On 10 January 2025, WHO received reliable reports from in-country sources regarding suspected cases of Marburg virus disease in the Biharamulo and Muleba Kagera region of the United Republic of Tanzania. As of 11 January 2025, nine suspected cases were reported including eight deaths (case fatality ratio (CFR) of 89%) across two districts. The cases presented with similar symptoms of headache, high fever, back pain, diarrhoea, haematemesis (vomiting with blood), malaise (body weakness) and, at a later stage of disease, external haemorrhage (bleeding from orifices).
Samples from two patients have been collected and tested by the National Public Health Laboratory. Results are pending official confirmation. Contacts, including healthcare workers, are reported to have been identified and under follow-up in both districts.
The Bukoba district in Kagera region experienced its first MVD outbreak in March 2023, and zoonotic reservoirs, such as fruit bats, remain endemic to the area. The outbreak in March 2023 lasted for nearly two months with nine cases including six deaths.
Kagera region in Tanzania with possible Marburg virus disease outbreak:
Follow media and official reports!
Travellers should be made aware of the ongoing outbreak. The risk for travellers is assessed as low, but it is high for family members and caregivers who have contact with sick people.
Preventive measures:
Upon return:
In case of symptoms
If you develop fever and nonspecific symptoms such as chills, headache, muscle pain or abdominal pain:
For clinicians:
The following countries have reported new confirmed cases of clade I infections within the past 6 weeks:
No new cases have been reported within 6 weeks from Zimbabwe (2 clade Ib cases).
A significant number of suspected mpox cases, that are clinically compatible with mpox remain untested due to limited diagnostic capacity in some African countries and thus never get confirmed. For updates, details, suspected cases, epidemic curves, see WHO LINK.
New imported mpox cases clade Ib outside of Africa:
Previously, imported clade Ib cases have also been reported in Canada (1), Germany (6), India (1), Pakistan (1), Sweden (1), Thailand (1), the United Kingdom (5), and the United States (1).
Follow local media and local health authority advice. Prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet Mpox).
General precautions (most important preventive measure!)
Vaccination
Recommendation of the Swiss Expert for Travel Medicine as of 15 January 2025:
1. Staying or travelling in African countries with mpox clade I outbreaks (as of 15 January 2025, these countries include Burundi, Central African Republic, D.R. Congo, Kenya, Republic of the Congo, Rwanda, and Uganda):
Vaccination against mpox should only be considered for individuals at high risk and for whom proper implementation of the above general precautions is not possible (risk evaluation / consultation of a specialist in travel medicine is recommended!). High-risk situations are considered such as:
2. Staying in countries with mpox clade II outbreaks in case of:
The available vaccine against mpox (e.g. Jynneos®) is also effective against clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms:
If you are diagnosed with mpox:
For clinicians:
The Lunar New Year is celebrated in different ways in many countries and cultures throughout Asia and worldwide and is variously also known as Chinese New Year, the Spring Festival, Tet and Seollal.
Celebrations officially start on 29 January 2025, with the festival likely to attract big crowds and international visitors.
The following precautions are recommended:
General precautions:
Recommended vaccinations and other health risks: See respective country page at www.healthytravel.ch.
On 29 November, an alert was raised by local health zone authorities of Panzi health zone in Kwango province after an increase in deaths, particularly among children under five years of age, following febrile illness.
Enhanced epidemiological surveillance was rapidly implemented, which in the absence of a clear diagnosis was based on the detection of syndromic cases of febrile illnesses with cough, body weakness, with one of a number of other symptoms compatible with acute respiratory and febrile illnesses. This resulted in a rapid increase in the number of cases meeting the definition, with a total of 891 cases reported as of 16 December 2024. However, the weekly number of reported deaths (48 deaths reported over the period) has remained relatively stable. As of 16 December, laboratory results from a total of 430 samples indicated positive results for malaria, common respiratory viruses (Influenza A (H1N1, pdm09), rhinoviruses, SARS-COV-2, Human coronaviruses, parainfluenza viruses, and Human Adenovirus). While further laboratory tests are ongoing, together these findings suggest that a combination of common and seasonal viral respiratory infections and falciparum malaria, compounded by acute malnutrition led to an increase in severe infections and deaths, disproportionally affecting children under five years of age.
There have been several cases of East African sleeping sickness among travelers returning from safari areas in Zambia and Zimbabwe (see map).
Regions highlighted within Zambia and Zimbabwe depicting the approximate risk area for the disease.
African trypanosomiasis, also called sleeping sickness, is endemic in many Subsaharan countries. It is transmitted by Tsetse flies. These flies are mainly attracted by bright, dark (especially blue) colours. They inhabit rural areas, including forests and savannah areas, and areas of thick vegetation along rivers and waterholes, depending on the fly species. Tsetse flies bite during the day, <1% are infected. Risk for infection in travelers increases with the number of fly bites, which does not always correlate with duration of travel. People most likely to be exposed to African trypanosomiasis infection are hunters and villagers with infected cattle herds. Tourists and other people working in or visiting game parks are at risk for contracting African trypanosomiasis if they spend long periods in rural areas where the disease is present. Travelers to urban areas are at minimal risk, although transmission has been observed in some urban settings in the past.
All travellers should be informed that sleeping sickness is endemic in Africa. Tsetse flies, the carriers of sleeping sickness, are mainly attracted by bright, dark (especially blue) colours. To prevention sleeping sickness, travelers should:
In case of a suspicious skin lesion, immediately consult a doctor as a rapid therapy as well as a supportive therapy must be initiated as soon as possible.
On 26 Dec 2024, the Colombian Agricultural (ICA) Institute declared a state of health emergency in the department of La Guajira and dictated measures to prevent and control the outbreak in the department. The outbreak was detected in a field owned by a Wayuu community in La Guajira where more than 20 goats died. Anthrax was confirmed in 2 patients who presented skin leasions.
Anthrax - caused by the spore-forming bacterium Bacillus anthracis, present on all continents, causes high mortality in ruminants. It is highly dangerous, both for animals and for public health, and has a rapid capacity to spread.
The Chinese Centre for Disease Control and Prevention (CDC) has reported a sharp increase in respiratory viral infections, including human metapneumovirus (hMPV) infections, in northern China since December 2024.
Human metapneumovirus can affect all age groups and normally causes mild-to-moderate respiratory illness but sometimes the infection can be severe in young children, older adults, and immunocompromised individuals. In the EU/EEA, hMPV is most active during late winter and spring, often circulating alongside other respiratory viruses. There is no vaccine or specific antiviral treatment available for hMPV. For more information: LINK.
Based on the current information, the European Centre for Disease Prevention and Control (ECDC) considers that the current epidemiological situation in China reflects a seasonal rise in respiratory infections caused by common respiratory pathogens and does not pose any specific concern for the EU/EEA.
Follow media and official reports. Practice hand hygiene.
Reminder: At risk person should be vaccinated against flu and SARS-Cov2 according to national guidelines.
Follow local media and local health authority advice. The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet Mpox).
General precautions
Vaccination
A vaccination against mpox is available (Jynneos®, manufactured by Bavarian Nordic). The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, as of 3 October 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi in case of:
2. People staying outside of Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi (worldwide) in case of:
At the present time, it is assumed that the available vaccine against mpox (e.g. Jynneos®) is also effective against clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms
If you are diagnosed with mpox:
For clinicians:
Further information on evaluation and diagnosis: see CDC LINK.
According to WHO, as of 25 November 2024, a total of 11’ 634 confirmed Oropouche cases, including two deaths, have been reported in the Region of the Americas, across ten countries and one territory: Bolivia (356 cases), Brazil (9563 cases, including two deaths), Canada (two imported cases), Cayman Island (one imported case), Colombia (74 cases), Cuba (603 cases), Ecuador (two cases), Guyana (two cases), Panama (one case), Peru (936 cases), and the United States of America (94 imported cases). Additionally, imported Oropouche cases have been reported in countries in the European Region (30 cases).
In addition, As of 7 December 2024, two adult cases of Oropouche virus disease have been reported by health officials on Barbados.
Oropouche virus
Prevention: The best way to protect yourself from Oropouche is to prevent insect bites 24/7 (also against other mosquito-borne diseases such as Dengue, Zika, Chikungunya), see factsheet.
Pregnant women and women planning to be pregnant should be provided with comprehensive information during pre-travel consultation on the Oropouche virus outbreaks and the potential of miscarriage, fetal malformation or death.
In the event of increased OROV transmission (= declared as an OROV outbreak according CDC Level 2 Travel Health Notice for Oropouche), the Swiss Expert Commission for Travel Medicine recommends:
According to the Japanese Ministry of Health, more than 150 cases of the fifth disease (erythema infectiosum) caused by parvovirus B19 are reported every week. Since the end of August 2024, more than 1’100 cases have been reported nationwide, a significant increase compared to the average incidence. Cases are reported especially in Kanagawa (> 160 cases), Saitama (> 250 cases) and Tokyo (> 260 cases) prefectures. The peak of the outbreak has not yet been reached.
An infection with parvovirus B19 is usually asymptomatic (up to 20%) to mild and self-limiting with cold-like symptoms, skin rash (“slapped cheek”) and arthralgia. High rates of virus circulation in the community pose a risk for pregnant women that have not been exposed to the virus previously and have developed protective immunity. Up to 10% of pregnant women infected with parvovirus B19 during the first 20 gestational weeks can experience complications such as hydrops fetalis and miscarriage. Other groups at risk of severe illness include individuals with blood disorders or weakened immune system.
This is a reminder to take mosquito-bite prevention measures in this summer season 24/7.
In addition, for travelers to Australia, the Swiss Expert Committee for Travel Medicine (ECMT) recommends a vaccination against JE for high-risk travellers such as:
At the 40th meeting, the Emergency Committee under the International Health Regulations (IHR) reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV) in the context of the global target of interruption and certification of WPV1 eradication by 2027 and interruption and certification of cVDPV2 elimination by 2029. Technical updates were received about the situation in Afghanistan, Cameroon, France, Ghana, Indonesia, Nigeria, occupied Palestinian territory (oPt), Pakistan, Spain and Zimbabwe.
The Committee unanimously agreed that the risk of international spread of poliovirus still remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.
Risk categories and advice aimed at reducing the risk of international spread of WPV1 and cVDPVs:
Wild poliovirus was reported in the following countries in 2024 and as of 2 Dec 2024:
Circulating vaccine derived poliovirus (cVDPV) in 2024 and as of 2 Dec 2024:
In 2024 and as of 8 November, approximately 480’000 chikungunya cases and 190 deaths have been reported worldwide.
The majority of countries reporting high chikungunya disease burden are from the Americas, especially in Brazil (403’726 cases, 190 deaths), Paraguay (2’744 cases), Argentina (768 cases, and Bolivia (418 cases).
In Asia, most cases are reported from India (69’544 cases), followed by Pakistan (4’964 cases and Thailand (584 cases).
In Africa, in 2024, chikungunya cases were reported from Senegal and La Réunion.
Of note, chikungunya is endemic in most subtropical and tropical countries, even if this is not shown on this map.
Within the last 12 months (November 2023 to October 2024), the notification rate of chikungunya cases per 100’000 population was reported as follows:
Optimal mosquito protection 24/7 (during the day against dengue, zika, chikungunya etc., at dusk and at night against malaria). In case of fever, ensure adequate hydrations and apply paracetamol products. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
In case of fever, malaria should be ruled out by blood tests.
In the past 3 months, vaccine-derived poliovirus type 2 (VDPV2) was detected in sewage samples in Barcelona, Spain; Warsaw, Poland; and Bonn, Düsseldorf, Dresden, Hamburg, Cologne, Mainz and Munich, Germany. The detected virus is genetically linked to a strain that emerged in Nigeria. This strain is circulating in several countries outside the Region, most widely in North and West Africa.
In all 3 countries in the European Region, the virus was isolated from environmental (sewage) samples only – no associated paralytic cases of polio have been detected.
Germany, Poland and Spain maintain strong disease surveillance and high levels of routine immunization coverage, estimated at 85–93% nationally with 3 doses of inactivated polio vaccine (IPV), which provides excellent protection from paralysis caused by poliovirus.
However, pockets of undervaccination exist in every country.
The detection of VDPV2 in wastewater is not surprising. People can shed the virus if they come from or have travelled to countries where oral poliovirus vaccine is still used. The risk for vaccinated people in Germany is very low due to the high vaccination coverage against polio.
For all individuals, including refugees and migrants: routine vaccination against polio according to national guidelines is important (Swiss FOPH recommendations |STIKO, Germany recommendations). Travellers going to countries where wild poliovirus or polio vaccine virus is endemic should get vaccinated against polio, see recommendations on the country pages at www.healthytravel.ch.
In 2024, 22’379 cases of whooping cough have been reported to the Robert Koch Institute (RKI) so far, already the highest annual number of cases since the nationwide reporting requirement was introduced in 2013. The average weekly incidence from 2020 to 2024 is twice as high as in the pre-pandemic years 2015 to 2019.
Pertussis incidence: cases per 100’000 population and week:
This is a reminder that a travel medicine consultation is an opportunity to check pertussis vaccination status.
Swiss recommendations: After the basic immunization against pertussis, booster doses are recommended in adolescents (11-15 years) and adults (25-29 years). Booster vaccination is also indicated in every pregnancy. In addition, adolescents and adults of all ages should receive a pertussis vaccination if there is regular contact with infants under 6 months of age due to work or family and the last vaccination against pertussis was 10 years ago or longer.
The National Center for Epidemiology, Prevention and Control of Diseases (CDC Peru) of the Ministry of Health (Minsa) has issued an epidemiological alert due to the increase in cases of dengue nationwide, associated with factors such as climatic variability and the circulation of the DENV-3 serotype.
An upward trend has been observed since week 40.
Prevention: Optimal mosquito bite protection 24/7, also in cities (also against other mosquito-borne diseases such as malaria, Zika, chikungunya).
In case of fever, ensure adequate hydrations and apply paracetamol products. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
In case of fever, malaria should be always ruled out by blood tests.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
The Fresno County Department of Public Health (FCDPH) is reporting a human rabies death, the first such case since 1992 in the county.
Officials say the Fresno County resident is suspected to have been bitten by a bat in Merced County in mid-October. The individual died on November 22 after one week of hospitalization.
Rabies can be transmitted by any mammals, including bats.
Prevention: Avoid contact with animals and do not feed them! Pre-exposure vaccination is particularly recommended for travellers with increased individual risk (working with animals, travel on two-wheelers, to remote areas, young children, cave explorers, possible contact with bats, etc.).
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination as soon as possible! For more information: see Flyer rabies.
Au cours des douze derniers mois, plus de 14 millions de cas de dengue (10’000 décès) ont été enregistrés dans le monde. Ceux-ci se répartissent comme suit:
Amérique: plus de 12 millions de cas, 7'000 décès (la plus grande épidémie de l'histoire!)
Afrique: plus de 100'000 cas de dengue
Asie:
Prevention: Optimal mosquito bite protection 24/7, also in cities (also against other mosquito-borne diseases such as malaria, Zika, chikungunya).
In case of fever, ensure adequate hydrations and apply paracetamol products. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
In case of fever, malaria should be always ruled out by blood tests.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
Within three weeks, mpox cases have increased by +4’758 to cumulative 14’078 confirmed cases (all clades), including 55 deaths. The following countries have reported new cases of clade I between 03 to 24 Nov 2024:
No new clade I cases have been reported within 3 weeks from Congo (22 clade Ia cases), Zimbabwe (2 clade Ib cases), and Zambia (1 clade Ib case).
A significant number of suspected mpox cases, that are clinically compatible with mpox remain untested due to limited diagnostic capacity in some African countries and thus never get confirmed.
For updates, details, suspected cases, epidemic curves, see WHO LINK).
Follow local media and local health authority advice. Prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet Mpox).
General precautions
Vaccination
A vaccination against mpox is available (Jynneos®, manufactured by Bavarian Nordic). The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, as of 3 October 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi in case of:
2. People staying outside of Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi (worldwide) in case of:
At the present time, it is assumed that the available vaccine against mpox (e.g. Jynneos®) is also effective against clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms
If you are diagnosed with mpox:
For clinicians:
Further information on evaluation and diagnosis: see CDC LINK.
Since mid of November 2024, six foreign tourists died and at least four other people got ill after drinking tainted alcohol in Vang Vieng, Vientiane Province. News reports and testimonies suggest the tourists may have consumed alcohol laced with methanol.
Methanol poisoning and deaths due to adulterated alcoholic beverages are frequently reported in many countries all over the world.
Worldwide, there were an estimated 10.3 million cases of measles in 2023, a 20% increase from 2022, according to new estimates from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). Inadequate immunization coverage globally is driving the surge in cases.
As a result of global gaps in vaccination coverage, 57 countries experienced large or disruptive measles outbreaks in 2023, affecting all regions except the Americas, and representing a nearly 60% increase from 36 countries in the previous year. The WHO African, Eastern Mediterranean, European, Southeast Asia and Western Pacific regions experienced a substantial upsurge in cases. Nearly half of all large or disruptive outbreaks occurred in the African region.
This is a reminder: Travel medicine consultation is a good opportunity to check measles vaccination status.
Swiss recommendations: all persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine. In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
In 2024 and as of 15 November 2024, Dengue cases were reported in the following countries:
Burkina Faso: a total of 89’728 dengue cases (91 deaths) have been reported in all 13 regions. Most cases (51%) have been reported from the Center region. DENV-1 and DENV-3 viruses have been identified.
Cabo Verde: a total of 35’230 dengue cases (14’137 confirmed; 21’093 suspected cases ) have been reported from all nine islands. Santiago Island accounted for 82% of all confirmed cases. Serotypes DENV-1 and DENV-3 were detected.
Senegal: a total of 181 confirmed dengue cases have been identified in nine regions in Senegal, with Pikine district in Dakar region having the most cases (16), 20% of all cases. Other regions reporting a high number of cases include Thies 16 (20.0%), Louga 7 (9.0%), Fatick 6 (7.0%), Kaffrine 6 (7.0%), and Saint-Louis 4 (5.0%).
Sudan: Dengue is currently emerging as a public health problem in most states of Sudan with more than 6’000 cases reported.
Prevention: Optimal mosquito bite protection 24/7, also in cities (also against other mosquito-borne diseases such as malaria, Zika, chikungunya).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
In case of fever, malaria should be always ruled out by blood tests.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
After a trip to Zimbabwe, African trypanosomiasis was diagnosed in a traveler in Vienna. The patient is hospitalized and under treatment.
African trypanosomiasis, also called sleeping sickness, is endemic in many Subsaharan countries (see map).
It is transmitted by Tsetse flies. These flies are mainly attracted by bright, dark (especially blue) colours. They inhabit rural areas, including forests and savannah areas, and areas of thick vegetation along rivers and waterholes, depending on the fly species. Tsetse flies bite during the day, <1% are infected. Risk for infection in travelers increases with the number of fly bites, which does not always correlate with duration of travel. People most likely to be exposed to African trypanosomiasis infection are hunters and villagers with infected cattle herds. Tourists and other people working in or visiting game parks are at risk for contracting African trypanosomiasis if they spend long periods in rural areas where the disease is present. Travelers to urban areas are at minimal risk, although transmission has been observed in some urban settings in the past.
For details, see WHO Factsheet.
As of 13 November 2024, a total of 494 confirmed cases of mpox and one death have been reported in Uganda. Confirmed cases have been reported in 38 districts, with the most affected districts including Kampala (61% of cases), Wakiso and Nakasongola. For details, see LINK.
Follow local media and local health authority advice. The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet Mpox).
General precautions
Vaccination
A vaccination against mpox is available (Jynneos®, manufactured by Bavarian Nordic). The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, as of 3 October 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi in case of:
2. People staying outside of Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi (meaning worldwide) in case of:
At the present time, it is assumed that the available vaccine against mpox (e.g. Jynneos®) is also effective against clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms
If you are diagnosed with mpox:
For clinicians:
In the province of Córdoba, an outbreak of trichinellosis has caused a health alarm after the Ministry of Health confirmed 41 cases in 5 localities.
Trichinella infections are frequently reported in Argentina. Homemade sausage foods do not usually go through sanitary and may be sold on the routes and roads of the country.
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.
On 8 November 2024, the Centers for Disease Control and Prevention (CDC), reported a higher than expected number of US travellers returning from the state of Telangana in India with chikungunya.
According to WHO, between 1 January and 20 October 2024, over 7.3 million malaria cases and 1’157 deaths (CFR 0.02%) were reported in Ethiopia (estimated population of around 124 million). Of the total cases reported in 2024, majority (95%) were laboratory-confirmed, with Plasmodium falciparum accounting for more than two-thirds of the cases. By contrast, in 2023, 4.1 million malaria cases including 527 deaths were reported, of which Plasmodium falciparum accounted for approximately 70% of all reported cases.
Four regions accounted for 81% of the reported cases and 89% of health facility malaria deaths in 2024: Oromia (44% cases; 667 deaths), Amhara (18% cases; 56 deaths), Southwest (12% cases; 250 deaths) and South Ethiopia Regional State (7% cases; 45 deaths). Due to favorable geo-ecological conditions, the Western part of the country is experiencing a high malaria burden and is highly affected by the current unprecedented surge as shown in the incidence map for week 42.
The increasing trend in the number of annual cases and endemic areas are likely influenced by reduced vector control efforts, exacerbated by acute and protracted conflicts affecting some Regional States.
Challenges remain in delivering essential health care services, including malaria treatment, in health facilities due to access challenges and barely functioning health facilities in areas affected by conflicts. The presence of other concurrent disease outbreaks and humanitarian emergencies in the country further exacerbates these challenges. WHO assesses the national risk for malaria in Ethiopia as high due to multiple factors including the spread of Anopheles stephensi, drought and food insecurity, climate change-induced extreme weather events and ongoing conflicts.
Geographical distribution of Malaria cases as of 20 October 2024:
The death of a young man who was bitten by a pet dog has triggered a debate about the spread of rabies in Morocco.
According to data from the Ministry of Health and Social Protection, Morocco recorded 414 cases of rabies between 2000 and 2020, averaging 20 cases per year, with 180 of these cases involving children under 15.
Information about rabies and what to do if exposed is important for all travellers!
Prevention: Avoid contact with animals! Do not feed animals either! Pre-exposure vaccination is particularly recommended for travelers with increased individual risk (working with animals, travel on two-wheelers, to remote areas, young children, cave explorers, possible contact with bats, frequent travels etc.).
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination as soon as possible! For more information: see Flyer rabies.
Zika is endemic in Thailand. CDC does not classify Thailand as an area with a current outbreak (see CDC map).
Optimal mosquito bite protection 24/7, also in cities (during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria).
For detailed ECTM recommendations on Zika, see link. In case of fever, malaria should always be ruled out by blood test.
On 27 September 2024, Rwanda reported its first Marburg virus disease outbreak (MVD), see also previous EpiNews.
Marburg virus disease (MVD) is a rare but severe hemorrhagic fever, caused by Marburg virus (MARV). Although MVD is uncommon, MARV has the potential to cause outbreaks with significant case fatality rates (up to 88%). All recorded MVD outbreaks have originated in Africa.
Transmission: Fruit bats are the natural reservoir of MARV. The majority of MVD outbreaks have been connected to human entry into bat-infested mines and caves. Humans can also get infected by direct contact with an infected animal (e.g., non-human primate).
Person-to-person transmission occurs by direct contact (through broken skin or mucous membranes) with infected blood, secretions, and body fluids or by indirect contact with contaminated surfaces and materials like clothing, bedding and medical equipment. MVD is not an airborne disease, and a person is not contagious before symptoms appear. As a result, if proper infection prevention and control precautions are strictly followed, the risk of infection is regarded as minimal.
Incubation period: usually five to ten days (range 2-21 days).
Symptoms: The onset of MVD is usually abrupt, with non-specific, flu-like symptoms such as a high fever, severe headache, chills and malaise. Rapid worsening occurs within 2–5 days for more than half of patients, marked by gastrointestinal symptoms such as anorexia, abdominal discomfort, severe nausea, vomiting, and diarrhea. In severe cases, a rash may develop, along with bleeding from various body areas.
Treatment: There are several experimental drugs and vaccines for Marburg, but none has been licensed to date.
Further information, see ECDC Factsheet Marburg Virus, CDC.
Follow media and official reports! Follow all the recommendations of the local health authorities!
Travellers should be made aware of the ongoing outbreak. The risk for travellers to Rwanda is assessed as low, but it is high for family members and caregivers who have contact with sick people.
Preventive measures:
Upon return from Rwanda:
In case of symptoms:
If you develop fever and nonspecific symptoms such as chills, headache, muscle pain or abdominal pain:
For clinicians:
According to WHO, between 2 to 29 September 2024 (week 36 to 39), 17 countries shared their meningitis epidemiological data.
Epidemic:
Alert:
For previous epidemics and alerts, see EpiNews or news at www.healthytravel.ch.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended:
If no alert or epidemic is reported, vaccination is recommended for travel to the ‘meningitis belt’ during the dry season (typically occurring from December to June) across sub-Saharan Africa if
Ethiopia is facing a significant malaria crisis, reporting a total of 5’723’754 cases from 1 January to 15 September 2024. Four regions of Oromia, Amhara, Southwest, and South Ethiopia Regional State comprise 80.0% of all cases. The resurgence of Malaria in Ethiopia is exacerbated by the suspension of malaria control programs, especially in conflict-affected regions, which has created vulnerable living conditions due to displacement, among others.
In Epidemiological Week 36 alone, there were 227’675 malaria cases and 18 deaths. A significant proportion of the cases (over 81.0%) came from four regions: Oromia (440%), Amhara (18.0%), Southwest (12.0%), and South Ethiopia Regional State (7.0%). Of the cases in week 36, 98.0% were confirmed through laboratory testing, and Plasmodium falciparum accounted for 62.0%
Prevention: Optimal mosquito bite protection 24/7, also in cities (also against other mosquito-borne diseases such as malaria, Zika, chikungunya).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
In case of fever, malaria should be always ruled out by blood tests.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
While further information is pending, in addition to the basic immunization against polio, a booster vaccination is recommended for:
On 28 October 2024, the US Center of Disease Control and Prevention reported a suspected imported case of Lassa fever in an Iowa resident. The case recently to West Africa (country unspecified) in early October 2024 and became ill upon return and was isolated in a hospital where he died end of October.
Lassa fever is endemic in West Africa with 100’000 to 300’000 cases reported each year.
Sporadic cases have been reported among returning travellers: In the past 10 years, EU/EEA countries have reported seven Lassa fever cases to ‘The European Surveillance System’ (TESSy). Two cases were reported by the UK (ex-Nigeria and ex-Mali) in 2009, one by Sweden (ex-Liberia) in 2016, two by Germany (ex-Togo and a secondary case infected in Germany) in 2016 and two by the Netherlands (ex-Sierra Leone) in 2019. In the USA, there have been nine imported Lassa fever cases since 1969.
The NHS has sounded an alarm with a 10-day COVID warning, calling for vigilance as the number of cases climbs. According to recent figures released by the UK Health Security Agency (UKHSA), there's been a 17.8% week-on-week increase in COVID infections in England and a sharp 27.3% rise in related fatalities.
In the EU/EEA, there has been a downward trend of COVID-19 activity since the peak in July 2024, including in most of the countries that experienced a later epidemic during the summer. People aged 65 years and above continue to represent the main age group at risk of hospitalization and severe outcomes due to COVID-19.
On 27 September 2024, Rwanda reported its first Marburg virus disease outbreak (see EpiNews as of 3 Oct 2024). Updates as of 18.10.2024:
Marburg virus disease (MVD) is a rare but severe hemorrhagic fever, caused by Marburg virus (MARV). Although MVD is uncommon, MARV has the potential to cause outbreaks with significant case fatality rates (up to 88%). All recorded MVD outbreaks have originated in Africa.
Transmission: Fruit bats are the natural reservoir of MARV. The majority of MVD outbreaks have been connected to human entry into bat-infested mines and caves. Humans can also get infected by direct contact with an infected animal (e.g., non-human primate).
Person-to-person transmission occurs by direct contact (through broken skin or mucous membranes) with infected blood, secretions, and body fluids or by indirect contact with contaminated surfaces and materials like clothing, bedding and medical equipment. MVD is not an airborne disease, and a person is not contagious before symptoms appear. As a result, if proper infection prevention and control precautions are strictly followed, the risk of infection is regarded as minimal.
Incubation period: usually five to ten days (range 2-21 days).
Symptoms: The onset of MVD is usually abrupt, with non-specific, flu-like symptoms such as a high fever, severe headache, chills and malaise. Rapid worsening occurs within 2–5 days for more than half of patients, marked by gastrointestinal symptoms such as anorexia, abdominal discomfort, severe nausea, vomiting, and diarrhea. In severe cases, a rash may develop, along with bleeding from various body areas.
Treatment: There are several experimental drugs and vaccines for Marburg, but none has been licensed to date.
Further information, see ECDC Factsheet Marburg Virus, CDC
WHO assesses the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level.
ECDC assess the overall risk for EU/EEA citizens visiting or living in Rwanda as low. This is because the likelihood of exposure to MVD – considering the low number of cases reported and the mode of transmission – and the impact are both assessed as low. For details, see LINK.
Follow media and official reports! Follow all the recommendations of the local health authorities!
Travellers should be made aware of the ongoing outbreak. The risk for travellers to Rwanda is assessed as low, but it is high for family members and caregivers who have contact with sick people.
Preventive measures:
Upon return from Rwanda:
In case of symptoms
If you develop fever and nonspecific symptoms such as chills, headache, muscle pain or abdominal pain:
For clinicians:
In urban districts of Hong Kong further cases of melioidosis were confirmed. Melioidosis is endemic in Hong Kong, though case numbers are low (18 so far in 2024). This serves as a reminder that this infection – though commonly associated with out-door and rural environments – is indeed also endemic in metropolitan surroundings.
Melioidosis is an endemic disease in Asia and Northern Australia. Cases have also been reported from Africa, the Caribbean basin, and the Americas. Cases may increase after hurricanes, heavy rain, typhoons, and other severe weather events.
Melioidosis mainly affects people who have direct contact with soil and water. Many have an underlying predisposing condition such as diabetes (most common risk factor), renal and liver disease, and others. Information on melioidosis: see CDC.
On 27 September 2024, Rwanda reported its first Marburg virus disease outbreak (see EpiNews as of 3 Oct 2024).
Marburg virus disease (MVD) is a rare but severe hemorrhagic fever, caused by Marburg virus (MARV). Although MVD is uncommon, MARV has the potential to cause outbreaks with significant case fatality rates (up to 88%). All recorded MVD outbreaks have originated in Africa.
Transmission: Fruit bats are the natural reservoir of MARV. The majority of MVD outbreaks have been connected to human entry into bat-infested mines and caves. Humans can also get infected by direct contact with an infected animal (e.g., non-human primate).
Person-to-person transmission occurs by direct contact (through broken skin or mucous membranes) with infected blood, secretions, and body fluids or by indirect contact with contaminated surfaces and materials like clothing, bedding and medical equipment. MVD is not an airborne disease, and a person is not contagious before symptoms appear. As a result, if proper infection prevention and control precautions are strictly followed, the risk of infection is regarded as minimal.
Incubation period: usually five to ten days (range 2-21 days).
Symptoms: The onset of MVD is usually abrupt, with non-specific, flu-like symptoms such as a high fever, severe headache, chills and malaise. Rapid worsening occurs within 2–5 days for more than half of patients, marked by gastrointestinal symptoms such as anorexia, abdominal discomfort, severe nausea, vomiting, and diarrhea. In severe cases, a rash may develop, along with bleeding from various body areas.
Treatment: There are several experimental drugs and vaccines for Marburg, but none has been licensed to date.
Further information, see ECDC Factsheet Marburg Virus, CDC.
WHO assesses the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level.
ECDC assess the overall risk for EU/EEA citizens visiting or living in Rwanda as low. This is because the likelihood of exposure to MVD – considering the low number of cases reported and the mode of transmission – and the impact are both assessed as low. For details, see LINK.
Follow media and official reports! Follow all the recommendations of the local health authorities!
Travellers should be made aware of the ongoing outbreak. The risk for travellers to Rwanda is assessed as low, but it is high for family members and caregivers who have contact with sick people.
Preventive measures:
Upon return from Rwanda:
In case of symptoms
If you develop fever and nonspecific symptoms such as chills, headache, muscle pain or abdominal pain:
For clinicians:
Information about rabies and what to do if exposed is important for all travellers!
Prevention: Avoid contact with animals and do not feed them! Pre-exposure vaccination is particularly recommended for travellers with increased individual risk (working with animals, travel on two-wheelers, to remote areas, young children, cave explorers, possible contact with bats, etc.).
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination as soon as possible! For more information: see Flyer rabies.
On 13 September 2024, the IHR NFP for Barbados notified WHO of one confirmed human infection with West Nile Virus (WNV) in a child. This marks the first detected human case of WNV reported from Barbados.
Additionally, no infections have been previously documented in birds or horses in this country, making this case both unusual and unexpected. However, the WNV has spread throughout the Caribbean, likely via infected migratory birds. It is possible that the virus is circulating in birds and horses undetected.
West Nile viruses belong to the flavivirus family and are transmitted by Culex mosquitoes. The main hosts are birds; humans are false hosts. Most cases are asymptomatic; clinically symptomatic cases develop fever and meningitis or encephalitis. Elderly persons, pregnant women and immunosuppressed persons are at higher risk for a neuroinvasive form of the disease.
The following precautions are recommended:
The number of people affected by leptospirosis and related deaths in Kerala is increasing. In the first 4 days of October 2024 alone, 45 people were diagnosed with the disease.
According to the Health Department, from 1 Jan to 4 Oct 2024, a total of 2’512 people have been diagnosed with leptospirosis, including 155 confirmed deaths. Additionally, 1’979 people sought treatment for symptoms related to the illness. Similarly, 131 deaths suspected to be caused by leptospirosis symptoms were also reported.
Health officials warn that the disease is now spreading during all seasons.
Leptospirosis: Leptospires are transmitted via the urine of rodents (especially rats), e.g. in water residues (rivulets, puddles, etc.) or mud. Transmission to humans occurs through direct or indirect contact with rodent urine via small skin lesions or mucosal surfaces. The clinical picture ranges from flu-like general symptoms to aseptic meningitis and sepsis. Vaccination is not available.
Prevention: Wear waterproof protective clothing/boots when wading through water! Cuts or scratches should be covered with waterproof bandages. Vaccination is not available for travelers.
As of 3 October, 130 locally acquired dengue cases have been reported by the Italian National Public Health Authority. These are 63 more cases than reported in the previous week's update. The newly reported cases were from Marche (51 cases), Emilia Romagna (14 cases) and Lombardy (one case). According to local authorities in the Marche Region, there is a decreasing trend in case numbers reported from Fano.
For 129 cases NUTS2 regions were reported:
An additional case (onset of symptoms 18 August, DENV 2) was reported by the Abruzzo region. However, the place of infection is currently under investigation as the infection may have occurred in another region.
Prevention: Optimal mosquito bite protection during the day, also in cities.
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
In 2024 and as of 2 October 2024, 18 countries in Europe have reported 1’202 locally acquired human cases of West Nile Virus (WNV) infection with known place of infection. The earliest and latest date of onset were respectively on 1 March 2024 and 26 September 2024.
Locally acquired cases were reported by Italy (422), Greece (202), Spain (114), Albania (102), Hungary (101), Romania (71), Serbia (53), Austria (34), Türkiye (30), France (27), Croatia (20), Germany (8), Slovenia (5), Kosovo (4), Slovakia (4), Bulgaria (2), North Macedonia (2) and Czechia (1).
In Europe, 88 deaths were reported by Greece (31), Italy (16), Albania (13), Romania (10), Spain (10), Bulgaria (2), Serbia (2), Türkiye (2), France (1) and North Macedonia (1).
Case numbers reported this year are above the mean monthly case count for the past 10 years. During the same period in 2023, 681 cases had been reported. However, numbers are lower than in 2018, when 1 728 cases had been reported by this time of year.
Distribution of locally acquired human West Nile virus infections in 2024 till 2 October 2024:
Of note, further regions of infection were reported in 2023.
The following precautions are recommended:
On 2 October 2024, Germany reported that two travellers returning from Rwanda were isolated at the University Medical Center Hamburg (UKE) on suspicion of Marburg virus disease (MVD). Both tested negative on 3 October. One of the cases is a medical student who worked in a hospital in Rwanda, where he was exposed to a patient infected with MVD around 25 September, while wearing appropriate protective equipment. He will continue to be monitored for his own safety until the end of the incubation period of up to 21 days. In the coming days, he is to remain in quarantine at the UKE's special unit for highly contagious infectious diseases, followed by home quarantine under the supervision of the responsible public health department.
The companion also tested negative and is showing mild symptoms of another disease. The companion had no contact with MVD-infected persons in Rwanda. The accompanying person will also continue to be monitored at the UKE over the weekend.
See news above.
The negative test result and the absence of symptoms during the returning trip rule out any risk to third parties. Thus, there was no risk of infection with the Marburg virus for either the air or rail travellers at any time.
On 27 September 2024, the Rwanda Ministry of Health announced the confirmation of Marburg virus disease in patients in health facilities in the country. As of 3 October, 36 cases of MVD have been reported, including 11 deaths (Case fatality rate: 31%). The cases are reported from seven of the 30 districts in the country (Gasabo, Gatsibo, Kamonyi, Kicukiro, Nyagatare, Nyarugenge and Rubavu districts). Among the confirmed cases, over 70% are health care workers from two health facilities in Kigali. Contact tracing is underway with 410 contacts under follow-up. The source of the infection is still under investigation.
One contact travelled to Belgium from Rwanda. WHO was made aware of this by the public health authorities in Belgium. They shared detailed information on the contact's situation, that they remained healthy, completed the 21-day monitoring period, did not present with any symptoms, and are not a risk to public health.
This is the first time MVD has been reported in Rwanda. The Government of Rwanda is coordinating the response with support from WHO and partners. The Ministry of Health of Rwanda announced several control measures including a ban on patient visits to hospitals, strengthening protocols in hospitals, and measures to limit contact with dead bodies.
Rwanda will start cinical trials of experimental vaccines and treatments for MVD in the next few weeks.
Marburg virus disease (MVD) is a rare but severe hemorrhagic fever, caused by Marburg virus (MARV). Although MVD is uncommon, MARV has the potential to cause outbreaks with significant case fatality rates (up to 88%). All recorded MVD outbreaks have originated in Africa.
Transmission: Fruit bats are the natural reservoir of MARV. The majority of MVD outbreaks have been connected to human entry into bat-infested mines and caves. Human can also get infected by direct contact with an infected animal (e.g., non-human primate).
Person-to-person transmission occur by direct contact (through broken skin or mucous membranes) with infected blood, secretions, and body fluids or by indirect contact with contaminated surfaces and materials like clothing, bedding and medical equipment MVD is not an airborne disease, and a person is not contagious before symptoms appear. As a result, if proper infection prevention and control precautions are strictly followed, the risk of infection is regarded as minimal.
Incubation period: usually five to ten days (range 2-21 days)
Symptoms: The onset of MVD is usually abrupt, with non-specific, flu-like symptoms such as a high fever, severe headache, chills and malaise. Rapid worsening occurs within 2–5 days for more than half of patients, marked by gastrointestinal symptoms such as anorexia, abdominal discomfort, severe nausea, vomiting, and diarrhea. In severe cases, a rash may develop, along with bleeding from various body areas.
Treatment: There are several experimental drugs and vaccines for Marburg, but none has been licensed to date.
Further information, see ECDC Factsheet Marburg Virus. CDC.
WHO assesses the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level.
Follow media and official reports. The risk for travellers is usually very low, but it is high for family members and caregivers who have contact with sick people.
Preventive measures:
Upon return from Rwanda:
In case of symptoms
If you develop fever and nonspecific symptoms such as chills, headache, muscle pain or abdominal pain:
For clinicians:
Further information on evaluation and diagnosis: see LINK.
According to WHO, between 29 to 1 September 2024 (week 31 to 35), 19 countries shared their meningitis epidemiological data.
Epidemic:
Alert:
For previous epidemics and alerts, see EpiNews or news at www.healthytravel.ch.
Vaccination with a quadrivalent meningococcal conjugate vaccine (Menveo® or Nimenrix®) is recommended:
If no alert or epidemic is reported, vaccination is recommended for travel to the ‘meningitis belt’ during the dry season (typically occurring from December to June) across sub-Saharan Africa if
As of 27 September 2024, a total of 294 Zika virus cases across 40 provinces have now been reported for 2024.
More than 750 Zika cases were reported in the whole of 2023. Due to an increased number of imported Zika cases in returning travellers (n=25), particularly with exposure in the second half of 2023 (n=21), ongoing transmission of Zika virus in Thailand was assumed, leading the Swiss ECTM to issue special recommendations in February 2024 (EpiNews 2 February 2024).
Zika is endemic in Thailand. The current numbers do not indicate an increasing ongoing transmission. CDC does not classify Thailand as an area with a current outbreak (see CDC map). As a result, the Swiss Expert Committee for Travel Medicine updates its ZIKA prevention recommendations for travellers to Thailand as follows:
Optimal mosquito bite protection 24/7, also in cities (during the day against dengue, chikungunya, Zika and other viruses, at dusk and at night against malaria).
For detailed ECTM recommendations on Zika, see link. In case of fever, malaria should always be ruled out by blood test.
In 2024, as of 06 October 2024, 16 countries have reported 7’524 confirmed cases (+770 new confirmed cases within 1 week), including 32 deaths. The three countries with the majority of the cases in 2024 (all clades) are Democratic Republic of the Congo (6’169), Burundi, (n = 987), and Nigeria, (n = 84).
(Note: A significant number of suspected mpox cases that are clinically compatible with mpox remain untested due to limited diagnostic capacity in some African countries and therefore never got confirmed.)
In 2024, 15 countries have reported both 31’527 suspected and laboratory tested cases (+5’160 within 1 week, all clades), including 998 suspected and confirmed deaths (+2 within 1 week).
According to WHO, in 2024 as of 29 Sept 2024 the cumulative confirmed mpox cases (+ cases since last update 29 Sep 2024) were reported in the below mentioned countries (for updates, details, suspected cases, epidemic curves, see WHO LINK):
Clade Ia and b:
Clade Ib
Clade Ia:
Clade II (a and/or b):
In addition, mpox cases have been reported in Africa in 2024 without specification of the clade:
Epicurve for Ib clade cases as 6 October 2024:
Follow local media and local health authority advice. The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet Mpox).
General precautions
Vaccination
A vaccination against mpox is available (Jynneos®, manufactured by Bavarian Nordic). The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, as of 3 October 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi in case of:
2. People staying outside of Province Equateur and / or Eastern D.R. Congo (South/North Kivu) and / or Burundi (worldwide) in case of:
At the present time, it is assumed that the available vaccine against mpox (e.g. Jynneos®) is also effective against clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms
If you are diagnosed with mpox:
For clinicians:
Die Zahl der in den USA im Jahr 2024 bisher gemeldeten Pertussis- oder Keuchhustenfälle ist nach den neuesten Daten der Centers for Disease Control and Prevention (CDC) mehr als viermal so hoch wie zum gleichen Zeitpunkt des letzten Jahres. Bis zum 14. September wurden 14’569 Pertussis-Fälle gemeldet. Dies entspricht einem Anstieg von 319 %.
Auch Australien verzeichnet einen deutlichen Anstieg der Pertussisfälle. Laut den dortigen Gesundheitsbehörden und Stand vom 21. September dieses Jahres wurde insgesamt 29’648 Fälle, die höchste Zahl seit 2011, als 38’748 Fälle gemeldet wurden, registriert.
Dies ist eine Erinnerung daran, dass eine reisemedizinische Beratung eine Gelegenheit ist, den Pertussis-Impfstatus zu überprüfen. Schweizer Empfehlungen: Nach der Grundimmunisierung gegen Keuchhusten werden Auffrischungsimpfungen bei Jugendlichen (11-15 Jahre) und Erwachsenen (25-29 Jahre) empfohlen.
Eine Auffrischungsimpfung ist auch bei jeder Schwangerschaft angezeigt. Zusätzlich sollten sich Jugendliche und Erwachsene jeden Alters gegen Keuchhusten impfen lassen, wenn beruflich oder familiär regelmässiger Kontakt mit Säuglingen unter 6 Monaten besteht und die letzte Impfung gegen Keuchhusten 10 Jahre oder länger zurückliegt.
Between epidemiological week (EW) 1 and EW 35 of 2024, 38 confirmed human cases including 19 deaths of yellow fever (YF) have been reported in 5 countries of the Americas Region: Bolivia (7 cases, including 4 with history of YF vaccination), Brazil (3 cases, including 1 case with history of YF vaccination in 2017), Colombia (8 cases, including 1 cases with history of YF vaccination), Guyana (2 cases), and Peru (18 cases). For details, see LINK.
Geographical distribution of municipalities with occurrence of yellow fever cases in humans in Bolivia, Brazil, Colombia, Guyana, and Peru, years 2022, 2023, and 2024 (as of EW 35):
Mozambican health authorities have detected measles outbreaks in 4 districts of the northern province of Cabo Delgado, and warned that the outbreaks have worsened over the past 2 months.
Neighbouring Malawi has also issued an alert after detecting measles cases.
This is a reminder that all travelers should be updated with measles vaccination.
Swiss recommendations: all persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine.
In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
The number for Zika cases in Pune have increased to more than 100 cases, including 5 deaths. All deaths were in elderly people with co-morbidities.
End of August 2024, the US CDC issued an alert on a Zika outbreaks in the state of Maharashtra.
There is currently an increased risk of transmission of the Zika virus in the state of Maharashtra, India. Please note that the Zika virus can also be transmitted sexually!
Prevention: Optimal mosquito protection 24/7: during the day against Zika, dengue and other arboviruses, at dusk and at night against malaria.
When travelling to areas with a Zika outbreak, as is now the case in the state of Maharashtra, India, the Swiss Expert Committee for Travel Medicine recommends using a condom/femidom during the trip and for at least 2 months after returning home to prevent possible sexual transmission of the virus.
Due to the risk of malformations in the unborn child, pregnant women are currently advised not to travel to the state of Maharashtra in India. If travelling is absolutely necessary, it is recommended that you speak to a specialist in travel medicine before departure.
Women planning to become pregnant should wait at least 2 months after their return (or that of their partner) from India before starting family planning. In the case of medically assisted reproduction, this period should be extended to at least 3 months. Please also read the Zika information sheet, especially if you are pregnant or if you or your partner are planning a pregnancy.
In 2024 and as of 4 September 2024, 15 countries in Europe have reported 715 locally acquired human cases of WNV infection. The earliest and latest date of onset were respectively on 1 March 2024 and 29 August 2024. Locally acquired cases were reported by Italy (287), Greece (138), Albania (74), Spain (54), Hungary (43), Romania (42), Serbia (27), Austria (18), France (15),
Türkiye (7), Croatia (3), Bulgaria (2), Germany (2), Kosovo (2) and North Macedonia (1).
In Europe, 51 deaths were reported by Greece (17), Albania (13), Italy (10), Spain (4), Romania (3), Bulgaria (2), France (1) and Serbia (1).
In addition, Slovenia reported three human cases of WNV infection through EpiPulse in the Pomurska and Podravska regions. These cases had not been reported through TESSy by 4 September and are therefore not included in this monthly WNV report.
Case numbers reported this year are above the mean monthly case count of the past 10 years. For instance, during the same period in 2023, 445 cases had been reported. Numbers are, however, lower than in 2018, when 1 048 cases had been reported by this time of year.
Distribution of locally acquired human West Nile virus infections in 2024 till 11 September 2024:
The following precautions are recommended:
Avoid bathing, washing, or walking in fresh water.
Consult a general practitioner or a specialist in travel and tropical medicine after suspected skin contact with fresh water during your trip.
The Los Angeles County Public Health Department has confirmed a case of locally acquired dengue from a resident who has no history of travel to areas where dengue fever is endemic. According to a release from the health department, the infected person resides in Baldwin Park.
It is the third case of locally acquired dengue in California and the first reported by the Los Angeles County Department of Public Health. Cases of locally acquired dengue were previously confirmed by Long Beach and Pasadena in fall 2023.
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
The Swiss Expert Committee for Travel Medicine (ECTM) recommends a vaccination with Qdenga® only for travelers from 6 years old who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission. For details, see ECTM Statement.
In 2024, as of 01 September 2024, 15 countries have reported 3’891 confirmed cases, including 32 deaths. The three countries with the majority of the cases in 2024 are The Democratic Republic of the Congo, (n = 3’361), Burundi, (n = 328), and Nigeria (n = 48).
Note: a significant number of suspected cases, that are clinically compatible with mpox are not tested due to limited diagnostic capacity and never get confirmed. WHO efforts on integrating these data is currently ongoing and will be included in future updates. Not all countries have robust surveillance systems for mpox, so case counts are likely to be underestimates.
According to WHO, in 2024 as of 1 Sept 2024, mpox due to monkeypox virus clade I were reported in (for updates, details, epidemic curves, see WHO LINK):
Clade Ia and b:
According to Africa CDC, update 31 Aug 2024: Since the last update (23 August 2024 ), the MoH reported 1’838 confirmed, 1’095 suspected and 35 deaths (CFR: 2.2%) of mpox from 16 provinces. This is a 137% increase in the number of new cases reported compared to the last update. Cumulatively, 4’799 confirmed, 17’801 suspected and 610 deaths (CFR: 3.4%) of mpox have been reported from all 26 provinces in DRC. Children <15 years accounted for 66% of cases and 82% of deaths. Of the confirmed cases, 73% were males. Clade Ia and Ib was isolated from the confirmed cases.
Clade Ib
Clade Ia:
Mpox due to monkeypox virus clade II (a and b) reported in 2024 (for updates, details, epidemic curves, see WHO LINK):
In addition, mpox cases have been reported in Africa without specification of the clade in 2024:
Clades globally detected (1 Jan 2022 to 01 Sept 2024), Link Outbreak status (active transmission = red), Link
WHO conducted the latest global mpox risk assessment in August 2024. Based on the available information, the risk was assessed as:
WHO risk assesment, see LINK.
Follow local media and local health authority advice. The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic (see also Factsheet mpox).
General precautions
Vaccination
A vaccination against mpox is available (Jynneos®, manufactured by Bavarian Nordic). The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, status 30 August 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Eastern D.R. Congo and Burundi in case of:
(of note: broader indication is under discussion)
2. People staying outside of Eastern D.R. Congo and Burundi (worldwide) in case of
At the present time, it is assumed that the available vaccine against mpox (e.g. Jynneos®) is also effective against the new clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms
If you are diagnosed with mpox:
For clinicians:
In two weeks (19 – 21 Sep 2024) the "Conference on Tropical Medicine and Global Health 2024" starts in Düsseldorf!
We would like to draw your attention once again to the exciting and varied programme with numerous national and international speakers (see www.dtg-conferences.de)!
The hosting societies German Society for Tropical Medicine, Travel Medicine and Global Health e.V. (DTG) and Swiss Society of Tropical and Travel Medicine (SSTTM) are delighted to welcome you to the conference!
Please note:
The State Department of Health confirmed a case rabies in a 56-year-old man who was bitten by a marmoset in the rural area of Piripiri, 166 km north of Teresina. The agency reported that the last cases of human rabies in the state occurred more than 10 years ago, in 2013, in the cities of Parnaíba and Pio IX.
In Brazil, rabies transmitted by the common marmoset primate is emerging and causing unpredictable human deaths. This primate, once endemic to the northeast of the country, has now invaded regions in the south through human-mediated introductions. However, the dynamics of rabies in this primate and the extent of spillover risk to humans remain unknown. Researchers found that outbreaks of rabies in marmosets reported to the Ministry of Health are continuously reported in new areas, including three new states since 2012, for details see publication.
Marmoset:
Prevention: Avoid contact with animals and do not feed them! Pre-exposure vaccination is particularly recommended for travelers with increased individual risk (working with animals, travel on two-wheelers, to remote areas, young children, cave explorers, possible contact with bats, etc.).
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination as soon as possible! For more information: see Flyer rabies.
Between early June and 15 August 2024, the Ministry of Health and Family Welfare of the Government of India reported 245 cases of acute encephalitis syndrome (AES) including 82 deaths (CFR 33%). Of these, 64 are confirmed cases of Chandipura virus (CHPV) infection. CHPV is endemic in India, with previous outbreaks occurring regularly, especially during the monsoon season. However, the current outbreak is the largest in the past 20 years.
The Chandipura virus (Vesiculovirus chandipura, CHPV) is a zoonotic arbovirus in the family Rhabdoviridae. The virus is endemic in several regions of India and has been detected in other countries in the South Asian subcontinent. Sporadic cases and limited outbreaks have been reported in India since 1965. The virus has also been detected in animals in some African countries (e.g. Nigeria, Senegal, Tanzania) without reported human cases.
The principal vector of CHPV in India is the sand fly Phlebotomus papatasi, which is also present in several regions of Europe. Other sand fly, mosquito and tick species are also potential vectors of the virus. A broad range of animals are suspected as vertebrate hosts of CHPV; however, little information is available on the natural ecological cycle of the virus.
The incubation period is typically short, ranging from 3 to 6 days.
CHPV infection may manifest in rapid course as a general febrile disease with meningitis and/or encephalitis (Acute Encephalitis Syndrome). Predominantly children below the age of 15 years are affected. The case fatality rate can reach 55–75%. Serological data indicate asymptomatic human infections.
There is no specific treatment or vaccine available.
WHO assessed the risk as moderate at the national level. The risk assessment will be reviewed as the situation of the outbreak evolves.
Prevention: Optimal insect bite protection 7/24 is of great importance. In case of symptoms: see medical advice immediately.
Sexually transmissible infections (STIs) represent some of the most prevalent infections globally, with an estimated 375 million new infections with one of the curable STIs each year. About 300’000 new diagnoses of bacterial STIs are reported annually by the European Union (EU)/European Economic Area (EEA) Member States to The European Surveillance System, the main source of epidemiological data for the region.
On World Sexual Health Day (4 September 2024), the European Centre for Disease Prevention and Control (ECDC) published a comprehensive review that underscores the urgent need to improve monitoring data and enhance targeted prevention interventions across Europe, see LINK
Swiss recommendations: all persons born after 1963 who have no documented protection against the infection (antibodies or 2 documented vaccinations) should be vaccinated twice with MMR vaccine.
In the event of an epidemic in the region or contact with a measles case, vaccination is recommended from the age of 6 months.
At least 6 people have died and more have been hospitalized in intensive care unit due to methanol intoxication after consumption of punched alcohol.
According to the police in Bangkok, samples of homemade liquor from the 18 stalls contained hazardous levels of methanol.
Two suspected Nipah cases have been reported from the state of Kerala. The case are hospitalized and isolated. Investigations are ongoing.
The Nipah virus (NiV) is a viral disease that can cause a severe clinical picture. It was first detected in 1999 during an outbreak in Malaysia and Singapore. Since then, several outbreaks have been reported in South and Southeast Asia.
NiV is most commonly transmitted via fruit bats through direct or indirect contact with their faeces. Tree fruit or sap made from it that is contaminated with bat faeces is often considered a source of infection. Human-to-human transmission has been reported when caring for infected patients. In addition, pigs can also be infected. The disease spectrum ranges from (mostly) asymptomatic courses to flu-like symptoms with high fever, headache and muscle pain to encephalitis with severe neurological or other complications. Mortality is high (40-70%).
The oropouche virus outbreak in Cuba is still ongoing and the detection of cases in returning travelers continuous.
The U.S. Centers for Disease Control and Prevention (CDC) reported on 27 Aug 2024 the detection of 21 cases of oropouche fever in people who returned from Cuba, 3 of whom required hospitalization. These cases were recorded up to 16 Aug 2024, and most of those affected presented symptoms between May and July 2024.
Canary islands: In August three cases of oropouche virus infection have been confirmed on Canary islands among travelers returning from Cuba.
According to WHO, as of 20 July 2024, a total of 8’078 confirmed oropouche cases, including two deaths, have been reported in the Region of the Americas, across five countries: Bolivia, Brazil, Colombia, Cuba, and Peru.
Oropouche fever is a viral disease that is transmitted by mosquito bites. The virus is found in several regions of the Americas, particularly in Brazil, Colombia, Cuba, Ecuador, French Guiana, Panama, Peru and Trinidad and Tobago.
The clinical picture includes dengue-like symptoms with sudden onset of high fever, headache, myalgia, skin rash, joint pain and vomiting. The disease usually lasts 3-6 days. A short-term recurrence of symptoms can occur in up to 60% of cases. Rare complications include inflammation of the brain. In 2024, a small number of cases of transmission from mother to unborn child (vertical transmission) were reported for the first time.
Prevention: Optimal mosquito protection 24/7 (also against other mosquito-borne diseases such as dengue, Zika, Chikungunyaand malaria).
Given its clinical presentation, Oropouche fever should be included in the clinical differential diagnosis for other common vector-borne diseases in the region of the Americas (e.g., malaria, dengue, chikungunya, Zika, yellow fever.
The occurrence of vertical transmission of OROV adds a new dimension to the pathogenicity of the virus. The extent of possible foetal malformations or death in the context of an OROV outbreak situation is currently still unclear and is being investigated. Until further data is available, pregnant women and women planning to be pregnant should be provided with comprehensive information during pre-travel consultation on the OROV outbreak and the potential of miscarriage, fetal malformation or death. The current outbreaks occur in regions where Zika virus is also endemic, and travel advice for pregnant women related to ZIKV can also adequately address the potential risk associated with Oropouche virus disease; for detailed ECTM recommendations on Zika prevention, see LINK.
Epidemiological situation: Mpox outbreaks are caused by different clades, clades 1 and 2, see EpiNews as of 16 August 2024. Historically, clade 1 has been associated with a higher percentage of people with mpox developing severe illness or dying, compared to clade 2 (responsible for the global spread in 2022). D.R. Congo (DRC) has been the most affected country, with a large increase of mpox cases due to MPXV clade I being reported since November 2023. In April 2024, sequencing of mpox cases from Kamituga in South Kivu province in eastern DRC, within the context of an observational study, identified a subtype of clade I, clade Ib. Both MPXV clade Ia and clade Ib have been circulating in DRC, while clade Ia has been detected in Congo and Central African Republic.
Geographical spread of the new MPXV clade Ib variant occurs via transport routes through sexual contact (e.g. sex workers), and then local transmission is observed in households and other settings (which are becoming increasingly important).
In recent weeks, confirmed mpox cases due to MPXV clade Ib have been reported by countries neighbouring DRC, such as:
On 14 August 2024, WHO declared the current clade I monkeypox virus outbreak a public health emergency of international concern (PHEIC).
The type of exposure reported by cases in DRC includes sexual contact, non-sexual direct contact, household contact and healthcare facility contacts. The cases reported in Rwanda had travel history to DRC and Burundi, investigation showed that the cases reported by Uganda took place outside the country, while the case reported in Kenya was detected at a point of entry. For clade Ib (reported in Eastern DRC, Burundi, Rwanda, Uganda and Kenya), close physical contact (sexual contact) has been documented as the predominant mode of transmission, while for clade Ia (in endemic areas of DRC, Congo and CAR) multiple modes of transmission have been documented including zoonotic transmission.
For details of the cases, epidemiology, public health response and WHO advice, see WHO LINK.
Follow local media and local health authority advice. The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic:
General precautions:
A vaccination against mpox is available (Jynneos®, manufacture Bavarian Nordic). There is an increased demand worldwide with risk of vaccine shortage. The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, status 30 August 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
People staying or travelling to Eastern D.R. Congo and Burundi in case of:
People staying outside of Eastern D.R. Congo and Burundi (worldwide) in case of
At the present time, it is assumed that the available vaccine (Jynneos®) is also effective against the new clade I. This vaccine is considered safe and highly effective in preventing severe mpox disease.
In case of symptoms:
If you are diagnosed with mpox:
For clinicians:
According to the media, the Nigerian government has mandated that incoming passengers to the country (through the airports), fill out a health declaration form to ensure safety against infectious diseases.
The reintroduction of the protocols by the Nigerian government through the Port Health Services under the Federal Ministry of Health and Social Welfare is connected to the recent outbreak of mpox (former ‘monkeypox’) in the Democratic Republic of Congo (DRC) and other African countries.
WHO Director-General Dr Tedros has determined that the upsurge of mpox (formerly monkeypox) in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR). The PHEIC will help to take further coordinated international action to support countries in combating disease outbreaks.
This PHEIC determination is the second in two years relating to mpox. Mpox was first detected in humans in 1970, in the DRC. The viral disease is caused by the Monkeypox virus (MPXV), which is present in the wildlife (in certain small mammals) and the disease is considered endemic in countries in central and west Africa. In July 2022, the multi-country outbreak of mpox was declared a PHEIC after an outbreak occurred in Europe and spread rapidly via sexual contact across a range of countries where the virus had not been seen before. That PHEIC was declared over in May 2023 after there had been a sustained decline in global cases.
Since November 2023, the Democratic Republic of the Congo (DRC) has seen a significant increase in mpox cases and the emergence of a new mpox clade I. The country has reported over 16’000 new cases and more than 500 deaths in 2024. Mpox outbreaks are caused by different clades, clades 1 and 2. Historically, clade 1 has been associated with a higher percentage of people with mpox developing severe illness or dying, compared to clade 2. The clades are now subdivided into clade 1a, 1b and clade 2a, 2b.
Details to Mpox, see LINKs of Swiss FOPH, Robert Koch-Institute Germany, ECDC, CDC.
Countries where mpox virus clade I and/or clade II have been detected:
Follow local media and local health authority advice.
The following prevention measures should be followed during a stay in countries where mpox is endemic/epidemic:
General precautions:
A vaccination against mpox is available (Jynneos®, manufacture Bavarian Nordic). There is an increased demand worldwide with risk of vaccine shortage. The Swiss Expert for Travel Medicine recommends vaccination against mpox in following situations, status 16 August 2024 (the recommendation will be updated regularly depending on the development of the outbreak):
1. People staying or travelling to Eastern D.R. Congo and Burundi in case of:
2. People staying outside of Eastern D.R. Congo and Burundi (worldwide) in case of:
At the present time, it is assumed that the available vaccine (Jynneos®) is also effective against the new clade I. This vaccine is considered safe and highly effective in preventing severe Mpox disease.
In case of symptoms:
For clinicians:
The European Center for Disease Control (ECDC) has issued a risk assessment on 16 August 2024 with specific advice, for details see LINK.
Following the massive flooding at the end of July, the number of leptospirosis cases is rising at an alarming rates.
The Philippine Department of Health on Saturday ordered all hospitals in the capital to ‘activate’ their leptospirosis capacity plan.
On 8 August 2024, three additional autochthonous cases of dengue have been reported in the Pyrénées, Orientales, Lozère and Gard departments.
On 2 August 2024, an autochthonous case of dengue in a person living in La Colle-sur-Loup, Alpes-Maritimes department, Provence-Alpes-Côte d'Azur region. This is the first locally acquired dengue case in the region in 2024. Recently, a second case was reported from the same region.
Overall, France has reported six locally acquired dengue cases in 2024.
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
At the end of July 2024, Swissmedic authorised the Qdenga vaccine from manufacturer Takeda Pharma AG. The vaccine is licensed for people aged four and over.
The Swiss Expert Committee for Travel Medicine (ECTM) assessed the published and unpublished data for the Qdenga® vaccine. In line with the recommendation of WHO and other European countries, the Swiss ECTM issues the following recommendation:
Previous dengue infection is defined as i) a laboratory confirmed dengue infection (PCR, antigen or seroconversion) or ii) a compatible history of dengue infection with a positive IgG serological test.
This is a precautionary decision, since the current data also include the possibility that people who are vaccinated with Qdenga® before a first dengue infection may experience a more severe course of the disease when infected after vaccination. A consultation with a specialist in tropical and travel medicine is recommended.
Travel medicine advisors should provide concise communication in accessible language on the complexity and risk/benefit evaluation for the use of dengue vaccines in travellers.
The full ECTM statement including background information is available at LINK.
Information on Dengue, including Factsheets: Vaccinations – HealthyTravel.
Swissmedic, 2.8.2024 | WHO 3.5.2024 position paper on dengue vaccine
Vaccination against Dengue fever for Travellers – Statement of the Swiss Expert Committee for Travel Medicine, an organ of the Swiss Society for Tropical and Travel Medicine, August 2024, LINK.
Information about rabies and what to do if exposed is important for all travelers.
Prevention: Avoid contact with animals! Do not feed animals either! Pre-exposure vaccination is particularly recommended for travelers with increased individual risk (working with animals, travel on two-wheelers, to remote areas, young children, cave explorers, possible contact with bats, etc.).
Behavior after exposure: After an animal bite/scratch: immediately wash the wound with water and soap for 15 minutes, then disinfect and in any case visit a medical center for post-exposure vaccination as soon as possible! For more information: see factsheet Rabies.
In June and July 2024, 19 imported cases of Oropouche virus (OROV) disease were reported for the first time in EU countries: Spain (12), Italy (5), and Germany (2), eighteen of the cases had a travel history to Cuba and one to Brazil.
The principal vector of OROV (Culicoides paraensis midge) is widely distributed across the Americas, but absent in Europe. To date, there has been a lack of evidence as to whether European midges or mosquitoes could transmit the virus. To date, no secondary transmission has ever been reported. Therefore, the risk of locally acquired OROV disease in the EU/EEA is low.
According to ECDC, the likelihood of infection for travellers to, or residing in epidemic areas in South and Central America is currently assessed as moderate. Further imported cases to Europe are likely.
Prevention: Optimal mosquito protection 24/7 (also against other mosquito-borne diseases such as dengue, Zika, Chikungunya and malaria).
Given its clinical presentation, Oropouche fever should be included in the clinical differential diagnosis for other common vector-borne diseases in the region of the Americas (e.g., malaria, dengue, chikungunya, Zika, yellow fever.
The occurrence of vertical transmission of OROV adds a new dimension to the pathogenicity of the virus. The extent of possible foetal malformations or death in the context of an OROV outbreak situation is currently still unclear and is being investigated. Until further data is available, Pregnant women and women planning to be pregnant should be provided with comprehensive information during pre-travel consultation on the OROV outbreak and the potential of miscarriage, fetal malformation or death. The current outbreaks occur in regions where Zika virus is also endemic, and travel advice for pregnant women related to ZIKV can also adequately address the potential risk associated with Oropouche virus disease; for detailed ECTM recommendations on Zika prevention, see LINK.
Due to heavy rainfalls and flooding, the risk for leptospirosis may be increased.
Wear waterproof protective clothing/boots when wading through water! Cuts or scratches should be covered with waterproof bandages. Vaccination for travelers is not available.
On 31 July 2024, France reported a confirmed, autochthonous case of chikungunya virus (CHIKV) disease in Île-de-France with suspected exposure in Paris (Paris Department) and Gennevilliers (Hauts-de-Seine Department). The case had the onset of symptoms on 18 July 2024. Since 1 May and as of 30 July 2024, nine imported chikungunya cases have been reported in France.
On 2 August 2024, the Alpes-Maritimes department reported its first locally acquired case of dengue in France for the 2024 season.
The health authorities are warning against the consumption of buffer fish products that have reached the markets. The buffer fish has migrated from the Indian Ocean via the Red Sea and the Suez Canal into the waters of the Mediterranean and is an invasive species. It can grow to more than one metre in length. It has been found in coastal waters from Turkey, Syria, Cyprus and Egypt to Gibraltar. The takifugu (fugu) or pufferfish can contain the toxin tetrodotoxin, which it absorbs and accumulates in the food chain via toxic microorganisms. The toxin is heat-resistant and odourless.
Tetrodotoxin is an extremely strong toxin that is mainly found in the liver and gonads of some fish such as pufferfish, hogfish and toadfish as well as in some amphibian, octopus and shellfish species. Poisoning in humans occurs when the muscle meat of fish is improperly prepared and consumed. Tetrodotoxin interferes with the transmission of signals from the nerves to the muscles and causes progressive muscle paralysis. The symptoms can lead to paralysis, unconsciousness, respiratory arrest and death within a few hours of consumption. There is no antidote.
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
General precautions:
Recommended vaccinations and other health risks:
Diseases transmitted by mosquitoes and ticks:
Prevention: Optimal mosquito bite protection 24/7, also in cities (during the day against dengue).
In case of fever, apply paracetamol products and hydration. If you have a fever, avoid taking medications containing acetylsalicylic acid (e.g., Aspirin®), as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medications containing acetylsalicylic acid if it is already part of your regular treatment for an underlying condition.
Note on vaccination against dengue fever with Qdenga®:
Performing the rituals of Hajj and Umrah is strenuous and often involves long walks in hot weather. Pilgrims must ensure that they are as physically fit as possible.
Ideally, pilgrims should see their doctor at least four to six weeks before the Hajj for advice on vaccinations, food and water precautions, risks from insect bites, heat exhaustion and how to avoid injury.
Pilgrims with pre-existing medical conditions should discuss with their doctor whether traveling is an option. If they are taking medication, they should ensure that they have a sufficient supply for the time abroad and that they have a copy of their prescription with them.
The following vaccinations are recommended or mandatory (see the website of the Ministry of Health of the Kingdom of Saudi Arabia for details).
Recommended precautions:
According to the WHO, 18 countries shared their epidemiological data on meningitis between March 4 and 10, 2024.
Epidemics:
Warnings:
Previous epidemics and warnings can be found under News at www.healthytravel.ch.
Seasonal meningitis epidemics occur in sub-Saharan Africa mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. 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. Vaccination against the most important strains of meningitis is available as prophylaxis for adults and children over 1 year of age.
According to the WHO, 18 countries submitted their epidemiological data on meningitis between February 18 and March 3, 2024 (week 7 to 9).
Epidemics:
Warnings:
Further information:
Previous epidemics and warnings can be found under News on www.healthytravel.ch
Seasonal meningitis epidemics in sub-Saharan Africa occur mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. 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. Vaccination against the most important strains of meningitis is available as a prophylaxis for adults and children over 1 year of age.
The number of dengue patients in Thailand has reached 17,783 cases so far in 2024, more than twice as many as in the corresponding period in 2023.
Optimal protection against mosquito bites around the clock, even in cities (during the day against dengue, chikungunya, Zika). In case of fever: paracetamol products and hydration. Avoid taking medication containing acetylsalicylic acid (e.g. Aspirin®) if you have a fever, as this can increase the risk of bleeding during a dengue infection. However, do not stop taking medicines containing acetylsalicylic acid if they are already part of your regular treatment for an underlying condition.
Based on the available data, many European countries and the Swiss Expert Committee for Travel Medicine (EKRM) currently recommend vaccination with Qdenga® only for certain travelers and in special situations. Advice from a specialist in tropical and travel medicine is therefore recommended.
La febbre dengue, endemica in molti Paesi tropicali e subtropicali, è una delle principali cause di malattia nei viaggiatori, ma la febbre dengue grave e le conseguenti ospedalizzazioni o morti sono rare in questa popolazione. Esistono due vaccini contro la febbre dengue, Dengvaxia® e Qdenga®. Mentre non esiste alcuna raccomandazione per l'uso di Dengvaxia® nei viaggiatori, Qdenga® è stato approvato per i viaggiatori in molti Paesi europei dal dicembre 2022. L'approvazione di Swissmedic per l'uso in Svizzera è prevista per la seconda metà del 2024.
Il Comitato svizzero di esperti in medicina dei viaggi (EKRM) ha valutato i dati pubblicati e non pubblicati sul vaccino Qdenga® e formula la seguente raccomandazione:
I consulenti sanitari di viaggio devono fornire informazioni in un linguaggio semplice sulle complessità e sui compromessi rischi-benefici dell'uso del vaccino contro la dengue nei viaggiatori.
Details of the position statement can be found at LINK.
According to the WHO, 18 countries submitted their epidemiological data on meningitis between January 29 and February 18, 2024 (week 5 to 7).
Epidemics:
Warnings:
Previous epidemics and warnings can be found under News at www.healthytravel.ch
Seasonal meningitis epidemics occur in sub-Saharan Africa mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. 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. Vaccination against the most important strains of meningitis is available as prophylaxis for adults and children over 1 year of age.
Between January 22 and 28, 2024 (week 4), 18 countries reported their meningitis epidemiological data.
Epidemics:
Warnings:
Previous epidemics and warnings can be found at www.healthytravel.ch.
Seasonal meningitis epidemics occur in sub-Saharan Africa mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. 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. Vaccination against the most important meningitis strains is available as prophylaxis for adults and children over 1 year of age.
According to Médecins Sans Frontières (MSF), 3,965 patients were treated for measles in Borno State in Nigeria from October to December 2023. The increase in the number of cases could be due to the fact that public health actors were unable to achieve the 95% vaccination rate due to the uncertain situation in the region. In addition, the interruption of routine childhood vaccinations during the COVID-19 pandemic contributed to the increase in cases.
On February 12, 2024, the Centres for Disease Control and Prevention (CDC) published the top 10 countries with measles outbreaks (data refer to the period July - December 2023):
Measles outbreaks are reported when the number of reported cases in an area is higher than the expected number of cases.
In the 2nd and 3rd week of 2024, 21 countries have reported their epidemiological data on meningitis:
Epidemic:
Warning:
Previous epidemics and warnings can be found at EpiNews or at www.healthytravel.ch.
Seasonal meningitis epidemics occur in sub-Saharan Africa mainly during the dry season, usually from December to June. They decline rapidly with the onset of rainfall. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. 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. Vaccination against the most important meningitis strains is available as prophylaxis for adults and children over 1 year of age.
In 2023, 171 cases of leptospirosis were recorded in Reunion Island, more than 70% of which occurred between January and June.
Leptospirosis is a bacterial disease that occurs worldwide, particularly frequently in tropical countries during the rainy or flooding season. It is transmitted through contact between small skin lesions and water contaminated with urine (mainly from infected rats, dogs, pigs, cows, etc.). The risk of infection increases when camping or during water-related activities (swimming, kayaking, wading through watercourses). The disease can be treated with antibiotics if diagnosed in time.
The following precautions are recommended:
General:
Recommended vaccinations and other health risks: See the relevant country page at www.healthytravel.ch/countries/. Vaccination against meningococcal disease may be considered.
It is strongly recommended that you protect yourself against mosquitoes around the clock throughout the country, including in cities, to prevent diseases such as
Dengue, Chikungunya and Zika. The city of Rio de Janeiro is malaria-free, but the disease is endemic in the Atlantic rainforest of the state of Rio de Janeiro. Further malaria risk areas and
recommended prevention measures can be found on the Brazil country page www.healthytravel.ch .
Since the beginning of 2023 and up to January 11, 2024, a total of 777 Zika virus infections (ZIKV) have been reported in Thailand. These have been registered in 36 provinces, with the central and northern regions being the most affected. According to the government, 758 people tested positive (including 33 pregnant women), compared to only 190 in 2022 and 63 in 2021. It is currently unclear whether the case numbers in 2023 are due to an increase in awareness and/or diagnostic capacity or an increase in ZIKV circulation.
In December 2023, three Zika cases were imported to Europe after a stay in Thailand.
Optimal measures to prevent mosquito bites around the clock, see factsheet Protection against mosquito and tick bites.
Although the US CDC map (last updated December 8, 2023) does not yet show Thailand as a country with a current Zika outbreak, an increased risk of Zika transmission in Thailand cannot be ruled out. As soon as more data is available, the Expert Committee on Travel Medicine (ECRM) will reassess the situation.
Until further information is available, the EKRM recommends that
For details, see the Swiss ECRM recommendation from 2019: LINK
The following precautions are recommended:
General:
Recommended vaccinations and other health risks: See the respective country page at www.healthytravel.ch/countries/.
The outbreak of Streptococcus suis infections in Thailand continues: 137 infections and 8 deaths have been reported within the last three weeks. The increase in infections is linked to the consumption of raw or undercooked pork, sausages and raw pork blood salad.
Infection with Streptococcus suis is usually asymptomatic in pigs. Humans can become infected by eating contaminated raw or undercooked pork and fresh blood or through direct contact with infected pigs or pork products. Symptoms include high fever, severe headache and dizziness, vomiting, diarrhea, neck stiffness, intolerance to light, decreased level of consciousness and hearing loss.
Health authorities are warning people to protect themselves after a case of Japanese encephalitis virus (JEV) infection was detected in New South Wales (NSW). Following the persistently wet and warm weather over the vacation period, mosquito populations in NSW are currently thriving.
In 2022, there was one outbreak of JEV in Australia with 45 cases detected mainly in the Murray Valley in New South Wales.
Optimal protection against mosquito bites, especially at dusk and at night. In addition, the Swiss Expert Commission for Travel Medicine (EKMT) recommends vaccination against JE for travelers to Australia for high-risk travelers such as:
According to the Thai Ministry of Health, there has been a significant increase in Zika virus cases, with around 100 new cases are reported every month.
Around 660 cases have been registered since June 2023, mainly in the northern and central areas. Cases of Zika virus have also been detected in people who had recently returned from Thailand. Zika is endemic in Thailand and other parts of the world, but a current outbreak (epidemic) is not currently recorded in Thailand, according to the US Center of Disease Control and Prevention (CDC) (see CDC map).
Optimum protection against mosquito bites around the clock, even in cities (during the day against chikungunya, dengue, Zika and other viruses, at dusk and at night against malaria). Detailed information on Zika can be found in the Zika information sheet.
If you have a fever, take paracetamol preparations and make sure you drink enough fluids. Do not take medicines containing acetylsalicylic acid (ASA) (e.g. Aspirin®) if you have a fever, as these increase the risk of bleeding. (Note: Do not stop taking medication containing ASA if it is part of a long-term medication for an underlying illness.
In the case of fever, malaria should always be ruled out by means of a blood test.
After a three-week trip to southern Thailand (Krabi, Khao Sok, Koh Phangan, Koh Samui), two German tourists in Tübingen were diagnosed with Zikainfection.
Although the CDC does not classify Thailand as a country with a current outbreak (see CDC map), Zika is endemic in Thailand.
The WHO's annual malaria report highlights the growing threat of climate change. In 2022, there were an estimated 249 million malaria cases worldwide in 85 malaria-endemic countries and territories - significantly more than the estimated number of cases before the COVID-19 pandemic. The main countries contributing to the increase in 2022 were Pakistan, Ethiopia, Nigeria, Uganda and Papua New Guinea. The WHO African region accounted for about 94% of cases worldwide. The number of deaths amounted to an estimated 608,000. In addition to the disruption caused by COVID-19, the global malaria response is facing a growing number of threats: Drug and insecticide resistance, humanitarian crises, resource scarcity, climate change impacts and delays in program implementation, particularly in countries with a high burden of the disease.
Details can be found at WMR LINK.
In October 2023, the following countries reported meningitis outbreaks:
Epidemic:
Warning:
Seasonal meningitis epidemics occur in sub-Saharan Africa mainly during the dry season, usually from December to June. They decline rapidly with the onset of the rains. In general, the meningococcal serogroups A, C, W and X are responsible for these outbreaks. The disease spreads from person to person by droplets. 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. Vaccination against the most important meningitis strains is available as prophylaxis for adults and children over 1 year of age.
Prevention: Good personal hygiene. Avoid close contact with sick people, including those with skin lesions or genital lesions. Avoid contact with sick animals. Avoid contact with contaminated materials used by sick people. Safer sex is recommended to prevent other sexually transmitted diseases. Do not eat bush meat.
Vaccination against Mpox is available and recommended for people at increased risk. Talk to your doctor about whether such a vaccination is recommended for you. Swiss recommendations: see LINK.
In case of symptoms: If you are diagnosed with Mpox, you should not have sex while you have symptoms and lesions. Use condoms for 12 weeks after infection. This is a precautionary measure to reduce the risk of transmitting the virus to a partner. Wash your hands frequently with soap and water or an alcohol-based hand sanitizer containing at least 60% alcohol.
On the World AIDS Day on December 1, here is a look back at the extent of the pandemic:
In 2022:
Since the beginning of the epidemic:
In Denmark, whooping cough (pertussis) cases have increased significantly during the spring and summer, with the authorities now reporting a figure more than ten times higher than normal. In the 37th week alone (up to September 16), 200 cases of whooping cough were detected (normally an average of around 20 cases per week).
Whooping cough is a respiratory infection that is characterized by a course lasting up to three months with severe coughing fits, often accompanied by howling breathing and vomiting immediately after the attacks.
An 8-year-old girl died of rabies in Agra, Uttar Pradesh, on October 25, 2023, after being bitten by a stray dog two weeks earlier. The child did not inform anyone in her family except her mother about the incident, and she was only given some home remedies instead of the necessary rabies vaccine. The family only contacted the Community Health Center when the girl developed symptoms after 15 days.
According to officials, as many as 5000 cases of dog bites are reported every month in both rural and urban Agra.
Ethiopia has faced malaria outbreaks in numerous regions since early 2023. The regions most affected include Gambela, Southwest Ethiopia (SWEPR), Afar, and Ahmara.
In addition to malaria, Ethiopia faces other health crises, including cholera, measles, dengue fever, and COVID-19, as well as a variety of natural disasters such as droughts, recurrent floods, food insecurity, and locust infestations, as well as man-made challenges such as conflict, internal displacement, and the effects of the Sudan conflict. These factors combined have significantly increased the country's need for health and humanitarian assistance.
The Ministry of Health documents can be downloaded at www.healthytravel.ch.
Although the Tanzania Ministry of Health document is of poor quality and was issued in 2016, travelers with this document have had no problems entering mainland Tanzania. To emphasize the timeliness of this document, the Swiss EKRM recommends that it be stamped by your travel clinic and dated and signed by you.
This tragic case demonstrates the importance of being informed about rabies and acting quickly in the event of a bite or scratch by a mammal in a rabies-endemic country.
Prevention: Avoid contact with animals! Do not feed animals either! Pre-exposure vaccination (2 injections and a booster after 1 year) is recommended especially for travelers with increased individual risk (traveling with two-wheelers, to remote areas, long-term stays, small children, cave explorers, contact with bats, etc.).
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 good medical facility as soon as possible for follow-up vaccination!
For more information: see flyer rabies.
In the Indian state of Assam (north-eastern part of the country), 432 cases of Japanese encephalitis (JE) were reported by the end of August, 24 of which were fatal. Cases have increased almost tenfold since the beginning of August 2023.
Ranchi district in Jharkhand state in northern India has also reported an increase in JE cases, although the numbers are still modest, with 12 cases in recent weeks.
The risk for travellers is low. Optimal protection against mosquito bites, especially at dusk and at night.
The indication for vaccination against Japanese encephalitis should be discussed individually and is recommended for:
Protect yourself against ticks during outdoor activities (see Factsheet Mosquito Protection). Vaccination is recommended when staying in endemic areas. Complete basic immunisation requires three vaccination doses. Protection for a limited period of time already exists after two vaccination doses. These first two vaccinations are usually given one month apart. The third vaccination is given 5-12 months after the second dose, depending on the vaccine. A booster vaccination is indicated after 10 years.
After recreational activities: Always check your body for ticks or tick bites. If redness occurs after a tick bite: Consult a doctor to rule out Lyme disease, which would require antibiotic treatment.
According to media reports, a case of canine rabies has been reported in the city of São Paulo in Brazil. The infection was confirmed by the Pasteur Institute. This is the first case of canine rabies since 1983.
The case is still under investigation and has already led to surveillance measures in the region and 367 animals have been vaccinated with rabies vaccine.
Information about rabies and what to do in case of exposure is important for all travelers!
Prevention: Avoid contact with animals! Do not feed animals either! Pre-exposure vaccination (2 injections and a booster after 1 year) is recommended especially for travelers with increased individual risk (traveling with two-wheelers, to remote areas, long-term stays, small children, cave explorers, contact with bats, etc.).
Post-exposure behavior: After an animal bite/scratch: Immediately wash the wound with soap and water for 15 minutes, then disinfect and in any case visit a quality medical center for post-exposure vaccination as soon as possible! For more information: see factsheet rabies.
Since the first week of August and as of 11 September 2023, 19 locally acquired dengue fever cases have been detected in the Lombardy (14) and Lazio (5) regions in Italy. The cases are grouped in three clusters:
All cases were laboratory confirmed by PCR and all cases have recovered or are improving.
A DENV-1 serotype virus was identified in the cases in Lombardy and in the metropolitan city of Rome, Lazio region. Epidemiological investigations have not identified any link between the cases in Lombardy and the cases identified in the Lazio region.
A DENV-3 serotype was detected in the cluster of cases in the province of Latina, Lazio region, indicating that this outbreak is independent from the other two in Italy.
Response and control measures are being implemented by Italian public health authorities. These include case finding, vector control activities, information to healthcare providers and the general public, and preventive measures for donors of substances of human origin (e.g. blood and organs).
So far, 146 imported dengue cases have been registered in Italy in 2023, most of them in the Lombardy region (50 imported cases) and Lazio region (28 imported cases).
For more details of the outbreak in Italy, see Rapid Communication of Eurosurveilance.
An outbreak of 4 autochthonous (locally transmitted) cases of dengue fever was detected in Gardanne in the department of Bouches-du-Rhône. Symptoms of the cases occurred between the second half of July and early August 2023.
At least 47 autochthonous cases were recorded in France in 2022. The affected regions were Occitania (9 cases) and Provence-Alpes-Cote d'Azur (36 cases).
Officials observe that the downward trend in terms of chikungunya continues, with a weekly average of about 40 cases per week in the last 3 weeks, dengue cases still remaining at an average of 100 weekly cases. The high dispersion of the cases is also maintained, covering practically the entire national territory.
The head of Health Surveillance, Guillermo Sequera, stated that it is striking that at the end of July we still have cases of dengue and chikungunya (usually there are no cases at this time). He expressed his concern about this scenario, considering that the rainy season is approaching -in October-, to this is added the phenomenon of El Niño, which could portend a complicated epidemiological scenario for the next season.
A man has been hospitalized in Ulan Bator with bubonic plague after eating marmot meat. This was reported by the National Center for the Study of Zoonotic Infections of Mongolia. According to Xinhua News Agency, the hospitalized man and 5 other people who were in close contact with him have been isolated.
While hunting marmots is illegal in Mongolia, many Mongolians regard the rodent as a delicacy and ignore the law. Of all the 21 Mongolian provinces, 17 are still at risk of the bubonic plague, urging the public not to hunt marmots or eat marmot meat.
According to the media, 8.64% of respiratory specimens handled by public laboratories tested positive for flu, higher than 8.57% recorded the week before, but below the baseline threshold level of 9.2%. The latest fatal case involved a 2-year-old boy who tested positive for influenza A and died on 28 July 2023.
Hong Kong has 2 flu seasons, one beginning in April and the second starting in August.
The ministries of health and agricultural development of the province have declared an epidemiological alert after the detection of cases of suspected trichinosis in the interior of Buenos Aires. So far, 29 people have been reported to have been exposed, 15 of whom developed symptoms; from the municipalities of Adolfo Alsina and Sallikelo, and the products included bacon and dried chorizo.
Samples of both products analyzed by the Applicant's laboratory tested positive for Trichinella spiralis. The sausages came from the plant "AGROINDUSTRIA LOS ANDRES SRL", with the trademark "Don Andrés" RPE No. 122-5 PAMS Exp No. 22500-39417/17 found in salami.
According to preliminary information, these products were distributed in the municipalities of Dayro, Hipólito Yrigoyen, Coronel Suárez, Saavedra, Tres Lomas, Trenque Lauquen, Puan, Rivadavia and Adolfo Alsina. Faced with this, medical teams were called in to strengthen the epidemiological surveillance of cases of trichinosis in the said municipalities, and the secretariats of health and food science departments of these areas were urged to continue the investigation.
Trichinellosis is a food-borne helminth infection caused by Trichinella spiralis. Homemade jerky and sausage are often the cause of many cases of trichinellosis. Salting, drying, freezing, smoking or microwaving meat alone does not consistently kill infective worms.
Therefore: Consume only well-cooked meat!
Optimal mosquito protection 24/7 (during the day against dengue, Zika, Chikungunya and other arboviroses, in the evening and at night against malaria). If you have a fever, take acetaminophen products and make sure you drink enough fluids. Do not take medications containing acetylsalicylic acid (e.g., Aspirin®), as they may increase the risk of bleeding. During and 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.
Optimal mosquito protection 24/7 (at dusk and at night against malaria, during the day against dengue, chikungunya and other arboviroses). Drug prophylaxis is recommended for parts of Palawan, see detailed information on the Phiilippines country page.
In case of fever >37.5° C, malaria should always be considered and excluded by blood tests.
So far this season (2023), 6 cases of Murray Valley Encephalitis (MVE) have been recorded, two of which were fatal. The Kimberley region has been particularly affected. This has been the worst season for MVE since 2012. Other arboviruses are also transmitted in Western Australia: dengue virus, Ross River virus, Japanese encephalitis virus, Barmah Forest virus, Kunjin virus, etc.
Murray Valley encephalitis virus is transmitted by mosquitoes. The risk of contracting and becoming ill is low, but the illness caused by the virus can be severe and possibly fatal.
Initial symptoms include fever, drowsiness, headache, stiff neck, nausea and dizziness. People who experience these symptoms should seek medical attention as soon as possible.
The Blitar District Health Office in East Java, Indonesia, reported 11 suspected diphtheria cases in the past 2 months, all of which required a stay in the intensive care unit of a hospital.
Diphtheria is caused by bacteria that are common 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 (breathing) and cutaneous (skin) diphtheria. The pathogen primarily affects the upper respiratory tract and produces a toxin that can lead to dangerous complications and late 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.
Protect yourself against ticks during outdoor activities (see Mosquito Protection Factsheet). Vaccination is recommended when staying in endemic areas. Complete basic immunization requires three doses of vaccine. Temporary protection exists after only two doses of vaccination. These first two vaccinations are usually given one month apart. The third vaccination is given 5-12 months after the second dose, depending on the vaccine. A booster vaccination is indicated after 10 years.
After recreational activities: Always examine their body for ticks or tick bites. If redness occurs after tick bite: Consult a physician to rule out Lyme disease, which would require antibiotic treatment.
In recent years, the world, and the Americas region in particular, has seen an exponential increase in international travel in search of medical care. While most patients seek this in the country in which they reside, there is a growing proportion of individuals who change countries for medical, dental or surgical treatment. This practice is referred to as medical and health tourism. For example, millions of Americans travel to other countries each year for medical care, especially to Mexico, Canada, and other countries in Central America, South America, and the Caribbean.
While there are few published studies on the number of people seeking medical care outside their country of residence, it is estimated that the annual number in the United States alone has increased from 750,000 to 1.4 million over a 10-year period (2007 to 2017). This number is expected to increase by 25% each year, both in the United States and globally. The main motivations for seeking outsourced medical care include lower costs, avoiding long waiting lists, the ability to access procedures that are not available in the country of residence, and the ability to combine health care with a vacation stay. Procedures related to cosmetic and aesthetic surgery account for the larg
