Switzerland is currently abroad, bringing back not only beautiful memories but also a range of diseases as unwanted souvenirs. These are the hotspots.
02.08.2024, 22:4302.08.2024, 22:49
Simon Maurer / ch media
Dengue fever is rising worldwide and is increasingly reaching Switzerland due to travelers returning from vacation. In the first seven months of this year, 294 cases of this reportable disease were documented by the Federal Office of Public Health. This figure is nearly as high as the total number of cases recorded in Switzerland for all of last year.
Infected tiger mosquitoes transmit the dangerous dengue virus with their bites. Image: keystone
“All of these cases are imported from abroad,” says Simon Ming of the Federal Office of Public Health. This trend can be attributed to numerous endemic outbreaks in Latin America during the first half of this year, whose consequences are now visible in Switzerland.
Swissmedic approves a dengue vaccine for the first time
As of Friday, the Swiss regulatory authority has authorized the use of “Qdenga,” a dengue vaccine developed by Takeda Pharmaceuticals. It is recommended for anyone traveling to tropical risk areas and who is over the age of 4. The vaccine consists of weakened dengue variants that stimulate the body’s immunity through the production of antibodies.
Olympic Games become a risky event
Travelers to Asia and America particularly risk contracting the dengue virus. The number of cases has surged over the past five years, with the World Health Organization (WHO) estimating up to 400 million cases globally each year. Esther Künzli, co-director of the Center for Tropical and Travel Medicine at the Swiss Tropical and Public Health Institute Swiss TPH in Basel, confirms this trend. “Anyone returning with fever symptoms from a country with high dengue infection rates should seek medical attention,” says Künzli. The disease is transmitted by infected mosquitoes and flu-like symptoms typically develop several days later. “When visiting your family doctor after vacation, it is important to mention the countries you visited.”
Esther Künzli, co-director of the Center for Tropical and Travel Medicine at the Swiss Tropical and Public Health Institute Swiss TPH. Image: zvg
However, one does not need to travel far to contract the virus. Recently, warnings about dengue infections associated with the Olympic Games in Paris have also emerged. The Asian tiger mosquito, known for transmitting various tropical diseases, has been spreading in the area for approximately ten years. This situation, combined with a high-profile event that attracts millions from around the world, concerns French infectious disease specialists. Authorities have therefore issued warnings for tourists and residents.
“It is still too early to assess the impact of the Summer Games on infection rates,” says Esther Künzli from the Tropical Institute. However, dengue fever is not the only infectious disease raising alarms among travel doctors. There are also outbreaks of other diseases in many other popular tourist destinations that merit attention. Here’s an overview:
Infectious diseases in the most popular holiday hotspots
graphic: stefan bogner / ch media
South America and Caribbean: Oropouche virus
This week, for the first time, two young women died from infections caused by the Oropouche virus. Although this virus is well-known, what is new is its spread, as it has been detected in Cuba since the start of the year. Since June, two cases of Oropouche infections have also been reported in Italy among individuals returning from Cuba. The virus is transmitted by gnats, a type of mosquito from the Amazon region in South America. Symptoms of an Oropouche fever outbreak are akin to those of the flu and usually reappear about two weeks after the initial illness has subsided. The virus has not been thoroughly researched, and treatment is purely symptomatic. Infections caused by the virus typically resolve, although the recovery process may take several weeks.
There have been isolated cases of the Oropouche virus reported in Europe. Image: Shutterstock
Balkans, Greece and Southern Europe: Antibiotic resistance
The careless use of antibiotics has led to multi-resistant bacteria, particularly in Southern Europe. Esther Künzli, an expert in this area, explains: “Antibiotic resistance has primarily been studied in hospital environments.” Research on infections among tourists abroad, especially in Europe, is scarce. The only certainty is that hospital stays in southern countries pose a high infection risk. Swimming in stagnant water and rivers is also hazardous: a recent study indicates that Greek rivers harbor clinically relevant resistant germs.
Southern Hemisphere: Rampant influenza viruses
On the opposite side of the globe, winter is just starting, ushering in the flu season. Anyone south of the equator may therefore contract new influenza virus subtypes that are typically prevalent at this time. Travelers who spend extended periods in Southern Hemisphere countries can get vaccinated locally against the flu variants indigenous to those areas. The flu vaccines recommended by the WHO, which are adapted for the southern hemisphere, are not approved in Europe due to limited demand.
Eastern Europe: Danger during sexual intercourse
In Eastern Europe, the infection rate for sexually transmitted diseases has remained higher than in the West for years. This trend applies to HIV, gonorrhea, and other sexually transmitted infections. In recent years, experts have expressed particular concern over the rise in gonorrhea infections, as this trend continues to grow among all monitored groups— heterosexual men, women, and gay men alike. “The stigma surrounding these diseases is greater in Eastern Europe, which results in patients being less likely to seek testing and therefore treatment,” says Esther Künzli. Unprotected sex is therefore especially inadvisable in these countries.
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North Africa and Asia: Diarrhea epidemics
Various pathogens causing diarrhea are currently widespread in North Africa and Asia. Health authorities, including the American Centers for Disease Control and Prevention (CDC), warn of a “high risk of infection in Egypt” and other North African countries. However, Swiss experts rarely recommend taking antibiotics as a preventive measure. “This is because the use of antibiotics significantly increases the colonization of the gastrointestinal tract with antibiotic-resistant bacteria,” explains Esther Künzli. When dealing with diarrhea, careful attention to food hygiene is crucial. The highest risk arises from unwashed salad and contaminated water. Public health officials recommend following this guideline regarding food: “Cook it, peel it, or forget it!” (aargauerzeitung.ch)
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Due to the high volume of traffic, there were long traffic jams on the roads along the north-south axis on Saturday. Various sections of the road had to be temporarily closed due to accidents. A motorcyclist was killed and five other people sustained minor injuries.
Switzerland’s Post-Vacation Health Risks: A Look at Emerging Diseases
Switzerland is currently facing increasing health risks as travelers return from abroad, carrying with them not only cherished memories but also the threat of infectious diseases. Many of these diseases stem from endemic outbreaks in tropical regions, with dengue fever leading the charge. Let’s delve into the most concerning hotspots and learn how to protect ourselves.
Dengue Fever: A Growing Concern
Dengue fever cases are on the rise worldwide, and Switzerland is witnessing the effects. In just the first seven months of 2024, the Federal Office of Public Health reported 294 cases of this notifiable disease, nearly matching the total for all of 2023. According to Simon Ming from the Federal Office of Public Health, “all these cases are imported from abroad.” The alarming increase is a direct result of dengue outbreaks in Latin America.
The primary carriers of the dengue virus, infected tiger mosquitoes, can pose a significant risk, especially to vacationers returning from tropical regions. Health experts have heightened their warnings, noting that anyone returning with flu-like symptoms must seek medical attention and inform their healthcare provider about their travel history.
Vaccination: A New Measure Against Dengue
In light of the growing dengue threat, Swissmedic has approved the “Qdenga” vaccine developed by Takeda Pharmaceuticals. This vaccine is recommended for anyone traveling to tropical risk areas aged four years and older. The vaccine uses weakened strains of the dengue virus to stimulate the immune response, providing a safeguard against potential infection.
Other Infectious Disease Hotspots Around the World
As travelers explore various regions globally, they should be aware of other diseases that are currently alarming health authorities.
South America and the Caribbean: Oropouche Virus
The Oropouche virus, primarily spread by gnats in the Amazon region, has recently gained attention due to fatalities in Cuba. Two young women lost their lives this week after contracting this viral infection. The symptoms of Oropouche fever resemble those of the flu, with potential recurrence weeks after initial recovery. Italian health authorities have documented cases linked to travelers returning from Cuba.
Balkans, Greece and Southern Europe: Antibiotic Resistance
Careless antibiotic use has led to an uptick in multi-resistant bacteria in Southern Europe. Esther Künzli, co-director at the Swiss Tropical and Public Health Institute, notes that antibiotic resistance in tourist areas often goes unnoticed. Swimming in stagnant waters can increase the risk of infections, underscoring the need for caution while traveling.
Southern Hemisphere: Influenza Viruses
As the winter season arrives in the southern hemisphere, so does a surge of influenza cases. Travelers should consider local vaccinations to protect against flu strains specific to these regions. Unfortunately, the WHO’s recommended vaccines for the southern hemisphere are not available in Europe.
Eastern Europe: Sexually Transmitted Diseases
Eastern Europe faces a growing problem with sexually transmitted infections (STIs), such as HIV and gonorrhea. The infection rates are staggering, particularly among younger populations. Health experts urge tourists to practice safe sex to avoid these risks while traveling in this region.
North Africa and Asia: Diarrhea Epidemics
Pathogens causing diarrhea are increasingly prevalent in North Africa and parts of Asia. The CDC specifically warns about high infection risks in countries like Egypt. Travelers are advised not to take antibiotics unnecessarily, as this practice can lead to antibiotic resistance. Instead, maintaining proper food hygiene—cooked, peeled, or forgotten—can mitigate risks.
Travel Health Tips
- Vaccinate: Ensure you are vaccinated against diseases prevalent in your destination.
- Research: Know the health risks associated with the regions you plan to visit.
- Monitor Symptoms: Pay attention to flu-like symptoms post-travel and seek medical advice promptly.
- Food Safety: Follow the “cook it, peel it, or forget it” rule to avoid foodborne illnesses.
- Practice Safe Sex: Use protection to reduce the risk of STIs.
Case Studies: Travel and Infectious Disease
Case Study 1: The Rise of Dengue Fever
A Swiss traveler returning from Brazil fell ill with dengue fever shortly after arriving back home. Despite initial flu-like symptoms, the patient did not recognize the importance of informing the doctor about their recent travel, leading to complications. This case underscores the significance of travel history in identifying infectious diseases.
Case Study 2: Oropouche Virus Infection Traced to Cuba
Two tourists visiting Cuba contracted the Oropouche virus. Initially misdiagnosed during their visit, their conditions worsened upon returning to Switzerland. This incident highlights the necessity of awareness regarding emerging infectious diseases in travel destinations.
Staying informed and taking proactive measures can significantly reduce the risk of bringing home undesirable health souvenirs. As Swiss National Health authorities continue to monitor global health trends, travelers must remain vigilant and prioritize their health while enjoying their journeys.
