Zusammenfassung Der Ständige Ausschuss Reisemedizin (StAR) der Deutschen Gesellschaft für Tropenmedizin, Reisemedizin und Globale Gesundheit (DTG) gibt jährlich Empfehlungen zu Reiseimpfungen. Diese Empfehlungen werden von unabhängigen Experten erstellt. Sie umfassen international verpflichtende sowie länderspezifische und gefährdungsbasierte Impfstrategien. Sie dienen als Entscheidungshilfe für medizinisches Fachpersonal und berücksichtigen Empfehlungen u. a. der WHO, des ECDC, der STIKO und nationaler Gesundheitsbehörden.

Malaria remains a major infectious disease worldwide, with a particularly high incidence in sub-Saharan Africa. For travelers visiting endemic areas, awareness of the risk of infection and the rigorous application of appropriate preventive measures are essential to prevent this life-threatening disease. In Switzerland, a transparent methodology was developed in collaboration with other European countries classifying malaria risk areas based on current epidemiological data and presenting harmonized preventive measures in detailed maps. These maps support travel medicine experts as well as primary care physicians in providing consistent, evidence-based, and practice-oriented travel medicine advice. They are available on the Swiss reference website for travel medicine: www.healthytravel.ch.

Background: Chikungunya virus (CHIKV) infection is an emerging disease of growing concern to international travelers due to the expanding geographic distribution of competent vectors, climate change, and frequent outbreaks in endemic and previously unaffected regions. Until recently, prevention relied exclusively on vector control and bite prevention; however, the recent approval of chikungunya vaccines has introduced a new preventive strategy. Methods: We conducted a narrative review of currently licensed chikungunya vaccines and candidates in clinical development, focusing on immunogenicity, safety, regulatory status, and implications for travel medicine practice. Results: Two vaccines have recently received regulatory approval: the live-attenuated vaccine IXCHIQ® and the virus-like particle vaccine Vimkunya®. Both demonstrated high immunogenicity based on neutralizing antibody thresholds accepted as surrogate markers of protection. Post-marketing safety signals associated with IXCHIQ®, particularly in older adults, have led to divergent regulatory decisions between authorities. The indication of vaccination in national recommendations varies somewhat depending on age, duration of travel, and individual risk factors. Several additional vaccine platforms remain under investigation, although some candidates have been discontinued. Conclusions: The recent approval of chikungunya vaccines marks a significant milestone in the field of travel medicine. However, uncertainties regarding long-term protection, safety in specific populations, and optimal targeting of travelers remain. Individualized risk–benefit assessment is essential, and further data are needed to refine vaccination strategies for travelers and populations at risk.

The recommendations of the Standing Committee on Travel Medicine (StAR) of the German Society for Tropical Medicine, Travel Medicine and Global Health (DTG) provide an evidence-based foundation for travel medicine counseling. These guidelines are based on scientific evidence, clinical expertise, and current epidemiological data. They include detailed, country-specific risk maps developed in collaboration with expert groups from Switzerland, Belgium, the Netherlands, and Austria. Malaria prevention is structured around 3 key pillars: exposure prophylaxis (avoidance of mosquito bites), chemoprophylaxis with antimalarial drugs, and standby emergency treatment (SBET). The selection of appropriate preventive measures requires individualized risk assessment. Avoiding mosquito bites remains essential - even when chemoprophylaxis is used. DEET is considered the gold standard among insect repellents; other options are recommended depending on the traveler's age and individual tolerability. Atovaquone/proguanil, doxycycline (off-label), and mefloquine remain the core pharmacological options for chemoprophylaxis, and their use must be tailored to the destination, type of travel, and the traveler's age and health status. Artemisinin-based combination therapies (e. g., artemether/lumefantrine) are approved for treatment only and not for prophylactic use. Standby emergency treatment may be recommended for travel to areas with moderate malaria risk and limited access to medical care. Country-specific recommendations and maps support differentiated risk assessment. The guidelines also provide specific recommendations for children, pregnant women, immunocompromised patients, and travelers with comorbidities. Particular attention is given to high-risk groups such as migrants from malaria-endemic regions, long-term travelers, expatriates, and participants in international volunteer programs. These recommendations serve as a practical guide for medical professionals involved in travel medicine counseling.

Key words travel medicine - malaria - repellents - chemoprophylaxis - pediatric travelers - pregnant travelers

The expert committees for travel medicine of Belgium, Germany, The Netherlands and Switzerland endorse joint malaria prevention recommendations for travellers. Here, the methodological approach underlying these recommendations, including evidence sources used, risk category definitions and the role of expert opinion, is outlined.

Background: Travellers frequently visit popular destinations like Brazil, India, Peru, Thailand, and Tanzania, each presenting varying malaria risks. The extent to which Travellers enter high-risk malaria-endemic areas in destinations with heterogeneous malaria risk remains unclear. We used geo-location via smartphone application to(i) describe where Travellers go within countries with heterogeneous malaria risk (Brazil, India, Peru, Thailand), and (ii) compare mosquito bite prevention behaviours between these destinations and Tanzania, considered entirely high-risk for malaria. Methods: This analysis is a sub-study of the TOURIST2 cohort, which prospectively recruited1,000 travellers (>= 18 years,travelling <= 4 weeks)from Swiss travel clinics (Zurich and Basel)between09/2017-04/2019. We included734travellers to Brazil, India, Peru, Thailand, and Tanzania who provided geo-location data. Daily health and geo-location data were collected using a smartphone application. Malaria risk was categorised using2022 malaria maps from the Swiss Expert Committee for Travel Medicine. Results: Of the734 travellers, 525 travelled to Brazil, India, Peru, and Thailand, and 225 to Tanzania. InBrazil, India, Peru, and Thailand, only 2% (n=13) visited high-risk malaria areas. In Peru, 4% (n=4)visited a high-risk area; in Brazil, 3% (n=6); in Thailand, 2%when crossing the border into Myanmar(n=3); and in India, 0%. Travellers to high-risk areas were more often male (62%), slightly older (median age 42.0), and planned longer trips (median 23.0 days) than other travellers. No participants were diagnosed with malaria. Travellers to Brazil, India, Peru and Thailand used mosquito bite prevention measureless frequently than Travellers to Tanzania. Those in Tanzania had higher, but still suboptimal, use of insect spray (65% of travel-days). Conclusions: Travellers to Brazil, India, Peru, and Thailand rarely visited high-risk malaria areas, and their adherence to mosquito bite prevention measures was generally low. In Tanzania, adherence was higher but still suboptimal.

Key words travel medicine - travel vaccines - immunocompromised travelers - paediatric travelers - pregnant travelers

This paper discusses challenges in formulating and harmonizing malaria prevention recommendations for travellers. It explores diverse approaches used by advisory groups to assess malaria risk and shares insights from the 2023 International Expert Committee for Travel Medicine meeting. It also explores future prospects for enhancing malaria prevention recommendations for travellers.

Dengue fever, endemic to most tropical and subtropical countries, is a major cause of illness in travellers, but severe dengue, hospitalisation and death are considered rare in this population. Two vaccines against dengue fever, Dengvaxia® and Qdenga®, are available. While there is no recommendation for the use of Dengvaxia® in travellers, Qdenga® has been licensed for travellers in many European countries since December 2022, most recently (29 July 2024) in Switzerland by Swissmedic. The Swiss Expert Committee for Travel Medicine (ECTM), having assessed available data on the Qdenga® vaccine, issues the following recommendations: (1) Vaccination against dengue fever virus with Qdenga® is not recommended for persons with no previous dengue fever infection. (2) Vaccination with Qdenga® may be recommended for travellers aged 6 years and older who have evidence of previous dengue infection, defined as (a) a laboratory-confirmed dengue infection (PCR, antigen or seroconversion) or (b) a compatible history of dengue infection with a positive IgG serological test AND expected exposure to a region with significant dengue transmission. Travel medicine advisors should provide clear information in accessible language on the complexity of dengue vaccines and the risk/benefit evaluation for their use in travellers.

Gegenwartig werden vielfach die Regelungen zur Eindammung der SARS-CoV-2-Pandemie wieder zuruckgenommen, auch mit dem Wunsch, Urlaubsreisen als Wirtschaftsfaktor wiederzubeleben. Dabei werden Kreuzfahrten besonders kritisch beurteilt, was die Gefahrdung von Passagieren und Crew durch COVID-19 angeht. Das liegt zum einen an der relativen Enge der Unterbringung und Versorgung an Bord, zum anderen an dem unglucklichen Beispiel der Diamond Princess", der ab 03.02.2020 in Yokohama/Japan trotz COVID-19-Fallen an Bord keine Evakuierung samtlicher Passagiere gestattet wurde .

The Swiss Expert Committee on Travel Medicine (ECTM) - a body of the Swiss Society of Tropical Medicine and Travel Medicine (FMH) - publishes recommendations and information on travel medicine on the website www.healthytravel.ch in four languages (German, French, Italian, English). HealthyTravel.ch, which has replaced Safetravel.ch, is the reference website for travelers' health advice in Switzerland supported by the Federal Office of Public Health (FOPH). It consists of a free version with basic travel medicine recommendations for the public, and a fee-based PRO version for professionals, containing more detailed information and recommendations. This article provides an overview of the available content and tips on how to make the best use of www.healthytravel.ch.

The Swiss Expert Committee on Travel Medicine (ECTM) - a body of the Swiss Society of Tropical Medicine and Travel Medicine (FMH) - publishes recommendations and information on travel medicine on the website www.healthytravel.ch in four languages (German, French, Italian, English). HealthyTravel.ch, which has replaced Safetravel.ch, is the reference website for travelers' health advice in Switzerland supported by the Federal Office of Public Health (FOPH). It consists of a free version with basic travel medicine recommendations for the public, and a fee-based PRO version for professionals, containing more detailed information and recommendations. This article provides an overview of the available content and tips on how to make the best use of www.healthytravel.ch.

The Swiss Expert Committee on Travel Medicine (ECTM) - a body of the Swiss Society of Tropical Medicine and Travel Medicine (FMH) - publishes recommendations and information on travel medicine on the website www.healthytravel.ch in four languages (German, French, Italian, English). HealthyTravel.ch, which has replaced Safetravel.ch, is the reference website for travelers' health advice in Switzerland supported by the Federal Office of Public Health (FOPH). It consists of a free version with basic travel medicine recommendations for the public, and a fee-based PRO version for professionals, containing more detailed information and recommendations. This article provides an overview of the available content and tips on how to make the best use of www.healthytravel.ch.Le Comité suisse d’experts en médecine des voyages (CFMV), un organe de la Société suisse de médecine tropicale et de médecine des voyages (FMH), publie sur le site internet www.healthytravel.ch des recommandations et des informations sur la médecine des voyages en quatre langues (allemand, français, italien et anglais). HealthyTravel.ch, qui a remplacé le site Safetravel.ch, est le site internet de référence pour les conseils de santé aux voyageurs soutenu par l’Office fédéral de la santé publique (OFSP). Il est composé d’une version gratuite, avec des recommandations de base en matière de médecine des voyages pour le public, et d’une version PRO, payante, pour les professionnels, contenant des informations et des recommandations plus détaillées. Cet article donne un aperçu des contenus disponibles et des conseils d’utilisation optimale du site www.healthytravel.ch.

Vaccinations are an integral part of pre-travel care. Gaps in routine vaccination should be closed. In particular, measles and influenza are important in the context of travel medicine. Vaccinations against yellow fever and meningococcal disease may be required for international travel. This article provides information on these and other travel vaccinations against hepatitis A, typhoid fever, rabies, Japanese encephalitis and cholera. Yellow fever endemic areas are located in Africa and in South America; there is no yellow fever in Asia. The meningococcal vaccine (A, C, W, Y) is required for pilgrims to Saudi Arabia. Additionally, it is recommended for travellers visiting the African "meningitis belt" during the dry season. A polio booster is required for countries with endemic wild-type polio virus (WPV) or circulating vaccine derived poliovirus (cVDPV). Hepatitis A is a common vaccine-preventable infection in travellers. The hepatitis A vaccination should therefore be recommended to all travellers going to endemic areas. South Asia is the most important region where travel-associated typhoid fever is acquired and where at the same time antimicrobial resistance is emerging. Two different vaccines against typhoid fever are available in Germany. The vaccine efficacy is 50-70% for both vaccines. Contacts with potentially rabid animals are a common travel-related problem. At the same time, vaccines for state of the art postexposure care are not provided in many countries. According to recent WHO recommendations, two vaccinations are sufficient for pre-travel priming against rabies. Japanese encephalitis is rare in travellers. Vaccination should be offered in case of travel to rural and peri-urban areas. Cholera is extremely rare in travellers going to endemic areas. Cholera vaccination is therefore usually not indicated in the context of travel medicine.