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Due to the COVID-19 pandemic, we were unable to travel long distance for some time. Fortunately, that has changed. The low temperatures and the cloudy weather are now giving some people the idea of booking a trip to Asia, South America or Africa. Preparation is half the battle, especially on trips like this.
This also applies to the necessary vaccinations. The Austrian standard vaccinations are a basic requirement, to which special travel vaccinations are added depending on the region and travel time. Sun and insect protection as well as a personal first aid kit complement the medical precautionary measures. We recommend going to a travel medical center at least six weeks before the start of your trip.
New dangers from dengue and chikungunya?
Only recently the headline “Dengue fever on Lake Garda” hit the media and caused a stir. “In fact, some cases of dengue fever acquired in the country have been recorded in Italy. This shows that some of the so-called tropical diseases are migrating further and further north,” explains Dr. Ursula Hollenstein, travel doctor and specialist in internal medicine. Dengue fever is indeed common worldwide. There are likely to be up to 390 million infections per year. While the initial infection is often mild, the risk of a severe course of a repeated infection is significantly increased and can even be fatal. 30 to 120 dengue virus infections are diagnosed in Austria every year - so far only in travelers returning from endemic areas. So there was no transmission in the country. However, smaller outbreaks have already been repeatedly observed in southern European countries, always starting from an infected returning traveler, but then with the infection spreading and spreading throughout the region.
A vaccine against dengue fever has now been approved and is also available in Austria. “No general vaccination recommendations have been published yet. Whether you should get vaccinated against dengue before traveling to an endemic area or not is best decided on the basis of individual advice,” advises Hollenstein. “The vaccination schedule with two vaccinations three months apart requires a lot of advance planning.”
The same mosquito that transmits dengue fever is also responsible for infections with the chikungunya virus. This virus has also been transmitted sporadically in Europe, but not in Austria. The main occurrence is currently in Brazil and India as well as in some Central and South American and Asian countries. “There was also a serious epidemic on some islands in the Indian Ocean some time ago,” reports the travel doctor. An illness can be very difficult for older or chronically ill people. What is particularly feared is the severe and often protracted joint pain and inflammation. A first vaccine has already been approved in the USA, and this may be the case in Europe next year.
Zika virus: Dangerous for pregnant women
The Zika virus, which is responsible for outbreaks in the Pacific and later in South America, also made headlines. Pregnant women and the unborn child are particularly at risk from this virus, which can lead to abnormal development and mental disabilities. It is transmitted by mosquitoes, but also through body fluids. “Since there is still no vaccine against it, other protective measures such as mosquito repellent and appropriate clothing are important in endemic areas,” emphasizes the tropical medicine specialist. “There is also comprehensive advice in travel medical centers.”
Japanese encephalitis: outbreak in Australia
Japanese encephalitis is known as a childhood disease in affected countries, primarily in South and Southeast Asia. The course of the disease in adults is less well described. However, the published case reports among tourists show serious symptoms and sequelae. Japanese encephalitis is related to TBE, which is well known to us, and also causes similar symptoms. Illnesses among travelers are rare. “But of course you have to monitor the situation,” emphasizes Hollenstein. In 2022, for example, there was an outbreak in Australia with several deaths. A vaccination against Japanese encephalitis is possible and can be carried out relatively quickly.
Yellow fever vaccination: A question of legal regulations
While many vaccinations are useful but not mandatory, the opposite is sometimes the case with those against yellow fever. It is generally required upon entry in some countries in West and Central Africa. In many other countries such a vaccination requirement only exists if you are traveling from a yellow fever country. This can sometimes be a problem on tours. Here you should inquire carefully. In any case, you should not expose yourself to the risk of becoming ill: In addition to almost symptomless infections, there are serious courses of the disease with bleeding and organ failure, which are fatal in over 50% of cases. Hollenstein explains: “According to WHO recommendations, one vaccination is sufficient, but the data on actual lifelong protection is not very robust, so a booster should be considered when traveling to a high-risk area if the first vaccination was more than ten years ago.”
Don't forget mosquito repellent
In countries with diseases that are transmitted by mosquitoes, mosquito repellent is also essential as a supplement to vaccination protection. It is broadly effective and can therefore reduce the risk of many diseases. There are several means to choose from. You shouldn't do without good sun protection and a travel first-aid kit tailored to your individual needs.
Get travel medical advice
Anyone planning a trip to a destination outside of Europe should seek travel medical advice in good time. Ideally no later than six weeks in advance. This is particularly important when basic immunizations – such as for hepatitis B – are missing. “In this context, the Austrian standard vaccinations can and should be brought up to date,” said Hollenstein. “Travel vaccinations with just one dose are currently best done as late as possible, i.e. around two to three weeks before departure, so as not to incur unnecessary costs in the event of a trip being cancelled. Vaccinations with multiple doses must be started earlier.”
