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Health Advice for Travellers
Swiss Expert Committee for Travel Medicine

 

Health Advice for Travellers
Swiss Expert Committee for Travel Medicine

 

Health Advice for Travellers
Swiss Expert Committee for Travel Medicine

South Korea

Latest News

General Information

  • Although the public health emergency of international concern for COVID-19 was declared over on 5 May 2023, COVID-19 remains a health threat
  • Adhere to the recommendations and regulations of your host country
  • Check entry requirements of destination country: see regulary updated COVID-19 Travel Regulations Map of IATA (LINK)

Vaccinations for all travellers

 
Risk Area
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Countrywide
 
 
 
 

 
Recommendation
  • Hepatitis A vaccination is recommended for all travellers going to tropical or subtropical countries.
 

  • Hepatitis A is a liver infection caused by a virus. It is also known as infectious jaundice.
  • The virus is easily transmitted by contaminated food or water but can also be transmitted through sexual contact.
  • A safe and very effective vaccine is available that affords long-lasting protection.
  • Hepatitis A vaccination is recommended for all travelers going to tropical or subtropical countries, and for risk groups.

EKRM_Factsheet_Layperson_EN_Hepatitis-A.pdf

  • Hepatitis A is a liver infection caused by a virus.
  • The virus is easily transmitted by contaminated food or water but can also be transmitted through sexual contact.
  • A safe and very effective vaccine is available that affords long-lasting protection.
  • Hepatitis A vaccination is recommended for all travelers going to tropical or subtropical countries, and for risk groups.
Hepatitis A is caused by a highly contagious virus that affects the liver. It is also known as infectious jaundice. Hepatitis A is very common in unvaccinated travelers.

Hepatitis A occurs all over the world, but the risk of infection is higher in countries with poor hygiene standards. There is an increased risk in most tropical and subtropical countries, as well as in some countries in Eastern Europe and around the Mediterranean.

In recent years, there have also been increasing cases in North America and Europe, including Switzerland, especially among men who have sex with men (MSM). Outbreaks in northern European countries can also occur when unvaccinated children become infected during family visits to tropical and subtropical countries. Upon return, they may transmit the virus within their care facilities.

Transmission occurs mainly through drinking water or food contaminated by faeces. Other transmission routes are close personal contacts, especially sexual contacts (anal-oral sex) or insufficient hand hygiene.
Several weeks after the infection symptoms such as fever, fatigue, nausea, lack of appetite, abdominal discomfort and diarrhea may occur. Within a few days yellow skin and eyes (jaundice) may follow. Most symptoms disappear after a few weeks, but fatigue can often last for months. Young children usually have few or no symptoms, but in older people, the disease can be severe and prolonged.
No specific treatment is available. Recovery from an acute hepatitis A infection can take several weeks or months and requires physical rest and diet.

There is a safe and very effective vaccine that consists of two injections at least 6 months apart. It provides lifelong protection after the second dose. Hepatitis A vaccination can also be given in combination with hepatitis B vaccination (3 doses required).

Vaccination against hepatitis A is recommended for all travellers to risk areas, as well as for persons at increased personal risk: persons with chronic liver disease, men who have sex with men, people who use or inject drug, persons with increased occupational contact with persons from high-risk areas or populations, and others.

  • Federal Office of Public Health (FOPH). Hepatitis A. https://www.bag.admin.ch/bag/en/home/krankheiten/krankheiten-im-ueberblick/hepatitis-a.html 
  • Swiss Hepatitis: https://en.hepatitis-schweiz.ch/all-about-hepatitis/hepatitis-a 
See map
  
 
 
 
 

 
Recommendation
All travellers should have completed a basic immunisation according to the Swiss vaccination schedule, LINK.
 

Worldwide
  
 
 
 
 

 
Recommendation

All travellers should have completed a basic immunisation and boosters according to the Swiss vaccination schedule, LINK.

 

Worldwide
  
 
 
 
 

 
Recommendation

All travellers should have completed a basic immunisation and boosters according to the Swiss vaccination schedule, LINK.

 

Worldwide
  
 
 
 
 

 
Recommendation

Travellers should be immune to chickenpox. Persons between 13 months and 39 years of age who have not had chickenpox and who have not received 2 doses of chickenpox vaccine should receive a booster vaccination (2 doses with minimum interval of 4 weeks), see Swiss vaccination schedule, LINK.

 

Vaccinations for some travellers

 
Risk Area
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Worldwide
  
 
 
 
  • Hepatitis B is a viral liver infection that is transmitted via contaminated blood or via sexual contact.
  • A safe and very effective vaccine is available that affords life-long protection.
  • Hepatitis B vaccination is recommended for all young people and at-risk travellers, especially if:
    • You travel regularly or spend long periods of time abroad.
    • You are at risk of practicing unsafe sex.
    • You might undergo medical or dental treatment abroad, or undertake activities that may put you at risk of acquiring hepatitis B (tattoos, piercing, acupuncture in unsafe conditions).
Under construction
Countrywide
 
 
 
  • Rabies is mainly transmitted by dogs (and bats), but any mammal can be infectious.
  • It is invariably fatal at the time when symptoms occur.
  • Rabies is best prevented by a pre-travel vaccination and appropriate behavior towards mammals.
  • Pre-travel vaccination is also recommended because vaccines and immunoglobulins are often not available in many travel countries. Vaccination before travel is highly recommended in particular for
    • long-term stay in endemic countries,
    • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas  or travel with toddlers and children up to 8 years,
    • professional work with animals or cave explorers (bats!),
    • for details, see SOP vaccination rabies (only available in HealthyTravel PRO).
  • Attention: a bite or scratch wound as well as contact with mammal saliva is an emergency! Find out about the necessary actions below!

EKRM_Factsheet_Layperson_EN_Rabies.pdf

This fact sheet contains important information about rabies. For optimal travel preparation, we recommend that you read this information carefully and take the fact sheet on your trip!
  • Rabies is mainly transmitted by dogs (and bats), but any mammal can be infectious.
  • It is invariably fatal at the time when symptoms occur.
  • Rabies is best prevented by a pre-travel vaccination and appropriate behavior towards mammals.
  • Pre-travel vaccination is also recommended because vaccines and immunoglobulins are often not available in many travel countries. Vaccination before travel is highly recommended in particular for
    • long-term stay in endemic countries,
    • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
    • professionals working with animals, or cave explorers (bats!).
  • Attention: a bite or scratch wound as well as contact with mammal saliva is an emergency! Find out about the necessary actions below!
Rabies disease is invariably fatal, transmitted through the saliva or other body fluids of infected warm-blooded animals (i.e. mammals).
Dogs are responsible for more than 95 % of human cases. Bats, cats and (rarely) monkeys and other mammals can transmit rabies as well. The highest risk areas are Asia, Africa and some Latin American countries (e.g. Bolivia). Rabies may occur anywhere in the world except in countries where successful eradication has been achieved.
Saliva from infected animals enters the human body through injured skin, either via bites and scratches or by licking already wounded skin. Once it has entered the body through the skin lesion, the rabies virus migrates along nerve pathways towards the brain. In most cases, this migration takes several weeks to months and proceeds without accompanying symptoms.
Symptoms usually only appear when the virus has reached the brain. In most cases, this is the case after 2-12 weeks (range: 4 days - several years!) and manifests itself as encephalitis (inflammation of the brain), which in 99.99% of cases is fatal within a few weeks. As soon as symptoms of encephalitis appear, a fatal course can no longer be prevented.

No treatment against rabies disease exists.

Post-exposure measures:

  • Immediate cleaning of the wound with plenty of water and soap for 10-15 minutes, followed by disinfection (e.g. Betadine, Merfen) and emergency post-exposure vaccination at the nearest health institution within 24 hours.
  • Tetanus booster vaccination is also required.
  • 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.
  • If full pre-exposure vaccination has not been given, in addition to vaccination, passive immunization is required with immunoglobulins.
  • It should be noted that immunoglobins (and sometimes vaccines) are often unavailable in low-resource settings, causing stress and uncertainty.

Stroking cute pets is not a good idea; refrain from touching wild or unfamiliar or dead animals.
All travellers to places where rabies may occur and who are likely to take repeated trips to areas where rabies occurs should have a pre-exposure vaccination. In addition, pre-exposure vaccination is highly recommended for travellers at particular risk:

  • long-term stay in endemic countries,
  • short journeys with high individual risk such as travellers on ‘two wheels’ or treks in remote areas, toddlers and children up to 8 years of age,
  • professionals working with animals, or cave explorers (bats!).

The shortened vaccination schedule can be proposed to most travellers: 2 shots, the first one at one month before departure if possible (minimum: 8 days before departure). A single third rabies booster vaccination is recommended before the next trip, at least after one year.

  • Obtain information about prevention of rabies in time before travelling.
  • In case of trips planned for longer than a few weeks, schedule a visit at the travel clinic 4 weeks before departure at the latest.
  • After possible exposure (bite, scratch injury) wound treatment and additional vaccinations are necessary even for those with a completed series of basic vaccinations.
  • This information leaflet should be printed and kept handy during the trip!
  • FOPH Switzerland (German): https://www.bag.admin.ch/dam/bag/de/dokumente/mt/infektionskrankheiten/tollwut/bag-bulletin-15-2021-tollwut-prep-und-pep.pdf.download.pdf/210412_BAG_Bulletin_15_2021_Tollwut%20PrEP%20und%20PEP_d.pdf 
  • FOPH Switzerland (French): https://www.bundespublikationen.admin.ch/cshop_mimes_bbl/14/1402EC7524F81EDBA5D6C3EBC18BA9FB.pdf 
Worldwide
  
 
 
 

 
Recommendation

Vaccination recommendation according to the Swiss Federal Office of Public Health (BAG), see LINK.

Entry requirement per country, see IATA LINK.

 

  • Covid-19 is a disease that affects the whole body, but mainly shows with respiratory symptoms such as cough and difficulty in breathing. It is caused by the SARS-CoV-2 virus.
  • The infection is mainly spread through respiratory droplets and possibly aerosols when infected persons cough, sneeze, speak or sing without wearing a mask.
  • The infection can be prevented very effectively by vaccination and an increasing number of vaccines are now approved and available for protection.
  • Vaccination is recommended according to the Swiss recommendations of the Federal Office of Public Health (FOPH), see LINK.
  • Furthermore, prevention relies heavily on people wearing face masks, on hand hygiene and on physical distancing (min. 1.5 m) if masks are not worn and people are not vaccinated.
For information, see LINK of the Federal Office of Public Health (FOPH)
Countrywide
  
 
 
 
  • Influenza is common all over the world including sub-tropical and tropical countries.
  • Vaccination offers the best protection. 
  • Vaccination against flu is recommended for all travellers who belong to an “at risk” group such as pregnant travellers, travellers with comorbidities, elderly people (>65 years), or who plan a a high-risk trip (e.g. cruise-ship, pilgrimage).
  • The influenza vaccine does not offer protection against avian flu.
Under construction

Countrywide

Transmission: May to October

 
 
 
  • Japanese encephalitis is a viral infection that is endemic in South and Southeast Asia and in Australia.
  • The virus causes an infection of the brain.
  • The risk of Japanese encephalitis is very low for travellers.
  • Follow diligent mosquito bite prevention measures in the evening and night.
  • A safe and effective vaccine is available that is recommended for high-risk travellers such as
    • Work / extensive outdoor activities in rural areas
    • Long-term stays (>4 weeks) or during an ongoing outbreak
    • For details, see SOP vaccination japanese encephalitis (only available in HealthyTravel PRO)

EKRM_Factsheet_Layperson_EN_Japanese-Encephalitis.pdf

EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf

CDC Map: Areas at Risk for Japanese Encephalitis | Japanese Encephalitis Virus | CDC

EKRM_Factsheet_Layperson_IT_Japanese_Encephalitis.pdf

  • Viral disease transmitted by night-biting mosquitoes in rural/suburban areas.
  • Very rare in travelers.
  • Mostly mild or without symptoms; severe illness is rare but has a high mortality.
  • Vaccine available for those at increased risk, such as long-term travelers to endemic areas.
Japanese encephalitis is caused by the Japanese encephalitis virus (JEV), a flavivirus, which is spread by mosquitoes. Epidemics of Japanese encephalitis were first described in Japan from the 1870s onward. It is the main cause of viral encephalitis in the Asia-Pacific region.
JEV is endemic in tropical regions of Eastern and Southern Asia and the Western Pacific regions. Epidemics are reported in these regions in subtropical and temperate climate zones. In 2016, a first autochthonous human case was reported in Angola, Africa. The virus exists naturally in a transmission cycle between mosquitoes, pigs and water birds. Birds may be responsible for the spread of JEV to new geographical areas. Humans mainly become infected in rural or suburban areas, when staying in close proximity to pigs.
JEV is transmitted through the bite of female Culex mosquitoes (mainly Culex tritaeniorrhynchus), which are active throughout the night, indoors and outdoors. For most travelers to Asia, the risk is very low but varies based on destination, season, length of travel and activities.
Most people infected are asymptomatic or experience only mild symptoms with fever and headache. About 1/250 people develop severe symptoms after 4-14 days of getting infected, as the infection spreads to the brain, characterized by an abrupt onset of high fever, headache, neck stiffness, disorientation, coma, seizures and paralysis. Up to 1 in every 3 persons developing severe symptoms consequently die. Permanent sequelae, such as behavioural changes, muscle weakness, or recurrent seizures occur in 30%–50% of those with encephalitis.
The diagnosis can be confirmed by serology in cerebrospinal fluid and serum, IgM antibodies usually become detectable 3-8 days after onset of symptoms.
There is no directed antiviral treatment available. Treatment consists of supportive care to relieve symptoms.
Mosquito bite prevention from dusk to dawn (Culex are active during the night) – sleeping under a mosquito net or in an air-conditioned room; repellants on exposed skin; wearing long clothes; treating clothes with insecticide. Vaccination is recommended in travelers at increased risk of infection (longer periods of travel in endemic regions, travel during the JEV transmission season, staying in rural areas especially near rice paddies or pig farms and participating in outdoor activities). The inactivated vaccine IXIARO® is given in two doses (ideally spaced 28 days apart, though the second dose can be given as early as 7 days after the first dose) before travel. In case of continuous risk or re-exposure, a booster dose can be given after 12 months, and then every 10 years. For children 12 months to 18 years, the use is "off-label". Reactions to the vaccine are generally mild and may include pain and tenderness at the injection site, headache, muscle aches, and low-grade fever.
  • WHO Factsheet Japanese Encephalitis: https://www.who.int/news-room/fact-sheets/detail/japanese-encephalitis
  • Solomon et al., Japanese Encephalitis, BMJ 2000: https://jnnp.bmj.com/content/jnnp/68/4/405.full.pdf
  • CDC Japanese Encephalitis: https://www.cdc.gov/japaneseencephalitis/index.html 

Malaria

 
Risk Area
Factsheet
Flyer
Infosheet
MAP
Bookmark
 
 
Malaria - Worldmap
 

 
Moderate risk
  • From March to December: in the north bordering North Korea and in the Yeoncheon-gun county of the province Gyeonggi.

Prevention: Mosquito bite prevention.
Discuss with a travel health advisor whether carrying a stand-by emergency self-treatment against malaria is necessary.

 

 
Low risk
  • From March to December: rural areas in the northern parts of the provinces of Incheon, Gangwon, Gyeonggi (exemptions see above), including demilitarized zone (DMZ).
     

Prevention: Mosquito bite prevention.

 

  • Malaria is a life-threatening parasitic infection, which is transmitted by mosquitoes at night.
  • Great care should be given to preventive mosquito protection from dusk to dawn in all malaria risk areas.
  • In high-risk areas, taking regular prophylactic medication is strongly advised.
  • For stays in low risk areas: discuss with a travel health advisor whether carrying stand-by emergency self-treatment against malaria is recommended.
  • If you belong to a special risk group (pregnant women, small children, senior citizens, persons with pre-existing conditions and/or with immune deficiency): seek medical advice before the trip as malaria can quickly become very severe.
  • If you have a fever >37.5°C on measuring under your arm or in your ear (a functioning thermometer is indispensable!) during or after the trip, see a doctor / hospital immediately and have a blood test done for malaria! This applies regardless of whether you used prophylactic medication or not!
  • For personal safety, we strongly recommend getting informed in detail about malaria and reading the following information.

    EKRM_Factsheet_Layperson_EN_Malaria.pdf

    EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf

    • From March to December: in the north bordering North Korea and in the Yeoncheon-gun county of the province Gyeonggi.

    Prevention: Mosquito bite prevention.
    Discuss with a travel health advisor whether carrying a stand-by emergency self-treatment against malaria is necessary.

    • From March to December: rural areas in the northern parts of the provinces of Incheon, Gangwon, Gyeonggi (exemptions see above), including demilitarized zone (DMZ).
       

    Prevention: Mosquito bite prevention.

    2024-09-21_EKRM_World_Malaria_Map_2024_(c)_EN.jpg

    For personal safety, we strongly recommend getting informed in detail about malaria and taking this factsheet with you on your trip.
    • Malaria is a life-threatening parasitic infection, which is transmitted by mosquitoes at night.
    • Great care should be given to preventive mosquito protection from dusk to dawn in all malaria risk areas.
    • In high-risk areas, the intake of prophylactic medication is strongly advised.
    • For stays in low risk areas: discuss with a travel health advisor whether carrying an emergency self-treatment against malaria is necessary.
    • If you belong to a special risk group (pregnant women, small children, senior citizens, persons with pre-existing conditions and/or with immune deficiency): seek medical advice before the trip as malaria can quickly become very severe.
    • If you have a fever >37.5°C on axillary or tympanic measurement (a functioning thermometer is indispensable!) during or after the trip, see a doctor / hospital immediately and have a blood test done for malaria! This applies regardless of whether you have used prophylactic medication or not!
    Malaria is a life-threatening acute febrile illness caused by parasites called Plasmodia, which are transmitted by mosquitoes at night (between dusk and dawn). Rapid diagnosis and treatment are crucial to prevent complications and death, and to cure the disease. To prevent malaria, diligent mosquito-bite protection is important, as well as taking additional prophylactic (preventive) medication when staying in high-risk areas. Risk groups such as pregnant women, small children, elderly persons or travellers with complex chronic conditions should seek specialized advice.
    Malaria occurs widely in tropical and subtropical areas of Africa, Asia, South and Central America (see also malaria map).
    Plasmodia are transmitted to humans by Anopheles mosquitoes, which only bite between dusk and dawn. They sometimes go unnoticed, because they are small and make almost no noise.
    After visiting a malaria endemic area, the symptoms usually appear seven days to one month after infection, but sometimes after several months or more than a year. Symptoms begin with fever and may appear very similar to flu. Other symptoms may include headache, muscle pain, nausea, and sometimes diarrhea or cough. The diagnosis can only be confirmed with a blood test.

    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.

    Malaria can be treated effectively, but without treatment, this disease can quickly cause complications and become fatal. People who have had malaria in the past are not protected from being infected again.

    Prevention of malaria requires a combination of approaches:

    1. Diligent mosquito-bite protection at dusk and at night until dawn is of key importance. Use it for all regions where malaria is present, including areas where the risk is minimal. Bite protection is also effective against other insect-borne diseases that often occur in the same region. It consists of the following measures:
      • Clothing: Wear long-sleeved clothes and long trousers. For additional protection, impregnate the clothes beforehand with insecticides containing the active ingredient permethrin (e.g. Nobite® Textile).
      • Mosquito repellents: Apply a mosquito repellent to uncovered skin.
      • Sleeping room: Sleep in an air-conditioned room or under an impregnated mosquito net. Cautiously use ‘knockdown’ sprays indoors or burn mosquito coils strictly outside, e.g. under a table in the evening.
      • Chemoprophylaxis: Depending on the region and season, it may be necessary to take a prophylactic medication. This is recommended for all destinations with a high risk of malaria (marked as red on our maps). It needs to be taken with food before, during, and after your stay. Discuss with your travel health advisor to ascertain if you need to take chemoprophylaxis for your trip. The appropriate medication and the right dosage will be prescribed.
    2. Taking standby emergency self-treatment (SBET, drugs used to self-treat malaria) with you is recommended for special risk situations (stay in regions with low malaria risk and if there is no or uncertain medical care available). Following such a course of SBET, please consult a doctor as soon as possible. Talk to your travel health advisor to determine whether carrying SBET is necessary, especially if you plan a trip where reliable medical infrastructure is not assured.
    3. For some risk groups, malaria can quickly develop to a dangerous disease. If you are pregnant, if you are travelling with small children, or if you are a senior citizen and / or if you have other illnesses /pre-existing conditions and / or you are immunocompromised, you should seek advice from a specialist in travel medicine to determine whether chemoprophylaxis is recommended for your trip – even if the area is marked as low risk malaria zone.

    For travellers, there is currently no malaria vaccination available.

    • Take a functioning clinical thermometer with you!
    • Malaria symptoms develop at the earliest 7 days after entering the malaria area. A fever > 37.5° always means suspicion of malaria!
    • In case you have fever during or even months after a stay in a malaria area:
      • Immediately consult a health care facility to rule out malaria through a blood test.
      • This should be done within a maximum of 24 hours and applies regardless of whether you have used prophylactic medication or not!
      • The blood tests should be repeated if the result is negative or doubtful and fever persists or recurs.
    • For persons having visited a malaria area with low risk and for whom SBET was prescribed:
      • If you have fever: immediately try to get tested for malaria.
      • If this is not possible, and fever persists for longer than 24 hours or recurs: start taking the standby emergency-self-treatment as it was prescribed by your travel health advisor.
      • Even if you have started your self-treatment against malaria: seek medical advice as quickly as possible to get the cause of your fever diagnosed.

    Other health risks

     
    Risk Area
    Factsheet
    Flyer
    Infosheet
    MAP
    Bookmark
     
     
    • Dengue fever is a viral disease that is disease that bite during daytime.
    • The best way to prevent these diseases is to protect yourself from mosquito bites, see LINK!
    • A vaccination (Qdenga®) against dengue is available.
      • However, based on the data available, the Swiss Expert Committee for Travel Medicine (ECTM) currently recommends vaccination with Qdenga® only for travellers who have evidence of previous dengue infection and who will be exposed in a region with significant dengue transmission, for details see LINK.

    • In case of fever: do not use any medication containing acetylsalicylic acid (e.g. Aspirin®, Alcacyl®, Aspégic®), as this can worsen bleeding in case of dengue infection.
    • Read the following information for optimal travel preparation.

    EKRM_Factsheet_Layperson_EN_Dengue.pdf

    EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf

    ECTM_Dengue vaccines_statement_EN_20240712.pdf

     
     
    • Mpox is a viral disease that typically causes a rash, swollen lymph nodes and fever.
    • An emerging variant is spreading rapidly in eastern D.R. Congo and neighbouring countries, leading the WHO to declare a new Public Health Emergency International (PHEIC) in August 2024.
    • Close physical contact (sexual or non-sexual) is the main route of transmission.
    • The disease is usually mild. Children, pregnant women and people with weakened immune systems are most at risk of complications.
    • Take general precautions (see factsheet) to prevent the disease.
    • There is a vaccination against Mpox, but it is currently only available for people at high risk.

    EKRM_Factsheet_Layperson_MPOX.pdf

    CDC Map: 2022 Monkeypox Outbreak Global Map
    • Mpox is a viral disease that typically causes a rash, swollen lymph nodes and fever.
    • An emerging variant is spreading rapidly in eastern D.R. Congo and neighboring countries prompting a new WHO declaration of a public health emergency of international concern (PHEIC), as of August 14th 2024.
    • Close physical contact (sexual or non-sexual) is the main mode of transmission.
    • The disease generally follows a mild course. Children, pregnant women, and people with weak immune systems are the most at risk of complications.
    • Vaccination against mpox is available, but limited to groups at high risk of exposure. 
    Mpox (formerly monkeypox) is a disease caused by the Monkeypox virus, a virus from the same family as the virus that causes smallpox. It is a viral zoonotic disease, which means it can spread from animals to humans. It can also spread between people.

    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, it 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: 

    • Seek medical attention immediately
    • If you are diagnosed with mpox
      • Please stay at home (isolate yourself) until your mpox rash has healed and a new layer of skin has formed. Staying away from other people and not sharing things you have touched with others will help prevent the spread of mpox. People with mpox should regularly clean and disinfect the spaces they use to limit household contamination.
      • Wash your hands often with soap and water or an alcohol-based hand sanitiser containing at least 60% alcohol.
      • You should not have sex while symptomatic and while you have lesions or symptoms. Use condoms for 12 weeks after infection. This is a precaution to reduce the risk of spreading the virus to a partner.
      • For more information on what do if you are sick, see CDC LINK.

    General precautions:

    • Worldwide:
      • avoid close, skin-to-skin contact with people who have or may have mpox or people who have a rash (e.g., pimples, blisters, scabs).
      • Wash your hands often with soap and water or an alcohol-based hand sanitiser containing at least 60% alcohol.
      • Avoid touching potentially contaminated personal items such as cups, bedding/clothing, towels or sharing eating utensils/cups, food or drink with a person who has, or may have mpox.
      • Avoid sex with sick persons; use of condoms for up to 12 weeks if you sexual partner have had mpox.
      • Follow advice of local authorities.
    • When travelling to endemic / epidemic areas in Africa, in addition to above mentioned general precautions: 
      • Avoid contact with and animals in areas where mpox regularly occurs.
      • Avoid eating or preparing meat from wild animals (bushmeat) or using products (creams, lotions, powders) derived from wild animals.

    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.

    • Seek medical attention immediately.
    • Mpox is not a sexual transmitted disease in the strict sense, physical contact with a person with symptoms of mpox (rash at any stage) is sufficient to transmit the disease. Condoms do not protect you from getting mpox!
    • Swiss Federal Office of Public Health (FOPH)                                                            
    • World Health Organisation: WHO FAQ
    • European Center of Disease Control and Prevention (ECDC)
    • US Center of Disease Control and Prevention (CDC)
    Worldwide
     
     
     
    • Sexually transmitted infections (STIs) are a group of viral, bacterial and parasitic infections; while many are treatable, some can lead to complications, serious illness or chronic infection.
    • STIs are increasing worldwide.
    • Read the following fact sheet for more information.

    EKRM_Factsheet_Layperson_DE_STI.pdf

    EKRM_Factsheet_Layperson_DE_HIV-AIDS.pdf

    • Geschlechtskrankheiten sind ein weltweit verbreitetes Gesundheitsproblem und können durch Prävention, regelmässiges Testen und Behandlung in den Griff bekommen werden.
    • Das Wissen um Risiken sowie Safer-Sex-Praktiken inklusive Kondomgebrauch sind wichtig. Falls Sie mehr dazu erfahren wollen, wie Sie sich während der Reise optimal schützen können, besprechen Sie dies mit einer Fachperson.
    • Hatten Sie eine Risikosituation, ist es wichtig mit einer Fachperson so rasch wie möglich Rücksprache zu halten, um zu erörtern, ob eine HIV-Post-Expositions-Prophylaxe (PEP) durchgeführt werden soll, um eine Ansteckung mit HIV zu verhindern.
    • Im Nachgang einer Risikosituation ist es wichtig sich auf Geschlechtskrankheiten testen zu lassen. Auch dann, wenn Sie keine Symptome haben.
    Reisende, die Gelegenheitssex haben, sind einem erhöhten Risiko ausgesetzt, sich mit sexuell übertragbaren Infektionen, sogenannten Sexually Transmitted Infections (STIs), einschliesslich HIV, anzustecken. Ein Auslandaufenthalt, wobei man auch neue Menschen kennen lernt, kann damit verbunden sein, sich anders zu verhalten und mehr Risiken einzugehen, als man dies zu Hause tun würde. Es ist wichtig daran zu denken, dass ungeschützter Sex und mehrere neue Sexualpartner ein Risiko für Geschlechtskrankheiten darstellen. Geschlechtskrankheiten können unter Umständen schwere Komplikationen verursachen und zudem auf weitere Partner*innen übertragen werden, sofern diese nicht rechtzeitig bemerkt und behandelt werden. Sind Sie nicht sicher, ob es sich um eine Risikosituation handelt, dann hilft der 'Risk-Check' von Love Live weiter.
    Geschlechtskrankheiten sind Infektionen, die durch sexuellen Kontakt (vaginaler, analer oder oraler Sex) übertragen werden. Sie werden durch mehr als 30 verschiedene Bakterien, Viren oder Parasiten verursacht, die in oder auf Ihrem Körper vorkommen. Es ist auch möglich, dass gleichzeitig mehr als eine STI gleichzeitig übertragen wird. Einige bedeutendsten STIs sind HIV (Informationsblatt HIV-AIDS), Hepatitis B, das humane Papillomavirus (HPV), Herpes simplex (HSV), Syphilis, Chlamydien und Gonorrhö.
    Geschlechtskrankheiten treten weltweit auf und können jeden und jede treffen, unabhängig von Alter, Geschlecht oder auch der sexuellen Orientierung. STIs kommen in vielen Ländern mit schwächerem Gesundheitssystem häufiger vor.
    Geschlechtskrankheiten werden in der Regel durch ungeschützten vaginalen, oralen oder analen Geschlechtsverkehr übertragen. Sie können aber auch durch andere intime Kontakte weitergegeben werden, wie z. B. Herpes und HPV, die durch Hautkontakt/Küssen übertragen werden. Andere können auch auf nicht sexuellem Wege übertragen werden, z.B. über Blut. Viele Geschlechtskrankheiten - darunter Syphilis, Hepatitis B, HIV, Chlamydien, Tripper, Herpes und HPV - können auch während der Schwangerschaft und bei der Geburt von der Mutter auf das Kind übertragen werden.
    • Brennen oder Juckreiz im Genitalbereich
    • Schmerzhaftes oder häufiges Wasserlösen oder auch Schmerzen im Unterleib
    • Ungewöhnlicher Ausfluss aus dem Penis oder der Vagina
    • Wunden, Rötungen, Bläschen im Mund/Lippen oder Genitalbereich sowie Warzen im Intimbereich
    • Manchmal auch Fieber (eher selten)

    Wichtig: Eine STI kann auch ohne oder mit nur leichten Symptomen auftreten. Auch wenn Sie sich dessen nicht bewusst sind, können Sie andere anstecken. Deshalb ist es wichtig sich testen zu lassen.

    Geschlechtskrankheiten können bei einer körperlichen Untersuchung oder durch die Untersuchung von Urin, einer Wunde, eines Bläschens oder eines Abstrichs aus der Vagina, dem Penis oder dem Anus diagnostiziert werden. Bluttests können bei der Diagnose helfen. Auch wenn Sie keine Symptome haben, sollten Sie mit ihrer Ärztin, ihrem Arzt sprechen, wenn Sie im Ausland ungeschützten Geschlechtsverkehr hatten. Denn eine frühzeitige Erkennung und Behandlung ist wichtig, um eine Errergerübertragung und Komplikationen durch unbehandelte STIs zu verhindern.
    Viele Geschlechtskrankheiten sind heilbar, andere wie z.B. HIV jedoch nicht und bedeuten, dass lebenslang Medikamente eingenommen werden müssen, damit es nicht zu Komplikationen kommt. Beispielsweise können mit Antibiotika bakteriell verursachte STIs geheilt werden. Eine frühzeitige Behandlung verringert zudem das Risiko von Komplikationen. Denn unbehandelt können einige STIs langfristig unter Umständen zu Gesundheitsproblemen führen, wie z.B. zu Unfruchtbarkeit, Geburtskomplikationen und einigen Arten von Krebs. Wenn eine schwangere Frau eine STI hat, kann dies zu Gesundheitsproblemen beim Baby führen. Auch Sexualpartner sollten gleichzeitig behandelt werden, um eine erneute Infektion zu verhindern (Ping-Pong-Übertragung).
    • Beachten Sie die Safer Sex Regeln von Love Live. Dazu gehört auch bei jedem Anal- oder Vaginalverkehr Kondome zu verwenden.
    • Denken Sie daran, dass es bei Oralverkehr auch zu Übertragungen von STIs kommen kann.  
    • Lassen Sie sich impfen! Es gibt Impfstoffe zum Schutz vor HPV, Hepatitis A und Hepatitis B.
    • Hatten Sie eine Risikosituation, ist es wichtig mit einer Fachperson so rasch wie möglich Rücksprache zu halten, um zu erörtern, ob eine HIV-Post-Expositions-Prophylaxe (PEP) durchgeführt werden soll, um eine HIV-Infektion zu verhindern. Am wirksamsten ist eine HIV-PEP innerhalb weniger Stunden danach.
    • Es gibt auch weitere Präventionsmassnahmen für spezielle Situationen (Präexpositionsprophylaxe HIV-PrEP). Sprechen Sie mit einer damit erfahrenen Fachperson vor Abreise darüber.
    • Denken Sie daran, dass Alkohol oder Drogen zu erhöhtem Risikoverhalten führen.
    • Denken Sie daran, dass Sie eine weitere Person/bekannter Partner*in bei ungeschütztem Sex anstecken können, sofern bei Ihnen eine unbehandelte STI vorliegt.
    • Menschen mit einer neu diagnostizierten STI sind angehalten ihre früheren Sexualpartner*innen zu informieren, damit auch sie behandelt werden können.

    Durch Bakterien oder Parasiten hervorgerufen
    Alle diese Krankheiten können geheilt werden. Wichtig ist dabei, frühzeitig zu testen und umgehend zu therapieren, um Komplikationen und v.a. weitere Übertragungen zu vermeiden.

    • Syphilis
      Auch bekannt als Lues. Sie wird durch das Bakterium Treponema pallidum verursacht. Das erste Anzeichen ist eine schmerzlose Wunde an den Genitalien, im Mund, auf der Haut oder im Rektum, die hochgradig ansteckend ist und nach 3 bis 6 Wochen spontan abklingt. Da diese schmerzlos ist, nehmen nicht alle Patienten*innen diese Läsion wahr. Oft heilt diese Infektion jedoch nicht von selbst aus. In der zweiten Phase können Hautausschlag, Halsschmerzen und Muskelschmerzen auftreten. Unbehandelt kann die Krankheit im Verborgenen (latent) bleiben, ohne dass Symptome auftreten. Etwa ein Drittel der Infizierten mit unbehandelter Syphilis entwickelt im Verlauf Komplikationen. Diese Spätform wird als  sogenannt tertiäre Syphilis bezeichnet . In diesem Stadium kann die Krankheit alle Organe befallen: am häufigsten das Gehirn, die Nerven und die Augen. Die Infektion kann während der Schwangerschaft auf den Fötus und bei der Geburt auf das Kind übertragen werden.

    • Chlamydia trachomatis
      Chlamydien können ungewöhnlichen Ausfluss aus dem Penis oder der Vagina, Unbehagen beim Wasserlösen und Unterleibsschmerzen verursachen. Oft treten keine Symptome auf. Unbehandelt können sie zu Unfruchtbarkeit führen und die Krankheit kann auf Sexualpartner*innen übertragen werden. Die Bakterien können auch während der Schwangerschaft auf den Fötus, oder während der Geburt auf das Kind übertragen werden und Augeninfektionen oder Lungenentzündungen verursachen.

    • Gonorrhoe
      Auch bekannt als Tripper. Zu den häufigsten Symptomen gehören Ausfluss aus der Vagina oder dem Penis und schmerzhaftes Wasserlassen. Symptome müssen aber nicht immer auftreten. Sowohl bei Männern als auch bei Frauen kann Gonorrhoe auch den Mund, den Rachen, die Augen und den Anus infizieren und sich auf das Blut und die Gelenke ausbreiten, wo sie in eine schwere Krankheit übergehen kann. Bleibt sie unbehandelt, kann sie eine Beckenentzündung verursachen, die zu chronischen Beckenschmerzen und Unfruchtbarkeit führen kann. Die Krankheit kann während der Schwangerschaft auf den Fötus übertragen werden.

    • Weitere bakterielle STIs: Mykoplasmen und Ureaplasmen. Diese können ebenfalls behandelt werden.

    • Trichomoniasis
      Sie wird durch einen Parasiten verursacht, der mit einer einzigen Dosis eines Antibiotikums behandelt werden kann. Trichomoniasis kann bei Frauen einen übel riechenden Scheidenausfluss, Juckreiz im Genitalbereich und schmerzhaftes Wasserlassen verursachen. Bei Männern treten in der Regel weniger oder keine Symptome auf. Zu den Komplikationen gehört das Risiko einer vorzeitigen Entbindung bei schwangeren Frauen. Um eine Reinfektion zu verhindern, sollten beide Sexualpartner behandelt werden.

    Durch Viren hervorgerufen

    • HIV/AIDS - siehe Informationsblatt HIV-AIDS

    • Herpes simplex Virus
      Im Lippen-Mundbereich, auch bekannt als Fieberbläschen, ist nicht heilbar. Herpes kann aber mit Medikamenten bei akuten Beschwerden kontrolliert werden. Die Symptome sind in der Regel schmerzhafte, wässrige Hautbläschen und finden sich an oder um die Genitalien, den Anus oder den Mund. Nach der Erstinfektion ruht das Virus im Körper und die Symptome können über Jahre hinweg wieder auftreten. Schwangere Frauen können die Infektion an ihre Neugeborenen weitergeben, was zu einer bedrohlichen Infektion führen kann.

    • Virale Hepatitis (siehe auch Hepatitis Schweiz)
      • Hepatitis A (HAV)
        Hepatitis A ist eine durch Impfung vermeidbare Leberinfektion, die durch das Hepatitis-A-Virus verursacht wird. Das Hepatitis-A-Virus findet sich im Stuhl und im Blut infizierter Personen. Hepatitis A kann durch verunreinigtes Wasser und Lebensmittel sowie bei anal-oralen sexuellen Aktivitäten übertragen werden. Die Patienten*innen leiden an einer akuten und oft schweren Erkrankung, erholen sich aber allermeist spontan.
      • Hepatitis B (HBV)
        Das Hepatitis-B-Virus wird durch sexuelle Kontakte sowie durch den Kontakt mit anderen Körperflüssigkeiten, wie z.B. Blut, übertragen. Zur Übertragung kann es z.B. auch bei medizinischen Eingriffen oder Brennen eines Tatoos unter nicht optimalen hygienischen Bedingungen kommen. Hepatitis B kann eine schwere Leberinfektion verursachen, die sowohl zu einer sofortigen Erkrankung, als auch zu einer lebenslang andauernden Infektion führen kann mit möglicher Folge einer dauerhaften Lebervernarbung (Zirrhose) und Krebs. Schwangere Frauen mit Hepatitis B können das Virus während der Geburt auf ihr Kind übertragen. Zu Beginn der Infektion haben Sie möglicherweise keine Symptome.  Das Virus kann auf Sexualpartner*innen übertragen werden. Hepatitis B kann mit antiviralen Medikamenten behandelt werden, ist aber nur selten heilbar. Eine Impfung kann eine Hepatitis-B-Infektion verhindern.
      • Hepatitis C (HCV)
        In den meisten Fällen wird Hepatitis C durch den Kontakt mit infiziertem Blut übertragen. Seltener kann es durch analen Sexualkontakt oder von der Mutter auf das Kind während der Schwangerschaft und Geburt übertragen werden. Die meisten Infizierten sind sich ihrer Infektion nicht bewusst, weil sie keine Symptome entwickeln, aber diese chronische Infektion kann zu Leberzirrhose und Krebs führen. Hepatitis C kann behandelt werden, eine Impfung gibt es nicht.

    • Humanes Papillomavirus (HPV)
      HPV ist die häufigste Geschlechtskrankheit. Es gibt eine Vielzahl verschiedener HPV-Typen, und einige von ihnen können Genital-, Anal- und Mundwarzen sowie Gebärmutterhals-, Penis- oder Rachenkrebs verursachen. Die Symptome können auch noch Jahre nach dem Sex mit einer infizierten Person auftreten. Zwei verfügbare Impfstoffe schützen gegen die wichtigsten HPV-Typen, die Gebärmutterhals-, Penis- oder Analkrebs verursachen.

    • Zika - siehe Informationsblatt Zika
      In den meisten Fällen wird es vor allem durch Stechmücken übertragen. Es kann aber auch sexuell übertragen werden. Eine Ansteckung mit Zika während der Schwangerschaft kann bei dem sich entwickelnden Fötus Geburtsfehler wie Mikrozephalie (kleiner Kopf mit neurologischen Ausfällen) verursachen. Die einzige Möglichkeit, eine sexuelle Übertragung des Virus während der Schwangerschaft zu verhindern, besteht darin, Vorsichtsmassnahmen (Kondome) zu treffen oder Sex (mindestens 2 Monate nach der Rückkehr) mit jemandem zu vermeiden, der kürzlich in ein Risikogebiet gereist ist, auch wenn der Reisende keine Symptome hat.
    • Love Life: www.lovelife.ch 
    • Sexuelle Gesundheit Schweiz: www.sexuelle-gesundheit.ch 
    • Hepatitis Schweiz: https://hepatitis-schweiz.ch/formen/was-ist-hepatitis 
    • World Health Organization (WHO). Factsheets. Sexually transmitted infections (STIs). 14 June 2019: www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis) 
    • Centers for Disease Control and Prevention (CDC). Factsheet: Information for Teens and Young Adults: Staying Healthy and Preventing STDs (2017): www.cdc.gov/std/life-stages-populations/stdfact-teens.htm 
    • Centers for Disease Control and Prevention (CDC). How You Can Prevent Sexually Transmitted Diseases: www.cdc.gov/std/prevention/ 
    • Centers for Disease Control and Prevention (CDC) Sexual Transmission and Prevention. Zika Virus: www.cdc.gov/zika/prevention/protect-yourself-during-sex.html 
    • Centers for Disease Control and Prevention (CDC) Zika and Pregnancy; Pregnant Women and Zika (March 2021): www.cdc.gov/pregnancy/zika/protect-yourself.html 
      
     
     

    There is a risk of arthropod-borne diseases other than malaria, dengue, chikungunya or zika in sub-/tropical regions, and some areas of Southern Europe. These include the following diseases [and their vectors]:

    • in Europe
      • Borreliosis, FSME (= tick-borne encephalitis), rickettsiosis [ticks]
      • Leishmaniasis [sand flies]
      • West-Nile fever [mosquitoes]
    • in Africa
      • Rickettsiosis, in particular African tick bite fever [ticks]
      • Leishmaniasis [sand flies]
      • African trypanosomiasis = sleeping sickness [tsetse flies]
      • West-Nile fever [mosquitoes]
    • in Asia 
      • Scrub typhus [mites]
      • Rickettsiosis [fleas or ticks]
      • Leishmaniasis [sand flies]
      • West-Nile fever [mosquitoes]
      • Crimea-Congo-hemorrhagic fever [ticks]
    • in North and Latin America  
      • Rickettsioses and in particular Rocky Mountain spotted fever [ticks]
      • Leishmaniasis and Carrion's disease [sand flies]
      • American trypanosomiasis = Chagas disease [triatomine bugs]
      • West Nile fever [mosquitoes]

    EKRM_Factsheet_Layperson_EN_Mosquito-and-tick-bite-protection.pdf

     
      
     
     
     
    • There are other important travel related health risks such as diarrhoea, road traffic accidents, air pollution and more.
    • For more information, see the section "Healthy Travelling".

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