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 !
While the official WHO declaration is still pending, Peru formally falls under category 1 of the WHO temporary poliomyelitis vaccination recommendations:
Outbreaks of botulism are very rare and may be associated with a natural, accidental, or possibly intentional source of infection.
If considering a visit despite COVID-19 pandemic, the following precautions are recommended:
General:
Recommended vaccinations and other health risks: see country page China
While the official WHO IHR statement is still pending, Botswana and Zambia formally fall under category 2 of the WHO temporary poliomyelitis vaccination recommendations:
Travelers are usually at low risk of contracting Ebola if you follow these precautions:
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.
While the official WHO declaration is still pending, Indonesia formally falls under category 2 of the temporary WHO poliomyelitis vaccination recommendations:
While the official WHO IHR statement is still pending, Botswana formally falls under category 2 of the WHO temporary poliomyelitis vaccination recommendations:
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:
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.
If considering a visit, the following precautions are recommended:
General Precautions:
The following vaccinations are recommended:
Country requirements:
Travelers are generally at low risk of contracting Ebola if you follow these precautions:
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.
Travelers are generally at low risk of contracting Ebola if you follow these precautions:
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.
Travelers are generally at low risk of contracting Ebola if you follow these precautions:
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.
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:
Travelers are generally at low risk of contracting Ebola if you follow these precautions:
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.
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:
If you have visited a West Nile fever transmission area, do not donate blood for at least 28 days after your return.
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.
Preliminary analysis of samples revealed two positive Marburg virus cases. The two patients from the southern Ashanti region - both deceased and unrelated - presented symptoms of diarrhea, fever, nausea and vomiting. Preparations for a possible outbreak response are being made rapidly as further investigations are in progress.
Marburg is transmitted to humans by bats (fruit bats) and spreads in humans through direct contact with bodily fluids of infected persons, surfaces, and materials. The disease begins abruptly with high fever, severe headache and discomfort. Many patients develop severe hemorrhagic symptoms within seven days. Mortality rates have varied from 24% to 88% in previous outbreaks, depending on the strain of virus and case management.
Most of the laboratory-confirmed cases (2933/3413; 86%) were reported from the WHO European Region. In Switzerland, there have been 81 confirmed cases since May 21 and up to June 29.
Clinical presentation: The cases so far have been mild, there have been no deaths yet. Hospitalised patients have mostly been admitted for local isolation orders. The clinical picture is characterised by lesions that are atypical of the clinical picture in endemic countries. Currently, there are mainly very few, non-grouped, painless pustular lesions on the genitals, perianally and orally. Whether transmission occurs through genital secretions or primarily only through close skin-to-skin contact is not yet clear. The draining lymph nodes are sometimes massively swollen, and fever usually occurs for a few days. The general condition is often only slightly reduced.
Transmission: The virus can be transmitted from person to person via the respiratory tract, through direct contact with body fluids of an infected person or with virus-contaminated objects. The incubation period is 5-21 days, usually about 7-17 days. Monkeypox is transmitted from infected animals through a bite or through direct contact with blood, body fluids or lesions of the infected animal. They can be transmitted to people who eat infected animals via abrasions in the mouth, source, NCDC.
Symptoms: Symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills. 1- 3 days after the onset of symptoms, a rash develops that may look like chickenpox or syphilis and spreads from the face to other parts of the body, including the genitals. The disease is usually mild. In immunocompromised individuals, the disease can be severe. The mortality rate is about 1% for the West African type and up to 10% for the Central African type.
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
The risk is higher for the disabled, pregnant, already fragile, poor, displaced, homeless, children, elderly, and outdoor workers!
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
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:
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
Travelers are usually at low risk of contracting Ebola if you follow these precautions:
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.
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.
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).
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).
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.
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).
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.
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
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
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
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
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
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
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
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
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:
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
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
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
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.
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
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
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
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
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
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
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
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
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
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
(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
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
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
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:
Recommended vaccinations:
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
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
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
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"):
References
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 '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
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"):
References
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
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
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
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
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 Aufentha
