull'igiene delle mani e sulla distanza fisica (minimo 1,5 m) se non si indossano le mascherine e non si è vaccinati.
- L'influenza è frequente in tutto il mondo, compresi i paesi subtropicali e tropicali.
- La vaccinazione offre la migliore protezione.
- La vaccinazione contro l'influenza è raccomandata per tutti i viaggiatori che appartengono a un gruppo "a rischio", come i viaggiatori in gravidanza, i viaggiatori con comorbilità, gli anziani (>65 anni) o che prevedono un viaggio ad alto rischio (ad es. crociere, pellegrinaggi).
- Il vaccino contro l'influenza non offre protezione contro l'influenza aviaria.
Informazioni generali influenza stagionale (influenza)
Consultare i seguenti link dell'UFSP:
- La rabbia è trasmessa principalmente dai cani (e dai pipistrelli), ma qualsiasi mammifero può essere infettivo.
- È invariabilmente fatale nel momento in cui si manifestano i sintomi.
- La rabbia si previene meglio con una vaccinazione prima del viaggio e con un comportamento adeguato verso i mammiferi.
- La vaccinazione prima del viaggio è consigliata anche perché spesso i vaccini e le immunoglobuline non sono disponibili in molti paesi in cui si viaggia. La vaccinazione prima del viaggio è altamente raccomandata soprattutto in caso di
- Viaggi ripetuti soggiorni di lunga durata in paesi endemici,
- viaggi brevi ad alto rischio individuale, come viaggiatori su "due ruote", trekking in regioni remote, viaggi con neonati e bambini
- persone che lavorano con gli animali o esploratori di grotte (pipistrelli!).
- Per dettagli, vedere SOP vaccinazione contro la rabbia (disponibile solo in HealthyTravel PRO).
- Attenzione: un morso o un graffio, così come il contatto con la saliva di un mammifero su una ferita aperta, è sempre un'emergenza! Scoprite di seguito le azioni necessarie!
- Rabies is mainly transmitted by dogs (and bats), but any mammal can be infectious.
- The disease is invariably fatal at the time when symptoms occur.
- Rabies is best prevented by a pre-travel vaccination and appropriate behavior towards mammals (avoiding contacts).
- Pre-travel vaccination (see section prevention) is also recommended because vaccines and immunoglobulins are often not available in many travel countries.
- Attention: a bite or a scratch wound as well as a contact with mammal saliva on an open wound is always an emergency! Find out about the necessary actions below!
Non esiste un trattamento specifico contro la malattia causata dal virus della rabbia.
Misure post-esposizione: Pulizia immediata della ferita con abbondante acqua e sapone per 10-15 minuti, seguita da disinfezione (ad es. Betadine, Merfen) e vaccinazione post-esposizione d'emergenza nell’ospedale più vicino entro 24 ore. È inoltre raccomandata la vaccinazione di richiamo contro il tetano se non è aggiornata. Per coloro che hanno ricevuto la vaccinazione antirabbica completa pre-esposizione prima del viaggio, sono sufficienti due dosi aggiuntive di un vaccino contro la rabbia (di qualsiasi marca) a un intervallo di 3 giorni. Se non è stata effettuata la vaccinazione completa pre-esposizione, oltre alla vaccinazione è necessaria l'immunizzazione passiva con immunoglobuline. Va notato che le immunoglobuline (e a volte i vaccini) spesso non sono disponibili in ambienti con scarse risorse, causando stress e incertezza.
È consigliato evitare di accarezzare animali domestici e di astenersi dal toccare animali selvatici, non familiari o morti.
Tutti i viaggiatori che si recano verso luoghi in cui la rabbia terrestre può manifestarsi e/o che probabilmente faranno viaggi ripetuti in zone in cui la rabbia è presente dovrebbero sottoporsi alla vaccinazione pre-esposizione. Inoltre, la vaccinazione pre-esposizione è altamente raccomandata per i viaggiatori particolarmente a rischio:
- soggiorni di lunga durata in paesi endemici,
- viaggi brevi ad alto rischio individuale, come viaggiatori su "due ruote", trekking in regioni remote, viaggi con neonati e bambini fino a 8 anni di età,
- professionisti che lavorano con gli animali o esploratori di grotte (pipistrelli!).
Lo schema di vaccinazione abbreviato può essere proposto alla maggior parte dei viaggiatori: 2 vaccinazioni, la prima possibilmente un mese prima della partenza (minimo 8 giorni prima della partenza). Una terza vaccinazione di richiamo per la rabbia è raccomandata prima del viaggio successivo, con un intervallo almeno di un anno.
- Informarsi a tempo opportuno sulla prevenzione della rabbia prima del viaggio.
- In caso di viaggi programmati per più di qualche settimana, prevedere una consultazione di medicina da viaggio al più tardi 4 settimane prima della partenza.
- Dopo un'eventuale esposizione (morso, graffio) sono necessari un trattamento della ferita e la somministrazione di dosi aggiuntive di vaccino contro la rabbia anche per coloro che hanno completato la serie di vaccinazioni di base.
- Questo foglio informativo dovrebbe essere stampato e tenuto a portata di mano durante il viaggio!
- UFSP Svizzra: LINK
Altri rischi per la salute
- La febbre dengue è la malattia trasmessa dagli insetti più comune al mondo.
- Bisogna prestare molta attenzione alla protezione dalle zanzare durante il giorno!
- La malattia può causare febbre alta, dolori muscolari e articolari ed eruzioni cutanee. In rari casi possono manifestarsi emorragie.
- Non esiste un trattamento specifico. La vaccinazione è raccomandata solo per le persone con evidenza di una precedente infezione da dengue.
- Per sicurezza personale, si consiglia fortemente di informarsi dettagliatamente sulla dengue.
Dengue_Factsheet_Public_ECTM_IT.pdf
Insect_and_Tick_Bite_Protection_Factsheet_Public_ECTM_IT.pdf
- La febbre dengue è la malattia trasmessa dagli insetti più comune al mondo.
- Bisogna prestare molta attenzione alla protezione dalle zanzare durante il giorno!
- La malattia può causare febbre alta, dolori muscolari e articolari ed eruzioni cutanee. In rari casi possono manifestarsi emorragie. Non esiste un trattamento specifico. La vaccinazione è raccomandata solo per le persone con evidenza di una precedente infezione da dengue.
- Per sicurezza personale, si consiglia fortemente di informarsi dettagliatamente sulla dengue.
In 3 casi su 4, l'infezione con il virus rimane asintomatica. Dopo un breve periodo di incubazione (5-8 giorni), 1 persona infetta su 4 presenta una brusca insorgenza di febbre, mal di testa, dolori articolari, agli arti e ai muscoli, oltre a nausea e vomito. Tipico è anche il dolore al movimento degli occhi. L'eruzione cutanea si manifesta di solito il 3° o il 4° giorno di malattia. Dopo 4-7 giorni, la febbre si riduce definitivamente, ma la stanchezza può persistere per diversi giorni o settimane.
In rari casi, la dengue può essere grave. Particolarmente sensibili sono i bambini e gli anziani locali, come anche le persone che hanno avuto una precedente infezione da dengue. I turisti presentano molto raramente una dengue grave. Nei primi giorni, la malattia assomiglia al decorso della classica febbre dengue, ma al 4°/5° giorno, di solito dopo che la febbre si è abbassata, le condizioni peggiorano. La pressione arteriosa si abbassa e i pazienti lamentano mancanza di respiro, disturbi addominali, epistassi e lievi emorragie cutanee o mucose. Nei casi più gravi, può presentarsi uno shock potenzialmente letale.
Non esiste un trattamento specifico per l'infezione da virus dengue. Il trattamento si limita alla mitigazione e al monitoraggio dei sintomi: riduzione della febbre, sollievo dal dolore agli occhi, alla schiena, ai muscoli e alle articolazioni e monitoraggio della coagulazione e del volume del sangue. I pazienti con sintomi gravi devono essere ricoverati in ospedale.
Per la riduzione della febbre o del dolore, si consigliano rimedi con il principio attivo paracetamolo o acetaminofene (ad esempio Acetalgin® Dafalgan®). I farmaci contenenti il principio attivo acido acetilsalicilico (ad esempio Aspirina®, Alcacyl®, Aspégic®) devono essere evitati.
Una protezione efficace contro le zanzare durante il giorno e soprattutto al tramonto è la migliore misura preventiva:
- Abbigliamento: indossare indumenti a maniche lunghe , pantaloni lunghi e applicare preventivamente uno spray insetticida sugli indumenti (vedi foglio informativo "prevenzione delle punture da artropodi").
- Repellente per zanzare: Applicare più volte al giorno un repellente per zanzare sulla pelle scoperta (vedi foglio informativo "prevenzione delle punture da artropodi").
- Igiene ambientale: Non lasciare contenitori con acqua stagnante(per es.sottovasidi fiori) nel proprio ambiente per evitare siti di riproduzione delle zanzare.
Per ulteriori informazioni, consultare il foglio informativo "Protezione dalle punture di zanzare e zecche".
Nota sulvaccino contro la dengue Qdenga®:
In considerazione dei dati attualmente disponibili, molti Paesi europei e il Comitato svizzero di esperti in medicina dei viaggi (CEMV) raccomandano attualmente la vaccinazione con Qdenga® solo per iviaggiatori, con evidenza di una precedente infezione da dengue e che si recheranno in una regione con una significativa trasmissione di dengue, vedi LINK. Si tratta di una decisione precauzionale, poiché i dati attuali includono anche la possibilità che le persone vaccinate con Qdenga® prima di una prima infezione da dengue possano avere un decorso più grave della malattia quando vengono infettate dopo la vaccinazione. Si raccomanda pertanto di consultare uno specialista in medicina tropicale e dei viaggi.
La protezione costante dalle zanzare durante il giorno (vedi sopra) è ancora considerata la misura preventiva più importante contro la febbre dengue!
- Non prendere prodotti contenenti il principio attivo dell'acido acetilsalicilico (ad es. Aspirina®, Alcacyl®, Aspégic®) in presenza di sintomi, poiché aumentano il rischio di emorragie in caso di infezione da dengue!
- Tuttavia, non interrompere l'assunzione di farmaci contenenti acido acetilsalicilico se questi fanno già parte del trattamento abituale per una patologia di base.
- Vaccination against Dengue fever for Travellers – Statement of the Swiss Expert Committee for Travel Medicine, an organ of the Swiss Society for Tropical and Travel Medicine, July 2024, LINK.
- Dengue Map (Center for Disease Control and Prevention – CDC): https://www.cdc.gov/dengue/areaswithrisk/around-the-world.html
- Zika is a usually mild viral disease transmitted by mosquitoes that bite during the day.
- Infection during pregnancy (any time) can cause fetal malformation.
- In areas with increased risk of Zika transmission, pregnant women or those planning a pregnancy should take extra precautions: please see the information below.
Zika_Factsheet_Public_ECTM_EN.pdf
Insect_and_Tick_Bite_Protection_Factsheet_Public_ECTM_IT.pdf
CDC LINK: Paesi e territori a rischio di Zika
Paesi e territori con trasmissione attuale o precedente del virus Zika al 27 maggio 2024: LINK
- Il foglio informativo contiene importanti informazioni sulla zika e sulle misure di prevenzione.
- Se lei o la sua compagna è incinta o se sta pianificando una famiglia, le consigliamo fortemente di informarsi dettagliatamente su Zika.
- Zika is a usually mild viral disease transmitted by mosquitoes that bite during the day.
- Infection during pregnancy (any time) can cause fetal malformation.
- In areas with increased risk of Zika transmission, pregnant women or those planning a pregnancy should take extra precautions: please see the information below.
The Zika virus was first found in 1947 in monkeys in Uganda’s Zika forest. Until May 2015, the virus circulation was mainly limited to Africa and South-East Asia. Then an epidemic spread to the Americas, starting in Brazil, and then to South and Central America, and the Caribbean. Since then, the disease has spread to most tropical and subtropical regions. While the risk of infection risk is currently low, epidemics may reappear and require specific travel advices (see below).
Zika symptoms can resemble those of malaria, which requires urgent treatment, or other mosquito-borne diseases such as dengue. Therefore: If you have a fever, consult a doctor for an accurate diagnosis! Treatment for Zika targets reduction of fever and joint pain (with paracetamol). Avoid aspirin and anti-inflammatory drugs (e.g. ibuprofen) as long as dengue fever is not excluded. There is no vaccine available.
If pregnant and experiencing fever during or after returning from a Zika virus transmission area, blood and/or urine tests are recommended. If Zika infection is confirmed, medical management should be coordinated with a gynecologist and specialists in infectious or travel medicine.
- Travelling in pregnancy poses an increased risk for the mother and the baby for mosquito-transmitted diseases. Please refer to the pregnancy factsheet.
- Always protect yourself from mosquito bites during the day and early evening, see factsheet mosquito-bite prevention.
- If traveling in an area with increased risk of Zika transmission (see areas in Zika Health Travel Notice):
- If you are pregnant: women at any stage of pregnancy should reconsider their travel plans. If travel is essential, consult a travel medicine specialist before departure.
- If your partner is pregnant: use condoms throughout pregnancy to prevent possible sexual transmission of Zika.
- If you or your partner is planning to become pregnant:
- Use condoms throughout your trip and for at least two months after returning home to prevent possible sexual transmission of Zika without symptoms.
- You should wait at least 2 months after returning from an area with an increased risk of Zika transmission before getting pregnant.
- Zika virus infection during pregnancy (any trimester) can cause fetal malformation.
- For most up-to-date information on Zika epidemics (= increased risk of transmission), please see ‘Zika Travel Health Notices’ of the US Center of Disease and Prevention (CDC): https://www.cdc.gov/zika/geo/index.html
- US Center of Disease Control and Prevention: Zika virus: https://www.cdc.gov/zika/index.html
- European Center for Disease Control and Prevenion: Zika virus disease
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]
- Sexuell übertragbare (oder transmissible) Infektionen (STI) sind eine Gruppe von viralen, bakteriellen und parasitären Infektionen; während viele behandelbar sind, können einige zu Komplikationen, schweren Erkrankungen oder zu einer chronischen Infektion führen.
- STI nehmen weltweit zu.
- Lesen Sie das folgende Informationsblatt für weitere Informationen.
- Geschlechtskrankheiten sind ein weltweit verbreitetes Gesundheitsproblem und können durch Prävention, regelmässiges Testen und Behandlung in den Griff bekommen werden.
- Das Wissen um Risiken sowie Safer-Sex-Praktiken inklusive Kondomgebrauch sind wichtig. Falls Sie mehr dazu erfahren wollen, wie Sie sich während der Reise optimal schützen können, besprechen Sie dies mit einer Fachperson.
- Hatten Sie eine Risikosituation, ist es wichtig mit einer Fachperson so rasch wie möglich Rücksprache zu halten, um zu erörtern, ob eine HIV-Post-Expositions-Prophylaxe (PEP) durchgeführt werden soll, um eine Ansteckung mit HIV zu verhindern.
- Im Nachgang einer Risikosituation ist es wichtig sich auf Geschlechtskrankheiten testen zu lassen. Auch dann, wenn Sie keine Symptome haben.
- Brennen oder Juckreiz im Genitalbereich
- Schmerzhaftes oder häufiges Wasserlösen oder auch Schmerzen im Unterleib
- Ungewöhnlicher Ausfluss aus dem Penis oder der Vagina
- Wunden, Rötungen, Bläschen im Mund/Lippen oder Genitalbereich sowie Warzen im Intimbereich
- Manchmal auch Fieber (eher selten)
Wichtig: Eine STI kann auch ohne oder mit nur leichten Symptomen auftreten. Auch wenn Sie sich dessen nicht bewusst sind, können Sie andere anstecken. Deshalb ist es wichtig sich testen zu lassen.
- Beachten Sie die Safer Sex Regeln von Love Live. Dazu gehört auch bei jedem Anal- oder Vaginalverkehr Kondome zu verwenden.
- Denken Sie daran, dass es bei Oralverkehr auch zu Übertragungen von STIs kommen kann.
- Lassen Sie sich impfen! Es gibt Impfstoffe zum Schutz vor HPV, Hepatitis A und Hepatitis B.
- Hatten Sie eine Risikosituation, ist es wichtig mit einer Fachperson so rasch wie möglich Rücksprache zu halten, um zu erörtern, ob eine HIV-Post-Expositions-Prophylaxe (PEP) durchgeführt werden soll, um eine HIV-Infektion zu verhindern. Am wirksamsten ist eine HIV-PEP innerhalb weniger Stunden danach.
- Es gibt auch weitere Präventionsmassnahmen für spezielle Situationen (Präexpositionsprophylaxe HIV-PrEP). Sprechen Sie mit einer damit erfahrenen Fachperson vor Abreise darüber.
- Denken Sie daran, dass Alkohol oder Drogen zu erhöhtem Risikoverhalten führen.
- Denken Sie daran, dass Sie eine weitere Person/bekannter Partner*in bei ungeschütztem Sex anstecken können, sofern bei Ihnen eine unbehandelte STI vorliegt.
- Menschen mit einer neu diagnostizierten STI sind angehalten ihre früheren Sexualpartner*innen zu informieren, damit auch sie behandelt werden können.
Durch Bakterien oder Parasiten hervorgerufen
Alle diese Krankheiten können geheilt werden. Wichtig ist dabei, frühzeitig zu testen und umgehend zu therapieren, um Komplikationen und v.a. weitere Übertragungen zu vermeiden.
- Syphilis
Auch bekannt als Lues. Sie wird durch das Bakterium Treponema pallidum verursacht. Das erste Anzeichen ist eine schmerzlose Wunde an den Genitalien, im Mund, auf der Haut oder im Rektum, die hochgradig ansteckend ist und nach 3 bis 6 Wochen spontan abklingt. Da diese schmerzlos ist, nehmen nicht alle Patienten*innen diese Läsion wahr. Oft heilt diese Infektion jedoch nicht von selbst aus. In der zweiten Phase können Hautausschlag, Halsschmerzen und Muskelschmerzen auftreten. Unbehandelt kann die Krankheit im Verborgenen (latent) bleiben, ohne dass Symptome auftreten. Etwa ein Drittel der Infizierten mit unbehandelter Syphilis entwickelt im Verlauf Komplikationen. Diese Spätform wird als sogenannt tertiäre Syphilis bezeichnet . In diesem Stadium kann die Krankheit alle Organe befallen: am häufigsten das Gehirn, die Nerven und die Augen. Die Infektion kann während der Schwangerschaft auf den Fötus und bei der Geburt auf das Kind übertragen werden. - Chlamydia trachomatis
Chlamydien können ungewöhnlichen Ausfluss aus dem Penis oder der Vagina, Unbehagen beim Wasserlösen und Unterleibsschmerzen verursachen. Oft treten keine Symptome auf. Unbehandelt können sie zu Unfruchtbarkeit führen und die Krankheit kann auf Sexualpartner*innen übertragen werden. Die Bakterien können auch während der Schwangerschaft auf den Fötus, oder während der Geburt auf das Kind übertragen werden und Augeninfektionen oder Lungenentzündungen verursachen. - Gonorrhoe
Auch bekannt als Tripper. Zu den häufigsten Symptomen gehören Ausfluss aus der Vagina oder dem Penis und schmerzhaftes Wasserlassen. Symptome müssen aber nicht immer auftreten. Sowohl bei Männern als auch bei Frauen kann Gonorrhoe auch den Mund, den Rachen, die Augen und den Anus infizieren und sich auf das Blut und die Gelenke ausbreiten, wo sie in eine schwere Krankheit übergehen kann. Bleibt sie unbehandelt, kann sie eine Beckenentzündung verursachen, die zu chronischen Beckenschmerzen und Unfruchtbarkeit führen kann. Die Krankheit kann während der Schwangerschaft auf den Fötus übertragen werden. - Weitere bakterielle STIs: Mykoplasmen und Ureaplasmen. Diese können ebenfalls behandelt werden.
- Trichomoniasis
Sie wird durch einen Parasiten verursacht, der mit einer einzigen Dosis eines Antibiotikums behandelt werden kann. Trichomoniasis kann bei Frauen einen übel riechenden Scheidenausfluss, Juckreiz im Genitalbereich und schmerzhaftes Wasserlassen verursachen. Bei Männern treten in der Regel weniger oder keine Symptome auf. Zu den Komplikationen gehört das Risiko einer vorzeitigen Entbindung bei schwangeren Frauen. Um eine Reinfektion zu verhindern, sollten beide Sexualpartner behandelt werden.
Durch Viren hervorgerufen
- HIV/AIDS - siehe Informationsblatt HIV-AIDS
- Herpes simplex Virus
Im Lippen-Mundbereich, auch bekannt als Fieberbläschen, ist nicht heilbar. Herpes kann aber mit Medikamenten bei akuten Beschwerden kontrolliert werden. Die Symptome sind in der Regel schmerzhafte, wässrige Hautbläschen und finden sich an oder um die Genitalien, den Anus oder den Mund. Nach der Erstinfektion ruht das Virus im Körper und die Symptome können über Jahre hinweg wieder auftreten. Schwangere Frauen können die Infektion an ihre Neugeborenen weitergeben, was zu einer bedrohlichen Infektion führen kann. - Virale Hepatitis (siehe auch Hepatitis Schweiz)
- Hepatitis A (HAV)
Hepatitis A ist eine durch Impfung vermeidbare Leberinfektion, die durch das Hepatitis-A-Virus verursacht wird. Das Hepatitis-A-Virus findet sich im Stuhl und im Blut infizierter Personen. Hepatitis A kann durch verunreinigtes Wasser und Lebensmittel sowie bei anal-oralen sexuellen Aktivitäten übertragen werden. Die Patienten*innen leiden an einer akuten und oft schweren Erkrankung, erholen sich aber allermeist spontan. - Hepatitis B (HBV)
Das Hepatitis-B-Virus wird durch sexuelle Kontakte sowie durch den Kontakt mit anderen Körperflüssigkeiten, wie z.B. Blut, übertragen. Zur Übertragung kann es z.B. auch bei medizinischen Eingriffen oder Brennen eines Tatoos unter nicht optimalen hygienischen Bedingungen kommen. Hepatitis B kann eine schwere Leberinfektion verursachen, die sowohl zu einer sofortigen Erkrankung, als auch zu einer lebenslang andauernden Infektion führen kann mit möglicher Folge einer dauerhaften Lebervernarbung (Zirrhose) und Krebs. Schwangere Frauen mit Hepatitis B können das Virus während der Geburt auf ihr Kind übertragen. Zu Beginn der Infektion haben Sie möglicherweise keine Symptome. Das Virus kann auf Sexualpartner*innen übertragen werden. Hepatitis B kann mit antiviralen Medikamenten behandelt werden, ist aber nur selten heilbar. Eine Impfung kann eine Hepatitis-B-Infektion verhindern. - Hepatitis C (HCV)
In den meisten Fällen wird Hepatitis C durch den Kontakt mit infiziertem Blut übertragen. Seltener kann es durch analen Sexualkontakt oder von der Mutter auf das Kind während der Schwangerschaft und Geburt übertragen werden. Die meisten Infizierten sind sich ihrer Infektion nicht bewusst, weil sie keine Symptome entwickeln, aber diese chronische Infektion kann zu Leberzirrhose und Krebs führen. Hepatitis C kann behandelt werden, eine Impfung gibt es nicht.
- Hepatitis A (HAV)
- Humanes Papillomavirus (HPV)
HPV ist die häufigste Geschlechtskrankheit. Es gibt eine Vielzahl verschiedener HPV-Typen, und einige von ihnen können Genital-, Anal- und Mundwarzen sowie Gebärmutterhals-, Penis- oder Rachenkrebs verursachen. Die Symptome können auch noch Jahre nach dem Sex mit einer infizierten Person auftreten. Zwei verfügbare Impfstoffe schützen gegen die wichtigsten HPV-Typen, die Gebärmutterhals-, Penis- oder Analkrebs verursachen. - Zika - siehe Informationsblatt Zika
In den meisten Fällen wird es vor allem durch Stechmücken übertragen. Es kann aber auch sexuell übertragen werden. Eine Ansteckung mit Zika während der Schwangerschaft kann bei dem sich entwickelnden Fötus Geburtsfehler wie Mikrozephalie (kleiner Kopf mit neurologischen Ausfällen) verursachen. Die einzige Möglichkeit, eine sexuelle Übertragung des Virus während der Schwangerschaft zu verhindern, besteht darin, Vorsichtsmassnahmen (Kondome) zu treffen oder Sex (mindestens 2 Monate nach der Rückkehr) mit jemandem zu vermeiden, der kürzlich in ein Risikogebiet gereist ist, auch wenn der Reisende keine Symptome hat.
- Love Life: www.lovelife.ch
- Sexuelle Gesundheit Schweiz: www.sexuelle-gesundheit.ch
- Hepatitis Schweiz: https://hepatitis-schweiz.ch/formen/was-ist-hepatitis
- World Health Organization (WHO). Factsheets. Sexually transmitted infections (STIs). 14 June 2019: www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
- Centers for Disease Control and Prevention (CDC). Factsheet: Information for Teens and Young Adults: Staying Healthy and Preventing STDs (2017): www.cdc.gov/std/life-stages-populations/stdfact-teens.htm
- Centers for Disease Control and Prevention (CDC). How You Can Prevent Sexually Transmitted Diseases: www.cdc.gov/std/prevention/
- Centers for Disease Control and Prevention (CDC) Sexual Transmission and Prevention. Zika Virus: www.cdc.gov/zika/prevention/protect-yourself-during-sex.html
- Centers for Disease Control and Prevention (CDC) Zika and Pregnancy; Pregnant Women and Zika (March 2021): www.cdc.gov/pregnancy/zika/protect-yourself.html
- Il mal d'altitudine può essere pericoloso fino a essere letale e può manifestarsi in qualsiasi viaggiatore.
- Il pericolo inizia a circa 2500 m e cresce con l'aumentare dell'altitudine.
- Le persone sono diverse per quanto riguarda la loro suscettibilità al mal di montagna, che non è legata alla loro forma fisica.
- Il mal di montagna grave, con accumulo di liquidi nel cervello o nei polmoni, può rapidamente essere letale.
- Se prevedete un soggiorno in altitudine, vi consigliamo fortemente di consultare il vostro medico per ricevere raccomandazioni e istruzioni dettagliate!
- Il mal d'altitudine può essere pericoloso fino a essere letale e può manifestarsi in qualsiasi viaggiatore.
- Il pericolo inizia a circa 2500 m e cresce con l'aumentare dell'altitudine.
- Se si prevede un soggiorno in altitudine, leggere attentamente questo foglietto illustrativo!
- A seconda del tipo di viaggio e/o di malattie pregresse, si consiglia fortemente di rivolgersi a uno specialista.
- Ascensione lenta. Regole di ascensione: al di sopra dei 2500 m la quota dove ci si ferma per dormire non deve essere aumentata di più di 300-500 m al giorno e per ogni 1000 m di aumento si deve prendere un giorno di acclimatazione supplementare.
- Se si manifestano sintomi che indicano un mal di montagna (vedi sopra), l'ascesa deve essere interrotta e può essere ripresa solo quando i sintomi non sono più presenti. Se i sintomi aumentano, scendere o trasportare il paziente a quote inferiori. Se i sintomi vengono ignorati, si possono sviluppare complicazioni potenzialmente letali del mal di montagna, come l'edema cerebrale d'alta quota e/o l'edema polmonare d'alta quota.
- Se non è possibile rispettare le regole di ascesa sopra indicate a causa della situazione o del terreno, l'assunzione di acetazolamide (DIAMOX®) può ridurre il rischio di sviluppare il mal di montagna acuto. La prescrizione del farmaco richiede un'indicazione medica e informazioni sui possibili effetti collaterali!
- Mal di testa: paracetamolo (ad es. PANADOL®, DAFALGAN®). Non usare sonniferi!
- Edema cerebrale d'alta quota: scendere immediatamente. Se disponibile: somministrazione di ossigeno, terapia medica d'emergenza.
- Edema polmonare d'alta quota (respiro affannoso anche a riposo, respiro sibilante, tosse stizzosa): discesa immediata. Se disponibile: somministrazione di ossigeno, terapia medica d'emergenza.
- L'mpox è una malattia virale che in genere provoca eruzione cutanea, ingrossamento dei linfonodi e febbre.
- Una variante emergente si sta diffondendo rapidamente nella R.D. Congo orientale e nei Paesi vicini, tanto da indurre l'OMS a dichiarare un'emergenza sanitaria di portata internazionale (PHEIC) nell'agosto 2024.
- Il contatto fisico stretto (sessuale o non sessuale) è la principale modalità di trasmissione.
- La malattia ha generalmente un decorso lieve. I bambini, le donne in gravidanza e le persone con un sistema immunitario debole sono i soggetti più a rischio di complicazioni.
- Assicuratevi di prendere le precauzioni generali (vedi factsheet) per prevenire la malattia.
- La vaccinazione contro l'mpox è disponibile, ma attualmente è limitata ai gruppi ad alto rischio di esposizione.
- L'Mpox è una malattia virale che in genere provoca eruzione cutanea, ingrossamento dei linfonodi e febbre.
- Una variante emergente si sta diffondendo rapidamente nella D.R. Congo orientale e nei Paesi limitrofi, tanto da indurre l'OMS a dichiarare un'emergenza sanitaria di portata internazionale (PHEIC).
- Il contatto fisico stretto (sessuale o non sessuale) è la principale modalità di trasmissione.
- La malattia di solito si risolve da sola, ma alcune persone possono sviluppare una malattia più grave e talvolta fatale. I bambini, le donne in gravidanza e le persone con un sistema immunitario debole sono i soggetti più a rischio di complicazioni.
- La vaccinazione contro l'mpox è disponibile, ma limitata ai gruppi ad alto rischio di esposizione.
Il vaiolo è stato riscontrato comunemente in Africa occidentale e centrale per molti anni, dove il presunto serbatoio - i piccoli mammiferi - è endemico. Esistono due tipi di virus del vaiolo delle scimmie, chiamati "cladi", che causano la malattia: il clade I in Africa centrale e il clade II in Africa occidentale. Dalla fine delle campagne di vaccinazione contro il vaiolo all'inizio degli anni '80, i casi di vaiolo sono aumentati, all'inizio lentamente e negli ultimi 5-10 anni in modo significativo, soprattutto nella Repubblica Democratica del Congo (RDC).
Nel 2022, una nuova sottoclade emergente del clade II è stata responsabile di un'epidemia globale che si è diffusa principalmente attraverso il contatto sessuale tra uomini che hanno rapporti sessuali con uomini. Ne è scaturita la prima emergenza sanitaria pubblica di interesse internazionale (PHEIC) dichiarata dall'OMS fino al 2023. Sebbene l'epidemia del clade II sia ora sotto controllo, continua a circolare in tutto il mondo.
Nel 2024, la continua diffusione dell'mpox clade I nelle regioni endemiche dell'Africa centrale, in particolare nella RDC, e l'emergere di una nuova sottoclade Ib nell'est della RDC e nei Paesi limitrofi hanno destato preoccupazione a livello globale e hanno spinto l'OMS a dichiarare una PHEIC per la seconda volta in due anni. L'attuale diffusione geografica della variante mpox clade Ib avviene per vie commerciali attraverso il contatto sessuale (ad esempio, le lavoratrici del sesso), seguita dalla trasmissione locale nelle famiglie e in altri ambienti (che sta diventando sempre più importante).
Trasmissione da animale a uomo
L'Mpox può diffondersi dall'animale all'uomo quando questi entra in contatto diretto con un animale infetto (roditori o primati).
Trasmissione da uomo a uomo
Il vaiolo si può diffondere da persona a persona attraverso uno stretto contatto fisico (sessuale e non) con una persona che presenta i sintomi del vaiolo. Le lesioni della pelle e delle mucose, i fluidi corporei e le croste sono particolarmente contagiosi. Una persona può infettarsi anche toccando o maneggiando indumenti, lenzuola, asciugamani o oggetti come utensili/piatti per mangiare che sono stati contaminati dal contatto con una persona con i sintomi. I membri della famiglia, gli assistenti familiari e i partner sessuali di un caso confermato di mpox sono a maggior rischio di infezione, così come gli operatori sanitari che trattano un caso senza un'adeguata protezione personale.
Il periodo di incubazione (tempo che intercorre tra l'infezione e la comparsa dei sintomi) varia da pochi giorni a 3 settimane. La Mpox provoca un'eruzione cutanea che può essere dolorosa, associata a linfonodi ingrossati e febbre. La febbre può iniziare già prima della fase esantematica. Altri sintomi includono dolori muscolari, mal di schiena e affaticamento. L'eruzione cutanea può essere localizzata o generalizzata, con poche o centinaia di lesioni cutanee. Colpisce principalmente il viso, il tronco, i palmi delle mani e le piante dei piedi. Può essere presente anche nelle aree genitali e sulle membrane mucose come la bocca e la gola. I sintomi durano in genere dalle 2 alle 4 settimane e la persona rimane contagiosa fino alla guarigione di tutte le lesioni (una volta cadute le cabine).
Le complicazioni includono infezioni batteriche secondarie, infezioni polmonari e cerebrali e coinvolgimento di altri organi, parto prematuro e altro. I bambini, le donne in gravidanza e le persone con un sistema immunitario debole sono più a rischio di sviluppare una forma grave di mpox.
La maggior parte delle persone affette da mpox guarisce spontaneamente e non necessita di un trattamento antivirale specifico. La gestione dell'assistenza consiste nell'alleviare il dolore e gli altri sintomi e nel prevenire le complicazioni (ad esempio, la superinfezione). Diversi trattamenti antivirali sono studiati in vari Paesi e possono essere utilizzati in studi o in situazioni cliniche secondo le raccomandazioni delle società mediche nazionali.
In caso di sintomi:
- Rivolgersi immediatamente a un medico
- Se vi è stata diagnosticata la sclerosi multipla:
- Rimanete a casa (isolati) finché l'eruzione cutanea non sarà guarita e non si sarà formato un nuovo strato di pelle. Stare lontano da altre persone e non condividere con altri gli oggetti che si sono toccati aiuta a prevenire la diffusione del vaiolo. Le persone affette da vaiolo devono pulire e disinfettare regolarmente gli spazi che utilizzano per limitare la contaminazione domestica.
- ü Lavarsi spesso le mani con acqua e sapone o con un disinfettante per mani a base di alcol contenente almeno il 60% di alcol.
- ü Non si devono avere rapporti sessuali quando si è sintomatici e quando si hanno lesioni o sintomi. Usare il preservativo per 12 settimane dopo l'infezione. Si tratta di una precauzione per ridurre il rischio di diffusione del virus al partner.
- ü Per ulteriori informazioni su cosa fare in caso di malattia, consultare il LINK del CDC.
Precauzioni generali:
- In tutto il mondo:
- evitare il contatto ravvicinato, pelle a pelle, con persone che hanno o potrebbero avere il virus dell'influenza aviaria o con persone che presentano un'eruzione cutanea (ad esempio, brufoli, vesciche, croste).
- Lavarsi spesso le mani con acqua e sapone o con un disinfettante per mani a base di alcol contenente almeno il 60% di alcol.
- Evitare di toccare oggetti personali potenzialmente contaminati come tazze, lenzuola/vestiti, asciugamani o di condividere utensili/tazze, cibo o bevande con una persona che ha o potrebbe avere il virus del vaiolo.
- Evitare i rapporti sessuali con persone malate; usare il preservativo per un massimo di 12 settimane se il partner sessuale ha avuto il virus del vaiolo.
- Seguire i consigli delle autorità locali.
- Quando si viaggia in aree endemiche/epidemiche in Africa, oltre alle precauzioni generali sopra menzionate:
- Evitare il contatto con gli animali nelle aree in cui il vaiolo si manifesta regolarmente.
- Evitare di mangiare o preparare carne di animali selvatici (bushmeat) o di utilizzare prodotti (creme, lozioni, polveri) derivati da animali selvatici.
Vaccinazione:
Esistono diversi vaccini contro il vaiolo (ad esempio Jynneos®, produzione Bavarian Nordic). Il vaccino Bavarian Nordic è stato originariamente sviluppato per combattere il vaiolo, ma offre una protezione incrociata contro il vaiolo. In Svizzera, il vaccino Jynneos® è autorizzato da Swissmedic dal 2024. I gruppi a rischio (ad esempio, gli uomini che hanno rapporti sessuali con altri uomini o le persone transgender con più partner sessuali) possono essere vaccinati dal 2022 e questa raccomandazione rimane invariata (vedi raccomandazioni dell'UFSP). Alla luce della situazione epidemiologica in Africa nel 2024, il Comitato svizzero di esperti in medicina dei viaggi raccomanda la vaccinazione contro l'mpox per i professionisti che sono/saranno in contatto con pazienti sospetti di mpox in regioni endemiche/epidemiche o che lavorano in un laboratorio in cui è presente il virus (per gli aggiornamenti, vedi news).
Il rischio per la popolazione generale e per i viaggiatori (turisti) è considerato estremamente basso se vengono seguite le precauzioni generali di cui sopra e se la vaccinazione non è raccomandata.
- Rivolgersi immediatamente a un medico.
- La varicella non è una malattia a trasmissione sessuale in senso stretto; il contatto fisico con una persona che presenta i sintomi della varicella (eruzione cutanea in qualsiasi stadio) è sufficiente per trasmettere la malattia. I preservativi non proteggono dall'infezione da mpox!
- Ufficio federale della sanità pubblica (UFSP)
- Organizzazione Mondiale della Sanità: FAQ DELL'OMS
- Centro europeo per il controllo e la prevenzione delle malattie (ECDC)
- Centro statunitense per il controllo e la prevenzione delle malattie (CDC)
- 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".