Tropical and travel medicine

Malaria is a potentially life-threatening disease. It is caused by parasites (so-called plasmodia), which are transmitted by mosquitoes. These are mainly active at dusk and at night. Malaria can be treated if it is diagnosed and treated quickly. Untreated malaria can be fatal, depending on the pathogen. Malaria manifests itself at the earliest 7 days after infection (up to months later) with flu-like symptoms. (Fever, aching limbs/muscles, headache, chills, etc). As preventive measures, protection against mosquito bites is recommended as well as - in high-risk areas - the regular intake of medication. If a disease nevertheless occurs, the malaria infection can be cured if it is diagnosed quickly and treated adequately. If left untreated, malaria can be fatal, depending on the type of plasmodia.

Therefore: any fever during or after a trip to a malaria risk area must be immediately medically clarified. Malaria occurs worldwide in tropical and subtropical areas - the exact geographical distribution can be seen on updated malaria maps (e.g. www.healthytravel.ch). High-risk groups for severe courses include pregnant women, small children, senior citizens or people with chronic diseases. For these persons, it is advisable to seek expert advice before travelling. Vaccination is not available in travel medicine.
 

Chikungunya is a febrile illness caused by a virus. It is widespread in Southeast Asia, India, Central/South America, the Arabian Peninsula and Sub-Saharan Africa. Local transmission has also occurred in Europe. The disease is transmitted by diurnal Aedes mosquitoes and manifests itself in flu-like symptoms. Joint pain can persist for months to years after infection.

The diagnosis is made by means of a blood test. Therapy focuses on the symptoms; there is no specific therapy. A vaccination is currently not available in travel medicine

Further info at: www.healthytravel.ch
 

Dengue fever is a viral infectious disease transmitted by mosquitoes. It is transmitted by the Ades mosquito, which is mainly active during the day and at dusk. The viruses occur worldwide in tropical and subtropical areas, and autochthonous cases are now also occurring in southern Europe.

The clinical picture is usually characterised by strong, flu-like symptoms (fever, headache, muscle / joint /and limb pain). In rare cases, usually in the context of a second infection or in people at risk (children, senior citizens, patients with severe chronic diseases), life-threatening bleeding and circulatory shock may occur. The diagnosis can be made with a blood test. Treatment is aimed at alleviating and monitoring vital functions and treat possible complications. For the treatment of pain and to reduce fever, paracetamol/acetaminophen is best; aspirin should not be used because of the risk of internal bleeding. A vaccine against dengue fever is available in some countries. However, there is still uncertainty about the effectiveness of the vaccine, especially in people who have not yet contracted dengue. No vaccine is currently licensed in Switzerland

Further information: www.healthytravel.ch
 

Japanese encephalitis is a viral infectious disease caused by the Japanese encephalitis virus (JEV). The virus is transmitted by nocturnal mosquitoes. The disease occurs in the tropical regions of East/Southeast Asia and in the western Pacific. Infection usually occurs in rural areas, often near wetlands (e.g. rice fields) and animal farms (pig farms). The risk of transmission is low for most travellers, but depends on the time of travel, type of travel and duration of travel. The disease is usually mild, there may be flu-like symptoms, in rare cases also brain inflammation with a high mortality rate. Treatment is symptom-oriented. Good mosquito protection, especially at night, is highly recommended. When travelling with an increased risk of infection, an appropriate vaccination is also indicated. (e.g. Ixiaro , 2 vaccinations at intervals of 28 days, in case of short-term departure an off-label scheme is possible) In case of longer stays in risk areas or increased risk due to corresponding activities (humanitarian missions/trekking in rural areas etc.) we recommend a prior travel medicine consultation.

Further information: www.healthytravel.ch
 

Rabies is a viral infectious disease transmitted by mammals. Transmission usually occurs through bite wounds or contact with saliva from the infected animal. It is usually dogs, but more rarely bats, cats or other mammals, which transmit the disease. The disease is spread worldwide. Once the disease breaks out, it is almost invariably fatal. The best way to protect yourself is to behave appropriately towards mammals (keep your distance, do not pet or feed mammals) or to be vaccinated. Basic immunisation before travel is recommended for people at risk (long-term stay in risk areas, contact/work with mammals, cave explorers, hiking/trekking in remote areas, etc.). If bites/scratches have occurred, this is considered an emergency and must be treated appropriately (washing out the wound, disinfection, immediate re-vaccination) For questions about the vaccination procedure or post-exposure prophylaxis, we recommend consulting a travel medicine specialist.

Further information at: www.healthytravel.ch
 

Bilharziasis (or schistosomiasis) is a parasitic infectious disease caused by worms. The worm larvae live in fresh water (ponds, lakes, slow-flowing rivers) and can penetrate the intact skin of humans when they are in the corresponding fresh water. Billarziosis occurs in Asia, Africa and certain areas of South America. Shortly after the larvae penetrate the skin, local itching may occur. After months or years, secondary damage can occur to the bladder, kidneys or digestive tract (intestine, liver). As a preventive measure, it is recommended to avoid bathing or wading in fresh water in risk areas. However, if you have come into contact with fresh water, we recommend that you seek medical advice and treatment from a specialist in tropical medicine. There are no vaccinations against schistosomiasis.

Further info at: www.healthytravel.ch
 

Typhoid fever is a serious infectious disease caused by bacteria (Salmonella typhi). Transmission usually occurs through contaminated food or drinking water. With adherence to optimal basic hygiene and access to safe food/drinks, the risk of infection is low. Vaccination is recommended for long-term residents in endemic areas or if local hygiene conditions are poor. In case of individual risk factors or previous health problems, travel medical advice is recommended.

Further information at: www.healthytravel.ch
 

Meningococcal meningitis is a very severe, life-threatening bacterial disease that can lead to death within a few hours if left untreated. Transmission takes place from person to person (so-called droplet infection). When travelling to risk areas (seasonal epidemics), the risk of infection is increased. In the so-called meningitis belt in sub-Saharan Africa, there are increased outbreaks every year during the dry season (usually December to June). For prevention when travelling to a risk area, vaccination with meningococcal vaccine is recommended (e.g. Menveo ©, MenQuadfi©) For pilgrims travelling to Saudi Arabia, appropriate vaccination is obligatory.

Further info at: www.healthytravel.ch
 

Hepatitis A is a liver infection caused by the hepatitis A virus. The disease occurs worldwide, increasingly in tropical/subtropical countries with reduced hygiene standards. Transmission occurs through contaminated food or water; transmission through sexual contact is also possible. The usual hygiene rules apply as a preventive measure. For travellers to tropical/subtropical countries, vaccination is also recommended, which provides long-lasting protection after administration of 2 doses

Further info at: www.healthytravel.ch
 

Yellow fever is a viral infection transmitted by mosquitoes and is potentially fatal. Typical symptoms are fever, chills, body/muscle pain and pain in the limbs. In 10-20% of infected persons, the course of the disease is severe with multiple organ failure. Treatment is symptom-oriented; there is no specific treatment. Good mosquito protection is recommended as well as the highly effective yellow fever vaccination. The vaccination is recommended for all persons travelling to a yellow fever endemic area from the age of 9 months. For certain countries, proof of yellow fever vaccination is mandatory upon entry. Pregnant women, patients with immunosuppressive medication or immunodeficiency should always contact a specialist in tropical/travel medicine before the vaccination, as the vaccination may only be administered to these persons with great caution or may even be contraindicated. The yellow fever vaccination may only be administered by official yellow fever vaccination centres.

Hint:

In 2016, the WHO changed its recommendations for yellow fever vaccination from a booster dose every 10 years to a single dose for life. However, this decision was based on limited data collected mainly in endemic populations. These individuals may be exposed to natural boosters (through contact with infected mosquitoes), which is not the case for travellers from non-endemic areas. As some experts have expressed concerns about the WHO's single-dose strategy, the Swiss Expert Committee on Travel Medicine recommends a single booster dose 10 years after the first dose (max. 2 doses in a lifetime) in immunocompetent individuals before lifelong immunity can be assumed

More info: www.healthytravel.ch
 

Zika is an infectious disease transmitted by diurnal Aedes mosquitoes. The typical symptoms are flu- like complaints (such as fever, limb/muscle pain, conjunctivitis) The disease is usually asymptomatic to mild, neurological or immunological complications are rare. However, infection during pregnancy can lead to severe malformations in the unborn child. Therefore, women are advised not to travel to an endemic area during pregnancy. Pregnancy should be avoided until 2 months after leaving an endemic area. The disease occurs worldwide in most tropical/subtropical regions. In case of a cica infection during pregnancy, it is essential to contact a tropical doctor and gynecologist. Good mosquito protection is recommended as a preventive measure. There is currently no vaccination available. 

Further information: www.healthytravel.ch
 

Travellers' diarrhea is a common "souvenir" from tropical/subtropical countries. Depending on the region, 10-40 people experience travellers' diarrhea at least once. It is usually an unpleasant, harmless and self-limiting illness. The pathogens are usually viruses or bacteria, and in cases of persistent diarrhoea also protozoa/parasites. As a preventive measure, good food and hand hygiene is important ("cook it, peal it, boil it or leave it"). Water should only be drunk from correctly sealed bottles, consumption of raw/undercooked meat/fish is not recommended. Salads, unpeeled fruit, soft ice cream, foods with raw eggs etc. Should also be avoided. Symptom-oriented therapy is usually sufficient. (sufficient fluid intake, possibly loperamide for a short time). If fever and/or blood in the stool occur, further medical clarification is absolutely recommended.

Further info at: www.healthytravel.ch

Important note

The above list of diseases is incomplete. Likewise, the contents are only intended as brief information, they are not complete and do not serve as guidelines. They are also no substitute for a discussion with a specialist and a serious independent examination of health risks before travelling to the tropics/subtropics. If you have any questions, you are welcome to make an appointment with us for a travel consultation.