Dengue
Virgin Islands (Brit. & USA)
Since the beginning of this year, 180 infections have been confirmed, 30 in the British and
150 in the American islands. Take precautions against the predominantly diurnal carrier
mosquitoes. A vaccination has been available since February 2023.
Yellow fever
Colombia
Since the beginning of this year, 26 infections have been confirmed in humans, 5 of whom
have died. The departments affected were Caquetá (S), Huilia S(W), Narino (SW),
Putumayo (SW), Tolima (Z) and Vaupés (SO). A yellow fever vaccination is recommended
for all travelers aged 9 months and over. Vaccination is mandatory when entering from some
endemic areas.
Rabies
Morocco
In October of this year, a young man died after being bitten by a domestic dog. A risk of
transmission, especially from stray dogs, is to be expected nationwide, including in cities and
tourist areas. If you come into contact with animals in a suspicious way, you should see a
doctor immediately. A prophylactic vaccination is recommended, especially for longer stays.
Japanese encephalitis
Nepal
This year, 80 infections and 23 deaths were registered in various districts. The Kathmandu
Valley is also affected. It is important to ensure that you have very good mosquito protection.
Pertussis
Netherlands
The number of cases has risen continuously since around the middle of last year. This year,
around 17,500 infections were reported. 6 babies and 3 adults died. The last major outbreak
occurred in 2012, and around 13,830 people were affected. Before staying abroad, you
should always check your standard vaccinations and supplement them if necessary.
Eastern equine encephalitis (EEE)
USA
This year, 18 infections with at least 3 deaths were reported. The states affected are Maine,
New York, Vermont, Massachusetts, New Jersey, New Hampshire, North Carolina,
Wisconsin and Rhode Island. This viral infection, transmitted by day and night-active
mosquitoes, can lead to severe encephalitis. Take precautions against mosquito bites.
Intestinal infections
Egypt
Risk of diarrhea nationwide. In recent years, there have been repeated cases of infections
with enterohemorrhagic Escherichia coli (EHEC) in returning travelers, especially from
Hurghada. Hepatitis A is also very common. Raw salads and insufficiently cooked food
should be avoided. Tap water should not be drunk. Pay attention to food hygiene and
vaccinations.
Safety note
Egypt
Travel to the north of the Sinai Peninsula, the Egyptian-Israeli border area (with the
exception of Taba) and remote areas of the Sahara is warned against. Unaccompanied,
individual excursions and overland trips in the south of the Sinai Peninsula are not
recommended (www.auswaertiges-amt.de).
Dengue
Australia
Since the beginning of this year, 1,972 cases have been reported nationwide. The states of
Western Australia, New South Wales and Victoria are once again particularly affected. Pay
attention to protection against day-active mosquitoes. A vaccination has been available
since February 2023.
Pertussis
Australia
By the beginning of November, around 41,800 cases had already been reported nationwide,
most of them in the states of Queensland and New South Wales. These are the highest
number of cases since 2016. Last year, a total of around 2,440 cases were recorded
nationwide. Before staying abroad, standard vaccinations should always be checked and
supplemented if necessary.
Ross River fever
Australia
Around 3,220 cases were reported nationwide this year. The state of Queensland is
particularly affected. Pay attention to mosquito protection.
Chikungunya
Brazil
Around 399,980 suspected cases and 184 deaths were reported this year. Most of the cases
come from the state of Minas Gerais, where the authorities declared a health emergency at
the end of January this year due to the epidemiological situation. The states of Mato Grosso
and Bahia are also badly affected. Last year, around 256,930 suspected cases were
registered nationwide, and around 146,250 infections were confirmed. 106 people died.
Compared to the same period last year, the number of cases has increased significantly. In
2022, a total of around 265,300 suspected cases were reported. 75 people died. In
mid-2014, health authorities reported the first local infections. Since then, the infection has
spread nationwide. Be sure to protect yourself from mosquitoes.
Dengue
Brazil
There is a high risk of dengue throughout the country. Since the beginning of this year,
around 9,792,000 suspected cases and 5,645 confirmed deaths have been registered
nationwide. Compared to the same period last year, the number of cases has more than
tripled. The authorities in 7 of the 27 states (Acre, Goiás, Minas Gerais, Espírito Santo, Rio
de Janeiro, Santa Catarina and the Federal District) have declared a health emergency due
to the epidemiological situation. Last year, around 3,028,600 suspected cases were
registered nationwide and 1,094 people died. In 2022, around 2,363,500 cases of illness and
around 930 deaths were recorded. Be sure to protect yourself from mosquitoes that are
mainly active during the day. A vaccination has been available since February 2023.
Yellow fever
Brazil
In mid-October, a teenager from neighboring Guyana fell ill in the state of Roraima. This
year, 3 infections have been confirmed in humans. One case of illness and one death were
reported in the state of São Paulo and one person died in the state of Amazonas.
Vaccination is recommended for stays in Brazil.
Oropouche fever
Brazil
Since the beginning of this year, around 3,230 infections have been confirmed in the state of
Amazonas. At the end of February, an illness was reported in the city of Rio de Janeiro.
Since the beginning of February, further illnesses have been reported in the states of
Rondonia, Acre, Para, Roraima and Tocantins. Outside the Amazon region, the following
states are affected: Bahia, Espírito Santo, Santa Catarina, Minas Gerais, Mato Grosso, Mato
Grosso do Sul, Sao Paulo, Rio de Janeiro, Piaui, Pernambuco, Ceará and Maranhao. In
March, a 24-year-old woman died in the state of Bahia. Nationwide, the number of cases has
risen to around 8,260, and 2 people have died. The virus is transmitted by midges and
predominantly nocturnal mosquitoes. The disease leads to an acute febrile syndrome
including joint and limb pain and vomiting. Take precautions against mosquitoes.
Dengue
Dominican Republic
Since the beginning of this year, around 9,790 cases have been registered. 9 people have
died. Last year, around 25,470 suspected cases were registered. 23 people have died. In
2022, around 10,440 suspected cases were reported. 42 people have died. The number of
cases in 2022 has roughly tripled compared to the previous year. The communities of
Santiago, Santo Domingo de Guzmán, Santo Domingo Norte, Santo Domingo Este and San
José de Ocoa were particularly affected. In 2021, around 3,750 infections and 26 deaths
were registered. Be sure to use mosquito repellent. A vaccination has been available since
February 2023.
Entry requirements
Dominican Republic
The Dominican government has completely sealed off the border with Haiti since September
15, 2023 until further notice. At the moment, travel by land, air or sea between the two
countries is not possible (www.auswaertiges-amt.de).
West Nile fever
Greece
Since the beginning of July this year, 352 cases have been registered in several regions. 31
people have died. The infection occurs sporadically in Greece, especially in the northern
regions. Take mosquito protection.
Intestinal infections
India
Risk of diarrheal diseases nationwide. Cholera is to be expected regionally. Typhoid,
paratyphoid and the orally transmitted forms of hepatitis are endemic throughout India.
Anthrax, both in the cutaneous and intestinal form, is a recurring problem among locals.
Take hygiene and vaccinations into account.
Dengue
India
Around 32,100 cases were registered nationwide by the end of June this year. 32 people
have died. The states of Kerala, Karnataka and Tamil Nadu are particularly affected. Last
year, around 234,430 cases and 91 deaths were reported. In 2022, around 233,250
infections and 303 deaths were recorded. Take precautions against day-active vector
mosquitoes (Aedes species). A vaccination has been available since February 2023.
Japanese encephalitis
India
In the first 9 months of this year, 945 cases of Japanese encephalitis (JE) were registered
nationwide. 68 people died. Most infections were again registered in the state of Assam
(NE). In 2023, 1,097 cases and 56 deaths were officially reported nationwide. Carry out
exposure prophylaxis and possibly vaccination!
Malaria
India
Since January of this year, around 151,520 cases have been reported nationwide. 34 people
have died. Most infections come from the states of Odisha, Chhattisgarh and Jharkhand.
Last year, around 223,960 cases were registered and 72 people have died. Very good
mosquito protection should always be observed, it is usually advisable to take emergency
medication with you and, depending on the outbreak, chemoprophylaxis should also be
discussed.
Safety advice
India
Travel to Jammu and Kashmir and Manipur is currently strongly discouraged.
Demonstrations and large gatherings of people should generally be avoided and the
instructions of the security forces should be followed. In addition, current media reports
should be followed during a stay (www.auswaertiges-amt.de).
Smog
India
Air pollution is currently extremely high in New Delhi and in the National Capital Territory of
Delhi (NCT) surrounding the capital. Due to the burning of crop residues in the fields in the
area, pollution, particularly from fine dust, regularly increases at this time of year. Young
children, the elderly and those with chronic respiratory diseases are particularly at risk. They
are advised to stay indoors during peak periods, avoid physical exertion and possibly wear
breathing masks. Travellers should pay close attention to local media reports.
Rabies
India
This year, 16 people have died in the state of Meghalaya (NE), with the districts of West
Khasi Hills and West Jaintia Hills particularly affected. In the state of Tamil Nadu (S), 22
people have died of rabies this year. In March this year, one case and 3 deaths were
reported in the state of Manipur (NE). Last year, deaths were reported in several states. In
September 2023, the first death since 2017 was reported in the state of Goa (W). India is
one of the countries with the highest number of cases in animals and humans in the world. In
2022, a total of around 310 people died. The main carrier is the (stray) dog. The big cities
are also affected. In the event of suspicious animal contact, seek medical attention
immediately and make sure that modern tissue culture vaccines are used. A preventive
vaccination is recommended for all travelers.
Zika virus
India
In the state of Gujarat (W), 500 people have fallen ill by the beginning of November this year.
Since June this year, 108 infections and 5 deaths have been confirmed in the city of Pune
(state of Maharashtra, W). The virus is present in large parts of the country. Be careful with
mosquito protection.
Intestinal infections
Indonesia
Risk of diarrhea nationwide. Cholera outbreaks are reported sporadically from West Papua,
and typhoid is to be expected. Continue to observe hygiene and vaccination against typhoid.
Dengue
Indonesia
By mid-September this year, around 197,396 infections had been confirmed nationwide.
1,161 people have died. The health authorities in Bali province have warned tourists of an
increase in the number of cases and, according to press reports, vaccination is
recommended for tourists and locals. Be sure to protect yourself against the predominantly
day-active carrier mosquitoes. A vaccination has been available since February 2023.
Entry requirements
Indonesia
Due to the increasing number of monkeypox cases worldwide, the authorities have adjusted
the entry requirements. Since August 29, 2024, travelers must fill out the electronic health
questionnaire at the Ministry of Health (https://sshp.kemkes.go.id/) before entering the
country (departure) and receive a QR code that must be presented at check-in and upon
entry.
Poliomyelitis
Indonesia
This year, 7 infections with vaccine-derived poliovirus type 2 (cVDPV2) were reported. Last
year, a total of 6 infections with infections were confirmed on the islands of Sumatra and
Java. A child had already fallen ill on the island of Sumatra in November 2022. This is the
first case of polio in the country since 2019. The emergence of VDPV makes the country a
country with a potential risk of international spread of the pathogen. As a result, all people
(locals and tourists) who have stayed in the country for more than 4 weeks should be able to
show proof of vaccination against polio when leaving the country. The vaccination must take
place between 4 weeks and one year before departure and be documented in an
internationally valid vaccination certificate.
Safety notice
Indonesia
Non-essential travel to five of the six provinces of the Indonesian part of the island of New
Guinea (Papua, Papua Barat, Papua Pegunungan, Papua Tengah and Papua Selatan) is not
recommended. Large crowds should generally be avoided and the instructions of the
security forces should be followed. In addition, current media reports should be followed
during a stay (www.auswaertiges-amt.de).
Dengue
Maldives
The number of new infections has risen sharply since the end of March this year, and by the
end of August around 3,090 people had fallen ill. The number of cases is now significantly
higher than the comparable figures for the last 2 years. A total of around 3,420 cases were
reported in 2023. Be sure to protect yourself against the predominantly diurnal carrier
mosquitoes. A vaccination has been available since February 2023.
West Nile fever
Austria
63 cases have been reported since the end of July this year. The Vienna area, northern
Burgenland and the Weinviertel are affected. The infection occurs sporadically in Austria.
The virus is transmitted from one host to the next by mosquitoes. It mainly infects birds, but
can also spread to humans, horses and other mammals. Take precautions against
mosquitoes.
Dengue
Spain
Since the beginning of September, 8 locally acquired infections have been registered in the
province of Tarragona (Catalonia). These are the first this year. Take precautions against the
predominantly diurnal vector mosquitoes. A vaccination has been available since February
2023.
Crimean-Congo hemorrhagic fever
Spain
This year, one infection each was acquired in the province of Salamanca (Castile and León
region) and in the province of Toledo (Castile-La Mancha region). A total of 12 infections
were reported between 2013 and 2022, and 4 patients died. The regions affected are Castile
and León and Extremadura in the northwest of the country. The pathogen is usually
transmitted by ticks, but occasionally also from person to person. Exposure prophylaxis (e.g.
repellents, covering clothing) and early tick removal are recommended.
West Nile fever
Spain
This year, 54 infections were reported in the Andalusia region, most of them in the province
of Seville. 20 infections were recorded in the Extremadura region. 10 people have died. The
virus is transmitted from one host to the next by mosquitoes. It mainly infects birds, but can
also spread to humans, horses and other mammals. Take precautions against mosquitoes.
Safety notice
South Africa
Given the significant social differences in the country and not least due to the worsening
electricity supply crisis, protests and demonstrations may occur. Violent clashes and traffic
disruptions cannot be ruled out. For example, there have already been repeated violent
actions in the Emalahleni area (on the main connecting road between Johannesburg and
tourist destinations in the east of the country, such as the Blyde River Canyon and the
Kruger National Park). The electricity crisis with frequent and prolonged power outages
continues. These lead to temporary power outages, including in private accommodation,
shops, banks and ATMs, public lighting, traffic lights and security systems. The power
outages can also affect the water supply and quality and continue to lead to restrictions on
internet connections and mobile communications. Gas stations can also be temporarily
affected. For safety reasons, the Tourism Security Unit of the Western Cape Government
recommends that travelers do not go hiking alone and only in groups. There have recently
been several robberies of tourists, especially on the hiking trails around Table Mountain
(Devil’s Peak, Lion’s Head and Signal Hill) in Cape Town. For safety reasons, the South
African National Park Service recommends that travelers refrain from using the so-called
Numbi Gate when entering the Kruger National Park and use alternative entrance gates.
When traveling to Addo Elephant Park from Port Elizabeth (Gqeberha), it is recommended
that you avoid using the R335 via Motherwell and instead use the N2 via Colchester.
Demonstrations and large gatherings of people should generally be avoided and the
instructions of the security forces should be followed. In addition, current media reports
should be followed during a stay (www.auswaertiges-amt.de).
Rabies
South Africa
Since the beginning of this year, 3 deaths have been registered. Last year, 11 cases were
confirmed in humans, and in 2022 there were 13. The provinces of Limpopo, KwaZulu-Natal
and Eastern Cape were particularly affected. A sharp increase in rabid dogs has been
observed nationwide since 2022. Rabies occurs in animals nationwide, affecting jackals,
mongooses, cows, unvaccinated dogs and cats, among others. At the beginning of June, an
infection in a South African fur seal (Arctocephalus pusillus) was confirmed for the first time
in Cape Town. By the end of July, 14 more cases had been registered. According to the
Cape Town City Council, 8 people have now also been bitten and all have been asked to
seek treatment. The population should keep themselves and their dogs away from the seals
in the entire coastal region of the Cape Peninsula. The most common source of infection for
humans is dog bites. If there is contact with such animals, seek medical attention
immediately; preventive vaccination is recommended if the risk is foreseeable and the stay is
longer.
Intestinal infections
Tanzania
Risk of diarrhea nationwide. Localized cholera outbreaks occur regularly. There have been
outbreaks in 21 regions since September last year. Pay careful attention to hygiene and
consider vaccination if necessary.
Entry requirements
Tanzania
With effect from October 1, 2024, all visitors to Zanzibar (except residents with a Tanzanian
residence permit) must take out mandatory entry insurance from the Zanzibar Insurance
Corporation (ZIC) for the duration of their stay (up to 92 days). This insurance can only be
taken out with ZIC. Other international travel insurance policies are not accepted. The
policies can be purchased from September 1, 2024. The current cost is USD 44 per person.
Further information is available on the Visit Zanzibar website (https://visitzanzibar.go.tz/).
Entry may be refused if the correct insurance is not proven.
Entry vaccination requirements
Tanzania
The WHO classifies the risk of infection with yellow fever in Tanzania as low, and vaccination
is not generally recommended. According to the official entry vaccination regulations (ITH
2020), a yellow fever vaccination is required when entering from endemic areas for people
older than 1 year. Experience has shown that the regulations change frequently and the
information provided by the various authorities differs from one another. The regulations are
sometimes interpreted and handled differently at some airports (Kilimanjaro Airport in
Arusha) or by individual border officials. Contrary to the official information, a yellow fever
vaccination is often required when entering Zanzibar. An official statement from the Zanzibar
Ministry of Health is published on the website of the Federal Foreign Office.
Malaria
Tanzania
After the disease was considered almost eliminated on the Zanzibar and Pemba island
group for many years, the number of cases has been increasing again for several years.
Since October last year, the number of cases on Zanzibar has risen sharply. Very good
mosquito protection should always be observed, and chemoprophylaxis is also
recommended.
Poliomyelitis
Tanzania
The first infection with vaccine-derived poliovirus type 2 (cVDPV2) was reported in July last
year. Another infection was reported at the beginning of September and at the end of
December. Due to the appearance of cVDPV2, the country is formally one of the countries
with a potential risk of the pathogen spreading internationally. As a result, all people (locals
and tourists) who have stayed in the country for more than 4 weeks must show proof of polio
vaccination when leaving the country. The vaccination must take place between 4 weeks
and a year before departure and be documented in an internationally valid vaccination
certificate. Pay attention to vaccination protection.
Safety note
Tanzania
Unnecessary travel to the southern part of the Mtwara region (immediate border region with
Mozambique) is not recommended (www.auswaertiges-amt.de).
Intestinal infections
Thailand
Risk of diarrhea nationwide, small cholera outbreaks are also to be expected locally. Pay
attention to hygiene.
Dengue
Thailand
Since the beginning of this year, around 86,250 cases and 70 deaths have been registered.
Last year, around 159,220 infections and 179 deaths were reported. The provinces of Trat,
Nan, Chanthaburi, Rayong and Mae Hong Son, as well as the capital Bangkok, were
particularly affected. Be sure to protect yourself from day-active mosquitoes. A vaccination
has been available since February 2023.
Measles
Thailand
This year, a sharp increase in the number of cases has been reported, particularly in the
south of the country. Before staying abroad, standard vaccinations should always be
checked and supplemented if necessary.
Dengue
USA
In the state of Florida, 59 local infections were reported by mid-October this year. The
counties affected are Miami-Dade, Monroe, Hillsborough, Orange, Pasco, Manatee and
Palm Beach. Health authorities in Los Angeles County (California) have recorded 15 local
infections since the beginning of September. At the beginning of October, authorities
confirmed a case in San Diego County for the first time. Be careful to protect yourself from
mosquitoes that are mainly active during the day. A vaccination has been available since
February 2023.
Eastern equine encephalitis (EEE)
USA
This year, 18 infections with at least 3 deaths have been reported. The states affected are
Maine, New York, Vermont, Massachusetts, New Jersey, New Hampshire, North Carolina,
Wisconsin and Rhode Island. This viral infection, transmitted by mosquitoes that are active
during the day and night, can lead to severe brain inflammation. Be careful to protect
yourself from mosquitoes.
Pertussis
USA
This year, around 22,250 cases were reported by the beginning of November, which is about
five times as many as in the same period last year. Before staying abroad, standard
vaccinations should always be checked and supplemented if necessary.
Sun protection
USA
Since the beginning of 2021, the sale of so-called reef-toxic sunscreens has been banned in
the state of Hawaii, including products containing oxybenzone (BP3) and octinoxate. These
substances are suspected of having a harmful effect on corals and other marine life.
Rabies
USA
At the end of September this year, a man around 65 years old died in the state of Minnesota.
At the end of July, he had contact with a bat. Human cases of rabies are rare in the USA.
After suspicious animal contact, a doctor should be consulted immediately.
West Nile fever
USA
By mid-October this year, 1,060 infections and at least 18 deaths had been registered. Most
infections come from the states of Texas, California, Mississippi and Nebraska. The peak of
the season is from July to October, but transmission is possible all year round. Be careful of
mosquito protection.
Intestinal infections
Vietnam
Risk of diarrheal diseases nationwide, cholera is also endemic. Be careful of food and
drinking water hygiene.
Dengue
Vietnam
Since the beginning of this year, around 100,050 cases of illness and 16 deaths have been
registered nationwide. Last year, around 166,620 infections and 42 deaths were reported. In
2022, around 367,730 cases of illness and 140 deaths were registered. The number of
cases was around 5 times higher than in 2021. Be careful of protection against
predominantly diurnal mosquitoes. A vaccination has been available since February 2023.
Rabies
Vietnam
60 deaths have been reported since the beginning of this year. Last year, a total of 82 people
died from rabies infection. If there is any suspicious contact with animals, a doctor should be
consulted immediately. Preventive vaccination is strongly recommended, especially if there
is a foreseeable risk and for longer stays. Advice from a doctor experienced in travel
medicine should be sought well in advance of the trip.
Bird flu
Vietnam
In March of this year, an infection with influenza A(H9N2) was reported for the first time in
Vietnam. In March of this year, a 21-year-old student fell ill with influenza A(H5N1) and
subsequently died. He had previously caught wild birds. After a break of more than 8 years,
a 5-year-old girl became ill with an influenza virus H5 in October 2022. She had eaten meat
from sick chickens and ducks. Between 2003 and 2014, a total of 128 people nationwide fell
ill with influenza A(H5N1), and there were 65 deaths. All of those affected were found to
have had contact with animals. Since 2014, numerous outbreaks have been registered in
domestic poultry across the country, with more than 129,000 animals killed. At the end of
May last year, there was an outbreak in Quang Ngai province with around 1,700 sick ducks.
Vaccination of poultry is widespread in the country. Since 2014, outbreaks of influenza
A(H5N6) have been reported repeatedly in poultry farms. Since the beginning of 2021, 3
outbreaks have already been reported in 2 provinces. There have been no human cases of
illness so far
Prague Center for Travel Medicine
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