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Health Advice for Travellers
Swiss Expert Committee for Travel Medicine

 

Health Advice for Travellers
Swiss Expert Committee for Travel Medicine

 

Health Advice for Travellers
Swiss Expert Committee for Travel Medicine

Latest news

The Swiss Expert Committee for Travel Medicine (ECTM) - a body of the Swiss Society for Tropical and Travel Medicine (FMH) - has revamped the Safetravel® website and renamed it to HealthyTravel.ch. The website continues to offer basic travel medicine recommendations for laypersons free of charge. Professionals can also subscribe to additional travel medicine information and recommendations such as in-depth country-specific information, vaccination recommendations with expert opinions, detailed maps (including malaria recommendations), fact sheets (including e.g. dosage information for malaria prophylaxis) and other important travel medicine content. These can be used during travel medicine consultation of patients and clients and can be individually compiled for the traveller, printed out or sent electronically.

 

The recommendations and content on HealthyTravel.ch reflect the recommendations of the Swiss Expert Committee for Travel Medicine. They are developed in cooperation with the Federal Office of Public Health (FOPH). The website is under construction and will be continuously expanded with additional content and updates. Please note that all content available on the website HealthyTravel.ch is protected by copyright and may not be passed on to third parties.

 

Further information can be found in the flyer (LINK). The Swiss Expert Committee for Travel Medicine will be happy to answer any questions at info@healthytravel.ch !

ECTM_Flyer_HealthyTravel_PRO_EN_October_2022.pdf

The Philippine Department of Health reports the death of 55 persons from rabies by 25 February 2023.
Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case consult a high-quality medical facility (post-exposure vaccination), see also factsheet rabies. For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, long-term stays, 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.
Outbreak News Today, 12.3.2023
Between the end of November 2022 and mid-March 2023, a total of 690 measles cases, including one death, were reported from seven districts in western Nepal. Almost half of the cases were from Banke district in Lumbini province, which borders India. The majority of cases involved children under the age of 15.
Measles is very contagious! A trip offers an ideal opportunity to check the protection against measles (2x vaccinated or passed measles disease) and if necessary to update the vaccination protection. This is especially important during humanitarian missions.
Outbreak News Today, 15.3.2023
As of February 2023, over 4.8 million new cases and over 39'000 deaths have been reported worldwide. Since the beginning of the pandemic, over 758 million confirmed cases and over 6.8 million deaths have been reported.
According to the latest update from the Chinese CDC, the COVID-19 situation in mainland China has stabilized between 10'000 and 15'000 cases per day, with fluctuations within this range. The downward trend in hospitalizations and deaths continues.
Country-specific COVID-19 entry requirements and travel restrictions, see:
- IATA (with interactive map). The websites are constantly updated.
- HUG (practical and user-friendly summary of entry requirements by country, in French, updated weekly based on IATA and WFP).
WHO, 1.3.2023
Health authorities in the city of Pergamino, in the Argentine province of Buenos Aires, report 19 cases of chikungunya. These are the first locally acquired cases ever reported in this city.
Optimal mosquito protection, especially during the day against chikungunya, dengue, Zika, etc. In case of fever, paracetamol preparations and hydration. Do not take acetylsalicylic acid-containing medications (e.g. Aspirin®), as these increase the risk of bleeding in the event of a dengue infection.
Outbreak News Today, 6.3.2023
The Municipal Health Secretariat of Caxias do Sul reports a yellow fever case in a howler monkey. This is the first suspected and then confirmed yellow fever case in 2023. The animal was found dead in Parada Cristal, a peri-urban area (transition between rural and urban areas), about 140 km north of Porto Alegre.
In South America, deaths in monkeys often precede cases of yellow fever in humans and thus are an indicator of the spread of the virus. In Brazil, the peak season for yellow fever infections is between December and May.
Yellow fever vaccination is recommended by the WHO for most regions of Brazil. Due to the increasing prevalence even in areas previously declared free of yellow fever, the Swiss Expert Committee for Travel Medicine (ECTM) recommends yellow fever vaccination for all regions in Brazil. For immunocompetent persons, a yellow fever vaccination with a one-time second vaccination after 10 years (i.e. a maximum of 2 vaccinations in a lifetime) is recommended.
An outbreak of leptospirosis has been reported in East Java: 249 cases have been registered since the beginning of the year, including 9 deaths. The majority of cases occurred in Pacitan. During all of last year (2022), there were 606 cases of leptospirosis in East Java province. Leptospirosis cases have also been recently reported in Central Java, Yogyakarta, and West Java.
Leptospirosis spreads more easily during the rainy season. It is transmitted through the urine of rodents (especially rats), e.g., in water residues (rivulets, puddles, etc.) or mud. Transmission to humans occurs via small skin lesions or mucosal contacts through direct or indirect contact with infected rodent urine. The clinical picture ranges from flu-like general symptoms to encephalitis or blood poisoning.
Wear protective clothing/boots when wading in water! Cut or scratch wounds should be covered with waterproof bandages. Vaccination is usually not available for travelers.
Via ProMED, 7.3.2023
Following the massive earthquakes of 6 February 2023 and numerous severe aftershocks, 44'218 deaths and 108'068 injuries were reported in Turkey and over 5'914 deaths and 10'857 injuries in northwestern Syria.
In northwestern Syria, there have been 506 cholera cases and 21 related deaths as of 27 February 2023, according to a report published by the United Nations (UN) Office for the Coordination of Humanitarian Affairs (OCHA). In addition, the number of suspected cholera cases in the region is estimated at 50'000.
Travelers should avoid nonessential travel to southeastern Turkey and northwestern Syria. Foodborne and waterborne illnesses, respiratory infections, and vaccine-preventable infections, as well as other health threats, are expected to be of concern in the coming weeks. Humanitarian workers should have their routine vaccinations (diphtheria-tetanus-polio, measles-mumps-rubella, chickenpox) up to date or, if necessary, refreshed, and be vaccinated against hepatitis A and B, covid-19, influenza, rabies, typhoid, and cholera (for assignments in Syria).
ECDC CDTR, 3.3.2023 | Reliefweb - OCHA, 28.2.2023
From early October 2022 to the end of January 2023, 18 states reported 315 suspected meningitis cases, including 54 confirmed and 50 deaths. Most cases originated in northern Jigawa State.
For a stay in Nigeria, vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended.
WHO AFRO, 5.2.2023
The diphtheria outbreak in Nigeria continues, with 523 suspected cases reported in the 5 states of Kano, Yobe, Katsina, Lagos, and Osun by early February.
In addition to the basic diphtheria immunization, persons traveling to or working in a country with diphtheria outbreaks should receive a booster 10 years after their last diphtheria vaccination.
Via ProMED, 14.2.2023 | NCDC EW 5/2023
A 7.8-magnitude earthquake struck southeastern Turkey and northwestern Syria on 6 February 2022, bringing the number of people killed by the earthquake in Turkey and Syria to more than 50'000. Turkey alone recorded 44'218 dead, the Turkish Disaster Agency said. The latest death toll from Syria was 5'900. Aftershocks are still shaking the region. According to the Turkish government, 20 million people in the country have been affected by the earthquake. For Syria, the United Nations estimates that 8.8 million people have been affected.
Travelers should avoid nonessential travel to southeastern Turkey and northwestern Syria.
Divers
The authorities in Equatorial Guinea on Monday declared the first outbreak of Marburg virus, a highly infectious disease from the same family of viruses that causes Ebola. Nine people are believed to have died from this viral hemorrhagic fever in the western province of Kie Ntem. The World Health Organization says 16 people have now been quarantined as suspected contact cases. The country's health minister said preliminary investigations linked the deaths to people who had attended a funeral ceremony. Movement was restricted around two villages where most of the cases were reported. This was the first recorded outbreak in the country and the third in sub-Saharan Africa. Ghana had confirmed a case last year and Guinea the year before as well.

Marburg virus disease is a hemorrhagic fever with a mortality rate of up to 88%. The disease begins abruptly with high fever, severe headache, and severe malaise. Many patients develop severe hemorrhagic symptoms within seven days. The virus is transmitted to humans by fruit-eating bats and spreads among people through direct contact with the body fluids of infected persons, surfaces, and materials. There are no approved vaccines or antiviral therapies to treat the virus. However, supportive care - oral or intravenous rehydration - and treatment of specific symptoms improve survival.
The risk for the traveler is low. Every traveler in West Africa should consult a doctor in case of fever in order to clarify the cause and especially to exclude malaria.
WHO, 13.2.2023
During week 05 (01/28/2023 - 02/03/2023), physicians in the Sentinella reporting system recorded 14 consultations for influenza-like illness per 1000 physician consultations, an increase from the previous two weeks. Predominantly circulating virus A(H3N2).
All travelers should be vaccinated against influenza, especially persons at risk.
BAG, 8.2.2023
The World Health Organization (WHO) has reported meningococcal meningitis outbreaks in "meningitis belt" countries. Since December 2022 and through mid-February, the epidemic threshold has been exceeded in Niger in the Zinder region and in Nigeria in Jigawa state. Other countries issue an alert (increase in cases without reaching the epidemic threshold): Benin: Borgou Region (Bembereke District and Sinende District), Aliboro Region (Gogounou District), Burkina Faso: Southwest Region (Batié District), Chad: Ennedi Province, (Amdjarasse District), DR Congo: Maindombe Province, Kiri Health Zone, and South Ubangi Zone, Zongo Health Zone, Nigeria: Akwa Ibom State, Senegal: Dakar Region (Dakar Centre District), South Sudan: Unity State (in the north of the country), Togo: Savannas Region (Oti South District), Ghana: Upper West Region (Nandom District), Côte d'Ivoire: Goutougo Region (Tanga District).

Seasonal meningitis epidemics occur in sub-Saharan Africa primarily during the dry season, usually from December to June. They decline rapidly with the onset of rains. Generally, meningococcal serogroups A, C, W, and X are responsible for these outbreaks. The disease spreads by droplets from person to person. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. As prophylaxis, vaccination against the main meningitis strains is available for adults and children over 1 year of age.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended for stays >30 days or even for shorter stays, depending on the individual risk (e.g., close contact with people, work in health care facilities, heavily occupied accommodation, risk of epidemics). In the case of alerts and epidemics, vaccination is recommended for stays >7 days or close contact with the population.
WHO Meningitis Bulletin, EW 2/2023 | Meningitis Dashboard | This day Live, 24.1.2023
After reassessment by a committee, the WHO advised that the COVID-19 pandemic remains a Public Health Emergency of International Concern (PHEIC).
Country-specific COVID-19 entry requirements and travel restrictions, see:
- IATA (with interactive map). The websites are constantly updated.
- HUG (practical and user-friendly summary of entry requirements by country, updated weekly based on IATA and WFP).
WHO, 30.1.2023
During 2022, several countries in South America recorded an increase in the number of dengue, Zika, and chikungunya cases. A total of 3'110'442 cases of arboviral diseases were reported. Of the total cases, 90.1% were dengue cases, 8.7% were chikungunya cases, and 1.2% were Zika cases.
Optimal mosquito bite protection around the clock (during the day against dengue, Zika, Chikungunya, etc., at dusk and at night against malaria). In case of fever, paracetamol products and hydration. Do not take medications containing acetylsalicylic acid (e.g., Aspirin®), as this increases the risk of bleeding from dengue infection. When staying in malaria areas, always rule out malaria if you have a fever.
PAHO, 25.1.2023
According to media reports, the Santa Fe Provincial Department of Health has issued a warning about a recent trichinellosis outbreak in several locations in the territory. To date, 26 suspected cases and 8 confirmed cases of this parasitic disease have been registered. The source is unknown; generally homemade sausages are responsible. Trichinella infections are frequently reported in Argentina.
Trichinellosis is caused by the larvae of an intestinal worm when eating inadequately cooked meat (mainly pork, but also game and other animals such as bear). Symptoms vary widely: muscle pain, inflammation of the eyelids and eye pain, diarrhea, and fever. Cardiac and neurological complications are possible and the disease is sometimes fatal.
Refrain from eating artisanal, non-certified or street-sold sausages. Cook pork and game thoroughly before eating. Trichinae are killed by heating above 70°C for more than 1 minute. Smoking, curing and drying are not safe measures to kill larvae.
MinutAR, 24.1.2023
In the last 2 weeks, 10 confirmed and 2 suspected cases of scrub typhus have been reported from the Los Lagos region in southern Chile. This represents a significant increase from previous years (with 1-2 cases in January). 
In South America, scrub typhus, a rickettsial disease, has only recently been detected. It is now endemic in a wide geographic area in southern Chile (from the Biobío region in the north to Tierra del Fuego in the south). The infection is caused by a bacterium of a novel Orientia species and is transmitted by mites. The disease exhibits marked seasonality, with cases occurring during the Australian summer months (December to March). After an incubation period of 6-21 days, a typical blackish skin lesion (scab) may appear, as well as fever, headache, muscle pain, swollen lymph nodes, and sometimes exanthema. If scrub spotted fever is suspected, antibiotic treatment (doxycycline) should be started as soon as possible to avoid possible neurologic (encephalitis) and cardiac complications, which can be fatal.
There is an increased risk during outdoor activities (e.g. camping, trekking). Prevention: Apply mosquito repellent to skin, wear insecticide-impregnated clothing during outdoor activities. Consult a physician if symptoms occur to quickly initiate antibiotic therapy (doxycycline).
Via ProMED, 31.1.2023
In the last three weeks of January 2023, more than 8'440 chikungunya cases were reported in Paraguay, compared with 2'443 cases in all of 2022.
In early February 2023, a chikungunya infection was also diagnosed in a returning traveler to Switzerland.
Optimal mosquito bite protection, especially during the day against dengue, Zika, Chikungunya, etc.. In case of fever, paracetamol preparations and hydration. Do not take medications containing acetylsalicylic acid (e.g. Aspirin®), as these increase the risk of bleeding during a dengue infection.
MoH, 3.2.2023 | personal communication Gilles Eperon, HUG, Geneve, Switzerland
The Victorian Health Authority in Australia is warning people in northern Victoria to take extra measures to avoid mosquito bites after a person contracted mosquito-borne Japanese encephalitis virus (JEV) while in the Buloke Shire and Swan Hill area. This is the second locally acquired JEV case this mosquito season.
In 2022, more than 40 human JEV cases were reported in the states of News South Wales, Queensland, South Australia and Victoria.
Optimal protection against mosquito bites, especially at dusk and at night. Vaccination is recommended especially for:
- Persons who work with pigs or live near or visit pig farms.
- People who work with mosquitoes or the virus itself (laboratory).
The Australian Department of Health recommends vaccination for stays in the Torres Strait region of Australia for:
- Travelers to rural areas.
- Stays in the region of one month or longer.
Australian Govt. Dept. of Health, 7.6.2022
Malawi is currently experiencing the worst cholera epidemic in 20 years. As of 22 January 2023, more than 29'000 cholera cases and more than 900 deaths have been reported. According to the Swiss Red Cross, the epidemic began in March 2022 but recently escalated. The country is now entering the rainy season, which typically results in higher cholera transmission. The outbreak has occurred in three waves so far, first in the south (March-June), then in an atypical dry season wave in the north (August-September), and now throughout the country. Cholera now puts more than 10 million people at risk, including more than five million children.
Despite these numbers of cases, imports from travelers are very rare. Maintain careful personal hygiene and consume only food and beverages from safe sources. Cholera vaccination is recommended only for humanitarian missions.
IFRC, 25.1.2023 | Swiss Red Cross | pers. Communication
According to a recent article published by Emerging Microbes & Infections, 16% of fever cases in some Colombian cities are due to the Oropouche virus (OROV).
Oropouche fever is caused by the Oropouche virus (OROV) and is transmitted to humans through mosquito bites. To date, there is no evidence of direct human-to-human transmission. It is endemic in several regions of the Americas. Human cases have been documented in rural and urban communities in Brazil, Peru, Ecuador, French Guiana, Panama, and Trinidad and Tobago. The symptoms are dengue-like with sudden onset of high fever, headache, muscle pain, rash, joint pain, and vomiting. The illness usually lasts 3-6 days. A brief return of symptoms may occur in up to 60% of cases. A rare complication is aseptic meningitis.
Optimal mosquito protection around the clock (also against other mosquito-borne diseases such as dengue, Zika, chikungunya and malaria).
In case of symptoms after a stay in an endemic area, think of Oropouche fever.
Emerging Microbes and Infections, 8.12.2022 | WHO
The World Health Organization (WHO) has reported meningococcal meningitis outbreaks in countries within the "meningitis belt." Since December 2022 through mid-January, the epidemic threshold has been exceeded in Niger, Zinder Region and Nigeria, Jigawa State. Other countries provide an alert (increase in cases without reaching the epidemic threshold): Benin: Borgou region (Bembereke district and Sinende district), Aliboro region (Gogounou district), Burkina Faso: Sud-Ouest region (Batié district), Chad: Ennedi province, (Amdjarasse district), DR Congo: Maindombe province, Kiri health zone, and Sud-Ubangi zone, Zongo health zone, Nigeria: Akwa Ibom state, Senegal: Dakar region (Dakar Centre district), South Sudan: Unity State (in the north of the country), Togo: Savane region (district of Oti Sud). 

Seasonal meningitis epidemics occur in sub-Saharan Africa primarily during the dry season, usually from December to June. They decline rapidly with the onset of rains. Generally, meningococcal serogroups A, C, W, and X are responsible for these outbreaks. The disease spreads through droplets from person to person. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. As prophylaxis, vaccination against the main meningitis strains is available for adults and children over 1 year of age.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended for stays >30 days or even for shorter stays, depending on the individual risk (e.g., close contact with people, work in health care facilities, heavily occupied accommodation, risk of epidemics). In case of alerts and epidemics, vaccination is recommended for stays >7 days or close contact with the population.
WHO Meningits Bulletin
On 20 November 2022, a suspected yellow fever case was reported from Dabola Health District, Faranah Health Region, in Guinea. The case is a 9-year-old child who died and whose yellow fever vaccination status is unknown. Two tests confirmed the yellow fever infection.
Vaccination against yellow fever is highly recommended for stays in Guinea.
WHO AFRO, 15.1.2023
The Kano State government in northern Nigeria has confirmed an outbreak of diphtheria in 13 local government areas of the state, with more than 100 suspected cases and at least three deaths. There have also been reports from Lagos, Osun and Yobe states.

Diphtheria is a bacterial, highly contagious infection that usually manifests with sore throat and can be fatal without immediate administration of diphtheria antitoxin and antibiotics. Vaccination is extremely effective in preventing this disease. The disease is more common in developing countries where the population is insufficiently vaccinated.
In addition to the basic immunization against diphtheria, persons traveling to or working in a country with diphtheria outbreaks should receive a booster 10 years after the last dose of diphtheria vaccine.
Outbreak News Today, 22.1.2023
The Thailand Bureau of Epidemiology reported a 61% increase in melioidosis cases last year compared to 2021 reports. According to disease surveillance data, 3'559 melioidosis patients were reported from 70 of Thailand's 77 provinces.
 
Melioidosis is a disease caused by the bacterium B. pseudomallei. It lives in soil and surface water, especially in Southeast Asia and northern Australia. You can become infected when the bacterium enters through a break in your skin or when you inhale or swallow it. Melioidosis is a life-threatening disease that requires immediate medical attention.
Avoid contact with soil/surface water, especially on minor wounds. Skin injuries should be disinfected. Wear protective clothing when wading through water.
Outbreak News Today, 23.1.2023
During the week of the 2 to 8 January 2023, nearly 2.9 million new cases and more than 11'000 deaths were reported worldwide. This represents a 9% and 12% decrease in weekly cases and deaths, respectively. However, these trends must be considered taking into account the decline in testing and reporting delays in many countries during the year-end vacation season. Since the beginning of the pandemic, more than 659 million confirmed cases and more than 6.6 million deaths have been reported worldwide.
For travelers returning from China, please note that there are entry restrictions for many countries. For travelers with Chinese passports, it is advised to check the restrictions in the destination country. Most European countries require a PCR test for travelers from China.
WHO, Weekly epidemiological update on COVID-19 - 11 January 2023
A sharp increase in reports was observed last year in La Réunion, with 165 cases of leptospirosis. A total of 3 people have died from the disease. Usually, an accumulation of cases is observed from November to April. 
Leptospires are transmitted through the urine of rodents (mainly rats), for example, in water residues (rivulets, puddles, etc.) or mud. Transmission to humans occurs via small skin lesions or mucosal contacts through direct or indirect contact with rodent urine. The clinical picture ranges from flu-like general symptoms to aseptic meningitis and sepsis.
Wear waterproof protective clothing/boots when wading through water! Cuts or scratches should be covered with waterproof bandages. Vaccination for travelers is not available.
Clicanoo, 6.1.2023
Uganda's Ministry of Health has declared the recent Ebola outbreak caused by the Sudan virus (SVD) to be over. This declaration follows a period of 42 days (twice the maximum incubation period for Sudan virus infections) since the last patient tested negative for the second time and no new cases have been reported. Since the outbreak declaration on 20 September 2022, a total of 164 cases with 77 deaths have been reported from nine districts.
Although the outbreak was successfully contained despite the lack of specific therapeutics and vaccines, surveillance and detection capabilities need to be strengthened.
WHO AFRO, 8.1.2023
There is currently a very high rate of COVID-19 transmission in China. The actual number of COVID-19 cases and deaths in China is unclear to date, and underreporting is assumed.
Reconsider traveling to China, Hong Kong, and Macao due to the rapid increase in COVID-19 cases and limited healthcare resources. If you do travel, follow the COVID-19 prevention measures (link FOPH) to protect yourself and others from COVID-19 infection.
WHO, 14.1.2023
Chinese New Year officially starts on 22 January 2023, with celebrations culminating with the Lantern Festival on 5 February 2023. The festival is likely to attract big crowds and international visitors, with movement of people within China expected to increase. Large crowds in small areas increase risk of accidents and spread of infectious diseases such as COVID-19 and flu (influenza).
China is currently experiencing a large COVID-19 outbreak. The World Health Organization (WHO) is monitoring this evolving situation very closely and there are increasing reports of severe disease in the country.

If considering a visit despite COVID-19 pandemic, the following precautions are recommended: 

General: 

  • COVID-19: Observe current situation, entry and return travel regulations, and precautions regarding COVID-19 in the country! Follow strict personal hygiene.
  • Mass events may favor gastrointestinal and respiratory infections, therefore: follow good personal and food hygiene. 
  • The risk of accidents may also be increased (CAVE alcohol!). 
  • To avoid sexually transmitted diseases (HIV, syphilis, gonorrhea, chlamydia, etc.): follow safer sex practices (condoms). 
  • Avian influenza is particularly prevalent in China. Contact with poultry and their droppings should be avoided. Do not visit bird and poultry markets/farms, do not import poultry meat from China. Travelers should also wash their hands frequently with soap and water. 

Recommended vaccinations and other health risks: see country page China

NaThNAC
No WHO region achieved and/or maintained the 95% elimination target. During the COVID-19 pandemic, measles-containing vaccine coverage decreased significantly. The U.S. CDC has identified the 10 countries with the most measles outbreaks last year. It is led by India, with 9'489 reports, followed by Yemen, Somalia, Zimbabwe, Pakistan, Ethiopia, Liberia, Indonesia and Nigeria.
A trip is an ideal opportunity to check the protection against measles (vaccinated twice or had measles) and if necessary to update the vaccination protection.
CDC Global Measles Outbreaks | WHO, 23.11.2022
A suspected case of yellow fever in an unvaccinated 67-year-old farmer from Kono District, Eastern Province in Sierra Leone tested positive for yellow fever at the Institut Pasteur in Dakar, Senegal. No other cases have been found in the region.
Protect yourself 24/7 against mosquitoes. Vaccination against yellow fever is strongly recommended. Proof of vaccination is mandatory for all travelers entering Sierra Leone, except for airport transit passengers.
WHO AFRO Bulletin, 18.12.2022
According to media reports, health authorities have released an epidemiological alert due to an outbreak of malaria in the state of Oaxaca in southern Mexico. So far, a total of 20 confirmed malaria cases have been identified. Of these, 16 cases are indigenous and 4 are imported. Prior to the onset of this outbreak, the state of Oaxaca was considered malaria-free.
Optimal mosquito bite protection 24/7 (at dusk and at night against malaria, during the day against dengue, chikungunya and other arboviruses). In case of fever >37.5° C, malaria should always be considered and ruled out through a blood test (see also factsheet Malaria).
ECDC/CDTR, EW 49
The HealthyTravel team wishes you a Merry Christmas and a happy 2023 with travel in good health.
The World Health Organization (WHO) has reported outbreaks of meningococcal meningitis in "meningitis belt" countries. Since late October and through the end of November, the epidemic threshold has been exceeded in the Nandom District, Upper West Region, in Ghana. Other countries provide an alert (increase in cases without reaching the epidemic threshold): Benin: Borgou Region (Bembereke District, Sinende), Alibori (Gogounou District), Ghana: Upper West Region (Lawra District), Mali: Koulikoro Region (Kati District), Niger: Zinder Region (Dungass District), Senegal: Dakar Region (Diamniadio District), South Sudan: Northern Bahr El Ghazal State (Awiel Centre County), Eastern Equatoria State (Ikotos County).
 
Seasonal meningitis epidemics occur in sub-Saharan Africa primarily during the dry season, usually from December to June. They decline rapidly with the beginning of rains. Generally, meningococcal serogroups A, C, W, and X are responsible for these outbreaks. The disease spreads by droplets from person to person. If symptoms (high fever, severe headache and vomiting) occur, a doctor should be consulted immediately and antibiotic therapy started, as the disease can lead to life-threatening conditions within hours. As prophylaxis, vaccination against the main meningitis strains is available for adults and children over 1 year of age.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended for stays >30 days or even for shorter stays, depending on the individual risk (e.g., close contact with people, work in health care facilities, heavily occupied accommodation, risk of epidemics). In case of alerts and epidemics, vaccination is recommended for stays >7 days or close contact with the population.
WHO Meningitis Weekly bulletin 31.10. - 27.11.2022 EW 44-47 | WHO Meningitis EW 47
According to the Indian Ministry of Health, nearly 250 rabies deaths have been reported from 18 states since the beginning of the year, with Karnataka having the highest number with 32 deaths, followed by Maharashtra and West Bengal with 24 deaths each. In fact, the number is estimated to be much higher (WHO estimate: 18'000-20'000). In the first 7 months of the year, about 1.45 million people were bitten by animals in India (97% by dogs, 2% by cats). Jackals, wolves, mongooses, and monkeys are other vectors. Rabies is present throughout the country.
Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high quality medical center (post-exposure vaccination), see also factsheet rabies. For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, long-term stays, small children, work with animals, cave explorers, etc.) a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is highly recommended.
The New Indian Express, 9.12.22
Hepatitis E cases continue to be reported in Bentiu refugee camp in South Sudan. Since the beginning of 2019, 3'592 cases and 26 deaths have been recorded.
Hepatitis E is a viral disease and is transmitted directly from one person to another through contaminated water/food or by feco-oral route. Symptoms include abdominal pain, yellowing of the skin (jaundice) and are flu-like (fever, muscle and joint pain). Pregnant women are particularly at risk, with a significantly increased mortality rate (10-30%).
Optimal food and drinking water hygiene: Avoid drinking unboiled water and consuming raw or insufficiently heated food. A vaccine against hepatitis E is licensed in China but not available in Switzerland.
WHO Africa Epidemiological Bulletin Week 44
According to health authorities, 9.4 million malaria cases were diagnosed in Mozambique in the first nine months of this year, 20% more than in the same period last year. Malaria is endemic in Mozambique, and the entire population is at risk of infection. In most parts of the country, malaria is transmitted throughout the year, with a seasonal peak during the rainy season, which is usually from December to April.
Optimal protection against mosquito bites 24/7 (at dusk and at night against malaria, during the day against dengue and other arboviruses) and taking a chemoprophylaxis against malaria are strongly recommended. Detailed information can be found on the Mozambique country page at www.healthytravel.ch. In case of fever, malaria should always be ruled out by a blood test, even if a chemoprophylaxis has been taken.
AllAfrica, 29.11.2022
Yellow fever: Between July 2021 and June 2022, 485 suspected yellow fever cases were recorded in primates in Paranà, Brazil. During the same period, 123 suspected cases were reported in humans. The peak season for yellow fever transmission in Brazil is from December to the end of May. 
Dengue fever: 1'390'673 probable dengue cases occurred in Brazil by the end of November. Compared to 2021, there was a 175.1% increase in cases this week.
Chikungunya: 170'199 probable chickungunya cases were reported by the end of November, an increase of 80.4%. 
Zika: By mid-November, there were 9'256 probable cases (47.1% increase).
  • Protect yourself optimally 24/7 against mosquitoes (see factsheet mosquito protection): during the day against yellow fever, dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria.
  • Vaccination protection against yellow fever is recommended for all regions in Brazil. Consult a specialist in tropical and travel medicine to obtain this!
  • For information on Zika, see the Zika factsheet at www.healthytravel.ch. 
  • If you should have a fever: take medication containing the active ingredient paracetamol and make sure you drink enough fluids. Do not use any medication containing the active ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). When staying in malaria regions, malaria should always be ruled out by means of a local blood test in the event of a fever >37.5 °C. Visit a medical facility for this purpose (see also factsheet malaria).
Gov.Br, Boletim Epidemiológico Vol.53 Nº44
9 suspected Chagas cases (caused by Trypanosoma cruzi) were reported from the Pratinha neighborhood in Belem, Brazil. All patients reported eating acai fruit before the onset of symptoms. Across the city of Belém, 11 cases of the disease have been reported, according to city officials.
Since the beginning of the year, 164 Chagas cases and two deaths have been registered in the state of Pará, according to authorities (2021: 285 cases, 2 fatal; 2020: 230 cases, 2 fatal). The city of Belém (capital of Pará) is considered the Brazilian municipality with the most acute Chagas cases in Brazil.
Chagas is very rare in travelers. The disease can be transmitted by predatory bugs and through food. Other transmissions include through blood/blood products, during pregnancy from mother to child (congenital), through organ transplantation, and laboratory accidents.
Avoid eating pressed acai berries, which are a known source of infection for Chagas (pressed predatory bugs in fruit juice).
Globo Noticias, 12.11.2022 | SESPA, 17.11.2022
Since the beginning of the year, a total of 6'788 suspected measles cases with 6'320 confirmed cases and 57 deaths have been reported in Ethiopia. There are currently confirmed measles outbreaks in 16 districts (woredas): Hadelela, Mecha North, Sekela, Dehana, Fedis, Ginir, Doba, Tulo, Basketo, Doyogena, Fik, Jigjiga City, Jigjiga Zuria, Dagah Bur, Gashamo, Sagag.
Review of measles protection should always be part of a travel medicine consultation. All persons born after 1963 who do not have documented protection against infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. In case of an epidemic in the area or contact with a measles case, vaccination is recommended from 6 months of age.
WHO EW 45
The National Department of Health has recorded a total of 4'109 malaria cases and 34 deaths across South Africa for the period from January to October 2022. These numbers are slightly lower than for the same period last year in 2021, but are expected to increase due to delays in data collection in the Malaria Information System.
 
Malaria transmission in South Africa is seasonal, with the number of cases increasing in October, peaking in January and February, and decreasing again towards May. Therefore, with the onset of summer in the southern hemisphere, malaria cases in South Africa are expected to increase (higher temperatures and heavier rainfall in endemic areas).
Optimal mosquito bite protection 24/7 (at dusk and at night against malaria, during the day against arboviruses). From September to May: It is recommended to take medication against malaria for stays in the northeast and east of Mpumalanga province (including Kruger and neighboring national parks) and in the north and northeast of Limpopo province, see also country page South Africa.
IOL News, 7.11.2022 | NICD, Malaria Oct 2022
Circulating type 2 vaccine poliovirus was reported from Zambia in mid-November 2022 from an environmental sample collected in Copperbelt on 4 October. Botswana also reported circulating type 2 vaccine poliovirus in early November.

While the official WHO IHR statement is still pending, Botswana and Zambia formally fall under category 2 of the WHO temporary poliomyelitis vaccination recommendations:

  • On departure from Botswana or Zambia, persons with residence or staying in the country for >4 weeks are strongly recommended to have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their 'International Certificate for Vaccination'.
  • For Stays <4 weeks: Basic immunisation and booster vaccination every 10 years (recommendation of the Swiss expert Committee for Travel Medicine).
GPEI, as of 9.11.2022
In 2022, 14 measles infections were imported in Minnesota by unvaccinated children/teens. Of them, 7 cases had to be hospitalized. Nationwide, 33 measles infections have been reported since the beginning of the year. From 2001 to 2016, 553 imported measles infections were recorded in the United States.
Review of measles protection should always be part of a travel medicine consultation. All persons born after 1963 who do not have documented protection against infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. In case of an epidemic in the area or contact with a measles case, vaccination is recommended from 6 months of age.
Minnesota Department of Health | CDC, Measles Cases and Outbreaks
Since November 2021, a multi-country Shigella outbreak in Europe has been associated with stays in some hotels in Cape Verde. So far, confirmed cases of Shigella sonnei have been reported in the Netherlands, Denmark, France, Germany, Portugal, and the United Kingdom.
Optimal food and drinking water hygiene (see factsheet diarrhea) and personal hygiene (regular hand washing and disinfection).
ECDC/CDTR EW 45, 6-12 November 2022
Since the beginning of 2022, almost 100 dengue cases have been registered in Senegal; 52 cases in the Matam region and 13 in the Kaffrine district. Only the regions of Saint-Louis, Ziguinchor, Kedougou, Sédhiou and Kolda have not reported any cases.
Optimal mosquito bite protection 24/7 (during the day against dengue, Zika, Chikungunya and other arboviruses). If you have a fever, take paracetamol products and drink plenty of fluids. Do not take any medicines containing acetylsalicylic acid (e.g. Aspirin®), as these can increase the risk of bleeding. After a stay in a malaria endemic area, malaria should also be considered if you have a fever and should always be ruled out by a blood test.
SENE News, 18.11.2022
As of 17.11.2022, a total of 141 confirmed Ebola cases and 55 confirmed deaths have been reported. At least 19 health workers have been infected and 7 of them have died. Currently 9 Ugandan districts are affected by this outbreak: Bunyangabu, Jinja, Kagadi, Kampala, Kassanda, Kyegegwa, Masaka, Mubende and Wakiso.
 
WHO estimates the public health risk to be low at the global level, high at the regional level and very high at the national level.

Travelers are usually at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with infected/deceased persons or their body fluids, and all wild animals, alive and dead.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruit and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safe sex, see LINK.

Vaccination against Ebola is not available to travellers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.

If you have symptoms of illness (fever >38 °C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area:
Isolate yourself and immediately contact the hotline in the country by phone or contact a tropical institute or a university hospital infectious disease unit. Always state that you may have had an exposure to Ebola.

ECDC, 18.11.2022 | WHO Afro, SitRep 49, 13.11.2022 | Ministry of Health Uganda, 12.11.2022 | WHO, 10.11.2022
According to media reports, there has been a significant increase in dengue cases in the eastern part of the Yucatan. In the Merida region, in the south of the state, and to a lesser extent in western and central Mexico, there has also been an increase in dengue cases. By the beginning of November 2022, 10'411 cases had been confirmed nationwide. This represents an increase of over 108% compared to the same period last year.
Optimal mosquito bite protection 24/7 (during the day against dengue, Zika, Chikungunya and other arboviruses). If you have a fever, take paracetamol products and drink plenty of fluids. Do not take any medicines containing acetylsalicylic acid (e.g. Aspirin®), as these can increase the risk of bleeding. After a stay in a malaria endemic area, malaria should also be considered if you have a fever and should always be ruled out by a blood test.
The Yucatan Times, 21.11.2022
In November 2022, a case of acute flaccid paralysis caused by a vaccine-derived polio virus was reported from Indonesia. The case is a 7-year-old unvaccinated child in Aceh (Pidie district) in Sumatra. The child had symptoms of paralysis of the left leg and was hospitalised on 18 October. Polio vaccination coverage in Indonesia has been insufficient for decades.

While the official WHO declaration is still pending, Indonesia formally falls under category 2 of the temporary WHO poliomyelitis vaccination recommendations:

  • On departure from Indonesia, persons staying in the country for >4 weeks are strongly recommended to have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their 'International Certificate for Vaccination'.
  • For stays <4 weeks: In addition to the basic immunisation against polio, a booster vaccination is recommended every 10 years (recommendation of the Swiss Expert Committee for Travel Medicine (ECTM).
Antara News, 19.11.2022 | Head Topics Indonesia, 19.11.2022 | CNBC Indonesia, 19.11.2022 | ECDC
Indonesia: On 21 November 2022, an earthquake of magnitude 5.6 occurred in West Java. The epicentre was located about 10 km southwest of Cianjur district (West Java province). Thousands of houses, schools, infrastructure facilities, roads and more were severely damaged. More than 270 people were killed and more than 150 are missing.
 
Nepal: In the early morning of 9 November 2022, an earthquake of magnitude 6.6 struck Doti district in far western Nepal, killing at least 6 people. The epicentre was in the rural community of Khaptad Chhanna in Doti district. According to the Nepalese government, six people were killed and eight injured. On the evening of 12 November, another strong earthquake occurred in Bajhang district. Since 14 November, those affected have been living in the open and are in urgent need of emergency shelter.
 
Solomon Islands: On 22 November 2022, an earthquake of magnitude 7.0 occurred in Solomon Islands, followed by several aftershocks. The epicentre was located 18 km southwest of Malango and 57.4 km southwest of the capital Honiara. There are reports of widespread damage to infrastructure, including water and power outages.
Follow the instructions of the authorities and the media.
ABC News, 23.11.2022 | ReliefWeb, Nepal: Earthquake | USGS, Earthquake Hazards Program, Solomon Islands
On 4 November 2022, circulating vaccine poliovirus type 2 (cVDPV2) was detected in an environmental sample in Botswana. The isolated virus is closely related to a case from Haut Lomami (D.R. Congo).

While the official WHO IHR statement is still pending, Botswana formally falls under category 2 of the WHO temporary poliomyelitis vaccination recommendations:

  • On departure from Botswana, persons with residence or staying in the country for >4 weeks are strongly recommended to have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their 'International Certificate for Vaccination'.
  • For Stays <4 weeks: Basic immunisation and booster vaccination every 10 years (recommendation of the Swiss expert Committee for Travel Medicine).
WHO, Global Polio Eradication Initiative
Eight counties in Kenya have recorded rabies cases, with the highest number reported in Nairobi, followed by Nakuru, Kwale, Kilifi, Wajir, Narok and Isiolo counties.
In Kenya, an estimated 2'000 people die each year from rabies caused by bites from rabid dogs.
Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high-quality medical centre (post-exposure vaccination), see also rabies factsheet. For long-term travellers and travellers with increased individual risk (travelling with two-wheelers, to remote areas, long-term stays, small children, working with animals, cave explorers, etc.), a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is highly recommended.
Nation Africa, 05.11.2022 | Frontiers in Public Health, 10.03.2022
The National Institute for Communicable Diseases of South Africa reports measles outbreaks in the Greater Sekhukhune and Mopani districts of Limpopo Province. Twenty-three people have fallen ill, of whom 20 were <15 years old.
Review of measles protection should always be part of a travel medicine consultation. All persons born after 1963 who do not have documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. In case of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
National Institute for Communicable Diseases South Africa, 3.11.2022
As of 13 November, a total of 140 confirmed Ebola cases and 55 confirmed deaths have been reported. The most affected district remains Mubende with 64 confirmed cases and 22 declared probable cases, followed by Kassanda. Two districts, Bunyangabu and Kagadi, have not reported any cases for more than 40 days. Uganda will close schools nationwide on 25 November after 23 Ebola cases were confirmed in school children; 8 children have died. On 5 November 2022, Uganda extended the three-week lockdown of Mubende and Kassanda, the two epicentres of the outbreak.

ECTM_weekly_EpiNews_EN_2022_11_18_image_3.jpg

Follow the official and media reports.
Since 1 November 2022, WHO considers the public health risk to be very high at the national level, high at the regional level and low at the global level.

Travelers are usually at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with infected/deceased persons or their body fluids, and all wild animals, alive and dead.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruit and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safe sex, see LINK.

Vaccination against Ebola is not available to travellers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.

If you have symptoms of illness (fever >38 °C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area:
Isolate yourself and immediately contact the hotline in the country by phone or contact a tropical institute or a university hospital infectious disease unit. Always state that you may have had an exposure to Ebola.

WHO Afro, SitRep - 49 | Ministry of Health Uganda, 12.11.2022 | WHO, 10.11.2022
The spread of influenza (flu) is currently increasing in the cantons of Graubünden and Ticino. The most frequently detected viruses by the National Reference Centre for Influenza (NZI) this week were rhinoviruses and Sars-CoV-2. Among the influenza viruses, influenza A(H3N2) was the most common.
 
The National Influenza Vaccination Day will take place on Friday, 25 November 2022. People interested in being vaccinated can spontaneously get vaccinated against influenza on this day at one of the participating medical practices or vaccination pharmacies for a recommended flat rate of CHF 30.
All persons at risk are recommended to be vaccinated against influenza every year. This applies to persons over 65 years of age, persons with pre-existing chronic diseases and/or immunodeficiency, pregnant women, premature babies, residents of old people's or nursing homes and contact persons of these risk persons, including caring contact persons of infants under 6 months of age. Influenza vaccination is also recommended for all medical and nursing staff, for persons working in the paramedical field, as well as for the staff of kindergartens, day-care centres and old people's and nursing homes.
BAG Lagebericht Schweiz: Saisonale Grippe
Ho Chi Minh City: according to the Center for Disease Control of Ho Chi Minh City, more than 62'000 dengue cases (25 deaths) have been reported in the city this year through early October, a sharp increase from last year (about 8'600). 75% of dengue deaths in the city involved adults. 
Nationwide, 224'771 dengue fever cases with 92 deaths have been recorded this year through the end of September. 

Central Highlands: According to a Ministry of Health report, more than 7'400 dengue fever cases have been reported in Gia Lai, Dak Lak, Dak Nong, and Kon Tum provinces since the beginning of the year through August, accounting for about 15% of cases registered nationwide.
Optimal mosquito bite protection 24/7 (during the day against dengue, Zika, Chikungunya and other arboviroses). If you have a fever, take paracetamol products and drink plenty of fluids. Do not take medications containing acetylsalicylic acid (e.g., Aspirin®), as they may increase the risk of bleeding. If you have a fever after a stay in a malaria endemic area, malaria should also be considered and always ruled out by a blood test.
Bloomberg, 6.10.2022
he 2022 recommendations are the same as in previous years since 2013. They are aimed at all adults and children with an increased risk of flu complications, as well as all persons who have regular close contact with persons at particular risk in their private or professional environment. These include people 65 years of age and older, people with pre-existing conditions, pregnant women, and health care workers. The vaccination recommendations are published in detail on the website www.schutzvordergrippe.ch. Vaccination is also recommended for all travelers.
FOPH, Protection against flu
Qatar will host the World Cup from 20 November to 18 December 2022. Regardless of the reason for their stay, visitors and fans will need a "Hayya" card to enter Qatar from 1 November to 23 December 2022, which will only be issued after booking a suitable accommodation.

If considering a visit, the following precautions are recommended:

General Precautions:

  • Follow entry requirements and precautions regarding COVID-19 in the country.
  • Mass events may favor gastrointestinal and respiratory infections, therefore: follow good personal and food hygiene.
  • The risk of accidents may also be increased (CAVE alcohol!).
  • To avoid sexually transmitted diseases (HIV, syphilis, gonorrhea, chlamydia, etc.): follow safer sex practices (condoms).
  • Mosquito-borne diseases: Optimal mosquito protection mainly during the day against dengue, zika, chikungunya and other arboviruses. In case of fever, paracetamol products and hydration. Do not take medication containing acetylsalicylic acid (e.g. Aspirin®), as this increases the risk of bleeding.
  • Middle East Respiratory Syndrome Coronavirus (MERS-CoV): People with an underlying disease such as diabetes should consult a doctor before travelling. WHO advises that travellers to the Arabian Peninsula should avoid contact with dromedaries, as well as visiting farms and markets where the animals are present. They should also avoid eating raw or incompletely heated camel products. In addition, the usual rules of everyday hygiene should be followed (same as for COVID-19).
  • It is strongly recommended that you take out health and travel insurance.
  • For further information: see www.healthytravel.ch.

The following vaccinations are recommended:

  • For all visitors: COVID-19, MMR, varicella (if infection not passed), influenza, tetanus, diphtheria, pertussis, poliomyelitis (basic immunization), hepatitis A and B, meningitis (MenACWY).

Country requirements:

  • Vaccination against polio is compulsory for entry from the following countries (with documentation in the International Certificate for Vaccination): Afghanistan, Pakistan
Ministère de l’Europe et des Affaires étrangères France, 3.10.2022 | FIFA World Cup 2022™ | FIFA Hayya
According to the World Health Organization (WHO), 54 confirmed cases and 20 probable cases of Ebola virus disease, including 39 deaths, have been recorded in Uganda since the outbreak was declared on 20 September. Among them were 11 health workers; four among them have died. The cases were mainly from Mubende. In addition, cases have been reported from Kampala, Bunyangabu, Kagadi, Kassanda, and Kyegegwa; they are epidemiologically linked to the cases reported from Mubende. 

WHO estimates the public health risk to be low at the global and regional levels and high at the national level.

Travelers are generally at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with sick/dead persons or their body fluids, and with all live and dead wildlife.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruits and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safer sex, see LINK.

Vaccination against Ebola is not available to travelers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.

If you have symptoms of illness (fever >38°C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area:
Isolate yourself and immediately contact the hotline by phone or contact a tropical institute or university hospital infectious disease department. Always state that you may have had an exposure to Ebola.

WHO media briefing, 12.10.22 | Uganda officials 12.10.22 | UNICEF, 7.10.2022 | Reliefweb, 11.11.2022 | BBC News
In the first eight months of this year, the country reported 40 human rabies deaths in 16 cities and provinces, with most cases coming from Ben Tre, Kien Giang and Gia Lai. Annually, approximately 400'000 people in Vietnam are vaccinated against rabies after being bitten by a dog or cat.
Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high-quality medical center (post-exposure vaccination), see also rabies information sheet. For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, long-term stays, small children, work with animals, cave explorers, etc.) a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is highly recommended.
VietnamPlus, 28.9.2022 | WHO, Rabies in Vietnam
The heavy monsoon rains, which have been ongoing since mid-July 2022, have affected many parts of the country, with 75% of all districts and more than 33 million people affected, most severely in Sindh and Balochistan provinces. More than 420'000 were forced to flee, at least 1'638 people died, and 12'865 were injured. Numerous houses, schools and roads were destroyed or damaged. Unprecedented highs of dengue fever and malaria (P. vivax and P. falciparum) have been recorded in the flooded areas, with hundreds of thousands of patients. Thousands of diarrheal cases and skin diseases were also recorded.
Proper disease surveillance is impossible in this situation. 

Humanitarian organizations have increased their precautions and outreach in response to the emergency situation following the flooding in Pakistan. MSF-Switzerland is active in the southwest mainly as a mobile clinic in Sindh with a base in Karachi in the malaria zone and on hills between the flooded areas.
Non-essential travel to affected areas should be avoided. Persons who are or will be involved in humanitarian missions should consult a specialist in tropical and travel medicine regarding vaccinations, malaria prophylaxis and other precautions prior to their mission.
TheNews Pakistan, 27.9.2022 | WHO, 17.9.2022 | MinuteMirror, 1.10.2022 | Reuters, 22.9.2022 | Reuters, 16.9.2022 | Open Access Government Pakistan, 17.9.2022 | UNICEF, 5.10.2022
Following the devastation caused by Hurricane Fiona, 72 suspected cases of leptospirosis have been reported to date.
Wear protective clothing/boots when wading through water! Leptospires are transmitted via the urine of rodents (especially rats), e.g. in water residues (rivulets, puddles, etc.) or mud. Transmission to humans occurs via small skin lesions or mucosal contacts through direct or indirect contact with rodent urine. Vaccination is not generally available.
Gobierno de Puerto Rico, 28.9.2022
As of 5 October 2022, there have been 63 confirmed and probable cases of Ebola virus disease in Uganda, including 29 deaths, according to WHO data. At least 10 health workers have contracted Ebola and four have died. 

On 4 October 2022, the Nigerian Center for Disease Control and Prevention warned of the high risk of Ebola introduction into Nigeria due to increased travel between the two countries. So far, no cases of Ebola have been detected in Nigeria. 

Three experimental vaccines against the Sudanese Ebola virus have been tested in human trials, but because outbreaks with this species are so rare, they have not yet been tested in the field. Testing will begin in October. 

According to ECDC, the risk of infection to EU/EEA citizens associated with this event is currently considered very low, despite uncertainty about the extent of the outbreak.

Travelers are generally at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with sick/dead persons or their body fluids, and with all live and dead wildlife.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruits and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safer sex, see LINK.

Vaccination against Ebola is not available to travelers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.

If you have symptoms of illness (fever >38°C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area:
Isolate yourself and immediately contact the hotline by phone or contact a tropical institute or university hospital infectious disease department. Always state that you may have had an exposure to Ebola.

WHO, 26.9.2022 | WHO TWITTER, 6.10.2022
The 15th EVD outbreak in the Democratic Republic of Congo - ended on 27 September 2022, 42 days after the burial of the outbreak's only EVD victim.
Authorities had reported resurgence of the virus in Beni, North Kivu province, on 22 August 2022. Genome sequencing of the virus confirmed that the case was a flare-up of the previous EVD outbreak in the region in 2018 - 2020.
Vaccination again played an important role in the response. 51 direct contacts of the Ebola victim and 303 contacts of contacts were vaccinated. This contrasts with the current EVD outbreak in Uganda, where responders are facing the Sudan strain (SDV) of the virus, for which there is no vaccine.
ReliefWeb, 27.9.2022
According to the report of the Judicial Committee, 21 people have already died of rabies in Kerala this year. In addition, 196'000 dog bites in humans have been documented. Six deceased had not received post-exposure prophylaxis (PEP) against rabies. In 2019, there were 289'000 stray dogs in Kerala.
Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high-quality medical center (post-exposure vaccination), see also rabies factsheet. For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, long-term stays, small children, work with animals, cave explorers, etc.) a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is highly recommended.
East Coast Daily, 25.9.2022
According to the Ministry of Health, a total of 332 malaria cases have been reported in Costa Rica since the beginning of the year, with the North Huetar region the most affected with a total of 300 cases, followed by the Caribbean Huetar region. P. falciparum is the most common parasite.
 
Malaria is transmitted by mosquitoes in the evening at dusk and at night. Symptoms of the disease include fever >37.5° C, chills, headache and flu symptoms, and occasionally diarrhea. The disease is potentially fatal and is a medical emergency! See also factsheet Malaria.
Optimal mosquito protection 24/7 (at dusk and at night against malaria, during the day against dengue, chikungunya and other arboviruses). In case of fever >37.5° C, malaria should always be considered and ruled out by blood test.
San Carlos Digital, 21.9.2022 | Ministerio de Salud Costa Rica, 1.9.2022
The number of cases is increasing because the original patient who was diagnosed with the disease was not diagnosed immediately, exposing other people to the virus. In addition, the outbreak is occurring in areas with (illegal) gold mines and refugee camps, making it difficult to manage. The source of infection is unknown.
 
According to WHO, there have been 63 cases (confirmed and probable) and 29 deaths so far. They have been reported in Mubende, Kyegegwa and Kassanda districts. At least 10 health workers have been infected, and four of them died. So far, no confirmed cases have been reported in the capital, Kampala.

Travelers are generally at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with sick/dead persons or their body fluids, and with all live and dead wildlife.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruits and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safer sex, see LINK.

Vaccination against Ebola is not available to travelers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.

If you have symptoms of illness (fever >38°C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area:
Isolate yourself and immediately contact the hotline by phone or contact a tropical institute or university hospital infectious disease department. Always state that you may have had an exposure to Ebola.

WHO, 26.9.2022 | WHO TWITTER, 6.10.2022
For the first time, 4 cases of circulating type 1 vaccine-derived poliovirus have been confirmed in the Democratic Republic of Congo. The cases occurred in Haut-Lomami province. In addition, 28 vaccine-derived poliovirus type 2 cases have been confirmed in Bas-Uele, Maniema, South Kivu, and Tanganyika provinces, bringing the total number of cases in 2022 to 110, which is already significantly more than in the entire year 2021.

Formally, D.R. Congo thus falls under the WHO temporary polio vaccination recommendations category 1 ("States infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread"), but the official WHO declaration is still pending:

  • Persons staying in the country for > 4 weeks must have received a polio booster vaccination (IPV) with documentation in the international vaccination certificate at the time of departure, which must not be older than 12 months. This is important to prevent the spread of poliomyelitis virus from the country and can be checked upon departure.
  • Stays < 4 weeks: In addition to the basic immunization against polio, a booster vaccination is recommended every 10 years (recommendation of the Swiss expert Committee for Travel Medicine (ECTM).
GPEI, 14.9.2022
Ghana has declared the end of the Marburg virus disease outbreak that was confirmed in July 2022. It was the first outbreak of Marburg virus in the country. No new infections have been reported for 42 days. A total of three cases (including two deaths) have been confirmed in the Ashanti, Savannah, and West Ghana regions since the outbreak began on 7 July 2022.
WHO, 16.9.2022
According to media reports, in southern Ghana, the Ashanti Region Health Directorate reports an increase in human rabies cases in three districts in the region. As of 12 September 2022, a total of four confirmed cases and one probable case have been reported in the region. The cases are from Asante Akim South, Bosomtwe and Kwabre East.
Information about rabies and what to do in case of exposure is important for all travelers:
Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high-quality medical center (post-exposure vaccination). For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, long-term stays, 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.
Ghana News Agency, 15.9.2022
On 20 September 2022, the Uganda Virus Research Institute confirmed a fatal Ebola virus infection in a 24-year-old man from Mubende district in central Uganda. The national rapid response team had previously investigated six suspected Ebola deaths in the same district. There are currently eight suspected cases. The source is not known. This is the first time since 2012 that there has been an outbreak in Uganda with the rare "Sudan" strain of Ebola virus. In 2019, there was an outbreak of the "Zaire" strain of Ebola. The virus was imported from neighboring D.R. Congo, where a large epidemic was then raging in the northeast. To date, there have been seven known outbreaks of the "Sudan" strain of Ebola virus: four in Uganda and three in Sudan.

Travelers are generally at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with sick/dead persons or their body fluids, and with all live and dead wildlife.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruits and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safer sex, see LINK.

Vaccination against Ebola is not available to travelers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.
If you have symptoms of illness (fever >38°C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area:
Isolate yourself and immediately contact the in-country hotline by phone or contact a tropical institute or university hospital infectious disease department. Always state that you may have had an exposure to Ebola.

WHO, 20.9.2022 | EMA, ERBEVO - Summary of Product characteristics | Health Policy Watch, 20.9.2022 | CIDRAP, 15.9.2022
Media reports from the Indian state of Kerala have described cases of "tomato flu" in young children. An investigation of 2 symptomatic children in the United Kingdom who had recently returned from Kerala with corresponding symptoms revealed that they had hand-foot-mouth disease (HFMD). HFMD is a common illness of young children with fever and rash mainly on the palms of the hands, soles of the feet, and in the mouth. The main causative agents are enteroviruses.
Optimal personal hygiene (often washing or disinfecting hands). Avoid touching your eyes, nose, and mouth. Clean and disinfect frequently touched surfaces and shared items, including toys and doorknobs. Avoid close contact with sick people.
The Pediatric Disease Journal, 19.8.2022 | CDC Prevention HFMD
According to the ministry's communicable disease control department, the number of cases of hand-foot-mouth disease (HFMD) has doubled compared to last year, with more than 26'000 cases reported nationwide by the end of July, significantly higher than the same period last year.
So far, more than 110 schools in Bangkok have been fully or partially closed for several days after the virus spread there. Children aged ≤ 4 years are affected in 85% of cases.
HFMD is a highly contagious viral disease with a worldwide distribution that primarily affects children. It is caused by various enteroviruses, In most cases, HFMD is benign and self-limiting, but severe neurological and even fatal courses have been repeatedly reported in Southeast Asia.
Optimal personal hygiene (often washing or disinfecting hands). Avoid touching your eyes, nose, and mouth. Clean and disinfect frequently touched surfaces and shared items, including toys and doorknobs. Avoid close contact with sick people.
Thailand warns public to be cautious of dengue fever, hand-foot-mouth disease, 29.8.2022
Hand-foot-and-mouth disease cases rise to over 6,000 this year, 5.9.2022
The Philippine Food and Drug Administration (FDA) warns against counterfeit immunoglobulins against rabies (Equirab 200ml). Immune sera should only be purchased from FDA approved facilities.
The rabies situation in 2022 is as follows: Since the beginning of the year, authorities reported 222 human rabies deaths in 16 of the country's 17 regions. This is a 17% increase from the previous year.
The Central Luzon region (including Metro Manila) reported the most cases, followed by Calabarzon, Davao, and Soccsargen (Region XII, Mindanao).
Considering the counterfeit immunoglobulins in circulation, travelers are advised to get vaccinated against rabies BEFORE traveling (2 doses). Avoid contact with animals and do not feed them.
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 revaccination as soon as possible! See also the factsheet rabies.
Philippines FDA warns of fake anti-rabies serum, 4.9.2022 | Philippines reports increase in rabies cases/deaths in 2022, 4.9.2022
A magnitude 6.6 earthquake occurred in Sichuan, China, on 5 September 2022, and the epicenter was located about 43 km southeast of Kangding. Most of the casualties and damage occurred near the epicenter in Luding County. Authorities reported at least 65 fatalities. Hundreds of people are cut off from the outside world. Nearly 250 houses collapsed and more than 13'000 were partially damaged. Power outages and interruptions to the water supply were also reported from the affected area.
Observe information from the authorities and the media.
China: Disruptions ongoing in Sichuan Province as of Sept. 6 following magnitude-6.6 earthquake
As of 5 September 2022, a total of 19 cases have been identified, including six deaths. Among the reported cases are eight health care workers (3 deaths) from a private clinic in the city of San Miguel de Tucumán. All cases occurred in the same health center.
Follow local indications. Other cases may still occur. In case of symptoms, especially coughing and shortness of breath, consult a doctor.

Legionella multiply especially in hot water systems, humidifiers, whirlpools and hydrotherapeutic facilities at water temperatures below 50°C. Particularly at risk of severe illness are older people, immunocompromised persons, such as transplant recipients and tumour patients, diabetics and persons with chronic lung diseases (smokers).
Legionella identified as cause of cluster of pneumonia cases in Tucuman, Argentina. PAHO, 3.9.2022
El Ministro anunció los nuevos criterios de inclusión para la detección del brote de legionella, 5.9.2022
WHO Legionellosis - Argentina, 5.9.2022 | Cases of pneumonia due to unknown cause - Tucumán Argentina, 1.9.2022
A measles outbreak has been ongoing in Tanzania since June 2022. As of 23 August 2022, a total of 223 suspected cases have been reported. Almost half of the cases involved children under five years of age. Most cases are reported from Magharibi B, Magharibi A, and Wete districts (west coast of Zanzibar Island).
Any person born after 1963 who does not have documented protection against infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. This is also important for Switzerland! In case of an epidemic in the area or contact with a measles case, vaccination is recommended from 6 months of age.
WHO, EW 35
The Niger Ministry of Health has reported a case of dengue fever in Niger for the first time. The patient is a 47-year-old man from Niger who entered from Cuba on 13 August 2022. Numerous dengue cases are currently registered on this Caribbean island.
Optimal mosquito bite protection 24/7 (during the day against dengue, Zika, Chikungunya and other arboviroses). If you have a fever, take Paracetamol products and drink plenty of fluids. Do not take medications containing acetylsalicylic acid (e.g., Aspirin®), as they may increase the risk of bleeding. After a stay in a malaria endemic area, malaria should also be considered in case of fever and should always be ruled out by a blood test.
WHO Africa, 4.9.2022
In 2022, an increase in cases of typhoid fever has been registered in various provinces (especially Negros Oriental / Central Visayas). Nationwide, there have been 7'681 suspected cases so far this year, twice as many as last year.
Follow optimal food and drinking water hygiene ('cook it, boil it, peel it or forget it'). Vaccination against typhoid fever is especially recommended for persons visiting friends and relatives (VFRs) and for travelers where sanitary conditions are poor during their stay.
Philippines: Negros Oriental reports a near doubling of typhoid fever, 25.8.2022
DSWD-DROMIC Preparedness for Response Report #13 on the Typhoid Fever Cases in Region VII as of 11 July 2022
The heavy monsoon rains, which have been ongoing since mid-July 2022, have affected many parts of the country; 75% of all districts have been impacted, most severely in Sindh and Balochistan provinces. The floods have affected more than 33 million people; more than 420'000 have been forced to flee and more than 1'000 people have died as a result of the disaster so far.
Follow the advice of the media and authorities. Non-essential travel to affected areas should be avoided. Large floods usually increase the risk of mosquito-borne diseases and gastrointestinal epidemics.
WHO/EMRO Situation reports on the flooding in Pakistan, 30.8.2022
Nepal has been seeing a rapid rise in the number of dengue cases in the past few weeks. In Kathmandu Valley, hundreds of patients have been admitted into hospitals, and the number of cases diagnosed in hospitals has surpassed 1'000 - more than in the previous outbreak in the summer 2019. In Kathmandu, CIWEC Hospital and Travel Medicine Center has also been seeing increasing cases of travelers, expatriates, and locals with dengue fever in the past week.
Optimal mosquito protection 24/7 (during the day against dengue, Zika, Chikungunya etc). Travelers are advised to bring good quality mosquito repellents from their home country while traveling to Nepal as there is a shortage of good quality repellents.
In case of fever, take paracetamol products and drink plenty of fluids. Do not take medicines containing acetylsalicylic acid (e.g. Aspirin®), as these may increase the risk of bleeding. After a stay in a malaria endemic area, malaria should always be ruled out by blood tests.
Nepali Times, 30.8.2022; pers. Communication P. Schlagenhauf
Nigerian authorities report 894 cases of Lassa fever in 25 states so far this year. Seventy percent of the confirmed cases are from Ondo, Edo and Bauchi states.
Lassa virus is endemic in West Africa. Outbreaks from Nigeria are consistently reported. The virus is transmitted via rodent excreta (Mastomys sp.), e.g., through contaminated food, or it is inhaled. Human-to-human transmission occurs through contact with body fluids of infected individuals. Lassa belongs to the group of hemorrhagic fevers. Symptoms of illness range from mild flu-like symptoms to fever with bleeding. The infection is often fatal.
Wash or disinfect hands regularly and maintain optimal food hygiene. Mouse-infested places should be avoided. Avoid contact with ill or deceased persons suspected of having Lassa fever.
OCHA Services, 27.8.2022
During the past few weeks, acute chikungunya infection was identified in 4 European travelers who had visited Bali. All 4 cases traveled to Bali as tourists between March and June 2022 and had the first symptoms either during the trip or shortly after returning to their home countries in Europe (the Netherlands, France, Germany, and Spain).
Optimal mosquito protection 24/7 (during the day against dengue, Zika, Chikungunya etc., at dusk and at night against malaria). In case of fever, paracetamol products and hydration. Do not take medicines containing acetylsalicylic acid (e.g. Aspirin®), as these may increase the risk of bleeding. After traveling to a malaria area, malaria should always be considered and ruled out by blood tests in case of fever.
David Hamer. GeoSentinel. Via ProMED, 19.8.2022
The Cuban Ministry of Health (Minsap) recorded 4'776 clinical cases of dengue fever in the third week of July, more than the 3'036 recorded in the entire first half of the year. The numbers are particularly high in Isla de la Juventud and in the provinces of Havana, Guantánamo, Camagüey, and Holguín. Since the beginning of the year, 29 confirmed cases in returned travelers to Europe have been reported.
Optimal mosquito protection 24/7 (during the day against dengue, Zika, Chikungunya etc). In case of fever, paracetamol products and hydration. Do not take medicines containing acetylsalicylic acid (e.g. Aspirin®), as these may increase the risk of bleeding.
Presentan en comisión de salud situación epidemiológica del país, 20.7.2022 | GeoSentinel, pers. communication
Several asylum seekers have contracted pharyngeal diphtheria at an asylum seekers' center - the first known cases in Switzerland in almost 40 years.
At least eight people living in a Bern asylum center contracted the disease but did not have respiratory problems. The infected group of people has been isolated, and more than 170 other asylum seekers, mostly unaccompanied minors, are in quarantine at the center. All residents have since been vaccinated against diphtheria.

Diphtheria is caused by bacteria that are spread worldwide. The pathogen produces a powerful toxin that can permanently damage organs such as the heart and liver. There are two types of the disease: respiratory and cutaneous (skin) diphtheria. The pathogen primarily affects the upper respiratory tract and produces a toxin that can lead to dangerous complications and long-term effects. Person-to-person transmission occurs through droplet infection (close physical contact, coughing, sneezing). It originates from a sick person or from someone who carries the bacterium without symptoms. Less commonly, infection occurs through contaminated objects or, in the case of cutaneous diphtheria, through direct contact. Effective vaccination protects against the disease.
There is no increased risk for the general population. Vaccination should be given to children at 2, 4, and 12 months of age and at ages 4 to 7 and 11 to 15 years. Additional booster vaccinations are recommended at ages 25, 45, and 65 years (i.e., every 20 years) and every 10 years thereafter. For high-risk persons, such as health care workers or contact persons etc., an interval of 10 years is recommended.
SwissInfo, 3.8.2022; BAG - Fälle von Diphtherie, 3.8.2022
On August 5, 2022, the Spanish Ministry of Health published two cases of Crimean-Congo hemorrhagic fever (CCHF) in Bierzo, in the province of León in the north of the country. The first case was a 49-year-old hunter with a known history of tick bites; his condition is stable. The second patient was a 51-year-old man who worked in forestry. He died on June 19, 2022, and was diagnosed with CCHF postmortem on July 20, 2022. Between 2013 and 2022, a total of 12 cases (including 4 deaths) were confirmed in Spain.
 
Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a tick-borne virus. The disease is prevalent in Eastern Europe, particularly in the former Soviet Union, throughout the Mediterranean region, northwest China, Central Asia, southern Europe, Africa, the Middle East, and the Indian subcontinent.
Tick protection through clothing and insecticides. Insect repellents should contain DEET. Also, avoid contact with blood and body fluids of animals or people with symptoms of infection in endemic areas. In the latter, gloves should be worn for tick removal.
ECDC, Crimean-Congo Haemorrhagic Fever; Infosalus, 8.8.2022; ECDC, Cases of CCHF (2022)
A case of yellow fever in a 67-year-old man has been confirmed in Pará de Minas, Minas Gerais state. Since the patient is a person who travels a lot, the location of the infection is unknown.
Vaccination against yellow fever is strongly recommended for all stays in Brazil.
Atualização Epidemiológica – Febre Amarela, July 2022
On July 23, 2022, the WHO Director-General declared the spreading global outbreak of monkeypox a Public Health Emergency of International Concern (PHEIC). According to the U.S. Centers for Disease Control and Prevention (CDC), a total of more than 25'000 cases have been reported to date in 76 non-endemic countries. The U.S. has the highest total with 6'325 cases, followed by Spain, Germany and the United Kingdom. In the past week, five deaths were recorded in non-endemic countries: two in Spain and one each in Brazil, Peru and India. The two fatal cases in Spain were unrelated and occurred in previously healthy men aged 31 and 44 years who died of encephalitis. According to the WHO Director-General, about 10% of infected persons are hospitalized for treatment of pain symptoms.
 
Clinical presentation: The clinical picture is characterised by lesions that are atypical of the clinical picture in endemic countries. Currently, there are mainly very few, non-grouped, painless pustular lesions on the genitals, perianally and orally. Whether transmission occurs through genital secretions or primarily only through close skin-to-skin contact is not yet clear. The draining lymph nodes are sometimes massively swollen, and fever usually occurs for a few days. The general condition is often only slightly reduced.

Transmission: The virus can be transmitted from person to person via the respiratory tract, through direct contact with body fluids of an infected person or with virus-contaminated objects. The incubation period is 5-21 days, usually about 7-17 days. Monkeypox is transmitted from infected animals through a bite or through direct contact with blood, body fluids or lesions of the infected animal. They can be transmitted to people who eat infected animals via abrasions in the mouth.

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.
Prevention: Good personal hygiene. Avoid close contact with sick people, including those with skin lesions or genital lesions, and animals at all costs. Avoid contact with contaminated materials used by sick people. During stays in West and Central Africa: Do not consume bushmeat.
If the clinical picture is suggestive, individuals should also be isolated, tested, and screened for monkeypox.
MANDATORY REPORTING: In Switzerland, every suspected case must be reported within 2 hours to the respective cantonal doctor and to the FOPH (tel. +41 58 463 87 06)! Specialist laboratories, such as the Reference Laboratory for Imported Viral Diseases (HUG) or the Spiez Laboratory or the ZBS1 at the Robert Koch Institute (RKI; consiliary laboratory for smallpox), offer molecular diagnostics for the identification of monkeypox infections (material: crust or vesicular fluid).
Geosentinel requests confirmed and suspected cases to be reported at: geosennel@geosentinel.org
ECDC: Epidemiological update: Monkeypox multi-country outbreak, 15.6.2022
ECDC: Monkeypox multi-country outbreak. Situation Updates
WHO: Monkeypox
WHO: Meeting of the IHR (2005) Emergency Committee regarding the multi-country monkeypox outbreak, 25.6.2022
WHO: Joint ECDC-WHO Regional Office for Europe Monkeypox Surveillance Bulletin, 17.6.2022 
CDC: Monkeypox. Global Map
Global Health (GH): Map Monkeypox
Johns Hopkins: Center for health security. Monkeypox
Delhi: In the capital, 169 dengue cases were registered by July 30, the highest number in the city since 2017. In addition, 33 malaria infections were reported.
Mumbai: The local health department had already registered 397 malaria cases by mid-July. Within a week, malaria cases increased by 63%. The number of dengue cases is also on the rise.
Optimal mosquito protection around the clock (at dusk and at night against malaria, during the day against dengue and other arboviruses). In case of fever, paracetamol preparations and hydration. Do not take medications containing acetylsalicylic acid (e.g., Aspirin®), as they may increase the risk of bleeding. Malaria should always be ruled out in cases of fever.
WION News, 1.8.2022; The Hindu; Mid-day, 27.7.2022
The Florida Department of Health in Miami-Dade County is warning of dengue infections after dengue was confirmed in one resident. This is the second local case this year. Dengue cases have also been reported in Miami-Dade in previous years.
Optimal mosquito protection 24/7 (during the day against dengue, Zika, Chikungunya, etc.). In case of fever: paracetamol products and hydration. Do not take medications containing acetylsalicylic acid (e.g., Aspirin®) as they may increase the risk of bleeding.
Florida Department of Health, 29.7.2022
The Santa Fe Health Department in Argentina confirms cases of trichinellosis. An outbreak with five cases was reported from the area of Granadero Baigorria and another outbreak with 35 cases was registered in the department of General López (various towns: Venado Tuerto, Wheelwright, Hughes, San Gregorio and Rufino). The source is unknown, mostly homemade sausages. Trichinella infections are frequently reported in Argentina.
Trichinellosis is caused by the larvae of an intestinal worm when eating insufficiently cooked meat (mainly pork, but also game and other animals such as bear). Symptoms vary widely: muscle pain, inflammation of the eyelids and eye pain, diarrhea, and fever. Cardiac and neurological complications are possible and the disease is sometimes fatal.
Refrain from consuming artisanal or non-certified sausage. Cook pork and game well before consumption. Trichinae are killed by heating above 70°C (>1 min). Smoking, curing, and drying are not safe measures to kill larvae.
La Tribuna del Sur, 22.7.2022; Santa Fe Provincia, 21.7.2022; Argentina.gob.ar
The Ghana Health Service reported a third and fourth suspected Marburg virus case (wife and child of the index case). The child died on 21. July 2022. Local tests were positive, and results from the Pasteur Institute are pending. Forty contacts remain under surveillance, including 11 health care workers.
Marburg is transmitted to humans by bats (fruit bats) and spreads in humans through direct contact with body fluids of infected persons, surfaces, and materials. The disease begins abruptly with high fever, severe headache, and malaise. Many patients develop severe hemorrhagic symptoms within seven days. Mortality rates have varied from 24% to 88% in previous outbreaks, depending on the strain of virus and case management.
Avoid contact with sick people and eating bushmeat or bats. Avoid caves that may harbor bats. See a doctor if you have a fever, also to rule out malaria.
REUTERS, 27.7.2022; Vidal France, 26.7.2022; Graphic Online, 24.7.2022
Since the start of the 2022 transmission season and through the end of July, EU/EEA countries have recorded 55 human West Nile fever infections in Italy (42), Greece (12), and Slovakia (1), and five deaths in Italy.
West Nile fever (WNV) is transmitted by mosquitoes during the day and at night. Only about 20% of those infected show symptoms, which can range from flu-like symptoms with fever, headache, and aching limbs. In rare cases, encephalitis (inflammation of the brain) and meningitis may occur. This more severe form of the disease can include headaches, neck stiffness, visual disturbances, paralysis, and other neurological symptoms, and can lead to a very long duration of illness, permanent paralysis, or death.

The risk is low. People who are over 60 years of age, have an underlying disease, or have a weakened immune system are at higher risk for the more severe form of West Nile virus.
The following precautions are recommended:

  • Protect yourself against mosquito bites during the day and at night (see factsheet mosquito and tick bite protection).
  • Do not touch sick or dead birds, as they may also be infected.

If you have visited a West Nile fever transmission area, do not donate blood for at least 28 days after your return.

ECDC/CDTR EW 30, 24-30 July 2022
According to the Ministry of Health, there have been 157 rabies-related deaths in the country since the beginning of the year. 119 victims had not received post-exposure prophylaxis (PEP). Many were infected from their own unvaccinated pets. The regions with the most cases are Central Luzon, followed by Calabarzon, Western Visayas, and Davao/Mindanao.
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.
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!
DOH reports 5% drop in rabies cases in first half of 2022
The 20 cases (3 deaths) of a previously unknown disease from the Lindi area in southern Tanzania have now been identified as leptospirosis.
Leptospires are bacteria that can be transmitted through the urine of rodents (especially rats). This can happen, for example, when wading through contaminated rivulets, puddles or mud. In this case, transmission to humans occurs via small skin lesions or mucosal contacts through direct or indirect contact with rodent urine. Symptoms of the disease range from flu-like general symptoms, headache, high fever to blood poisoning. Treatment requires antibiotic therapy.
Wear protective clothing/boots when wading through water! No vaccination is available for travelers.
Tanzania confirms outbreak of leptospirosis, 18.7.2022
One case of circulating poliovirus type 2 has been reported in Tamanghasset, Algeria. The virus is associated with cases in Zamfara, Nigeria, and had not previously been detected in Algeria.

Formally, this means Algeria falls again under the WHO temporary polio vaccination recommendations (category 2: "States infected with cVDPV2, with potential or demonstrated risk of international spread"), confirmation by the IHR committee is still pending. Meaning: Persons staying in the country for > 4 weeks are strongly recommended to have a min. 4 weeks and a a max. 12 months old polio booster vaccination (IPV) with documentation in the international vaccination certificate when leaving Algeria. This is important to prevent the spread of poliomyelitis virus from the country and can be checked upon departure. Persons staying in the country for <4 weeks are recommended to have a booster vaccination every 10 years in addition to a basic polio immunization.

GPEI, 13.7.2022
To protect your health, your family, and others, FDRE Ministry of Health, Ethiopian Public Health Institute (EPHI) requires you to complete this form before boarding and present the hard/soft copy of the certificate/QR code or google form response summary to the health desk at arrival. The form is available at: LINK. Your information will be held confidential and used only for public health purposes.
A Zika infection was diagnosed in 5 tourists from Germany, Israel, and the United Kingdom who had recently returned from Thailand. They visited the following areas: Phuket, Phi Phi Island, Koh Samui, Khao Lak, Bangkok, and Chang Mai. The country is not classified as an area with a current outbreak at this time (see CDC map).
Optimal mosquito protection around the clock (during the day against dengue, Zika, Chikungunya, etc., at dusk and at night against malaria). In case of fever, paracetamol supplements and hydration. Do not take acetylsalicylic acid-containing medications (e.g., Aspirin®), as they may increase the risk of bleeding. During stays in malaria areas, a differential diagnosis should always be made in case of fever in order to exclude malaria. Detailed recommendations on Zika can be found here.
Geosentinel via ProMED, 4.7.2022
Since the beginning of the year, the Costa Rican Ministry of Health has reported 256 cases of malaria. The trend has been increasing for 5 years. The three regions with the most cases are Huetar Norte with 226 cases, Huetar Caribe with 22 cases and Central Pacific with 8 cases.
Protect yourself optimally around the clock (24/7) against mosquito bites (see factsheet mosquito and tick bite protection): at dusk and at night against malaria, during the day against dengue and other arboviruses. 
In case of fever > 37.5°C: consult a doctor or go to a clinic immediately and take a blood test for malaria (see also factsheet Malaria)!
Ministerio de Salud Costa Rica, 30.6.2022

Preliminary analysis of samples revealed two positive Marburg virus cases. The two patients from the southern Ashanti region - both deceased and unrelated - presented symptoms of diarrhea, fever, nausea and vomiting. Preparations for a possible outbreak response are being made rapidly as further investigations are in progress.

Marburg is transmitted to humans by bats (fruit bats) and spreads in humans through direct contact with bodily fluids of infected persons, surfaces, and materials. The disease begins abruptly with high fever, severe headache and discomfort. Many patients develop severe hemorrhagic symptoms within seven days. Mortality rates have varied from 24% to 88% in previous outbreaks, depending on the strain of virus and case management.

Avoid contact with sick people and the consumption of bushmeat or bats. Avoid caves that may contain bats. Consult a doctor if you have a fever, also to exclude malaria.
WHO, 7.7.2022

Most of the laboratory-confirmed cases (2933/3413; 86%) were reported from the WHO European Region. In Switzerland, there have been 81 confirmed cases since May 21 and up to June 29.

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

Prevention: Good personal hygiene. Avoid close contact with sick people, including those with skin lesions or genital lesions, and animals at all costs. Avoid contact with contaminated materials used by sick people. During stays in West and Central Africa: Do not consume bushmeat.

If the clinical picture is suggestive, individuals should also be isolated, tested, and screened for monkeypox.

MANDATORY REPORTING: In Switzerland, every suspected case must be reported within 2 hours to the respective cantonal doctor and to the FOPH (tel. +41 58 463 87 06)! Specialist laboratories, such as the Reference Laboratory for Imported Viral Diseases (HUG) or the Spiez Laboratory or the ZBS1 at the Robert Koch Institute (RKI; consiliary laboratory for smallpox), offer molecular diagnostics for the identification of monkeypox infections (material: crust or vesicular fluid).

Geosentinel requests confirmed and suspected cases to be reported at: geosennel@geosentinel.org

ECDC: Epidemiological update: Monkeypox multi-country outbreak, 15.6.2022
ECDC: Monkeypox multi-country outbreak. Situation Updates
WHO: Monkeypox
WHO: Meeting of the IHR (2005) Emergency Committee regarding the multi-country monkeypox outbreak, 25.6.2022
WHO: Joint ECDC-WHO Regional Office for Europe Monkeypox Surveillance Bulletin, 17.6.2022 
CDC: Monkeypox. Global Map
Global Health (GH): Map Monkeypox
Johns Hopkins: Center for health security. Monkeypox
As of June 24, 2022, the Florida Department of Health confirmed 13 cases (2 deaths) of Vibrio vulnificus infection. In 2021, Florida reported 34 cases and 10 deaths. Vibrio vulnificus is a bacterium that normally lives in warm seawater. Infections with Vibrio vulnificus are rare. If saltwater is swallowed or shellfish or mussels are eaten, the bacteria can be ingested and lead to gastroenteritis. If the bacteria enter the body through small skin lesions (e.g., injuries to coral or fish spines), there is a risk of fulminant sepsis, especially in immunocompromised individuals or those with chronic liver or kidney disease, diabetes, or iron storage disease. The bacterium is inactivated by cooking or freezing.
  • 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.
Florida Health, Vibrio vulnificus
An outbreak of meningococcal serogroup C disease in gay and bisexual men is reported in Florida, USA. So far, 24 cases and 7 deaths have been reported.
In response to this outbreak, the U.S. Centers for Disease Control and Prevention (CDC) recommends gay, bisexual, and other men who have sex with men to get vaccinated against meningococcal disease (MenACWY) if they live in, or travel to, Florida. CDC also stresses the importance of routine MenACWY vaccination for people with HIV.
CDC Assists with Meningococcal Disease Outbreak Investigation in Florida, 22.6.2022
Florida Department Of Health In Orange County Advises On Meningococcal Disease and Vaccines in Florida, April 2022
CDC Meningococcal Disease in Florida, 2022
Since the beginning of 2022, there have been 1'715 cases and 73 deaths of monkeypox reported from eight endemic and two non-endemic countries in the African Union. According to WHO, these countries are Benin, Cameroon, Central African Republic, Republic of Congo, D.R. Congo, Ghana, Nigeria, and South Africa. From February 2020 until today, 12'141 cases and 363 deaths of monkeypox have been documented in Africa. The number of cases continues to increase in Africa.
Good personal hygiene. Avoid close contact with sick people at all costs. Also avoid contact with people who have skin or genital lesions. Avoid contact with contaminated materials used by sick people. Contact with sick animals should also be avoided. During stays in West and Central Africa: Do not consume bushmeat.
Africa CDC, 27.6.2022
Heat waves can have significant impacts, including an increase in heat-related deaths. They are among the most dangerous natural events, but rarely receive proper attention because resulting deaths and damage are not always immediately visible. From 1998 to 2017, more than 166'000 people died as a result of heat waves, including more than 70'000 during the 2003 heat wave in Europe.
Globally, extreme temperature events are observed to be increasing in frequency, duration, and magnitude. Between 2000 and 2016, the number of people exposed to heat waves increased by about 125 million.
Heat waves can strain health care and emergency services and increase stress on water, energy, and transportation supplies, which can lead to power shortages or even blackouts. Food and nutrition security can also be affected if crops or livestock are destroyed by extreme heat.
Direct impacts: Heat illness (dehydration, heat cramps, heat stroke), accelerated death from respiratory illness, cardiovascular disease, kidney disease, and other chronic diseases), stroke, diabetes, etc. Indirect effects: Impacts on health services, increased risk of accidents (drowning, workplace accidents, etc.). Disruption of infrastructure (electricity, water, etc.). Increased transmission of foot and water borne diseases, algal blooms.

The risk is higher for the disabled, pregnant, already fragile, poor, displaced, homeless, children, elderly, and outdoor workers!

  • Keep your living space cool.
  • Stay away from heat.
  • Drink water regularly, avoid alcohol.
  • Wear light and loose clothing.
  • Wear a hat or cap and sunglasses.
  • Take cool showers and foot baths.
  • Eat small meals more often.
WHO Heatwaves
WHO Public health advice on preventing health effects of heat
WHO Heat and Health
The "Pride Season" begins and events will take place all over the world. Participants will be primarily lesbian, gay (MSM), bisexual, transgender and queer (LGBTQ) people. It is important to take protective measures against sexually transmitted infections (STIs), including COVID-19 and other infections transmitted through close human-to-human contact, such as monkeypox, HIV, gonorrhea, etc.
MSM are at increased risk of monkeypox infection in non-endemic countries such as Europe or the USA, etc. Safer sex and abstinence from contact with infected persons are important.
CDC, 8.7.2022, CDC (factsheet), 8.7.2022, ECDC, 8.7.2022
Since the end of December 2019, there have been 535'143'050 reported cases of COVID-19 worldwide, including 6'328'694 deaths. In the EU/EEA, 1'112'088 deaths have been recorded. As of mid-June 2022, the total number of weekly reported cases in the EU/EEA increased by 9.2% compared to the previous week. The countries with the highest 14-day reporting rates per 100'000 inhabitants are: Portugal, Luxembourg, Iceland, Germany and France. 
Since the beginning of the year, 755'014 suspected cases of typhoid fever, including 376 deaths, have been reported in the Democratic Republic of Congo.
Follow optimal food and drinking water hygiene ("cook it, boil it, peel it or forget it"). Vaccination against typhoid fever is especially recommended for persons visiting friends and relatives (VFRs) and for travelers where sanitary conditions are poor during their stay.
WHO Bulletin on Outbreaks, EW 24
Since the beginning of the year, 555 clinical cases of yellow fever have been reported from all ten regions of Cameroon. In Uganda, 199 clinical cases were registered during the same period.
Vaccination against yellow fever is recommended for all travelers to these countries. It is mandatory for entry within 6 days from a yellow fever endemic area (also for airport transit there).
WHO Africa 5.6.2022, WHO EW 24
Since the beginning of the year, 17'497 dengue cases have been registered in Malaysia (10 deaths). This is an increase of more than 57% compared to the reported cases in the same period in 2021.
Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot.
WHO, 2.6.2022
More than 100 cases of anisakiasis have been reported in Japan, caused by fish contaminated with parasites. Mackerel, bonito and sashimi are most likely the source. People experience reactions such as severe abdominal pain and vomiting after eating contaminated fish. Several supermarkets have stopped selling fish products and closed the markets for fresh fish.
Do not eat raw or undercooked fish. Raw fish is a common dish in Japan and infections with Anisakis parasites are known.
Global Food Mate, 9.6.2022
So far this year, more than 13'000 cases of dengue fever have been reported in Singapore. The weekly number of dengue cases is expected to increase and reach another historic high. The start of the traditional peak of the dengue season is June.
Optimal mosquito protection 24/7: during the day against dengue, Zika, chikungunya etc. (see factsheet mosquito and tick bite protection). In case of fever: paracetamol products and hydration. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue).
NEA Singapore, accessed 7.6.2022
Malaria cases in the north-eastern Kavango East region of Namibia continue to increase. By the end of April 2022, the most affected district was Andara with 249 cases, followed by Rundu (146) and Nyangana (104). With the emergence of COVID-19, an increase in malaria cases has been observed worldwide.
Protect yourself optimally around the clock (24/7) against mosquito bites (see factsheet mosquito and tick bite protection): at dusk and at night against malaria, during the day against dengue and other arboviruses).
During stays in regions with high risk (link risk areas), it is also strongly recommended to take preventive medication (medicinal prophylaxis).
If you have a fever > 37.5°C: go to a doctor or clinic immediately and have a blood test for malaria! This applies regardless of whether you have taken prophylactic medication or not (see also factsheet malaria).
The Namibian, 26.4.2022, WHO AFRO, 26.5.2022
Since the beginning of the year, a total of 7,394 Zika cases have been reported in the Americas region. The countries particularly affected are Guatemala, Paraguay, Brazil, El Salvador and Bolivia. Currently, none of the above countries is classified as an area where an epidemic is taking place (CDC map).
Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria). Detailed information on Zika can be found in the factsheet zika.
PAHO, accessed 7.6.2022

According to the ECDC (as of June 8, 2022), a total of 1'177 cases have been confirmed worldwide (including EU/EEA). Cases occurred mainly in gay, bisexual and other men who have sex with men (GBMSM), though not exclusively. Most of the cases outside the UK, Canada and US are reported to be linked to travel. However, cases with no known travel history, contact with other cases, animals or specific events are also reported.

Clinical presentation: The cases so far have been mild, there have been no deaths yet. Hospitalised patients have mostly been admitted for local isolation orders. The clinical picture is characterised by lesions that are atypical of the clinical picture in endemic countries. Currently, there are mainly very few, non-grouped, painless pustular lesions on the genitals, perianally and orally. Whether transmission occurs through genital secretions or primarily only through close skin-to-skin contact is not yet clear. The draining lymph nodes are sometimes massively swollen, and fever usually occurs for a few days. The general condition is often only slightly reduced.

Transmission: The virus can be transmitted from person to person via the respiratory tract, through direct contact with body fluids of an infected person or with virus-contaminated objects. The incubation period is 5-21 days, usually about 7-17 days. Monkeypox is transmitted from infected animals through a bite or through direct contact with blood, body fluids or lesions of the infected animal. They can be transmitted to people who eat infected animals via abrasions in the mouth, source, NCDC.

Symptoms: Symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills. 1- 3 days after the onset of symptoms, a rash develops that may look like chickenpox or syphilis and spreads from the face to other parts of the body, including the genitals. The disease is usually mild. In immunocompromised individuals, the disease can be severe. The mortality rate is about 1% for the West African type and up to 10% for the Central African type.

Prevention: Good personal hygiene. Avoid close contact with sick people, including those with skin lesions or genital lesions, and animals at all costs. Avoid contact with contaminated materials used by sick people. During stays in West and Central Africa: Do not consume bushmeat.

The individual risk of contact with a patient with monkeypox depends on the type and duration of contact. In case of very close contact with a case (e.g., family members, aeroplane neighbours, medical staff, sexual partners), the risk of infection is moderate, otherwise low.

If the clinical picture is suggestive, persons should also be isolated, tested and reported for monkeypox.

MANDATORY REPORTING: In Switzerland, every suspected case must be reported within 2 hours to the respective cantonal doctor and to the FOPH (Tel. +41 58 463 87 06) ! Special laboratories, such as the Reference Laboratory for Imported Viral Diseases (HUG) or the Spiez Laboratory or the ZBS1 at the Robert Koch Institute (RKI; consiliary laboratory for smallpox), offer molecular diagnostics for identifying monkeypox infections (material: crust or vesicular fluid).

 

Geosentinel asks to report confirmed and suspected cases at: geosennel@geosentinel.org

ECDC, 9.6.2022, WHO, 4.6.2022, others
Besides an increase in syphilis infections among men who have sex with men (MSM), the continuous rise since 2014 is attributed rather to heterosexual transmissions.
Follow Safer Sex practices at all costs! Sexually transmitted diseases are on the rise worldwide!
Via ProMED, 13.5.2022
An Israeli traveler contracted the Zika virus during a stay in northern Thailand. An English couple who had travelled to Thailand in March 2022 also contracted Zika. They had visited Phuket, some islands and an elephant sanctuary.
The spread of Zika is known in Thailand.
Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria). Detailed information on Zika can be found in the factsheet zika.
GeoSentinel Personal Communication
News_HealthyTravel_22_05_20_Monkeypox.JPG

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.

In case of corresponding clinic, persons without travel history should also be isolated, tested and reported for monkeypox.

MANDATORY REPORTING: In Switzerland, every suspected case must be reported within 2 hours to the respective cantonal doctor and to the FOPH (Tel. +41 58 463 87 06) ! Special laboratories, such as the Reference Laboratory for Imported Viral Diseases (HUG) or the Spiez Laboratory or the ZBS1 at the Robert Koch Institute (RKI; consiliary laboratory for smallpox), offer molecular diagnostics for identifying monkeypox infections (material: crust or vesicular fluid).

 

Geosentinel asks to report confirmed and suspected cases at: geosennel@geosentinel.org

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

Since the beginning of the year, more than 7'300 dengue cases have been registered in Singapore, including 1'005 in the last week of April alone. Dengue is mainly transmitted by Aedes aegypti mosquitoes. In March 2022, the incidence of these mosquitoes in Singapore was about 48% higher than in the same period last year.
Optimal mosquito protection during the day, also in cities. In case of fever, take paracetamol products and drink fluids. Do not take medicines containing acetylsalicylic acid (e.g. Aspirin®), as these increase the risk of bleeding.
Outbreak News Today, 7.5.2022
According to media reports citing the Ministry of Health of São Tomé and Príncipe, more than 40 cases of dengue fever (30 of which were laboratory-confirmed) have been reported nationwide since 11 April 2022.
Dengue is also endemic in African countries, although the extent of its spread is unclear due to lack of surveillance and diagnostics. Optimal mosquito protection 24/7 (at dusk and at night against malaria, during the day against dengue and other arboviruses). In case of fever, malaria should always be considered and excluded by a blood test.
RFI, 23.4.2022
The number of measles cases reported globally increased by 79% in the first 2 months of 2022, to 17'338 cases, compared to the same period in 2021. WHO and UNICEF warn that ideal conditions prevail for severe measles outbreaks (and outbreaks of other vaccine-preventable diseases). Pandemic-related disruptions, inequalities in access to immunisation and the redistribution of resources have severely affected routine childhood immunisation in many places.
Measles are highly contagious and can lead to severe symptoms of the disease with a potentially fatal outcome, especially for immunocompromised patients. They can also cause serious secondary damage. Therefore, a medical consultation should always be used to also review the measles vaccination status: Persons born after 1963 who do not have documented protection against infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. When travelling to an epidemic area, vaccination is recommended for infants as early as 6 months of age.
WHO, 27.4.2022
A national state of emergency has been declared due to severe flooding and landslides that have caused devastating damage in KwaZulu-Natal and parts of the Eastern Cape.
According to the South African government, 435 people have died and over 48 are still missing as of 19 April 2022. In addition, more than 40'000 people have been displaced and thousands of homes destroyed or damaged, including health centres. Electricity and water supplies have collapsed.
Follow current information from the authorities and the media. Tourist travel to the affected areas is not advised. After large floods, the risk of mosquito-borne and gastrointestinal diseases usually increases.
WHO Afro, 24.4.2022
A 45-year-old man from the village of Bagayiri, Boussé district, Plateau Central region, died of yellow fever in Ouagadougou on 20 March 2022. The man had not been vaccinated against the disease.
Yellow fever is endemic in Burkina Faso. Vaccination protection is strongly recommended for all travellers, proof of vaccination is mandatory upon entry.
ProMed, 6.5.2022
According to the WHO, a 31-year-old man from Mbandaka who had been vaccinated against Ebola was confirmed to be infected with Ebola; the man died on 21.4.2022. The source of infection is not known. The virus of this outbreak appears to be different from that of previous outbreaks in this province (2018 and 2020). A second Ebola case, a close patient contact, was confirmed on 25.4.2022.
Ebola is a viral, haemorrhagic, very severe or fatal disease. It is transmitted through direct contact with body fluids and excretions of an infected person (blood, saliva, vomit, stool, sweat, semen, urine, etc.) or with infected animals (especially monkeys, antelopes, rodents, bats). The symptoms are sudden high fever, muscle pain, fatigue, sore throat or headache, followed by diarrhoea, vomiting and internal and external bleeding. Early hospitalisation with supportive care (hydration, maintenance of normal blood pressure) can improve the prognosis.

Travelers are usually at low risk of contracting Ebola if you follow these precautions:

  • Avoid contact with infected/deceased persons or their body fluids, and all wild animals, alive and dead.
  • Avoid handling or eating bush/wild meat.
  • Wash and peel fruits and vegetables before eating.
  • Wash hands regularly and thoroughly with soap and water (or use a sanitizer if soap is not available).
  • Practice safe sex, see LINK.

Vaccination against Ebola is not available to travelers.
For humanitarian missions, it is recommended to consult a travel medicine specialist.
If you have symptoms of illness (fever >38 °C, headache, diarrhea, bleeding symptoms, etc.) during travel until 21 days after being in the affected area: Isolate yourself and immediately contact the in-country hotline by phone or contact a tropical institute or university hospital infectious disease unit. Always state that you may have had an exposure to Ebola.

ProMed, 6.5.2022
A 41-year-old man from ElSalto/Jalisco in Mexico has died of rabies. He had been bitten on the right hand by a bat in January 2022. He had a medical consultation on 9.4.2022 due to pain in his arm, received a rabies vaccination for the first time on 13.4.2022 and died on 18.4.2022.
In Jalisco, the last humane rabies case from dog bites occurred in 1995. From 1996 to 2021, there were only seven cases associated with wild animals.
This tragic case shows that a bat bite must be taken very seriously! Even in areas declared to be free of terrestrial rabies, rabies can be transmitted through contact with bats. In case of suspected exposure, the affected area must be immediately washed with water and alkaline soap for 15 min, disinfected and then rabies postexposure prophylaxis must be administered immediately.
Secretaría de Salud, 6.5.2022
An unvaccinated tourist (country of origin unknown) died of yellow fever in the state of Tocantins. In March 2022, the deceased had gone sport fishing on Lago Peixe/Angical, between Peixe, São Salvador, and Parana.
The vaccination rate against yellow fever is insufficient in the region.
Due to the increasing spread even in areas previously declared free of yellow fever, the Swiss Expert Committee for Travel Medicine (ECTM) recommends yellow fever vaccination protection for the whole country of Brazil. For immunocompetent persons, a yellow fever vaccination with a one-time second vaccination after 10 years (i.e. a maximum of 2 vaccinations in a lifetime) is recommended.
ProMED-mail (promedmail.org) – Archive number 20220414.8702607
Sweden experienced a record year for TBE in 2021 with 553 cases. The warm summer of 2020, with an increase in the population of the small rodents, as well as Covid-19-related reduced foreign travel, are cited as factors for the increase in TBE infections in 2021.

Protect yourself against ticks during outdoor activities (see factsheet mosquito and tick bite protection). Vaccination against TBE is recommended for (planned) stays in endemic areas (CH: throughout Switzerland except cantons of Geneva and Ticino).
After recreational activities: Always examine your body for ticks or tick bites. If redness appears at least 3 days (7-10 days on average) after tick bite: consult a physician to rule out erythema migrans (Lyme disease), which would require antibiotic treatment.

Outbreak News Today, 11.4.2022
According to IATA (International Air Transport Association), Paraguay has adjusted the entry requirements for yellow fever (see bold). Vaccination against yellow fever is mandatory for entry within 6 days (not for airport transit there) from:
- Brazil, Bolivia, Peru and Venezuela.
Exempt from this entry requirement are: Persons >60 years old and children <1 year old.
Yellow fever is endemic in Paraguay. The WHO recommends travellers to have a yellow fever vaccination for the whole country. In addition, there are above-mentioned country-specific entry requirements to contain the spread of the virus.
IATA, Travel International Manual, April 2022; WHO, 2021.
According to IATA (International Air Transport Association), Nicaragua has adjusted the entry requirements for yellow fever for children (see below). 
Yellow fever vaccination is mandatory for entry from the following countries (not for airport transit there): Angola, Argentina, Benin, Bolivia, Brazil, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Côte d'Ivoire, Ecuador, Equatorial Guinea, Ethiopia, Franz. Guyana, Gabon, Gambia, Ghana, Guinea, Guinea Bissau, Guyana, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Panama, Paraguay, Peru, Rwanda, Senegal, Sierra Leone, Sudan, South Sudan, Togo, Trinidad and Tobago, Uganda and Venezuela.
Exempt from this entry requirement are: Persons >60 years old and children <9 months old.
The yellow fever virus does not occur in Nicaragua. The above-mentioned entry requirements are in place to avoid importing the virus.
IATA, Travel International Manual, April 2022
In certain information sheets (French version, not English version) of the Embassy of Mozambique in Geneva, proof of a yellow fever vaccination is still required for visa applications. After personally contacting the embassy in Geneva, the ECTM (Expert Committee on Travel Medicine) was assured that this does not apply to people entering from Europe.
Yellow fever is not endemic in Mozambique. However, according to IATA (International Air Transport Association), vaccination against yellow fever is mandatory when entering the country within 6 days from a yellow fever endemic area.
The Ugandan Ministry of Health reports an outbreak of yellow fever with a total of 8 cases from the districts of Wakiso and Masaka on Lake Victoria. Four of the cases are reported to have not been vaccinated against yellow fever, there is no information on the vaccination status of the others.
Vaccination against yellow fever is recommended for all travellers. It is mandatory for entry within 6 days from a yellow fever endemic area (also in case of airport transit there).
WHO AFRO, 29.3.2022, Outbreak News Today, 31.3.2022
Health authorities report continued malaria transmission in the region of Zona Norte in the country. Since September 2021, increased numbers of malaria cases have been reported in Medio Queso, San Gerardo, Cuatro Esquinas, Isla Chica, La Trocha, Las Delicias, Coquita, Santa Cecilia and San Francisco.

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): at dusk and at night against malaria, during the day against dengue and other arboviruses.
If you should have a fever > 37.5°C: visit a medical facility immediately and take a blood test for malaria (see also factsheet malaria).

HPS Weekly Report, Week 9, 8.3.2022
A Chikungunya outbreak is reported in Wajik County (located in the north of the country). The dengue outbreak of 2021 in Mombasa and Mandera continues in 2022.

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).

Outbreak News Today, 13.3.2022
According to authorities, 18 deaths from rabies were reported last year, compared to seven deaths in 2020. Bukidnon province was responsible for the most deaths. According to the authorities, one reason for the increase could be that it was difficult to get vaccinated against rabies due to the pandemic.
Avoid contact with animals! Do not feed animals either! For long-term travellers and travellers with increased individual risk (travelling with two-wheelers, to remote areas, small children, working with animals, cave explorers, etc.) a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is recommended. 
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 centre as soon as possible for a post-exposure vaccination (see also factsheet on rabies) !
Outbreak News Today, 29.3.2022

In the first three months of 2022, 99 probable cases of leptospirosis were registered in Petrópolis, compared to only three reports in the same period of 2021. The region was hit by heavy rains and flooding in February 2022, which increased again in recent days.

Leptospires are bacteria that can be transmitted via the urine of rodents (especially rats). This can happen, for example, when wading through contaminated rivulets, puddles or mud. Transmission to humans occurs via small skin lesions or mucosal contacts through direct or indirect contact with rodent urine. Symptoms of the disease range from flu-like general symptoms, headache, high fever to blood poisoning. Antibiotic treatment is necessary to prevent complications and accelerate healing.

Wear protective clothing/boots when wading through water! No vaccination is available for travellers.
Via ProMED, 6.4.2022
On 23 March 2022, the Ministry of Health of Côte d'Ivoire reported 11 confirmed dengue cases to the WHO, including 1 death. Nine cases originated from Abidjan (particularly from the districts of Cocody Bingerville and Treichville Marcory), and 2 cases from the hinterland districts of Adiaké and Daloa.
A traveller returning to Switzerland who had been in Côte d'Ivoire was also recently diagnosed with dengue infection.
Dengue outbreaks have been recorded repeatedly in Côte d'Ivoire in recent years.

The dengue virus also occurs in Africa! The spread on the African continent is probably underestimated due to a lack of diagnostics.

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).

WHO AFRO, 29.3.2022
According to the World Health Organisation (WHO), a chikungunya outbreak was detected in Dolo Ado district in Somali Region on 17 January 2022. A total of 311 suspected cases were reported, three of them confirmed.
Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).
Outbreak News Today, 15.3.2022
According to IATA (International Air Transport Association), Egypt has adjusted its entry requirements. Vaccination against polio is now mandatory for entry from the following countries (with documentation in the 'International Certificate for Vaccination'):
- Guinea-Bissau
- Mauritania
- Ukraine
In addition, polio vaccination is still mandatory from the following countries: Afghanistan, Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, China, D.R. Congo, Republic of Congo, Côte d'Ivoire, Ethiopia, Gambia, Ghana, Guinea, Iran, Kenya, Liberia, Madagascar, Mali, Niger, Nigeria, Pakistan, Senegal, Sierra Leone, Somalia, Sudan, South Sudan, Tajikistan, Togo, Uganda and Yemen.
The vaccination must be administered at least 4 weeks before entry and must not date back more than 1 year.
IATA, Travel International Manual, April 2022

At the beginning of March, an almost 4-year-old girl from Jerusalem was diagnosed with acute flaccid paralysis. Circulating vaccine poliovirus type 3 (cVDPV3) was detected in the stool. In the course, another 5 persons were diagnosed with cVDPV3 and one suspected case is still awaiting test results. All 7 persons had not been vaccinated against polio.

Further testing revealed genetic links to VDPV3 strains detected in environmental samples collected from sites in Jerusalem and Bethlehem between September 2021 and January 2022. Health authorities are currently conducting epidemiological and virological investigations on site to further determine the source and origin of the isolated virus and the associated potential risk of further spread.

Formally, Israel falls under the temporary polio vaccination recommendations of WHO category 1 ("States infected with WPV1, cVDPV1 or cVDPV3 with potential risk of international spread"), a confirmation by the International Health Regulation (IHR) Committee is still pending:
On departure from Israel, persons with residence in the country for >4 weeks must have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their 'International Certificate for Vaccination'. This is important to avoid the spread of poliomyelitis viruses from the country and can be checked on departure.
Stays < 4 weeks: In addition to the basic immunisation against polio, a booster vaccination is recommended every 10 years (recommendation of the Swiss Expert Committee for Travel Medicine (ECTM).
Polioeradication, via ProMED, 30.3.2022

The Brazilian Ministry of Health reports a 35.4% increase in dengue cases in the first two months of this year compared to 2021, with 30 deaths and 128,379 cases registered, according to the report. The municipalities with the most probable dengue cases were Goiânia, Brasília, Palmas, Sinop and Aparecida de Goiânia.

 

Consequences for travelers

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria if you are in a risk area. If you have a fever: take medication containing the active ingredient paracetamol and make sure you drink enough fluids. Do not use any medicines containing the active ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the tendency to bleed in the case of a dengue infection (see also factsheet dengue). During stays in malaria areas, malaria should always be ruled out by means of a blood smear if the fever is >37.5 °C. Visit a medical facility to do so (see also factsheet malaria).

 

References

Outbreak News Today, 25.3.2022

Since the beginning of 2022, 33 suspected Lassa cases have been recorded in Liberia, 17 confirmed and 5 fatal. The cases come from Bong County, Grand Bassa Counte and Nimba County. In Togo, 1 case was confirmed in the north of the country at the end of February.

Lassa virus is transmitted via rodent excretions, e.g. through contaminated food, or it is inhaled. Human-to-human transmission occurs through contact with body fluids of infected persons. Lassa belongs to the group of haemorrhagic fevers. The symptoms of the disease range from mild flu-like symptoms to fever with bleeding.

 

Consequences for travelers

Wash or disinfect hands regularly and maintain optimal food hygiene. Mouse-infected places should be avoided. Avoid contact with ill or deceased persons suspected of having Lassa fever.

 

References

Outbreak News Today, 18.3.2022

The World Health Organisation (WHO) reported four cases of monkeypox in the last week of February, including 2 deaths in the Central African Republic. At least one monkeypox epidemic is recorded in the country every year.



Consequences for travelers

Monkeypox is endemic in countries in West and Central Africa. The individual risk of contact with a patient with monkeypox depends on the type and duration of contact. Transmission occurs from animal to human through contact with infected material (usually "bush meat" preparation). In case of very close contact with a patient (e.g. family members, neighbours on an plane, medical staff), the risk of infection is moderate, otherwise low.

 

References

Outbreak News Today, 18.3.2022

In India, two women from Vemulamada village in the southern state of Andhra Pradesh died of rabies on the same day, two months after being bitten by a cat. According to the villagers, the cat had contracted rabies because it had previously been bitten by a rabid dog. The cat also died later on. According to the report, the women received tetanus toxoid injections and medication for the cat bite, but no mention was made of post-exposure prophylaxis (PEP) against rabies.

 

Consequences for travelers

Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high-quality medical centre (post-exposure vaccination). For long-term travellers and travellers with increased individual risk (travelling with two-wheelers, to remote areas, long-term stays, small children, etc.), a pre-exposure vaccination is recommended before the stay.

 

References

Outbreak News Today, 11.3.2022

News_HealthyTravel_22_03_09_Bild_1.png

A yellow fever outbreak has been confirmed in Isiolo district (see map). So far, 4 people have died and investigations are pending for another 15 people. The first case was apparently already confirmed in January.
The outbreak takes place in a sparsely populated and not very attractive area for tourists. Nevertheless, the epidemic potential of yellow fever is evident with very low vaccination coverage nationwide.  
Vaccination campaigns are planned. The last local cases of yellow fever occurred in the early 1990s.

 

Consequences for travelers

Yellow fever vaccination is now recommended by the Swiss Expert Committee for Travel Medicine (ECTM) for all travellers to Kenya (whole country) until further data becomes clear. For immunocompetent persons, a yellow fever vaccination with a one-time second vaccination after 10 years (i.e. a maximum of 2 vaccinations in a lifetime) is recommended. In the case of travellers returning from Kenya from this region who exhibit fever, a yellow fever infection must be considered and ruled out by means of laboratory analyses (incubation period typically 3-6 days).

 

References

Kenya on alert as it reports outbreak of yellow fever – MINISTRY OF HEALTH

https://promedmail.org/ - Archive Number: 20220309.8701889

Health authorities in Malawi declare an outbreak on 17 Feb 2022 after a case of wild poliovirus type 1 is confirmed in Malawi/Lilongwe (disease began in Nov 2021). The pathogen is related to a strain from Pakistan (Sindh), where wild polio is still circulating.

Africa was declared free of indigenous wild polio in August 2020 after all forms of wild polio were eliminated in the region. In Malawi, the last clinically confirmed case of wild polio was reported in 1992.

Polio is transmitted through water or contaminated food and can cause permanent, disabling paralysis. There is no treatment, but vaccination prevents the disease.

 

Consequences for travelers

The vaccination reliably protects against infection: 4 doses during childhood or 3 doses during adulthood and a booster vaccination every 10 years for all countries in sub-Saharan Africa and for countries that are classified as vulnerable to polio outbreaks.

 

References

WHO Outbreak News, 4.3.2022

Two cases of circulating poliovirus type 2 have been reported, one in each of the provinces of Nampula and Cabo Delgado. These cases occurred already in December 2021.

 

Consequences for travelers

Formally, Mozambique is again included in the temporary polio vaccination recommendations of the WHO (category 2: "States infected with cVDPV2, with potential or demonstrated risk of international spread"), a confirmation by the IHR committee is still pending. This means:

Persons who are staying in the country for > 4 weeks are strongly recommended to have a minimum of 4 weeks and a maximum of 12 months of recent polio vaccination (IPV) with documentation in the international vaccination card when leaving Mozambique. This is important to avoid the spread of poliomyelitis viruses from the country and can be checked upon departure.  

Persons staying in the country for < 4 weeks are recommended to receive a booster vaccination every 10 years in addition to a basic immunisation against polio.

 

References

Polioeradication, 15.2.2022

According to media citing the National Institute of Communicable Diseases of South Africa, at least 160 cases of typhoid fever have been reported since 16 February 2022, a significant increase over the average incidence. Cases have been recorded in 8 of the 9 provinces, with the highest number of cases recorded so far in Guateng (45 cases) and Western Cape (64 cases, including in Cape Town and Garden Route N.P.). The source of infection is still under investigation; in the Western Cape, well water has been ruled out as a source.

 

Consequences for travelers

Optimal food and drinking water hygiene is recommended. In case of poor sanitary conditions, vaccination against abdominal typhoid may be considered. In case of fever, a doctor should be consulted.

 

References

Outbreak News Today, 16.2.2022

According to IATA (International Air Transport Association), Egypt has adjusted the entry requirements (new countries marked in bold): Vaccination against polio is mandatory for entry from the following countries (with documentation in the 'International Certificate for Vaccination'):

Afghanistan, Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, China, Côte d'Ivoire, D.R. Congo, Ethiopia, Gambia, Ghana, Guinea, Iran, Kenya, Liberia, Madagascar, Mali, Niger, Nigeria, Pakistan, Republic of Congo, Senegal, Sierra Leone, Somalia, Sudan, South Sudan, Tajikistan, Togo, Uganda and Yemen.

 

Consequences for travelers

The vaccination must be administered at least 4 weeks before entry and must not date back more than 1 year.

 

References

IATA, Travel International Manual, February 2022

The Rio Carnival will take place from 20 to 30 April 2022. The events will be held throughout the city of Rio de Janeiro.

 

Consequences for travelers

Mass events can promote gastrointestinal and respiratory infections. Good food and personal hygiene and plenty of hydration are recommended. The risk of accidents may also be increased. To avoid sexually transmitted diseases (HIV, syphilis, gonorrhoea, chlamydia, etc.): be sure to follow safe sex practices!

Recommended vaccinations: COVID-19 vaccination (see also entry regulations!), yellow fever, MMR varicella (if infection has not been passed), tetanus, diphtheria, pertussis, poliomyelitis (basic immunisation only), hepatitis A and B, influenza and meningococcal ACWY. Further vaccinations depending on travel style and destination, see country page Brazil www.healthytravel.ch.

Mosquito protection 24/7 is strongly recommended throughout the country, including cities, to avoid various arboviruses such as dengue, chikungunya, Zika. The city of Rio de Janeiro is malaria-free, but malaria is endemic in the Atlantic rainforest of Rio de Janeiro state. For more malaria risk areas and recommended prevention measures, see country page Brazil www.healthytravel.ch.

 

References

Various

Timor-Leste has been reporting an outbreak of dengue cases since the end of 2021. In the month of January 2022 alone, a total of 1,286 cases were registered. This compares to 901 cases in the whole of 2021 and 1'451 cases in the whole of 2020. More than half of the cases were reported from the capital region of Dili.

 

Consequences for travelers

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria)

 

References

WHO DON, 4.2.2022

Dengue infections in the state of Minas Gerais in Brazil are increasing sharply after heavy rains. According to the health department, a 224% increase was observed with a total of 577 cases at the beginning of February.

 

Consequences for travelers

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection). If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue).

 

References

Outbreaknewstoday, 7.2.2022

According to official sources, at least 74 children have died of measles in Badakhshan province in northern Afghanistan.

Since the end of July 2021, measles cases and deaths have increased in all provinces, with the highest weekly number observed in the last four weeks in January 2022. Measles vaccination uptake rates are very low among the population. The World Health Organisation warned of many measles deaths in Afghanistan as early as November 2021.

Measles is a highly contagious viral disease transmitted through the respiratory tract. It is spread all over the world. The disease can be prevented very effectively with a vaccine.

 

Consequences for travelers

A trip offers an ideal opportunity to check the protection against measles (2x vaccinated or passed measles infection) and if necessary to update the vaccination protection. This is especially relevant for humanitarian missions.

 

References

Via ProMED 11.2.2022

In 2021, a total of 21'030 malaria cases were registered by 21.11.2021, compared to 27'573 cases in the same period in 2020. The reporting figures have increased compared to previous years.

In addition, Nicaragua is the country in Central America with the highest increase in Plasmodium falciparum malaria. This type of malaria is a severe form of malaria that can quickly become fatal if left untreated.

 

Consequences for travelers

Protect yourself optimally against mosquitoes around the clock (see factsheet mosquito and tick bite protection): during the day against dengue fever, chikungunya, Zika and other viruses, at dusk and at night against malaria. In addition, if you are staying in high-risk areas (north-eastern Nicaragua), it is recommended that you take medicinal malaria prophylaxis. If you have a fever >37.5 °C, you should consult a local doctor to rule out malaria. Visit a medical facility for this purpose (see also factsheet malaria).

 

References

Outbreaknewstoday.com, mesvaccins.net, 31.1.2022

Health authorities in South Africa reported the first case of human rabies in 2022. The diagnosis was confirmed in a four-year-old child in Gqerberha (Port Elizabeth) of the Eastern Cape province. He was bitten on the lip by a dog he was playing with on 1 December 2021. Post-exposure prophylaxis (PEP) against rabies was not arranged. One month later, the child was admitted to hospital with rabies symptoms. 

In 2021, a total of 19 confirmed human rabies cases were reported in the Eastern Cape provinces.

 

Consequences for travelers

Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a high-quality medical centre (post-exposure vaccination). For long-term travellers and travellers with increased individual risk (travelling with two-wheelers, to remote areas, long-term stays, small children, etc.), a pre-exposure vaccination before the stay (2 injections and a booster after 1 year) is recommended.

 

References

Outbreaknewstoday.com, mesvaccins.net, 3.2.2022

2022 is the Year of the Tiger; Chinese New Year falls on Feb. 1, 2022, and a highlight will be the Lantern Festival on Feb. 15, 2022. In addition, the Olympic and Para-Olympic Games in Beijing, Yanqing, in Zhangjiakou and in Hebei Province are scheduled for February 4-20 and March 4-13, 2022, respectively.

 

Consequences for travelers

If considering a visit despite COVID-19 pandemic, the following precautions are recommended: 

General: 

  • COVID-19: Observe current situation, entry and return travel regulations, and precautions regarding COVID-19 in the country! See also advice FOPH Coronavirus/Travel.
  • Mass events may favor gastrointestinal and respiratory infections, therefore: follow good personal and food hygiene. 
  • The risk of accidents may also be increased (CAVE alcohol!). 
  • To avoid sexually transmitted diseases (HIV, syphilis, gonorrhea, chlamydia, etc.): follow safer sex practices (condoms). 
  • Avian influenza is particularly prevalent in China. Contact with poultry and their droppings should be avoided. Do not visit bird and poultry markets/farms, do not import poultry meat from China. Travelers should also wash their hands frequently with soap and water. 

Recommended vaccinations and other health risks: 
See China country page

 

References

Diverse. Olympische Spiele, Bejing 2022

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

Outbreak News Today, 5.1.2022

Due to an increase in leptospirosis cases, the Department of Antioquia has issued a warning. So far, the municipalities most affected are Medellín, with 70 confirmed cases, Apartadó (54 cases), Turbo (29 cases) and Puerto Berrío (18 cases). Large accumulations of waste in some areas (especially in the city of Medellín) favor the presence of rodents.

In 2021, the total number of leptospirosis cases registered nationwide was 2269, including 14 deaths. The cities of Cali, Bogotá and Medellín were particularly affected.

Consequences for travelers

Wear protective clothing/boots when wading through water! Leptospires are transmitted via the urine of rodents (especially rats), e.g. in water residues (rivulets, puddles, etc.) or mud. Transmission to humans occurs via small skin lesions or mucosal contacts through direct or indirect contact with rodent urine. The symptoms range from flu-like general symptoms to meningitis (aseptic meningitis) to sepsis. The disease can be treated with antibiotics. Vaccination is not generally available. 

 

References

Outbreak News Today, 28.12.2021

In Andresito, Misiones province in northeastern Argentina, two people have died from botulism and six affected persons are still in intensive care. The source of infection is believed to be homemade sausages that the affected persons had consumed.

Botulism, caused by toxins from the bacterium Clostridium botulinum, is usually associated with home-canned food, be it home-canned vegetables, meat or fish. Botulinum toxin cannot be smelled, nor does it have a specific taste. Botulinum toxins are among the most potent poisons known and are on the list for potential bioweapons agents.

 

Consequences for travelers

Consumption of home-made sausages should be avoided. Food botulism is prevented by proper preparation of canned food and industrial controls. Bombed canned foods are considered suspect and must be destroyed.

 

References

Via ProMED 12.1.2021, FOPH

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

https://promedmail.org/ 

According to the World Health Organization (WHO), 1'380'955 clinical cases of typhoid fever have been reported in the DRC since the beginning of 2021 and up to December 12, including 502 deaths.

 

Consequences for travelers

Follow optimal food and drinking water hygiene ("cook it, boil it, peel it or forget it"). Vaccination against typhoid fever is especially recommended for persons visiting friends and relatives (VFRs) and for travelers where sanitary conditions are poor during their stay. For more details, see factsheet typhoid fever

 

References

https://promedmail.org/ 

In 2021, nine countries in the WHO African Region (Cameroon, Chad, Central African Republic (CAR), Côte d'Ivoire, Democratic Republic of Congo (DRC), Ghana, Niger, Nigeria, and Republic of Congo) reported human yellow fever cases that were confirmed in the laboratory. The number of cases in these outbreaks is increasing compared to previous years. Yellow fever cases classified as probable have also been reported in Benin, Burkina Faso, Gabon, Mali, Togo, and Uganda.

Some of the affected countries are classified as fragile, conflict-affected, or vulnerable, where population immunity to yellow fever is low.

 

Consequences for travelers

Yellow fever vaccination is strongly recommended when traveling to yellow fever endemic areas, see country pages www.healthytravel.ch/countries/ or 'Reisemedizinischen Tabellen' of the FOPH: LINK.

 

References

WHO DON, 23.12.2021

A 13-year-old girl contracted rabies after being bitten by her own dog, according to the head of the Zoonosis Program of the Departmental Health Service (SEDES) in Potosí, southeastern Bolivia. A few days after the bite, she had a series of health problems for which she was admitted to the intensive care unit of a medical center. The rabies diagnosis was confirmed by laboratory tests.

 

Consequences for travelers

Avoid contact with animals (never feed them!). After an animal bite/scratch, wash the wound with running water and soap for 15 minutes, disinfect and in any case visit a quality medical center (post-exposure vaccination). For long-term travelers and travelers with increased individual risk (travel with two-wheelers, to remote areas, long-term stays, 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.

 

References

Outbreak News Today, 3.1.2022

The epidemiological authority of the state of Santa Catarina has reported 8 human cases of yellow fever this year, including three deaths. None of the victims were vaccinated. In addition, monkey deaths continue to be observed in Santa Catarina State: In 2021, there were a total of 625 cases in monkeys, and yellow fever infection was confirmed in 137 cases.

Yellow fever is a life-threatening viral disease transmitted by mosquitoes. There is no specific therapy, but there is a very effective vaccination. It is the best way to protect yourself from yellow fever. In addition, optimal mosquito protection is important. For children under 9 months, pregnant women, nursing mothers, people with immunodeficiency or thymus disease who want to travel to Brazil, we recommend to consult a specialist in travel and tropical medicine.

 

Consequences for travelers

In Brazil, the main season for yellow fever infections is between December and May. Yellow fever vaccination is recommended by the WHO for most regions in Brazil. Due to the increasing spread even in areas previously declared to be free of yellow fever, the Swiss Expert Committee for Travel Medicine (ECTM) recommends yellow fever vaccination for all of Brazil. For immunocompetent persons, a yellow fever vaccination with a one-time second vaccination after 10 years (i.e. a maximum of 2 vaccinations in a lifetime) is recommended.

 

References

Via ProMED, 14.12.2021

A yellow fever outbreak occurred in Ghana in October 2021. The following regions are affected: Savannah, Upper West (in the northwest), Bono (in the center), and Oti (in the east). Of approximately 600 clinical cases, 102 laboratory-confirmed cases and 46 deaths have been reported.

 

Consequences for travelers

Vaccination against yellow fever is mandatory for traveling to Ghana.

 

References

Via ProMED, 13.12.2021

Das «Center for Disease Control and Prevention» (CDC) hat ganz Indien als Land mit einer aktuellen Zika-Epidemie eingestuft, wobei der Ausbruch hauptsächlich in Uttar Pradesh stattfindet. Seit Oktober 2021 wurden 109 bestätigte Fälle gemeldet. Wie in früheren Nachrichten berichtet, wurden auch in anderen Teilen Indiens (Kerala, Maharasthra) Zika-Fälle registriert.

Das Zika-Virus wird v.a. von Mücken übertragen, die tagsüber stechen und in vielen tropischen Regionen vorkommen. Etwa 80% der Infektionen verlaufen asymptomatisch. Die klinischen Symptome sind in der Regel nicht schwerwiegend und dauern zwischen 5 und 7 Tagen: Fieber, roter Hautausschlag (Rash) mit Juckreiz, Gelenkschmerzen, Bindehautentzündung (rote Augen), manchmal Kopf- und Muskelschmerzen. Es kann zu neurologischen (Guillain-Barré-Syndrom) und immunologischen Komplikationen kommen. Es gibt keinen Impfstoff und keine spezifische Therapie gegen das Zika-Virus. Eine besondere Situation besteht für schwangere Frauen, da ein Risiko schwerer Missbildungen beim ungeborenen Kind besteht.

 

Folgen für Reisende

Aktuell besteht ein erhöhtes Übertragungsrisiko für das Zika-Virus in Indien. Beachten Sie, dass das Zika-Virus auch sexuell übertragen werden kann! Prävention: Optimaler Mückenschutz 24/7: Tagsüber gegen Zika, Dengue und andere Arbovirosen, in der Dämmerung und nachts gegen Malaria.
Bei Reisen in Gebieten mit einem Zika Ausbruch, wie dies in Indien nun der Fall ist, empfiehlt das Schweizerische Expertenkomitee für Reisemedizin während der Reise und mindestens 2 Monate nach der Rückkehr ein Kondom/Femidom zu verwenden, um eine mögliche sexuelle Übertragung des Virus zu verhindern.
Wegen des Risikos für Fehlbildungen beim ungeborenen Kind wird schwangeren Frauen derzeit davon abgeraten, nach Indien zu reisen. Bei unbedingt notwendigen Reisen wird empfohlen, vor der Abreise mit einem Facharzt für Reisemedizin zu sprechen.
Frauen, die planen, schwanger zu werden, sollten nach ihrer Rückkehr (oder der des Partners) aus Indien mindestens 2 Monate mit der Familienplanung abwarten. Im Falle einer medizinisch unterstützten Fortpflanzung sollte dieser Zeitraum auf mindestens 3 Monate verlängert werden. Lesen Sie auch das Informationsblatt Zika, insbesondere wenn Sie schwanger sind oder Sie oder Ihre Partnerin eine Schwangerschaft planen.

 

Referenzen

CDC Travel News, 9.12.2021, ECDC 13.11.2021, EKRM statement 2019

In den letzten vier Wochen wird ein Anstieg der Malariafälle in der Nordzone (Gemeinden Medio Queso, San Gerardo, Cuatro Esquinas, Isla Chica, La Trocha, Las Delicias und Coquital) beobachtet. Bis zum 27.11.2021 wurden 138 Fälle registriert. Nachdem in den Jahren 2013-2015 keine lokal erworbenen Fälle in Costa Rica registriert wurden, kommt es seit 2016 wieder zu vermehrten Meldungen von lokal erworbenen Malariafällen, wobei die Anzahl pro Jahr jedoch unter 100 Fällen blieb.

Malaria wird abends und nachts durch Mücken übertragen. Die Symptome der Erkrankung sind Fieber >37,5° C, Schüttelfrost, Kopfschmerzen und Grippesymptome sowie gelegentlich Durchfall. Die Krankheit ist potenziell tödlich und stellt einen medizinischen Notfall dar!

 

Folgen für Reisende

Optimaler Mückenschutz 24/7 (in der Dämmerung und nachts gegen Malaria, tagsüber gegen Dengue, Chikungunya und andere Arbovirosen). Bei Fieber >37.5° C sollte immer an eine Malaria gedacht und diese mittels Blutuntersuchung ausgeschlossen werden.

 

Referenzen

Outbreak News Today, 4.12.2021, Ministerio de Saude, 3.12.2021

In Queensland, the number of cases with Ross River Virus (RRV) infections is increasing, with over 150 people tested positive on the Sunshine Coast. Due to rainfall and the associated increase in the mosquito population, more people are expected to become ill in the coming weeks.

Ross River virus disease is the most common mosquito-borne infectious disease in Australia; it occurs throughout of the country but is found primarily in Queensland, Victoria, and Western Australia. Transmission occurs through Culex and Aedes mosquitoes. After an acute phase with fever, skin rash, and joint pain, RRV can sometimes cause long-lasting pain in various joints (polyarthritis).

 

Consequences for travelers

Optimal mosquito protection is recommended around the clock (24/7) (see factsheet mosquito and tick bite protection). There is neither a specific medication nor a vaccination.

 

References

Via ProMED, 29.11.2021

According to the WHO, more than 200 suspected cases of yellow fever infection were reported between Oct. 15th and Nov. 27th, 2021, of which 70 cases were laboratory-confirmed. The number of deaths has risen to at least 40. Yellow fever was likely introduced into the region by nomads from Nigeria who moved into Savannah region of Ghana. At least 8 regions are now affected by the outbreak, including tourist areas. A vaccination campaign and further investigations have been initiated.

 

Consequences for travelers

Vaccination against yellow fever is strongly recommended for all travelers. Proof of yellow fever vaccination is mandatory upon entry.

 

References

WHO DON 1.12.2021, Via ProMED, 1.12.2021

According to media reports, seven people have died in Zanzibar after eating turtle meat; three people are still being treated in hospital.

Turtle meat is a popular delicacy among residents. In rare cases, turtle meat can be toxic due to a biotoxin called chelonitoxism. Symptoms include nausea, vomiting, dysphagia, and abdominal pain. Severe cases can lead to coma and multiple organ failure.

 

Consequences for travelers

Refrain from consuming the meat of sea turtles! It is prohibited in most countries due to conservation efforts!

 

References

Via ProMED, 29.11.2021

According to media reports, malaria cases in Limpopo province have doubled from 206 to over 400 cases in two weeks. The districts Vhembe and Mopani are most affected. Authorities expect a further increase in malaria cases during the rainy season in the coming weeks.

 

Consequences for travelers

Optimal mosquito protection is necessary at dusk and at night in the north/northeast of the country. In addition, from September to May, the use of chemoprophylaxis against malaria is recommended for stays in the high-risk areas (northeast and east of Mpumalanga Province, incl. Kruger & neighboring parks, as well as north and northeast of Limpopo Province.).

 

References

Outbreak News Today, 25.11.2021

Between October 8th and November 11th, 2021 86 cases of dengue fever infections were registered in the district of Richard Tol, Saint Lois region. So far, Dengue virus serotypes 1 and 3 (DENV 1 and DENV 3) have been reported.

Dengue is endemic in Africa. The exact extent of its spread on the African continent is unclear, as a diagnosis is often not made and epidemiological surveillance is poor.

 

Consequences for travelers

Protect yourself optimally around the clock (24/7) against mosquitoes (see factsheet mosquito and tick bite protection): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this can increase the bleeding tendency in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).

 

References

WHO AFRO 23.11.2021

(source image: PAHO Zika weekly report, accessed 19.11.2021) The high incidence in Guatemala compared to the other countries is striking. However, these numbers need to be interpreted with caution, as epidemiological surveillance may be limited due to the COVID-19 pandemic. Case numbers in the Caribbean are incomplete, see link for details.

 

Consequences for travelers

Currently, none of the above countries is classified as an area with a current outbreak (see CDC map). Prevention: Optimal mosquito protection is necessary around the clock (24/7): during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this may increase the risk of bleeding in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria). Detailed information on Zika can be found in the Zika factsheet.

 

References

PAHO Zika weekly report, accessed 19.11.2021

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News_HealthyTravel_21_11_18_Bild_1.png

According to media reports, at least 80 fishermen have fallen ill with an unclear skin disease in the suburbs of Dakar. Already, in 2020 several hundred fishermen in Senegal were affected by an unclear vesicular, highly itchy skin affliction, which was accompanied by fever and had occurred after returning from the sea (incubation period of several days). Close contacts, such as family members, were not affected at that time. Images of skin disease 2020 (source image: AFRIK.COM, 20.11.2021):

 

Consequences for travelers

Very likely low risk for travelers. For information, follow current media reports. In case of unclear skin symptoms after contact with seawater, consult a physician.

 

References

RFI, 8.11.2021,  AFRIK.COM, 20.11.2021

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

Outbreak News Today, 12.11.2021, NCDC, week 43, 2021

The Beijing Olympic and Paralympic Games are scheduled for February 4-20 and March 4-13, 2022, respectively. About 3,000 athletes from 80 countries are expected. The competitions will be held in Beijing, Yanqing, Zhangjiakou, and the Hebei province.

According to current regulations, international spectators are not allowed to attend. Local spectators will be allowed to attend the Games; information on additional conditions is still pending.

 

Consequences for travelers

If considering a visit, the following precautions are recommended:

General:

  • Follow entry requirements and precautions regarding COVID-19 in the country.
  • Mass events can favor gastrointestinal and respiratory infections: follow good personal and food hygiene.
  • Accident risk may also be increased (be cautious with alcohol!).
  • Follow safer sex practices (i.e., the use of condoms) to avoid the transmission of sexually transmitted diseases (HIV, syphilis, gonorrhea, chlamydia, etc.).
  • Avian influenza is prevalent in China. Contact with poultry and their droppings should be avoided. Do not visit bird and poultry markets/farms, do not import poultry meat from China. Travelers should wash hands frequently with soap and water.

Recommended vaccinations:

  • COVID-19, MMR, varicella (for people with no chickenpox infection in the past), influenza, tetanus, diphtheria, pertussis, poliomyelitis (basic immunization and booster every 10 years if stay < 4 weeks or annually if stay > 4 weeks), hepatitis A and B.
  • Depending on individual risk: pre-exposure rabies vaccination.

 

References

Diverse. Olympische Spiele, Bejing 2022

Diphtheria cases were reported in four countries in 2021:

Dominican Republic: A total of 56 suspected diphtheria cases were reported between week 1 and 42 in 2021, of which 18 were confirmed (14 by laboratory testing and 4 by epidemiologic investigation), including 12 confirmed deaths. Regarding other cases: 31 of the total reported in 2021 were discarded, one was classified as probable, and 6 remain under investigation.

Haiti: A sustained diphtheria outbreak has been ongoing since 2014 (over >1,300 suspected cases). In 2021 (week 1-38), the number of suspected cases reported (164 cases) is similar to the number reported in the same period in 2019 (165 cases), although higher than the number of suspected cases reported in the same period in 2020 (110 cases).

Colombia: 7 suspected diphtheria cases were reported between week 1 and 41 (2021), of which 1 was laboratory-confirmed, 5 cases were excluded, and 1 case is still under investigation.

Brazil: 1 diphtheria case

The WHO Americas Region has seen a steady decline in vaccination coverage against diphtheria since 2010. The coverage rate for the third dose of diphtheria, tetanus, and pertussis (DTP3) vaccine in the Americas Region declined from 94% to 84% between 2010 and 2020. In addition, the COVID-19 pandemic has also affected epidemiologic and laboratory surveillance systems for vaccine-preventable diseases.

 

Consequences for travelers

A booster vaccination against diphtheria (together with tetanus) is necessary in addition to a basic immunization. The optimal time for the booster vaccination for stays in areas with a diphtheria epidemic is unclear. Travelers to countries with diphtheria outbreaks should receive a booster vaccination if the previous booster vaccination is more than 10 years old, as the diphtheria protection is shorter-lasting than the tetanus protection. For high-risk individuals, such as those on humanitarian missions, a shorter interval (e.g., 5 years) should be considered.

 

References

PAHO, 5.11.2021

Forty-two suspected cases of yellow fever (YF) were reported between October 15th, 2021, and November 3rd, 2021. Infection was proven by PCR at least in three blood samples collected from suspected cases.

The cases occurred primarily amongst nomadic settlers from the two districts of West Gonja and North Gonja in the Savannah region of northwestern Ghana (bordering Côte d'Ivoire). Eleven of the 42 suspected cases, including all three PCR-positive cases, died.

 

Consequences for travelers

Yellow fever is endemic in Ghana. The last outbreak was in 2016. The current outbreak once again emphasizes the importance of a yellow fever vaccination when staying in Ghana. Proof of a yellow fever vaccination is required upon entry into Ghana.

 

References

WHO AFRO 7.11.2021

More than 1.1 million cases of typhoid fever have been reported from the beginning of the year (2021) until the end of September, including 19,734 confirmed cases and 411 deaths. This is a significant increase compared to 2020 (total 715,920 suspected cases, 178 deaths). These figures should be interpreted with caution because bacterial cultures are not usually possible and the test used in most cases (Widal test) is not very sensitive and specific for the diagnosis of typhoid fever.

 

Consequences for travelers

Maintain optimal food and drinking water hygiene. Vaccination against typhoid fever is recommended especially for people visiting friends and relatives (VFRs) and for people traveling with poor hygienic conditions.

 

References

Outbreak News Today, 9.11.2021

Ukrainian health officials report a polio case in an unvaccinated 12-year-old child with acute flaccid paralysis from Transcarpathia (southwest of the country) in a new report on the current polio situation in Ukraine. There is no information yet regarding the type of polio.

An epidemiological investigation was conducted after this case was reported. No further person was found to be infected with the poliovirus. The previously detected cVDPV2 cases in Ukraine in the Rivne region are not connected to the current case.

 

Consequences for travelers

Ukraine is now considered a category 2 in the WHO temporary poliomyelitis vaccination recommendations ("States infected with cVDPV2, with or without evidence of local transmission"):

  • On departure from Ukraine, persons with residence in the country for >4 weeks are strongly recommended to have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their 'International Certificate for Vaccination' (according to WHO, 20.8.2021).
  • Stays < 4 weeks: in addition to the basic immunisation against polio, a booster vaccination is recommended every 10 years (recommendation of the Swiss Expert Committee for Travel Medicine (ECTM).

 

References

Outbreak News Today, 4.11.2021

India, Delhi: Health authorities in Delhi have reported 531 additional dengue fever cases in one week, bringing the total number of cases in the city to over 1,500. This is the highest number of reported cases since 2018, with over 46,000 cases recorded in India, which now ranks second in the world after Brazil (60,000 cases). According to media reports, this sharp increase in dengue fever cases has led to a shortage of hospital beds in both government and private hospitals.

 

Consequences for travelers

Optimal mosquito protection measures 24/7: during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this may increase the risk of bleeding in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).

 

References

Outbreak News Today, 1.11.2021, Outbreak News Today, 23.10.2021

More than 23,000 dengue cases (including 89 deaths) have been recorded since the beginning of 2021, with the majority of cases (20,000) reported in Dhaka.

 

Consequences for travelers

Optimal mosquito protection measures 24/7: during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this may increase the risk of bleeding in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).

 

References

Outbreak News Today, 1.11.2021, Outbreak News Today, 23.10.2021

Diphtheria bacteria were detected in three people in the Ky Son district in the Huu Lap commune (northwest of the country).

 

Consequences for travelers

A booster vaccination is necessary in addition to a basic immunization against diphtheria (together with tetanus, etc.). The optimal time for the booster vaccination for stays in areas with a diphtheria epidemic is unclear. Travelers to countries with diphtheria outbreaks should receive a booster vaccination if the previous booster vaccination is more than 10 years old, as the diphtheria protection is shorter-lasting than the tetanus protection. For high-risk individuals, such as those on humanitarian missions, a shorter interval (e.g., 5 years) should be considered. Please talk to your doctor if you belong to this group.

 

References

Outbreak News Today, 27.10.2021, Outbreak News Today, 23.10.2021

In the district of Ghaziabad in the state of Uttar Pradesh, 13 diphtheria cases were registered until October 2021, compared to 14 cases in the entire 2020.

 

Consequences for travelers

A booster vaccination is necessary in addition to a basic immunization against diphtheria (together with tetanus, etc.). The optimal time for the booster vaccination for stays in areas with a diphtheria epidemic is unclear. Travelers to countries with diphtheria outbreaks should receive a booster vaccination if the previous booster vaccination is more than 10 years old, as the diphtheria protection is shorter-lasting than the tetanus protection. For high-risk individuals, such as those on humanitarian missions, a shorter interval (e.g., 5 years) should be considered. Please talk to your doctor if you belong to this group.

 

References

Outbreak News Today, 27.10.2021, Outbreak News Today, 23.10.2021

In Ernakulam district, Kerala state, the number of confirmed leptospirosis cases have continued to increase in October 2021 (now 29 confirmed cases and 48 suspected cases) compared to September 2021 (18 confirmed 51 suspected cases). Since the beginning of 2021, 304 suspected cases have been reported in Ernakulam (confirmed: 133 cases).

Monsoon-related flooding occurs regularly between June and September, with October and November constituting the post-monsoon season. As a result, outbreaks of leptospirosis are common during this period.

 

Consequences for travelers

Wear protective clothing/boots when wading through water! Leptospira are transmitted through the urine of rodents (mainly rats), which can contaminate small bodies of water (creeks, puddles, etc.) and mud. Transmission to humans occurs through small skin lesions or mucosal contacts through direct or indirect contact with the rodent urine. Symptoms range from flu-like symptoms, aseptic meningitis to sepsis. Vaccination is not generally available.

 

References

The Hindo, 28.10.2021

The 'Pan American Health Organization' (PAHO) has reported 122,203 chikungunya fever cases in the Americas in the year 2021, compared to 103,000 cases reported for the entire year of 2020. Brazil accounts for the majority of cases (97%).

Chikungunya fever is a viral infection transmitted by Aedes mosquitoes. The disease is typically manifested by severe joint pain in the hands and feet, which can last for weeks or months in some patients.

 

Consequences for travelers

Optimal mosquito protection measures 24/7: during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria. If you should have a fever: take medication containing the ingredient paracetamol and make sure you drink enough fluids. Do not take any medication containing the ingredient acetylsalicylic acid (e.g. Aspirin®), as this may increase the risk of bleeding in the event of a dengue infection (see also factsheet dengue). If you have visited a malaria area and have a fever >37.5 °C, you should always exclude malaria by taking a blood smear on the spot. Visit a medical facility for this (see also factsheet malaria).

 

References

Outbreak News Today, 30.10.2021

According to WHO, three laboratory-confirmed cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the Biombo and Bissau regions on October 26, 2021. The most recent date of symptom onset was July 15, 2021. The detected cVDPV strain is genetically linked to a strain circulating in Nigeria. cVDPV had not previously been detected in Guinea-Bissau.

 

Consequences for travelers

Guinea-Bisseau is now considered as category 2 of the WHO temporary poliomyelitis vaccination recommendations ("States infected with cVDPV2, with or without evidence of local transmission"):

  • On departure from Guinea-Bisseau, persons with residence in the country for >4 weeks are strongly recommended to have received a polio booster vaccine (IPV) no longer than 12 months ago with documentation in their 'International Certificate for Vaccination' (according to WHO, 20.8.2021).
  • Stays < 4 weeks: in addition to the basic immunisation against polio, a booster vaccination is recommended every 10 years (recommendation of the Swiss Expert Committee for Travel Medicine (ECTM).

 

References

Polioeradication, 29.10.2021

Over 120 cases of salmonella have been reported since 2019 in Germany (68 cases), Sweden (37 cases), Norway (5 cases), Denmark (9 cases), and the Netherlands (2 cases). Cases have also been reported in the United States and Canada. The salmonella outbreak is linked to sesame products (tahini and halva) imported from Syria. Fourteen batches have tested positive for one or more of the Salmonella-outbreak strains. Tahini is a paste made from raw sesame seeds. Halva is a confectionery product that contains a high percentage of sesame seeds.

The recurrent occurrence of cases and the repeated discovery of positive samples since 2019 indicate that contaminated sesame-based products have been circulating in the EU market for more than two years.

 

Consequences for travelers

Considering the limited information on the production and distribution of the sesame products from Syria, there is still a risk of new salmonella infections in the EU/European Economic Area. Caution should be shown when consuming these products (tahini, halva).

 

References

ECDC, 14.10.2021

In the Punjab province, cases of dengue infections are increasing significantly, with more than 300 cases per day. Between January and October 76th, 2021, 5’700 infections have been recorded  in the province, including 18 deaths. All four dengue virus strains are circulating (DENV-1, DENV-2, DENV-3, and DENV-4).

 

Consequences for travelers

Optimal mosquito protection is necessary around the clock (24/7) (Daytime risk: Dengue, Zika, Chikungunya, etc.; Dusk / nighttime risk: Malaria). Dengue fever is transmitted in urban areas. In case of fever, fever-reducing medications containing paracetamol should be favored, as well as hydration. Do not take fever-reducing medications containing acetylsalicylic acid (e.g., Aspirin ®), as they increase the risk of bleeding. For travelers staying in regions with malaria risk, a malaria infection should always be excluded in the case of fever.

 

References

Outbreak News Today, 16.10.2021

The Minister of Health declared a health emergency on the 10th of October (2021) for 51 districts in 15 regions in Peru due to a dengue fever outbreak. The affected regions are Piura, San Martín, Loreto, Huánuco, Junín, Cajamarca, Cusco, Madre de Dios, Ayacucho, Lima, Amazonas, Ucayali, Pasco, Tumbes and Ica. The health emergency is expected to last 90 days and is intended to prevent and control the dengue outbreak. 36’000 dengue fever infections have been registered since January 2021, which corresponds to an incidence rate of 111 infections per 100’000 inhabitations. The current incidence rate and number of cases are significantly higher than the previous three years.

 

Consequences for travelers

Optimal mosquito protection is necessary around the clock (24/7) (Daytime risk: Dengue, Zika, Chikungunya, etc.; Dusk / nighttime risk: Malaria). Dengue fever is transmitted in urban areas. In case of fever, fever-reducing medications containing paracetamol should be favored, as well as hydration. Do not take fever-reducing medications containing acetylsalicylic acid (e.g., Aspirin ®), as they increase the risk of bleeding. For travelers staying in regions with malaria risk, a malaria infection should always be excluded in the case of fever. 

 

References

Outbreak News Today, 11.10.2021, MoH Peru, Epid. Bulletin, KW 40, 2021

Two hundred cases of schistosomiasis and diarrhea have been reported in children due to drinking contaminated water from pools and rivers in the Boni forest (Garissa district) in eastern Kenya, a region threatened by Al Sahab terrorism. Boni residents have been forced to drink untreated, dirty water as their water sources have dried up due to a devastating drought.

 

Consequences for travelers

Avoid all contact with freshwater, especially bathing and wading near the shore and drinking untreated drinking water. Bathe only in chlorinated pool water and in the ocean (saltwater), as this does not pose a risk in regards to schistosomiasis infections. A schistosomiasis infection should be ruled out after possible exposure.

For more information: see HealthyTravel: Factsheet Schistosomiasis

 

References

Outbreak News Today, 12.10.2021

In der Provinz North-Kivu wurde ein neuer, im Labor bestätigter Fall mit einer Ebola-Virus-Infektion festgestellt. Es handelt sich dabei um ein 3-jähriges Kind, welches Anfang Oktober erkrankte. Nachbarn des erkrankten Kindes (2 Kinder und deren Vater) waren bereits Mitte bzw. Ende September an Ebola verdächtigen Symptome verstorben, eine Labordiagnose wurde jedoch nicht gestellt. Inzwischen wurde ein weiterer Fall in der Stadt Beni bestätigt.
Am 3. Mai war der Ebola Ausbruch in der Nort Kivu Provinz erst als beendet erklärt worden.

Ebolafieber ist eine virale, hämorrhagische, äusserst virulente Krankheit. Sie wird durch direkten Kontakt mit Körperflüssigkeiten und -ausscheidungen einer erkrankten Person (Blut, Speichel, Erbrochenes, Stuhl, Schweiss, Sperma, Urin usw.) oder mit infizierten Tieren (v. a. Affen, Antilopen, Nagern, Fledermäuse) übertragen. Die Symptome sind plötzliches hohes Fieber, Muskelschmerzen, Müdigkeit, Hals- oder Kopfschmerzen, gefolgt von Durchfall, Erbrechen und innerlichen und äusserlichen Blutungen. Eine frühzeitige Hospitalisierung mit unterstützender Pflege (Hydratation, Erhaltung eines normalen Blutdrucks) kann die Prognose verbessern.

 

Folgen für Reisende

Das Risiko einer Ebola-Infektion besteht für Personen, die in das Ausbruchsgebiet reisen, bei engem, ungeschütztem Kontakt mit einer an Ebola erkrankten oder verstorbenen Person (und deren Körperflüssigkeiten) sowie bei ungeschütztem Geschlechtsverkehr mit einem Ebola-Patienten oder Überlebenden (12 Monate). Es wird empfohlen, sich regelmäßig die Hände zu waschen und zu desinfizieren (insbesondere vor dem Berühren der Augen, der Nase und des Mundes, nach dem Umgang mit potenziell kontaminierten Gegenständen und nach dem Toilettengang) sowie den Kontakt mit einem möglicherweise infizierten Tier zu vermeiden und kein Buschfleisch zu essen. Bei humanitären Einsätzen wird empfohlen, einen Spezialisten für Reisemedizin zu konsultieren.

 

Referenzen

WHO DON, 10.10.2021

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

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

 

Folgen für Reisende

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

 

Referenzen

ECDC CDTR, 8.10.2021

Polioeradication (accessed 14.10.2021)

Seit Jahresbeginn 2021 wurden in Peru insgesamt 14 Fälle von Gelbfieber gemeldet, von denen 10 bestätigt wurden. Die Betroffenen waren nicht gegen Gelbfieber geimpft.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Stillende und Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Ein Impfschutz gegen Gelbfieber wird bei Aufenthalten in Gebieten die unter 2’300m östlich der Anden liegen empfohlen (nicht für Aufenthalte in Cusco, Lima, Machu Picchu und für den Inca Trail).

 

Referenzen

PAHO, 6.10.2021

Seit September 2017 besteht ein Gelbfieberausbruch in Nigeria. Seit Jahresanfang 2021 und bis Ende August wurden insgesamt 1’312 Verdachtsfälle registriert.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Stillende und Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Eine Impfung gegen Gelbfieber ist bei Aufenthalten in diesem Land obligatorisch und muss in einem offiziellen Impfzentrum (oder von einem zugelassenen Arzt) durchgeführt werden und spätestens 10 Tage vor Einreise erfolgt sein, damit ein Schutz gewährleistet ist. Bei immunkompetenten Personen ist eine Gelbfieberimpfung mit einer einmaligen Auffrischimpfung nach 10 Jahren (d. h. maximal 2 Impfungen im Leben) empfohlen.

Zwischen Ende August und Mitte September 2021 wurden insgesamt 20 Verdachtsfälle und 22 bestätigte Fälle von Pest (19 Lungenpest Fälle, 3 Beulenpestfälle) gemeldet. Die gemeldeten Fälle befinden sich in zwei nicht benachbarten Regionen: Itasy und Haute Matsiatra. Beide Regionen sind als Pest-Endemiegebiete bekannt.
Die Pest ist auf Madagaskar endemisch, die Hauptübertragungszeit findet zwischen September und April statt. Jedes Jahr werden 200-700 Fälle gemeldet, hauptsächlich die Beulenpestform. 2017 gab es einen großen Ausbruch mit v. a. Lungenpest.

Die Pest wird durch Bakterien (Yersinia pestis) verursacht und durch Flöhe von Nagetieren (vor allem Ratten) oder auch Haustieren übertragen. Es gibt die sogenannte Beulen (Bubonen)-Pest und die seltener auftretende systemische (Pestsepsis) und Lungenpest. Letztere wird von Mensch zu Mensch über Tröpfchen über die Atemwege von Patienten mit Lungenpest übertragen. Diese Form ist äußerst ansteckend. Symptome der Lungenpest sind neben Fieber vor allem Lungenbeschwerden wie Brustschmerzen, Atemnot und Husten. Eine Antibiotikatherapie muss innerhalb von 24 Stunden nach Beginn der Symptome begonnen werden. Die Bubonenpest äussert sich durch Fieber, Schüttelfrost und Grippesymptome (Kopf-, Muskel- und Halsschmerzen) und oft eine Schwellung der Lymphdrüsen (Beulen).

 

Folgen für Reisende

Das Risiko für Reisende ist sehr gering. Schützen Sie sich vor Flöhen, in dem Sie regelmässig Repellentien auftragen und Permethrin imprägnierte Kleidung tragen. Vermeiden Sie Kontakt mit Ratten und toten oder kranken Tieren, sowie erkrankten Personen. Konsultieren Sie bei Fieber, schmerzhaften Lymphknoten und/oder Atembeschwerden rasch einen Arzt.

 

Referenzen

WHO DON, 1.8.2021

Laut Medienberichten wurde bis Anfang Oktober bei sieben Personen in Venezuela eine Gelbfieberinfektion festgestellt. Die Fälle traten in den Bundestaaten Monagas und Anzoategui auf. Die Durchimpfungsrate gegen Gelbfieber ist in der Bevölkerung von Venezuela ungenügend. Aufgrund der politischen Lage ist die medizinische Infrastruktur eingeschränkt.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Stillende und Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Ein Impfschutz gegen Gelbfieber wird bei Aufenthalten in den meisten Bundesstaaten von Venezuela, einschliesslich Monangas und Anzoategui dringend empfohlen.

 

Referenzen

Outbreak News Today, 3.10.2021

Masernausbrüche werden aus mindestens 14 Ländern Afrikas berichtet mit einigen Hundert bis mehreren Tausend Fällen seit Jahresbeginn 2021.

Masern sind eine hoch ansteckende Viruserkrankung, die über die Atemwege übertragen wird. Sie ist in der ganzen Welt verbreitet. Mit einem Impfstoff lässt sich die Krankheit sehr wirksam verhindern.

 

Folgen für Reisende

Eine Reise bietet eine ideale Gelegenheit, den Schutz vor Masern zu kontrollieren (2x geimpft oder durchgemachte Masern) und wenn nötig den Impfschutz zu aktualisieren.

 

Referenzen

WHO | Regional Office for Africa, Woche 38, 13.-19.9.2021

Seit Jahresanfang 2021 wurden 5 Fälle von humaner Tollwut bekannt und 234 Fälle bei Tieren. Betroffen waren Personen aus allen Landesteilen.

Tollwut kann durch Speichel von infizierten Säugetieren (vor allem Hunden, Katzen, Affen, Fledermäusen) übertragen werden. Durch rasche Behandlung – Wunde unter fliessendem Wasser und mit Seife mindestens 15 Minuten lang ausgiebig waschen und spülen, Immunglobulin und 4 Impfdosen - kann verhindert werden, dass sich die Infektion zur tödlichen Tollwut entwickelt. Immunglobuline und moderne, hoch gereinigte Impfstoffe sind in vielen Regionen nicht erhältlich. Kinder sind besonders gefährdet, da Expositionen häufig unbemerkt erfolgen.

 

Folgen für Reisende

Kontakt mit Tieren vermeiden (auf keinen Fall füttern!). Nach einem Tierbiss/-kratzer, die Wunde mit fliessendem Wasser und Seife 15 Minuten lang waschen, desinfizieren und in jedem Falle ein qualitativ hochwertiges medizinisches Zentrum aufsuchen (post-expositionelle Impfung). Für Langzeitreisende und Reisende mit erhöhtem Individualrisiko (Reisen mit Zweirädern, in entlegene Gebiete, Langzeitaufenthalte, Kleinkinder, Arbeiten mit Tieren, Höhlenforscher usw.) ist eine prä-expositionelle Impfung vor dem Aufenthalt (2 Injektionen und eine Auffrischimpfung nach 1 Jahr) empfehlenswert.

 

Referenzen

Outbreak News today, 23.9.2021

Bei einem 18 Monate alten, gegen diese Krankheit nicht geimpften Kind aus dem Dorf Mala im Distrikt Kemo in der Zentralafrikanischen Republik wurde eine Gelbfieberinfektion bestätigt.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Stillende und Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Eine Impfung gegen Gelbfieber ist bei Aufenthalten in diesen Ländern obligatorisch und muss in einem offiziellen Impfzentrum (oder von einem zugelassenen Arzt) durchgeführt werden und spätestens 10 Tage vor Einreise erfolgt sein, damit ein Schutz gewährleistet ist. Bei immunkompetenten Personen ist eine Gelbfieberimpfung mit einer einmaligen Auffrischimpfung nach 10 Jahren (d. h. maximal 2 Impfungen im Leben) empfohlen.

 

Referenzen

WHO | Regional Office for Africa, Woche 38, 13.-19.9.2021

Am 13. August 2021 wurden im Institut Pasteur in Dakar fünf aus der Côte d’Ivoire stammende Gelbfieberfälle bestätigt.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Stillende und Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Eine Impfung gegen Gelbfieber ist bei Aufenthalten in diesen Ländern obligatorisch und muss in einem offiziellen Impfzentrum (oder von einem zugelassenen Arzt) durchgeführt werden und spätestens 10 Tage vor Einreise erfolgt sein, damit ein Schutz gewährleistet ist. Bei immunkompetenten Personen ist eine Gelbfieberimpfung mit einer einmaligen Auffrischimpfung nach 10 Jahren (d. h. maximal 2 Impfungen im Leben) empfohlen.

 

Referenzen

WHO | Regional Office for Africa, Woche 38, 13.-19.9.2021

Der Bundesstaat Tamaulipas an der Ostküste Mexikos, der an Texas grenzt, hat Medienberichten zufolge in diesem Jahr bisher 3’407 Abdominaltyphus Infektionen gemeldet. Damit steht Tamaulipas an der Spitze der gemeldeten Fälle in Mexiko, dicht gefolgt vom Bundesstaat Sinaloa (3'381 Fälle).

Abdominaltyphus ist eine bakterielle Erkrankung, die durch kontaminierte Nahrungsmittel und Wasser übertragen wird. Symptome sind Fieber, Bauchschmerzen, Durchfall oder Verstopfung. Antibiotika sind wirksam und eine vorbeugende Impfung ist verfügbar (um die 60% Schutzwirkung).

 

Folgen für Reisende

Nur gekochte Nahrungsmittel und abgekochte Getränke oder Mineralwasser konsumieren. Je nach Reiseart und Hygienestandard kann eine Impfung empfohlen werden. Sie sollte spätestens 2-3 Wochen vor der Abreise erfolgen.

 

Referenzen

ProMED, 28.9.2021

Laut Medienberichten nimmt die Anzahl der gemeldeten Tollwutfälle bei Hunden  in Tema, Region Greater Accra zu: über 115 Tollwut-Verdachtsfälle wurden gemeldet. Auch andere Regionen scheinen eine Zunahme zu verzeichnen. So ist erst kürzlich eine 23-jährige Frau nach einem Hundebiss in Techiman, nördlich von Kumasi, an Tollwut gestorben, sowie zwei kleine Kinder.

Tollwut kann durch Speichel von infizierten Säugetieren (vor allem Hunden, Katzen, Affen, Fledermäusen) übertragen werden. Eine rasche Behandlung – Wunde unter fliessendem Wasser und mit Seife mindestens 15 Minuten lang ausgiebig waschen und spülen, Gabe von Immunglobulinen und insgesamt 4 Impfdosen - kann verhindern, dass sich die Infektion zur tödlichen Tollwut entwickelt. Leider sind hochwertige Tollwutimpfstoffe, insbesondere Immunglobuline in vielen Ländern nicht immer verfügbar. Kinder sind besonders gefährdet, da Expositionen häufig unbemerkt erfolgen.

 

Folgen für Reisende

Kontakt mit Tieren vermeiden (auf keinen Fall füttern!). Nach einem Tierbiss/-kratzer, die Wunde mit fliessendem Wasser und Seife 15 Minuten lang waschen, desinfizieren und in jedem Falle ein qualitativ hochwertiges medizinisches Zentrum aufsuchen (post-expositionelle Impfung). Für Expatriierte und Reisende mit erhöhtem Individualrisiko (Reisen mit Zweirädern, in entlegene Gebiete, Langzeitaufenthalte, Kleinkinder usw.) ist eine prä-expositionelle Impfung vor dem Aufenthalt (2 Injektionen und eine Auffrischimpfung nach 1 Jahr) empfehlenswert.

 

Referenzen

News Ghana, 13.9.2021

Outbreak News Today, 4.9.2021

Sieben bestätigte und weitere sechs Verdachtsfälle von Leptospirose wurden bei Personen gemeldet, die im Fluss Argensou in Auzat und Vicdessos in Ariege (Südfrankreich) Wassersportaktivitäten wie Canyoning betrieben haben.

Leptospirose ist eine bakterielle Erkrankung, die weltweit vorkommt, besonders häufig in tropischen Ländern während der Regen- oder Überschwemmungszeit. Sie wird bei Kontakt von kleinen Hautverletzungen mit durch Urin verunreinigtem Wasser (v. a. von infizierten Ratten, Hunden, Schweinen, Kühen usw.) übertragen. Das Ansteckungsrisiko erhöht sich beim Campen oder bei Aktivitäten im Zusammenhang mit Wasser (Schwimmen, Kajakfahren, Durchwaten von Wasserläufen). Die Krankheit kann, wenn rechtzeitig diagnostiziert, mit Antibiotika behandelt werden.

 

Folgen für Reisende

Die französischen Gesundheitsbehörden rufen Personen, die im obengenannten Bereich gebadet oder geangelt haben, dazu auf, beim Auftreten von Symptomen schnell ihren Arzt aufzusuchen.

 

Referenzen

Via ProMED 12.9.2021, ARS

In einer Tierklinik in Niedersachsen ist ein Hund an Tollwut gestorben. Der Welpe war Anfang September aus dem Mittelmeerraum ohne die vorgeschriebene Tollwutimpfung importiert worden. Post-mortem Tollwutteste fielen positiv aus. Über 50 Kontaktpersonen mussten sich einer post-expositionellen Impfung unterziehen.

 

Folgen für Reisende

Eine Tollwut-Impfung ist u.a. Voraussetzung für den Import eines Tieres. Der illegale Import von Hunden und anderen Tieren ist ein ernst zunehmendes Problem und gefährdet Mensch und Tier! Bitte halten Sie sich an die Vorschriften.

 

Referenzen

NDR, 16.9.2021

Tierklinik Posthausen – Facebook, 11.9.2021

Rabies-Bulletin-Europe, 16.9.2021

RKI - Tollwut

Südafrika: Innerhalb einer Woche (23.-31.8.2021) wurden 7 im Labor bestätigte humane Fälle in den Provinzen Limpopo, KwaZulu-Natal und Eastern Cape sowie zusätzlich 3 als wahrscheinlich beurteilte Fälle gemeldet.

Tollwut kann durch Speichel von infizierten Säugetieren (vor allem Hunden, Katzen, Affen, Fledermäusen) übertragen werden. Durch rasche Behandlung – Wunde unter fliessendem Wasser und mit Seife mindestens 15 Minuten lang ausgiebig waschen und spülen, Immunglobulin und 4 Impfdosen - kann verhindert werden, dass sich die Infektion zur tödlichen Tollwut entwickelt. Immunglobuline und moderne, hoch gereinigte Impfstoffe sind in vielen Regionen nicht erhältlich. Kinder sind besonders gefährdet, da Expositionen häufig unbemerkt erfolgen.

 

Folgen für Reisende

Kontakt mit Tieren vermeiden (auf keinen Fall füttern!). Nach einem Tierbiss/-kratzer, die Wunde mit fliessendem Wasser und Seife 15 Minuten lang waschen, desinfizieren und in jedem Falle ein qualitativ hochwertiges medizinisches Zentrum aufsuchen (post-expositionelle Impfung). Der Zugang zu hochwertigen Tollwutimpfstoffen ist in Südafrika nicht immer gewährleistet! Für Langzeitreisende und Reisende mit erhöhtem Individualrisiko (Reisen mit Zweirädern, in entlegene Gebiete, Langzeitaufenthalte, Kleinkinder usw.) ist eine prä-expositionelle Impfung vor dem Aufenthalt (2 Injektionen und eine Auffrischimpfung nach 1 Jahr) empfehlenswert.

 

Referenzen

Via ProMED, 3.5. und 6.5.2021. Opinion, 9.9.2021

Bolivien: Die Fälle von Hunde- und Katzentollwut haben sich in diesem Jahr in Cochabamba gegenüber dem gleichen Zeitraum des Vorjahres verdoppelt; vier Gemeinden haben den Notstand ausgerufen. Laut Angaben des offiziellen Tollwutprogrammes von Bolivien wurden 2021 bereits 45 Fälle bei Tieren registriert, 4 Personen sind verstorben. Massen-Impfkampagnen für Tiere wurden angekündigt.

Tollwut kann durch Speichel von infizierten Säugetieren (vor allem Hunden, Katzen, Affen, Fledermäusen) übertragen werden. Durch rasche Behandlung – Wunde unter fliessendem Wasser und mit Seife mindestens 15 Minuten lang ausgiebig waschen und spülen, Immunglobulin und 4 Impfdosen - kann verhindert werden, dass sich die Infektion zur tödlichen Tollwut entwickelt. Immunglobuline und moderne, hoch gereinigte Impfstoffe sind in vielen Regionen nicht erhältlich. Kinder sind besonders gefährdet, da Expositionen häufig unbemerkt erfolgen.

 

Folgen für Reisende

Kontakt mit Tieren vermeiden (auf keinen Fall füttern!). Nach einem Tierbiss/-kratzer, die Wunde mit fliessendem Wasser und Seife 15 Minuten lang waschen, desinfizieren und in jedem Falle ein qualitativ hochwertiges medizinisches Zentrum aufsuchen (post-expositionelle Impfung). Der Zugang zu hochwertigen Tollwutimpfstoffen ist in Bolivien nicht immer gewährleistet! Für Langzeitreisende und Reisende mit erhöhtem Individualrisiko (Reisen mit Zweirädern, in entlegene Gebiete, Langzeitaufenthalte, Kleinkinder usw.) ist eine prä-expositionelle Impfung vor dem Aufenthalt (2 Injektionen und eine Auffrischimpfung nach 1 Jahr) empfehlenswert.

 

Referenzen

Via ProMED, 3.5. und 6.5.2021. Opinion, 9.9.2021

Die Demokratische Republik Kongo hat einen Meningokokken-Meningitis Ausbruch in der nordöstlichen Provinz Tshopo gemeldet, in der mindestens 261 Verdachtsfälle und 129 Todesfälle aufgetreten sind. Die Sterblichkeitsrate ist mit 50 % sehr hoch.

Saisonale Meningitis-Epidemien kommen in Subsahara-Afrika vor allem während der Trockenzeit vor. Im Allgemeinen sind die Serogruppen der Meningokokken A, C, W und X für diese Ausbrüche verantwortlich. Die Krankheit verbreitet sich durch Tröpfchen von Mensch zu Mensch. Falls Symptome (hohes Fieber, starke Kopfschmerzen und Erbrechen) auftreten, sollte sofort ein Arzt konsultiert und mit einer Antibiotikatherapie begonnen werden, da die Krankheit innert Stunden zu lebensbedrohlichen Zuständen führen kann. Als Prophylaxe steht für Erwachsene und Kinder über 1 Jahr eine Impfung gegen die wichtigsten Meningitisstämme zu Verfügung.

 

Folgen für Reisende

Aufgrund der aktuellen Epidemie wird eine Impfung gegen Meningokokken empfohlen.

 

Referenzen

WHO Afro, 8.9.2021

Laut Medienberichten wurden zwischen Ende August und Anfang September 30 Verdachtsfälle mit Lungenpest gemeldet, von denen 12 Fälle bestätigt wurden. Sieben Personen verstarben. Die Fälle traten in Itasy, einer in der Nähe der Hauptstadt Antananarivo gelegenen Region im Zentrum des Landes auf.
Die Pest ist auf Madagaskar endemisch, die Hauptübertragungszeit findet zwischen September und April statt. Jedes Jahr werden 200-700 Fälle gemeldet, hauptsächlich die Beulenpestform. 2017 gab es einen großen Ausbruch mit v. a. Lungenpest.

Die Pest wird durch Bakterien (Yersinia pestis) verursacht und durch Flöhe von Nagetieren (vor allem Ratten) oder auch Haustieren übertragen. Es gibt die sogenannte Beulen (Bubonen)-Pest und die seltener auftretende systemische (Pestsepsis) und Lungenpest. Letztere wird von Mensch zu Mensch über Tröpfchen über die Atemwege von Patienten mit Lungenpest übertragen. Diese Form ist äußerst ansteckend. Symptome der Lungenpest sind neben Fieber vor allem Lungenbeschwerden wie Brustschmerzen, Atemnot und Husten. Eine Antibiotikatherapie muss innerhalb von 24 Stunden nach Beginn der Symptome begonnen werden. Die Bubonenpest äussert sich durch Fieber, Schüttelfrost und Grippesymptome (Kopf-, Muskel- und Halsschmerzen) und oft eine Schwellung der Lymphdrüsen (Beulen).

 

Folgen für Reisende

Das Risiko für Reisende ist sehr gering. Schützen Sie sich vor Flöhen, in dem Sie regelmässig Repellentien auftragen und Permethrin imprägnierte Kleidung tragen. Vermeiden Sie Kontakt mit Ratten und toten oder kranken Tieren, sowie erkrankten Personen. Konsultieren Sie bei Fieber, schmerzhaften Lymphknoten und/oder Atembeschwerden rasch einen Arzt.

 

Referenzen

Outbreak News Today, 8.9.2021

Innerhalb einer Woche wurden von den Gesundheitsbehörden in Hongkong drei Fälle mit einer Gelflügelinfluenza (H5N6) gemeldet. Der jüngste Fall betrifft einen 55-jährigen Mann, der in Liuzhou, Guangxi, lebt. Er ist Landwirt und hatte Kontakt mit lebendem Geflügel. Er entwickelte am 17. August Symptome und wurde noch am selben Tag zur Behandlung eingeliefert. Der Zustand des Patienten ist kritisch.

Im Allgemeinen ist das Vogelgrippe Infektionsrisiko für Menschen äusserst gering und kommt fast ausschliesslich bei engem Kontakt mit infiziertem Geflügel (Atemsekrete und Fäkalien) vor.

 

Folgen für Reisende

Optimale persönliche Hygiene, welche auch im Rahmen der COVID-19 Pandemie wichtig ist. Kontakt mit Geflügel und deren Ausscheidungen sollte vermieden werden. Kein Besuch von Vogel- und Geflügelmärkten/ -farmen.

 

Referenzen

Outbreak News Today, 23.8.2021

Laut Medienberichten wurden in der Region Chuvisca, Bundesstaat Rio Grande do Sul, 4 tote Brüllaffen aufgefunden. Bei einem der Affen konnte eine Gelbfieberinfektion bestätigt werden. Die betroffene Region, in denen die toten Affen gefunden wurden, liegt zwischen Porto Alegre und der Grenze zu Uruguay.
Todesfälle bei Affen gehen in Südamerika häufig humanen Gelbfieberfällen voraus und sind damit ein Indikator für eine (vermehrte) Zirkulation von Gelbfieberviren.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Stillende und Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Die Gelbfieberimpfung wird von der WHO für die meisten Regionen in Brasilien empfohlen. Aufgrund der zunehmenden Ausbreitung auch in bisher als gelbfieberfrei erklärten Gebieten sollte die Indikation für aktuell noch als gelbfieberfreie deklarierte Regionen ebenfalls großzügig gestellt werden (Hauptsaison für Gelbfieber ist Dezember bis Mai)! Empfehlung des Schweizerischen Expertenkomitees für Reisemedizin (EKRM): bei immunkompetenten Personen wird eine Gelbfieberimpfung mit einer einmaligen Zweitimpfung nach 10 Jahren (d. h. maximal 2 Impfungen im Leben) empfohlen.

 

Referenzen

Via ProMED 7.8.2021

Am 6. August 2021 wurde die WHO über einen bestätigten Fall mit einer Marburg-Virus-Infektion in der Präfektur Guéckédou, Region Nzérékoré, im Südwesten Guineas informiert. Das Dorf, in dem der Fall auftrat, liegt sowohl in der Nähe der Grenze zu Sierra Leone als auch zu Liberia. Dies ist der erste bekannte humane Fall mit einer Marburg-Virus-Infektion in Guinea. Inzwischen wurde ein zweiter Fall bestätigt; beide Fälle kommen aus Temessadou.

Das Marburg-Virus ist ein dem Ebola-Virus verwandter Erreger, welcher ein sogenanntes hämorrhagisches Fieber auslösen kann. Das Virus wird bei Kontakt mit Blut und anderen Körperflüssigkeiten von Infizierten übertragen. Nach einer Inkubationszeit von 5-10 Tagen treten Symptome mit plötzlichem hohem Fieber, Muskelschmerzen, Müdigkeit, Hals- oder Kopfschmerzen auf, gefolgt von Durchfall, Erbrechen und innerlichen sowie äusserlichen Blutungen, welche meist zum Tod führen. Es gibt weder ein spezifisches Medikament noch eine Impfung. Bisher wurden sporadische Fälle insbesondere aus Uganda, Kenia und D.R. Kongo gemeldet. 2018 wurde das Marburg Virus erstmals in Sierra Leone bei Frucht-Fledermäusen identifiziert, ein Hinweis, dass das Virus auch in West Afrika zirkuliert.

 

Folgen für Reisende

Das Risiko für Reisende ist sehr gering, für Familienangehörige und Pflegepersonen, die mit Erkrankten Kontakt haben, allerdings gross. Vermeiden Sie Kontakt mit kranken Personen. Konsumieren Sie kein Buschfleisch (bushmeat) oder Fledermäuse. Ebenso sollten Höhlen, die Fledermäuse beherbergen können, gemieden werden. Bei Fieber konsultieren Sie bitte sofort einen Arzt, dies ist auch wichtig um andere Erkrankungen wie z.B. eine Malaria auszuschliessen.

 

Referenzen

WHO DON, 9.8.2021

WHO AFRO, 8.8.2021

CDC - Marburg hemorrhagic fever

Die griechischen Gesundheitsbehörden haben die ersten drei West-Nil-Fieber Fälle der Saison aus der Region Pella in Zentralmazedonien gemeldet.

West Nil Fieber (WNF) ist eine virale Krankheit (Flavivirus), die in zahlreichen Regionen Europas, Zentralasiens, Nordamerikas und Afrikas durch Stechmücken auf den Menschen übertragen wird. Sie verläuft meist ohne Symptome (80%) oder wie eine Grippe. Selten (< 1 %) kommt es zu neurologischen Störungen oder zu einer Gehirnentzündung mit möglichem tödlichem Ausgang. Ältere Personen, Schwangere und Immunsupprimierte haben ein höheres Risiko für einen schweren Krankheitsverlauf. Es gibt keine spezifische Behandlung.

 

Folgen für Reisende

Schützen Sie sich gegen Mückenstiche tagsüber und nachts (lange Hosen, langärmlige Kleider, Mückenschutzmittel). Berühren Sie keine erkrankten oder toten Vögel, da diese ebenfalls infiziert sein können. Wenn Sie ein West Nil Fieber Übertragungsgebiet besucht haben, sollten Sie mindestens 28 Tage nach ihrer Rückkehr kein Blut spenden.

 

Referenzen

Outbreak News Today

Aktuell besteht ein Dengue-Ausbruch (Typ 3) in Mombasa (Januar bis Juni 2021: über 710 Fälle) und Mandera County (52 Fälle, eine hohe Dunkelziffer wird vermutet). In Kenia kommt es seit fünf Jahren jedes Jahr zu Ausbrüchen von Dengue-Fieber.

Dengue Fieber ist eine virale Krankheit, die durch tagaktive Mücken v. a. in den Städten während und kurz nach der Regenzeit übertragen wird. Die Symptome sind hohes Fieber, Kopf-, Gelenk- und Muskelschmerzen und ein Hautausschlag. Die Krankheit verläuft meist gutartig und heilt normalerweise nach 10 Tagen aus. Seltener kann sie zu Blutungen führen.

 

Folgen für Reisende

Optimaler Mückenschutz 24/7 (in der Dämmerung und nachts gegen Malaria, tagsüber gegen Dengue und andere Arbovirosen. Bei Fieber: Paracetamol-Produkte und Flüssigkeitszufuhr. Keine Medikamente einnehmen die Acetylsalicylsäure (z. B. Aspirin®) enthalten, da diese die Blutungsgefahr erhöhen. Bei Fieber >37,5 °C muss auch an eine Malaria gedacht und diese vor Ort mittels Blutausstrich ausgeschlossen werden (eine medikamentöse Malariaprophylaxe wird neben der Durchführung eines Mückenschutzes unbedingt empfohlen!).

 

Referenzen

WHO Africa, 11.7.2021

Laut WHO wurden in diesem Jahr 2 Gelbfieberfälle bestätigt: Bei dem ersten Fall handelt es sich um einen 34-jährigen Mann aus der Provinz Nord und beim zweiten Fall um eine 47-jährige, nicht gegen Gelbfieber geimpfte Frau aus der Provinz Bas Uele. Drei weitere Verdachtsfälle aus der Provinz Equateur, Kinshasa und Nord-Ubangi werden noch untersucht.

Gelbfieber ist eine hämorrhagische, virale Krankheit und wird durch Mücken übertragen. Sie beginnt mit hohem Fieber, Schüttelfrost, Muskel- und Kopfschmerzen und Verdauungsstörungen und kann bei gewissen Patienten zu Blutungen und Gelbsucht führen, die tödlich sein können. Es gibt keine spezifische Therapie, die Impfung ist das beste Mittel, sich vor dieser Krankheit zu schützen. Nicht geimpfte Personen (bei Kontraindikation) müssen sich unbedingt gegen Mückenstiche schützen. Für Kinder unter 9 Monaten, Schwangere, Personen mit schwerer Immunschwäche oder Thymus Krankheiten, wird eine Zuweisung zu einem Spezialisten in Reise- und Tropenmedizin empfohlen.

 

Folgen für Reisende

Eine Impfung gegen Gelbfieber ist bei Aufenthalten in der D.R. Kongo obligatorisch und muss in einem offiziellen Impfzentrum (oder von einem zugelassenen Arzt) durchgeführt werden und spätestens 10 Tage vor Einreise erfolgt sein, damit ein Schutz gewährleistet ist. Bei immunkompetenten Personen ist eine Gelbfieberimpfung mit einer einmaligen Auffrischimpfung nach 10 Jahren (d. h. maximal 2 Impfungen im Leben) empfohlen.

 

Referenzen

WHO Africa, 25.7.2021

Im Bundesstaat Amapa ist ein 21-jähriger Mann an Gelbfieber verstorben. Der Mann stammte aus dem Staat Pará (Rio Tambaqui do Vieira, in Afua), wo er laut Behörden sehr wahrscheinlich auch die Infektion erworben hatte.

Gelbfieber ist eine lebensbedrohliche virale Erkrankung, die durch Mücken übertragen wird. Es gibt keine spezifische Therapie, jedoch eine sehr wirksame Impfung. Sie ist das beste Mittel, sich vor Gelbfieber zu schützen. Daneben ist ein optimaler Mückenschutz wichtig. Für Kinder unter 9 Monaten, Schwangere, Stillende, Personen mit Immunschwäche oder einer Thymus-Krankheit, die nach Brasilien reisen möchten, empfehlen wir einen Spezialisten in Reise- und Tropenmedizin zu konsultieren.

 

Folgen für Reisende

Die Impfung gegen Gelbfieber wird von der WHO für die meisten Regionen Brasiliens empfohlen. Seit ein paar Jahren breitet sich Gelbfieber zunehmend auch in bisher gelbfieberfreie Gebiete aus. Auch nicht geimpfte Reisende sind bereits nach einem Aufenthalt in Brasilien gestorben. Das Schweizerische Expertenkomitee für Reisemedizin empfiehlt deshalb einen Gelbfieberimpfschutz für Aufenthalte in allen Gebieten Brasiliens. Die Impfung muss in einem offiziellen Impfzentrum oder von einem dafür zugelassenen Arzt mindestens 10 Tage vor der Einreise nach Brasilien durchgeführt werden, um einen ausreichenden Schutz gegen Gelbfieber zu gewährleisten. Bei immunkompetenten Personen wird eine einmalige Auffrischung nach 10 Jahren empfohlen (d.h. maximal 2 Impfstoffdosen im Leben).

 

Referenzen

Outbreak News Today, 26.7.2021

Seit Anfang Jahr wurden im mexikanischen Bundesstaat unmittelbar südlich des US-Bundesstaates Kalifornien 23 Fälle von Rocky Mountain Spotted Fever (RMSF) diagnostiziert, davon sind acht Personen verstorben. Die Verstorbenen waren alles Kinder und Jugendliche; Gründe dafür sind am ehesten die engeren Kontakte mit ihren Hunden, die die infizierten Zecken nach Hause bringen und die grundsätzlich erhöhte Mortalität bei Kindern und Jugendlichen.

RMSF wird durch Rickettsia rickettsii verursacht, eine durch Zecken übertragene Infektion. Entsprechend werden die meisten Fälle im Sommer gemeldet. Die Infektion zeigt sich anfänglich mit unspezifischen Symptomen. Der typische Ausschlag zeigt sich häufig erst nach wenigen Tagen, so dass die Diagnose bei Symptombeginn nicht leicht zu stellen ist. Die Infektion lässt sich mit einer raschen Doxyzyklin-Therapie gut behandeln. Kinder < 10 Jahren haben ein 5-fach erhöhtes Risiko an RMSF zu versterben.

 

Folgen für Reisende

Schützen Sie sich gegen Zecken (gut abschliessende Kleidung und die Socken über den Hosen tragen, Applikation von Insektiziden auf der Kleidung) und untersuchen sie Körper und Haare regelmässig. Manchmal kann ein Zeckenstichbiss unbemerkt bleiben. Finden Sie eine Zecke, entfernen Sie sie mit Hilfe einer Pinzette, indem Sie sie so nah wie möglich an der Haut fassen und allmählich rausziehen. Vermeiden Sie es, die Zecke zu zerdrücken (Kontaminationsrisiko), niemals mit einem Streichholz verbrennen oder verschiedene Flüssigkeiten anzuwenden. Waschen und desinfizieren Sie die Bissstelle und Ihre Hände. Konsultieren Sie bei Fieber oder Hautrötung für eine eventuelle Behandlung einen Arzt.

Aus den USA und Kanada werden verschiedene Expositionen gegenüber tollwütigen Tieren gemeldet (Waschbären, Fuchs, eigene Hunde). In allen Fällen konnten die Tiere identifiziert und getötet werden (inkl. Diagnosesicherung) und die exponierten Menschen erhielten eine korrekte postexpositionelle Prophylaxe (PEP) gegen Tollwut.

Tollwut kann durch Speichel von infizierten Säugetieren (vor allem Hunden, Katzen, Affen, Fledermäusen) übertragen werden. Durch eine rasche Behandlung – Wunde unter fliessendem Wasser und mit Seife mindestens 15 Minuten lang ausgiebig waschen und spülen, Gabe von Immunglobulin und 4 aktiven Impfdosen - kann verhindert werden, dass sich die Infektion zur tödlichen Tollwut entwickelt. Immunglobuline und moderne, hoch gereinigte Impfstoffe sind in vielen Regionen nicht erhältlich. Kinder sind besonders gefährdet, da sie häufig Bissen im Gesicht ausgesetzt sind und das Virus nur einen kurzen Weg zurücklegen muss, um das Gehirn zu erreichen bzw. auch kleine Wunden unbemerkt geschehen können.

 

Folgen für Reisende

Kontakt mit Tieren vermeiden (auf keinen Fall füttern!). Nach einem Tierbiss/-kratzer, die Wunde mit fliessendem Wasser und alkalischer Seife 15 Minuten lang waschen, desinfizieren und in jedem Falle ein qualitativ hochwertiges medizinisches Zentrum aufsuchen (post-expositionelle Impfung). Für Reisende mit erhöhtem Individualrisiko (Reisen mit Zweirädern, in entlegene Gebiete, Langzeitaufenthalte, Kleinkinder, Höhlenforscher, Kontakt mit Tieren / Fledermäuse etc.) empfiehlt das Schweizerische Expertenkomitte für Reisemedizin eine prä-expositionelle Impfung vor der geplanten Reise (2 Injektionen und eine Auffrischimpfung nach 1 Jahr).

 

Referenzen

Outbreak News Today; via ProMED-mail

In Kolumbien ist ein junger Mann im Departement Huila, im Südwesten des Landes an Tollwut verstorben. Weitere Informationen sind nicht bekannt. Letzten September war im gleichen Departement eine 26-jährige Frau nach einem Biss durch ihre Hauskatze verstorben.

Tollwut kann durch Speichel von infizierten Säugetieren (vor allem Hunden, Katzen, Affen, Fledermäusen) übertragen werden. Durch eine rasche Behandlung – Wunde unter fliessendem Wasser und mit Seife mindestens 15 Minuten lang ausgiebig waschen und spülen, Gabe von Immunglobulin und 4 aktiven Impfdosen - kann verhindert werden, dass sich die Infektion zur tödlichen Tollwut entwickelt. Immunglobuline und moderne, hoch gereinigte Impfstoffe sind in vielen Regionen nicht erhältlich. Kinder sind besonders gefährdet, da sie häufig Bissen im Gesicht ausgesetzt sind und das Virus nur einen kurzen Weg zurücklegen muss, um das Gehirn zu erreichen bzw. auch kleine Wunden unbemerkt geschehen können.

 

Folgen für Reisende

Kontakt mit Tieren vermeiden (auf keinen Fall füttern!). Nach einem Tierbiss/-kratzer, die Wunde mit fliessendem Wasser und alkalischer Seife 15 Minuten lang waschen, desinfizieren und in jedem Falle ein qualitativ hochwertiges medizinisches Zentrum aufsuchen (post-expositionelle Impfung). Für Reisende mit erhöhtem Individualrisiko (Reisen mit Zweirädern, in entlegene Gebiete, Langzeitaufenthalte, Kleinkinder, Höhlenforscher, Kontakt mit Tieren / Fledermäuse etc.) empfiehlt das Schweizerische Expertenkomitte für Reisemedizin eine prä-expositionelle Impfung vor der geplanten Reise (2 Injektionen und eine Auffrischimpfung nach 1 Jahr).

 

Referenzen

Outbreak News Today; via ProMED-mail

China wurde von der Weltgesundheitsorganisation (WHO) als malariafrei zertifiziert. Das Land hat in der Bekämpfung der Malaria innerhalb der letzten 70 Jahre eine bemerkenswerte Leistung erbracht: in den 1940er Jahren wurden landesweit jährlich 30 Millionen Malaria-Fälle gemeldet. Ab den 1950er Jahren wurde eine nationale Malaria-Eliminationsstrategie entwickelt. Die Zertifizierung der Malaria-Eliminierung wird von der WHO erteilt, wenn ein Land nach eingehender Prüfung nachgewiesen hat, dass landesweite Übertragungen für mindestens die letzten drei aufeinander folgenden Jahre unterbrochen wurden. Das Land muss ausserdem nachweisen, dass es in der Lage ist, ein Wiederaufflammen von Übertragungen zu verhindern.

 

Folgen für Reisende

Auch wenn nun keine spezifische Malaria-Prävention mehr indiziert ist, sollten Mückenschutzmassnahmen weiterhin 24/7 durchgeführt werden: tagsüber gegen Mücken, die z.B. Dengue, Chikungunya und Zika übertragen können und nachts gegen mückenübertragene Erkrankungen wie die Japanische Enzephalitis.

 

Referenzen

WHO, 25.6.2021

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