In an increasingly interconnected world, the risks posed by infectious diseases to international travellers have grown more complex. As global mobility resumes in the wake of the pandemic, new health concerns are emerging, such as the spread of the mpox virus, a potentially lethal disease formerly known as monkeypox. Coupled with longstanding threats like malaria, travellers face renewed focus on vaccines, health precautions, and informed decision-making.
Mpox Spreading by Global Travellers
Originally confined to regions in Africa, mpox has recently seen a more aggressive resurgence in other parts of the world. In August, Sweden confirmed the first case of a more severe strain of mpox—clade Ib—outside of the African continent. Soon after, cases began emerging in Asia, with Thailand confirming its first case and suspected cases being investigated in Pakistan and the Philippines.
The World Health Organization (WHO) has escalated the situation, declaring the mpox outbreak in several African nations a “public health emergency of international concern.” The virus, which once killed one in 10 infected individuals, now has a fatality rate of up to 3.3%, according to recent data.
The United States has taken steps to combat the virus, with the Centers for Disease Control and Prevention (CDC) recommending two doses of the Jynneos mpox vaccine for high-risk groups. As international cases rise, the need for awareness and preventative measures becomes more urgent.
The Return of Dengue
While mpox captures global headlines, another mosquito-borne virus—dengue—is also spreading rapidly. Until recently, there was no widely available vaccine for travelers. However, recent developments have brought the Qdenga vaccine to Europe and beyond, and Dengvaxia is available in the United States.
Yet Dr. Nicky Longley, a consultant in infectious diseases and travel medicine at University College London Hospitals, advises caution. “The Qdenga vaccine reduces the risk of getting severely ill and dying if you catch dengue a second time,” says Longley, “but if you haven’t had dengue before, it offers almost no protection.”
One traveller, UK-based writer Chris Dwyer, contracted dengue while visiting Malaysia in 2014. He recalls how the illness left him with joint pain, fever, and a temperature that worsened until he required hospitalisation. His experience was harrowing, and knowing that subsequent dengue infections pose even greater risks, he now considers getting vaccinated.
“I am seriously considering getting jabbed with Qdenga now, as I’m frequently in Asia and know how dangerous it would be to get sick again,” Dwyer said.
Malaria’s New Frontier
Recent developments in malaria vaccines offer a glimmer of hope, especially in Africa, where the disease claims hundreds of thousands of lives each year. Babies in South Sudan and the Ivory Coast were among the first to receive the new vaccine, marking a significant step toward controlling the disease in the region.
Yet, for travellers, the situation is not as optimistic. “It’s just not a suitable vaccine for travellers because you need constant boosters and exposure, and it doesn’t offer full protection,” Longley explains. The vaccine is designed to reduce deaths in African children rather than prevent the disease outright for global visitors.
Anniina Sandberg, a Finnish travel expert who has explored remote African regions for decades, shared her near-death experience with malaria during a trip to Tanzania. After months of taking antimalarial drugs, she stopped, naively believing the locals’ regular recovery from malaria made the disease seem like “just a bout of flu.” Soon after, she became severely ill, contracting not only malaria but also typhoid fever, which she described as a cautionary tale for anyone traveling to malaria-prone areas.
“You can be super cautious, but you can never eliminate every health risk when traveling, in any destination,” Sandberg warned. Her experience underscores the importance of taking preventative measures, including antimalarial medication, while in high-risk regions.
The Hidden Dangers of Rabies
Rabies is another threat that travellers may underestimate. Although the disease is relatively rare in many parts of the world, it is still present in over 150 countries. Sandberg had a close encounter with a potentially rabid sheep while in Tanzania, narrowly avoiding infection after receiving post-exposure rabies shots in her native Finland.
Longley emphasises the importance of rabies vaccination for travellers: “If you haven’t had the vaccine before, we normally say you should start treatment within a week, but obviously, the sooner, the better.” With rabies fatal, once symptoms appear, the race against time for effective post-exposure treatment is critical.
The Future for International Travellers
As global health threats evolve, so too must travelers’ strategies for protecting themselves. Experts advise vaccinations, insect repellent, and proper planning before heading to potentially dangerous regions. “The advice is often more important than the vaccine you think you want,” Longley stresses, emphasising the need for informed decisions ahead of any trip.
Travellers must remain vigilant whether it is the resurgence of pox, the ongoing challenge of dengue and malaria, or lesser-known risks like rabies and tick-borne encephalitis. With the right precautions and awareness, they can enjoy their adventures safely, even in the most remote corners of the globe.
