African_Trypanosomiasis_ECTM_Factsheet_Layperson_EN.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
T.b. rhodesiense HAT has a short incubation period in travelers (less than 3 weeks). It is generally an acute, life-threatening disease with fever, headache, nausea/vomiting and a trypanosomal chancre (see picture) at the tsetse bite site. In travelers, sleeping disorders or neuro-psychiatric deficits are only rarely present.
T.b. gambiense HAT is only exceptionally reported in travelers. It affects local rural population in endemic areas. The disease evolves over months or years. First stage is characterized by fever, itching, headache and lymph nodes. Once the parasite invades the CNS (second stage), various neurologic or psychiatric symptoms, including sleep disturbance, can occur.
HAT can be cured in both first and second stages. Specific treatment requires advice by a specialist in tropical medicine.
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.
Chikungunya_ECTM_Factsheet_Layperson_EN.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
The infection may cause some or all of the following symptoms: sudden onset of high fever, headache, muscle and joint pain, joint swelling, rash. The rash usually appears after the onset of the fever and usually affects the trunk and extremities. The joint pain and swelling usually occur symmetrically on both sides and mainly affect the hands and feet - but larger joints such as the knees or shoulders can also be affected. The intense joint pain can be very debilitating for those affected.
Around 5 - 10 % of those infected have persistent severe joint and limb pain even after the fever has subsided, which in some cases lasts for several months or, although rarely, even years.
Preventive measures against mosquito bites during the day: Apply mosquito repellent to uncovered skin; wear long clothing; treat clothing with insecticide. For more information, see the information sheet "Protection against insect and tick bites". Another very important protective factor is so-called 'environmental hygiene': breeding sites for mosquitoes in the immediate vicinity of human dwellings should be avoided by removing all forms of containers with water (e.g. flowerpot saucers, uncovered water containers, etc.).
Vaccination: Two Chikungunya vaccines are currently approved in the US and EU (IXCHIQ® and VIMKUNYA®), but not yet in Switzerland. The Swiss Expert Committee for Travel Medicine is currently reviewing the recommendation for travellers.
Dengue_ECTM_Factsheet_Layperson_EN.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
ECTM_Dengue_Vaccination_Statement_EN_Publication_Sept_2024.pdf
CDC Map: Distribution of dengue
Dengue fever is the most common insect-borne infectious disease worldwide. There are 4 known serotypes of dengue virus, so it is possible to be infected with dengue more than once. Approximately 1 in 4 infected individuals develop symptoms of dengue, resulting in high fever, muscle and joint pain, and skin rash. In rare cases, most often after a second infection, life-threatening bleeding and shock (severe drop of blood pressure) may occur.
In 3 out of 4 cases, an infection with the virus remains asymptomatic. After a short incubation period (5-8 days), 1 out of 4 infected people present an abrupt onset of fever, headache, joint, limb and muscle pain, as well as nausea and vomiting. Eye movement pain is also typical. A rash usually appears on the 3rd or 4th day of illness. After 4 to 7 days, the fever finally subsides but fatigue may persist for several days or weeks.
In rare cases, severe dengue can occur. Particularly susceptible are local children and seniors as well as people who have experienced a prior dengue infection. Tourists extremely rarely present with severe dengue. In the first days, the disease resembles the course of classic dengue fever, but on the 4th/5th day, and usually after the fever has subsided, the condition worsens. Blood pressure drops, and patients complain of shortness of breath, abdominal discomfort, nosebleeds, and mild skin or mucosal hemorrhages. In the most severe cases, life-threatening shock may occur.
There is no specific treatment for dengue virus infection. Treatment is limited to mitigation and monitoring of symptoms: fever reduction, relief of eye, back, muscle and joint pain, and monitoring of blood clotting and blood volume. Patients with severe symptoms must be hospitalised.
For treatment of fever or pain, paracetamol or acetaminophen are recommended (e.g. Acetalgin® Dafalgan®). Drugs containing the active ingredient acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®) must be avoided.
Effective mosquito protection during the day and especially during twilight hours (i.e. sunset) is the best preventive measure:
For further information, please refer to the factsheet on "Mosquito and tick bite protection".
Note on the dengue vaccine Qdenga®:
Consistent mosquito protection during the day (see above) is still considered the most important preventive measure against dengue!
Of note
Hepatitis A occurs worldwide, but the risk of infection is higher in countries with poor hygiene conditions. There is an increased risk in most tropical and subtropical countries as well as in some countries in Eastern Europe and around the Mediterranean. Outbreaks in northern European countries can also occur when unvaccinated children become infected during family visits to tropical and subtropical countries and transmit the virus in their care facilities on their return.
In recent years, there has also been an increase in cases in North America and Europe, including Switzerland, particularly among men who have sex with men (MSM).
There is a safe and very effective vaccine that consists of two injections at least 6 months apart. It offers lifelong protection after the second dose. The hepatitis A vaccination can also be administered in combination with the hepatitis B vaccination (3 doses required if given to persons 16 years and older).
Vaccination against hepatitis A is recommended for all travellers to risk areas and for people with an increased personal risk, such as people with chronic liver disease, men who have sex with men and people with an increased occupational risk, such as in the health service or in contact with waste water.
Please consult the following link of the FOPH:
Information on the human papilloma virus (HPV)
EKRM_Factsheet_Layperson_EN_Japanese-Encephalitis.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
EKRM_Factsheet_Layperson_IT_Japanese_Encephalitis.pdf
EKRM_Factsheet_Layperson_EN_Malaria.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
Fever during or after a stay in a malaria-endemic area is an emergency! Prompt diagnosis and treatment are required as the health of people with malaria can deteriorate very quickly. That means: if you have fever >37.5° (use a thermometer!) you need to test for malaria within a maximum time-frame of 24 hours, regardless of whether or not you have used prophylactic medication (malaria chemoprophylaxis). Try to reach a doctor or hospital where you can reliably receive such a test. If the first test is negative, it should be repeated on the following day if the fever persists.
Prevention of malaria requires a combination of approaches:
For travellers, there is currently no malaria vaccination available.
The incubation period (time between infection and onset of symptoms) ranges from a 2 to 21 days (usually 5 to 10 days). The onset of MVD is usually abrupt, with initially 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 diarrhoea. As the disease advances, clinical manifestations can become more severe and include liver failure, delirium, shock, bleeding (hemorrhaging), multi-organ dysfunction and death.
In case of symptoms
If think that you have had an exposure at risk and develop fever with nonspecific symptoms such as chills, headache, muscle pain, malaise or abdominal pain:
The risk for travellers is very low if the below precautions are followed, but it is high for family members and caregivers who have contact with sick people.
General precautions during travel to affected areas:
General information on measles, mumps and rubella (MMR)
Please consult the following FOPH links:
Meningococcal ACWY vaccination is recommended in Switzerland as a complementary vaccination for children between 1 – 4 years and for adolescents between 11 – 19 years. Furthermore, it is recommended as a risk group vaccination for persons with certain medical conditions, for persons with close contact to a patient with meningococcal disease and for travelers to endemic areas.
For more detailed information on the disease and Swiss national recommendations (in German, French, Italian) see:
Mpox has been commonly found in West and Central Africa for many years where the suspected reservoir - small mammals - is endemic. There are two types of Monkeypox virus called ‘clades’ that cause the disease mpox - clade I in Central Africa and clade II in West Africa. Since the end of smallpox vaccination campaigns in the early 1980’s, cases of mpox have increased, slowly at first and significantly in the last 5-10 years, especially in the Democratic Republic of Congo (DRC).
In 2022, a new emerging subclade of clade II was responsible for a global epidemic that spread mainly through sexual contact among men who have sex with men. It resulted in the first public health emergency of international concern (PHEIC) declared by the WHO until 2023. Although the clade II epidemic is now under control, this virus variant continues to circulate worldwide.
In 2024, the continued spread of mpox clade I in endemic regions of Central Africa, particularly in the DRC, and the emergence of a new subclade Ib in Eastern DRC and neighboring countries have raised global concern and prompted the WHO to declare a PHEIC for the second time in two years. The current geographical spread of the mpox clade Ib variant occurs via commercial routes through sexual contact (e.g. sex workers), followed by local transmission in households and other settings (which is becoming increasingly important).
Animal to human transmission
Mpox can spread from animal to human when they come into direct contact with an infected animal (rodents or primates).
Human to human transmission
Mpox can be spread from person to person through close physical contact (sexual and non-sexual contact) with someone who has symptoms of mpox. Skin and mucous membrane lesions, body fluids, and scabs are particularly infectious. A person can also become infected by touching or handling clothing, bedding, towels, or objects such as eating utensils/dishes that have been contaminated by contact with a person with symptoms. Household members, family caretakers, and sexual partners of a confirmed case of mpox are at higher risk for infection as are health care workers who treat a case without adequate personal protection.
The incubation period (time between infection and onset of symptoms) ranges from a few days up to 3 weeks. Mpox causes a rash / skin eruption that can be painful associated with swollen lymph nodes and fever. Fever may start already before the rash phase. Other symptoms include muscle aches, back pain, and fatigue. The rash may be localized or generalized, with few or hundreds of skin lesions. It mainly affects the face, the trunk and the palms of hand and soles of the feet. It can also be present in genital areas and on mucous membranes such as in the mouth and throat. Symptoms usually last 2 to 4 weeks and the person remains contagious until all lesions have healed (once the cabs have fallen off).
Complications include secondary bacterial infections, infections of the lung and brain and involvement of other organs, still birth and others. Children, pregnant women, and people with weak immune systems are at higher risk to develop a severe form of mpox.
The majority of person with mpox recovers spontaneously and do not need specific antiviral treatment. Care management consists of relieving pain and other symptoms and preventing complications (e.g., superinfection). Several antiviral treatments are studied in various countries and may be used in trials or in clinical situations according to the recommendations of national medical societies.
In case of symptoms:
General precautions:
Vaccination:
There are several vaccines against mpox (e.g. Jynneos®, manufacture Bavarian Nordic). The Bavarian Nordic vaccine was originally developed to fight against smallpox, but offers a cross-protection against mpox. In Switzerland, the Jynneos® vaccine has been licensed by Swissmedic since 2024. Groups at risk (e.g., men who have sex with men or transgender people with multiple sex partners) are eligible for vaccination since 2022 and this recommendation remains unchanged (see FOPH recommendations). In light of the epidemiological situation in Africa in 2024, the Swiss Expert Committee for Travel Medicine recommends vaccination against mpox for professionals who are / will be in contact with suspect mpox patients or animals in endemic/epidemic regions or who work in a laboratory with the virus (for updates, see news).
The risk to the general population and travelers (tourists) is considered extremely low if the above-mentioned general precautions are followed and vaccination is not recommended.
EKRM_Factsheet_Layperson_EN_Polio.pdf
Regular hand washing after using the bathroom and before eating or preparing food. Avoidance of undercooked or raw food that is potentially contaminated with fecal material.
The most important prevention is vaccination. A very effective and well-tolerated vaccine against polio is available (inactivated (killed) polio vaccine (IPV)), which is part of the basic vaccination schedule during childhood. Combination vaccines (e.g. with diphtheria and tetanus) are also available. After basic vaccination, a booster dose is recommended every 10 years for travel to certain countries (see country page recommendations). WHO recommends a yearly vaccination for residents or long-stay visitors (minimum 4 weeks) in a country with ongoing polio infections or circulating vaccine-derived polio viruses. This recommendation not only targets individual protection, but aims to prevent the international spread of the virus.
No treatment against rabies disease exists!
Post-exposure measures: clean the wound immediately with plenty of water and soap for 10-15 minutes, then disinfect the wound (e.g. Betadine®, Merfen®), and immediately (i.e. during the trip!) get emergency post-exposure vaccination against rabies: for those having received full pre-exposure rabies vaccination before travel, two additional vaccine shots (any available brand) at an interval of 3 days suffice and should be administered as soon as possible on site (i.e. also while travelling). If full pre-exposure vaccination has not been given, in addition to vaccination, passive immunization is required with immunoglobulins within the shortest delay on site.
Of note, immunoglobins (and sometimes vaccines) are often unavailable in low-resource settings, causing stress and uncertainty. Tetanus booster vaccination may be also warranted.
Petting any mammals while travelling is not a good idea, even if they are cute! Do not feed them! Refrain from touching wild or unfamiliar or dead animals.
Vaccination against rabies (preexposure vaccination) is highly recommended for:
The shortened vaccination schedule can be proposed to most travellers: 2 doses given at least 7 days apart before departure. A single lifetime booster dose (3rd dose) is recommended after one year or later when further travelling to rabies endemic countries is undertaken. If you have an immune deficiency, please consult your doctor, as different vaccination intervals apply to you.
Wichtig: Eine STI kann auch ohne oder mit nur leichten Symptomen auftreten. Auch wenn Sie sich dessen nicht bewusst sind, können Sie andere anstecken. Deshalb ist es wichtig sich testen zu lassen.
Durch Bakterien oder Parasiten hervorgerufen
Alle diese Krankheiten können geheilt werden. Wichtig ist dabei, frühzeitig zu testen und umgehend zu therapieren, um Komplikationen und v.a. weitere Übertragungen zu vermeiden.
Durch Viren hervorgerufen
There is a risk of arthropod-borne diseases other than malaria, dengue, chikungunya or zika in sub-/tropical regions, and some areas of Southern Europe. These include the following diseases [and their vectors]:
If you are planning or have had a trip with very basic accommodations or a long-term stay in rural areas, inform yourself about Chagas disease.
Under construction
Depending on the geographical region and the species, ticks may carry and transmit different pathogens. Diseases include the human ehrlichiosis, Lyme disease, tularemia, babesiosis, tick-borne relapsing fever, Rocky Mountain spotted fever, other rickettsioses, some arboviral diseases, and several flaviviruses causing encephalitis such as tick-borne encephalitis (TBE). Some ticks may also cause tick paralysis.
In Europe, commonly transmitted disease by ticks include Lyme disease (borreliosis), tick-borne encephalitis and tularemia.
In the US (and less so in South America) important tick-borne diseases represent babesiosis, anaplasmosis and ehrlichiosis, Powassan disease and severe fever with thrombocytopenia syndrome (STFS).
Other important pathogens transmitted by ticks are bacterial organisms causing rickettsial diseases, which are found throughout the world. Among returned travelers, rickettsial diseases have been estimated to be the fourth most common cause of fever, with symptoms such as rash, abdominal pain, and a dry, black/dark scab at the site of the infecting bite.
Tick-borne diseases may occur worldwide, but distribution is based on geographical location (see map).
Areas with increased risk of TBE include central and eastern Europe and the Baltic and Nordic countries. TBE is also prevalent in Russia all the way from the western border with Europe to its eastern border.
Lyme borreliosis is the most prevalent tick-transmitted infection in temperate areas of Europe, North America and Asia, and its geographic distribution is ever-increasing. Central Europe is the region with the highest tick infection rates (young ticks/nymphs >10%; adult ticks >20%) in Europe, specifically in Austria, Czech Republic, southern Germany, Switzerland, Slovakia and Slovenia.
Babesiosis is found in certain regions of North America and forested areas in Europe and East Asia. Anaplasmosis is common in North America, Europe, and China.
Ehrlichiosis is common in the US, certain areas of Europe, South America, and Africa.
Powassan disease is found in the northeastern US and far eastern Russia, whereas Severe Fever with Thrombocytopenia Syndrome (SFTS) occurs in the US and Asia-Pacific region.
Rickettsial infections are present worldwide. African Tickbite Fever (ATBF) is the most commonly reported rickettsial infection acquired during travel and occurs in southern Africa (especially Botswana, South Africa, and Zimbabwe).Mediterranean Spotted Fever (MSF), reported among returning US and UK travelers, occurs over much of Africa, Europe, India, and the Middle East; whereas Rocky Mountain Spotted Fever (RMSF) is commonly found throughout Canada, parts of Central and South America, and the US.
Crimean-Congo hemorrhagic Fever (CCHF) is a rare but serious viral disease transmitted by tick bites or contact with infected animal blood. It is the most widespread viral hemorrhagic fever, found in Eastern and Southern Europe, the Mediterranean, northwestern China, central Asia, Africa, the Middle East, and the Indian subcontinent. Healthcare workers and those handling livestock face higher risk.
The key to prevent tick-borne diseases is to protect yourself from tick bites (see also fact-sheet "Mosquito and tick bite prevention"):
The best prevention against tick-borne encephalitis (TBE) is to get vaccinated; this is recommended if living or travelling in an endemic area. The vaccine protects against all virus subtypes.
“Cook it, boil it, peel it or forget it” – this simple slogan would be sufficient to prevent typhoid fever nearly entirely. However, only few travelers fully adhere to this advice. Nevertheless, the value of food and water hygiene cannot be stressed enough: avoid buying water bottles without proper sealing, avoid drinking tap water from unknown sources, avoid eating cooled / frozen foods (i.e. ice cubes in water or ice cream) and avoid eating raw fruits and vegetables that you yourself have not peeled and washed with clean drinking water.
Two types of vaccines are available:
Please consult the following link of the FOPH:
General information about chickenpox (varicella) and shingles (herpes zoster)
EKRM_Factsheet_Layperson_EN_Yellow-fever.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
As against all mosquito-borne diseases, prevention from mosquito bites is during day and night (see “Insect and tick bite protection” factsheet). The available vaccine is highly efficacious and provides a long-term protection. It is recommended for people aged 9 months or older who are travelling to yellow fever endemic areas. In addition, providing proof of vaccination may be mandatory for entry into certain countries.
The vaccine is a live-attenuated form of the virus. In immunocompetent persons, protection starts about 10 days after the first vaccination. Reactions to yellow fever vaccine are generally mild and include headache, muscle aches, and low-grade fevers. Side effects can be treated with paracetamol but aspirin and other nonsteroidal anti-inflammatory drugs, for example ibuprofen or naproxen, should be avoided. On extremely rare occasions, people may develop severe, sometimes life-threatening reactions to the yellow fever vaccine – which is why this vaccine is used with caution in immunocompromised individuals, pregnant women and the elderly for safety reasons. Talk to your travel health advisor if you belong to this group.
ZIKA_ECTM_Factsheet_Layperson_EN.pdf
EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf
CDC LINK: Countries and Territories at risk for Zika
WHO Map: LINK
The Zika virus was first found in 1947 in monkeys in Uganda’s Zika forest. Until May 2015, the virus circulation was mainly limited to Africa and South-East Asia. Then an epidemic spread to the Americas, starting in Brazil, and then to South and Central America, and the Caribbean. Since then, the disease has spread to most tropical and subtropical regions. While the risk of infection risk is currently low, epidemics may reappear and require specific travel advices (see below).
Zika symptoms can resemble those of malaria, which requires urgent treatment, or other mosquito-borne diseases such as dengue. Therefore: If you have a fever, consult a doctor for an accurate diagnosis! Treatment for Zika targets reduction of fever and joint pain (with paracetamol). Avoid aspirin and anti-inflammatory drugs (e.g. ibuprofen) as long as dengue fever is not excluded. There is no vaccine available.
If pregnant and experiencing fever during or after returning from a Zika virus transmission area, blood and/or urine tests are recommended. If Zika infection is confirmed, medical management should be coordinated with a gynecologist and specialists in infectious or travel medicine.
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