R21/Matrix-M. It is the new pediatric malaria vaccine unveiled on Oct. 2, 2023, by the World Health Organization (WHO) and licensed for malaria control in children aged 6 months/5 years.

Malaria is on the rise everywhere in the tropic in the post Covid years. Cases are increasing but child mortality from malaria is also increasing again, particularly in the Sub Sahel area of Africa. About 20 years ago, awareness began in many African countries of the use of permethrin-treated mosquito nets to prevent mosquitoes from biting children and adults at night, during sleep. And the effectiveness of this simple tool was not long in manifesting itself with an excellent decrease in cases.

Today, in the era of new vaccines, the prospects of fighting the disease are changing, although there is still a long way to go.

Two years ago a first malaria vaccine, the RTS-S (Mosquirix) vaccine was approved and put on the market starting in Ghana. In two years, this new vaccine, which should be considered a true lifesaver, has demonstrated more than 75 percent efficacy. Early data on the vaccine’s use show that the long-standing fight against malaria has taken a big step forward. It is noteworthy that the vaccine is made and marketed for the pediatric population between the ages of 6 months and 5 years. A vaccine designed to significantly affect infant mortality.

This pediatric vaccine has been produced by GlaxoSmithKline Biologicals since 2021, the year of commercialization, and has been used specifically in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique, and Tanzania. By 2025, the pharmaceutical company plans to produce and deliver 18 million doses destined for 12 African countries.

The sentence spoken by WHO Director-General Tedros Adhanom Ghebreyesus highlights the level of achievement in prevention that we have reached: “As a malaria researcher, I dreamed of the day when we would have a safe and effective vaccine against malaria. Now we have two.”

It should be noted that since the first RTS-S vaccine was put on the market, requests to obtain vaccine doses have far exceeded the supply of the manufacturer. The advent of a second vaccine is intended to cover the undoubtedly huge demand coming from most countries in the tropical region.

The R21/Matrix-M will be produced by the Indian pharmaceutical company “Serum Institute of India,” which is the largest vaccine producer in the world. The production capacity of the new vaccine will be 100 million doses per year, which in the next two years apparently will be increased to 200 million doses per year.

The two recent malaria vaccines both target the pediatric population and have demonstrated the safety and efficacy necessary for widespread vaccination practice.

The new R21/Matrix-M vaccine has been shown in tests to be more than 75 percent effective, when administered just before the wet and rainy season. Three doses are to be administered to achieve maximum coverage and reduction in infant mortality. The price set for the R21 /Matrix-M vaccine is between two and four U.S. dollars per dose.

 

Map of malaria in the world (Courtesy WHO-WHO)

These are the numbers of malaria in the world before Covid-19.

In the post-Covid era these numbers have undergone a major increase:

– 229 million estimated malaria cases globally;
– 87 countries where the disease is endemic;
– Over 400,000 deaths from malaria;
– 274,000 children under the age of 5 who died from malaria 67 percent of the total;
– 215 million (94 percent) children affected by malaria on a global basis;
– 95% of deaths occurred in 29 African countries.
– 6 African states had more than 50 percent of malaria deaths.
– Nigeria 23%;
– Congo-K (DRC) 11 percent;
– Tanzania 5%;
– Mozambique 4%;
– Niger 4%;
– Burkina Faso 4%.

The summer heat in our country continues. This long summer just doesn’t seem to want to give way to autumn. But the arrival of respiratory viruses, including the famous “flu paramyxovirus,” will not be delayed by this weather.

The first cases of influenza have already been reported in northern Italy, and even in Europe the virus has been arriving for a few weeks, still manifesting itself in sporadic cases. Once again this year, respiratory diseases will characterize the autumn-winter period. Indeed, it is better to identify the period at risk of virosis between the months of October 2023 and April 2024, since talking about seasons is increasingly relative, alas!

A bad climate situation that also undermines our responsiveness to infection. We need to be aware that these climatic alterations will increasingly affect our state of response to disease. And we have already seen the first signs of this all over the world.

With seasonal flu, virologists have identified the arrival of 262 different types of respiratory viruses. And let’s not forget Covid-19, always present and also on the rise. Covid which, however, with its variants, has learned to live with our bodies and defenses, thanks to past vaccination campaigns.

There are issues related to co-infections with other viruses. The issue of vaccinations becomes a priority in order to control the development of the disease.; who should and how to do them; and again all the issues related to respiratory syndromes, with an ever watchful eye on the Covid-19 situation.

National and international reports confirm that we are in the presence of an increasing circulation of Covid-19 worldwide, with its newer and also newer variants. These cases have also spread to Italy and have increased with the start of post-summer production and commercial activities and the opening of schools.

The attention of all of us, insiders, is also caught by an early onset of cases of the new flu, which will grow between October and November and then peak between December and February 2024. During this period, the real problem will be cases of co-infection between the two viruses in older, weaker individuals with debilitating diseases.

Since the Sars-CoV-2 virus appeared, we have realized how aggressively influenza/Covid co-infections occur and put the previously mentioned population groups at risk. Influenza illness becomes more severe with the presence of a Covid that becomes even more aggressive. These population groups should follow the advice to have both vaccinations. We will discuss this in detail in another article, but in the meantime we can say that in the same session it is possible to get the flu vaccine and the Covid vaccine inoculated. And now let us begin to delve into the topic regarding influenza in its characterizing aspects.

Influenza is a respiratory, infectious, acute disease caused by a virus of the Orthomyxovirus family (influenza viruses) that infects the superficial cells of the mucosa of the upper airways of our body, i.e., the nose, pharynx, and larynx (throat) causing a major inflammatory reaction that is often painful.

The infection can involve the mucosa of the trachea even going so far as to infect the mucosa of the lower airways involving the bronchi, and even the cells of the pulmonary alveoli (a story known to all by Covid).

This virus aggression triggers a reaction of local immune cells, under the superficial mucosa of the respiratory tract, which triggers the activation of the inflammatory system. This process aims to defend the respiratory mucous membranes and the whole organism from virus attack.

The result is an increasing inflammation, fever elevation, dilation of local vessels with edema and swelling. This reaction of our body aims to defend ourselves but the result is the appearance of symptoms that grow by the hour. We are in the midst of flu symptoms. But also of other less aggressive viruses.

By now we know this defensive (but also offensive) mechanism that also characterizes the response to Coronavirus, see responses to Covid-19, and many other microorganisms. Typical flu symptoms thus result from the body’s inflammatory response to the virus, and this causes the malaise and the great state of prostration. Many viruses and bacteria generate this type of response, which is labeled “flu,” but which, in most cases does not stem from the “flu virus sensu strictu.”

More than 200 flu-like viruses have been surveyed that attack our respiratory system and beyond and manifest themselves with more limited symptoms creating reduced health problems compared to those caused by the “real flu virus.”

From this we can understand why almost always those who have taken the flu vaccine still get sick.With the flu vaccine we protect ourselves from the more aggressive seasonal virus. So-called winter “flu” is in most cases caused by all the other viruses with which, in winter, we come in contact.

We protect ourselves against the most aggressive virus, the Orthomyxovirus seasonal flu virus.In fact, when the influenza virus circulates, many other viruses and bacteria that cause symptoms quite similar to those caused by influenza, but less severe and less widespread, circulate simultaneously in Italy during the autumn-winter period. Among the most frequent viruses are Adenoviruses, Rhinoviruses, Coronaviruses and also the respiratory syncytial virus, which is particularly aggressive in children.

Influenza disease is caused by 3 types of viruses in the Orthomyxoviridae family :
type 1 ” Influenzavirus A.”
type 2 ” Influenzavirus B”;
type 3 ” Influenzavirus C”.

Influenza A and C viruses have the characteristic of infecting different animal species, including humans, and can be transmitted between species.
Influenza B viruses infect humans practically exclusively.

Influenza viruses of types A and B have 2 molecules (glycoproteins) in their surface that characterize them and mutate continuously (the famous annual mutations for which the vaccine constantly changes).

These are the glycoproteins present in the outer part of the virus:

– Hemagglutinin molecule labeled H and constitutes the viral portion that binds to respiratory mucosal cells.
– Neuraminidase molecule marked with the letter N and has the function of facilitating the escape of the virus from cells once it has replicated.

Hemagglutinins (H) and neuraminidases (N) are glycoproteins with antigenic characteristics, i.e., molecules recognized by the cells of the immune system that activate the body’s defense functions. Influenza viruses are recognized by our defense system through these molecules present on the surface of influenza viruses.

Hemagglutinin, which is found in the outer capsule of the virus, acts as a key to enter respiratory cells.In fact, the virus’ hemagglutinin binds to the surface of the respiratory mucosal cell and allows viral DNA to enter the cell itself.Within the respiratory cell, the virus reproduces in millions of copies (daughter viruses).

Neuraminidase, on the other hand, comes into play when the influenza virus, which has reproduced thousands and thousands of times, has to leave the infected cell to infect new ones and begin a new reproductive cycle. And the infection spreads into the respiratory mucosa. The neuraminidase is a molecule that is responsible for releasing the virus from the surface of the cell itself, to which it is attached, so that it can be released and get it out of the cell, infect other respiratory cells, and allow the virus to reproduce, which grows exponentially. In this way, the symptoms also grow exponentially.This is the mechanism, expressed in a simplified way, of how the virus acts inside us.

Influenza is a disease characterized by a series of symptoms resulting from the body’s response to the invasion and reproduction of the virus within our respiratory cells.The reaction of the immune defense system causes the sudden onset of fever, even high fever, accompanied by coughing, muscle aches.A particularly uncomfortable headache also characterizes the growth of symptoms.These are accompanied by chills, poor appetite, great feeling of fatigue, and inflammation and soreness of the upper airway.

Nausea, vomiting, and diarrhea also characterize the flu particularly in children.Symptoms generally wear off within a week, or ten days, the response time for the immune system to neutralize the virus and its reproduction.But in the over-65s, young children, particularly under one year of age, and those with chronic illnesses, symptoms can be more severe, persistent, with greater risk of more serious complications or worsening of the underlying condition.

Influenza is transmitted by air, through the droplets of our saliva. So in outdoor environments, even more so those that are closed and poorly ventilated. It can be direct transmission through coughing, sneezing, or very close contacts of people who have the virus. Or indirect transmission by contaminating oneself with the virus present on objects or surfaces contaminated with it.

To decrease the risk of infection, it is best to (1) avoid crowded and unventilated places; (2) wash hands with soap and water to avoid contamination by virus spread on surfaces of all kinds, better soap than disinfectants such as alcohol-based cleaners or disinfectant wipes that ruin the defensive bacterial flora on our skin; (3) do not touch your eyes, nose and mouth with your own contaminated hands; if you cough or sneeze, cover your nose or mouth with a paper towel; (4) it is most important to keep rooms ventilated and sunny if possible.

If you want to avoid spreading the virus to other people, and especially to the elderly and frail, use a face mask in case of flu symptoms.

The incubation period of seasonal flu is usually 4 to 5 days. Generally, adult people begin to spread viruses from one two days before the onset of symptoms, and this spreading ability remains until 5 days after the onset of symptoms. In children and people who are more frail and have underactive immune systems, the infection may last longer, up to 8 to 10 days.

The new dengue vaccine (QDENGA) offered to tourists from all over the world who come to Rome.
Dengue viral fever is increasing exponentially in many Asian and Latin American countries.
Millions of tourists from all over the world come to Rome throughout the year. Many tourists come from countries where dengue is endemic and creates major health problems. In many of these countries, the vaccine for Dengue (QDENGA- for the 4 types of the virus) is not yet on the market. Dr. Paolo Meo, director of the Cesmet Traveller’s Clinic, suggests that travellers staying in Rome for a few hours or a few days book an informative interview and vaccination at the Cesmet Vaccination Centre. Cesmet can also vaccinate non-Italian citizens. It is possible to book the vaccination by agreeing on the day and time according to the availability of the person and the centre.
When you book your trip to Italy and know the date of your stay in Rome, take the opportunity to book the day and time of the vaccination. Take advantage of this opportunity: enjoy Rome and dedicate 10 minutes of your time to get a vaccine considered life-saving against Dengue in your country. Our experience is that there are no side effects to the Dengue vaccine.
Click here for information about the vaccine and costs, or send a message (WhatsApp or SMS) to +393466000899.

Info from the desk of
Dr. Paolo Meo
Infectious diseases physician
Director of Cesmet in Rome

Brief advice for travelers in the country  

What should I do when I go to Indonesia?

Indonesia is the land of fantasy and adventures. The only nation in the world with approximately 17,500 islands , of which more than 15,000 are uninhabited. The islands of this immense archipelago are a treasure chest of wonders, of nature, of animals and plants, of stories of pirates and conquerors. Adventures to be experienced during your trip. Enjoy your stay until the end while protecting your health. Follow the advice, prepare your trip and travel with peace of mind.

            

In Indonesia, infectious diseases caused by viruses, bacteria and parasites are mainly transmitted by the bites of mosquitoes and small insects. Dengue virus disease, malaria, other diseases increase during the rainy season. Even small outbreaks of Japanese encephalitis virus increase during periods of high humidity. The use of effective, natural repellents is essential as the first level of protection. (Nozeta/Neem is a great product). Many tour planners or do-it-yourself tourists and travelers, with the habit of adventure, are convinced that Indonesia is free from any form of ailment. It is not so! Intestinal forms, with even severe diarrhea, malaria and other diseases are present in many islands;both in inland villages and towns and in forested territories; marshy and humid areas are the most dangerous. Arboviruses (Dengue, Chikungunja, Zika) are transmitted from human to human through the bite of tiger (Ades) mosquitoes. In many islands, even the main ones, especially during the rainy season, ancient outbreaks of cholera also resurface in the suburbs of large cities. Correct information, good preventive preparation before the trip, and shrewd behavior allow us to fully enjoy this trip.
Feel free to ask for advice to get to know problems and solutions well

– Dr. Paolo Meo, tropical infectious disease doctor

Health alerts

FEBRUARY 2023: MEASLES spreads in many regions

During the year 2022, the number of measles cases in much of Indonesia has grown exponentially. More than 3,341 widespread cases were reported in 223 regencies/cities in 31 provinces. And the trend in the first quarter of 2023 is growing. Compared to 2021 there was a significant increase of about 32 times. The reason is that for 2 consecutive years Indonesia has not been able to meet the target for routine immunization services. So many children have not been regularly immunized due to COVID-19.
The situation in Indonesia in the last 2 to almost 3 years since the impact of the COVID-19 pandemic has had negative consequences for vaccination coverage. In recent months, the government has been stepping up surveillance on measles and rubella.
TheMeasles is an acute infectious disease whose complications can usually be serious. If measles affects a malnourished child, this child can be immediately accompanied by complications such as severe diarrhea, pneumonia, inflammation of the brain, infection of the lining of the eye which can lead to blindness. Measles is caused by the measles virus and is transmitted by droplets, splashes of saliva when coughing, sneezing, speaking or through nasal secretions. And measles is a very contagious disease.
Before traveling to the islands of the country, travelers should check their immunity situation and in the uncertainty think about carrying out a dose of the vaccine.

 

MARCH 2023: EST JAVA cases of leptospirosis on the rise

East Java Governor Khofifah Indar Parawansa said that an outbreak of leptospirosis, or a disease caused by rat urine, has been detected in several areas of East Java. For this reason, Khofifah asked residents to increase vigilance and continue to improve their clean and healthy lifestyle during the rainy season, trying not to urinate outdoors.

Based on data from the East Java Provincial Health Office, there were 606 cases of leptospirosis in 2022. This year, as of March 5, 2023, 249 cases with 9 deaths have been recorded. Of the 249 total cases, the majority occurred in Pacitan, i.e. 204 cases with 6 deaths. Furthermore, 3 cases and 2 deaths occurred in Probolinggo Regency, 3 cases in Gresik, 8 cases in Lumajang, 5 cases and 1 death in Probolinggo City, 22 cases in Sampang and 4 cases in Tulungagung.
Leptospirosis is caused by the bacteria Leptospira hicterohaemorragica.

The disease spreads through the urine of animals infected with leptospira bacteria and contaminates the environment, especially in environments where there is standing water and contact with injured skin can cause contamination. “Animals infected with this bacterium do not die, but in humans it can cause death,” explained the governor. The disease also spreads through water or soil that has been contaminated with the urine of infected animals. Animals that carry the _Leptospira_ bacteria include rats, cows, pigs, and other animals, but rats are the primary source.

MARCH 2023: CHIKUNGUNYA

Cases of chikungunya virus haemorrhagic fever, a particularly acute disease due to an often abnormal inflammatory reaction, were reported as early as February 2022 in various islands, but in particular in Sumatra, the southern archipelago and the island of Bali. Epidemic outbreaks flared up in many of the Indonesian islands after the last rainy season of 2023. Primary prevention consists of protection from mosquito bites.

FEBRUARY 2023: MALARIA

Rising temperatures and humidity lead to an increase in the spread of different types of mosquitoes (Aedes and Anopheles), with the spread of viral and parasitic diseases. This is what has occurred in an anomalous way, with the increase in cases of malaria, even fatal ones, in areas of the country at an altitude of over 1800 metres. In the internal areas of the islands of Sumatra, Java, part of Borneo and in territories of Western Guinea the presence of anopheles mosquitoes increased during the rainy season and cases were recorded in the areas described and also in many of the islands of the archipelago . This confirms the need for correct and updated information on the real epidemiological situations in the country, in order to implement the best preventive protocol and the most adequate prophylaxis.

Protection from mosquito bites is necessary and it is important to consider the use of pharmacological prophylaxis.

 

Climate, weather, health and environment

Current weather situation

Click here for the weather situation and the forecast soon:       Meteo Forecast 

What are the different seasons in the country and how are they characterized and how does the climate influence the spread of diseases?

Located on the equator, Indonesia has a warm humid climate with average temperatures of around 28°C all year round. There are two distinct seasons:
the dry season which runs from April to October
and the monsoon season which runs from November to March with rains prevailing in January and February. The different altitudes and the enormous extension of the archipelago greatly influence the characteristics of the climate: above 1000 m the temperature is never very high and it is cold at night. In general, the climate tends to be hotter and more humid during the day and more temperate at night.

weather and seasonal characteristics in Bali

Bali has a tropical climate with temperatures that remain high and constant throughout the year, with an average temperature of 30°C in July and August, and 34°C in March and April [3]. Bali experiences a rainy season from November to March, with occasional rain during the dry season from April to October [1]. Bali’s seas are warm and suitable for swimming all year round, with average temperatures ranging from 27 to 29 degrees Celsius [1]. Bali receives an average of 1,700mm of rainfall annually, with the southern region being the least rainy and the inland and northern regions most prone to heavy rainfall [1]. The best time to visit Bali is during the dry season from April to September, with July and August being the driest months [2]. Visitors should bring light, natural fiber clothing, a hat, a light jacket,

References: [1] Bali climate: temperature, rainfall, when to go [2] Bali, when to go: the best time to visit the … [3] The best time for a trip to Bali

weather and seasonal features in jakarta

Jakarta has a tropical monsoon climate with two distinct seasons based on rainfall patterns [1][3]. The dry season runs from June to September and is ideal for outdoor activities with mostly sunny days and moderate humidity [1]. On the other hand, the rainy season runs from January to April and can cause inconvenience with heavy rains and high humidity [1][3]. January is the wettest month with 300 mm of rainfall, while August is the driest with only 43 mm [3]. The best time to visit Jakarta is during the dry season when temperatures remain high but with lower humidity and no significant rainfall [1]. October to December also offers milder weather with occasional light rain. However, December to March should be avoided due to heavy rains [3]. Visitors should pay attention to temperature fluctuations between indoor and outdoor locations, especially during the dry season [1]. Average temperatures range from a minimum of 22°C to a maximum of 31°C [1].

References: [1] When to go to Jakarta: climate, temperatures and seasons [2] Indonesia climate: temperatures, rainfall, sunshine [3] Jakarta climate: when to go to Jakarta (Jakarta)

What consequences does climate change have on the seasons and the climate?

Some examples:
There would be at least 115 small islands in the large Indonesian archipelago that will probably be under water in the future, or nearly so. It is the rise in sea level that causes the phenomenon, a rise caused by ongoing climate change.

Northern coast of the island of Java at risk
Several institutes, including the National Agency for Research and Innovation (BRIN) of Indonesia, calculate that a rise of one meter in sea level will be enough to cause permanent flooding of the northern coast of the island of Java. We are talking about one of the places with the highest population density in the world.
Already today, the rising sea has caused the sinking of several parts of small islands. Scientists believe that as the sea rises, there will be bigger waves that will only “reshape” the coasts. The terrestrial sediments of the same coasts will then fall into the sea causing floods in other areas.

Indonesian islands seeing the fastest sea level rise:
– Rondo Island, located in the Strait of Malacca, lost 1856 m² of land every year from 1993 to 2009. The rate of sea level rise in this area of the sea has been 1.3 mm per year in recent years.
– In the island of Berhala , in the central part of the same Strait of Malacca, a rate of rise of 3.46 mm per year has been recorded;
– On Nipah Island, near Singapore, there was a rate of rise of 3.48 mm per year.
These two islands lost respectively 3178 m² and 3409 m² of coastline per year from 1993 to 2009.

Taking into consideration just five small remote islands of Indonesia, the scientists calculate that, in just 10 years, there has been a reduction of the land area of ​​0.005 square kilometers to 0.09 square kilometers, an area comparable to that of 13 football fields . These are calculations also made using satellite images. Scientists explain that the damage to the climate is now irreversible and that sea level will in any case rise by a range that should go from 0.6m to 1.1m by 2100.
This does not mean that we should keep our hands on it. hand: mitigation efforts can be made. For example, various trees, including maritime pine, can be planted on islands with sandy structures, to reduce erosion and improve soil compaction.

What are the characteristics of the environment of the destination areas of your trip?

Read and learn more about the different environments and choose how to organize your stay according to your interests:

Indonesia is an archipelago located off the coast of Southeast Asia, extending 5100 km from east to west and 1800 km from north to south, with approximately 17,500 islands , of which over 15,000 are uninhabited [1]. The major islands are characterized by volcanic mountains covered with dense forests , sloping down to coastal plains covered with marshy marshes which, in turn, give way to shallow seas and coral reefs. The country borders Malaysia in northern Borneo and Papua New Guinea in central New Guinea. The country is prone to natural disasters due to its location at the intersection of the Pacific and Eurasian tectonic plates [2]. Indonesia has a tropical or equatorial climate, characterized by a wet season (October to April) followed by a dry season (May to September). The humidity rate can reach 80% in some periods and the temperature fluctuates between 26 and 30 degrees Celsius throughout the year [2]. Indonesia has an uneven population distribution: some areas are overpopulated, such as Java and Bali, while others are virtually uninhabited due to environmental factors such as malaria [3].

List of the most important islands with their characteristics   Sumatra: the island of gold and silver mines present in the territory in large quantities. Famous for earthy food and coffee.      Java: The main rice-exporting island of the archipelago.      Jakarta.      Borneo Famous for over 360 cultivated spices. Rich in flora, fauna and the wildest animals!      Sulawesi Known for the art of building boats of centuries-old tradition; famous for its seafaring life;      Western New Guinea The island of beautiful scenery, adventurous activities like caving and cliff jumping
   

What diseases can I find in Indonesia? What are the real risks

What diseases are present and what are the preventive practices and vaccinations to do?

JAVA

In Indonesia, travelers may risk catching various infectious diseases such as dengue fever, typhoid fever, hepatitis A and B, Japanese encephalitis and rabies, which are endemic to the country [2]. Malaria is also present in some areas throughout the year, with the highest risk in Sumba and Papua [2]. In addition, Indonesia is prone to fecal-orally transmitted diseases, such as traveler’s diarrhea, cholera, amoebiasis, and shigellosis [1]. Travelers are also advised to take precautions against viral bleeding diseases [1]. Travelers are recommended to consult their healthcare professionals or travel medicine clinics for advice on vaccinations and malaria prophylaxis [2].

BALI

Bali is known to have a high risk of dengue fever, which is a mosquito-borne flu-like illness [2][3]. Malaria is also present in some areas of Indonesia, including Bali, but the risk is low and prophylaxis is recommended [2]. Typhoid fever and hepatitis A are also prevalent and travelers are advised to get vaccinated before traveling to Bali [2]. Mosquito-borne diseases such as chikungunya and Zika virus are also present in Bali, according to [3]. Additionally, travelers can experience gastrointestinal illnesses such as traveler’s diarrhea and dysentery due to contaminated food and water [3]. Visitors are encouraged to take precautions to avoid mosquito bites and practice safe food and water habits to prevent disease.

SUMATRA

According to information provided by the CDC and WHO, travelers to Sumatra should take precautions against various infectious diseases, including dengue fever, malaria, typhoid, and rabies [2]. The risk of malaria in Sumatra is considered moderate to high and malaria prophylaxis is recommended [1]. Additionally, visitors to Sumatra may encounter other mosquito-borne diseases such as chikungunya and Zika virus [3]. Travelers are advised to consult their healthcare professionals or travel medicine clinics for advice on vaccinations and malaria prophylaxis before traveling to Sumatra. Safe food and water habits and insect bite precautions should also be practiced to prevent disease.

Both the WHO “World Health Organization” and the American CDC “Centers for Disease Control and Prevention” constantly monitor and report the various diseases present in Indonesia. Our direct experience in different areas of the country confirms the presence of a series of endemic diseases in most of the territory, including large cities.

Malaria : (click here)

Malaria, a disease caused by Plasmodium, is transmitted by Anopheles mosquitoes and is a major public health problem in many of Indonesia’s islands.

Traveler’s diarrhea : (click here)

Traveller’s diarrhea is among the most common diseases during stays in About 60% of travelers in the country suffer from these annoying intestinal infectious forms. It can be caused by various pathogens, including bacteria, viruses and parasites. It may be appropriate to use some drugs in prevention.

Cholera : (click here)

Cholera is an acute infectious disease, present with several outbreaks in many Indonesian islands. Developed for some time also in the large islands, it has spread to Jakarta, Sumatra, Java, Borneo, Selayari, and other parts of the country. It was developed by being transmitted through contaminated water and food. It is important to take the oral cholera vaccine / traveler’s diarrhea before travelling.

HIV/AIDS :

HIV/AIDS is a public health problem in the country. According to the CDC, the HIV prevalence rate in several Indonesian islands is 3.5%. It is important to be careful in sexual intercourse with several random partners and the protection and use of condoms is recommended.

Dengue and arbovirus : (click here)

several outbreaks of dengue haemorrhagic fever are present in most of the islands. Particularly in densely populated islands and towns and villages. The presence also increases in the internal areas of the islands. Dengue is a viral disease transmitted by the bite of Aedes mosquitoes. The disease is widespread in urban areas. Prevention consists in paying attention to insect bites and protection with repellents. We recommend NOZETA – NEEM oil, very effective and with repellent and soothing characteristics.

chikungunya :

Epidemic outbreaks of this dengue-like arbovirus disease occur sporadically on many islands in the archipelago.

Tuberculosis (TB) :

TB is another disease present in some islands of the Indonesian archipelagoS developed especially in the villages and suburbs of the big city. It has a high mortality rate.

Anger : (click here)

present widespread cases in the country especially in wild animals. Watch out for monkeys and bats. It is appropriate to evaluate the risks for any vaccination practice.

Neglected Tropical Diseases (NTD) : (click here)

NTDs are a group of neglected diseases affecting people living in poverty and rural areas. In Indonesia, NTDs include lymphatic filariasis, onchocerciasis, and schistosomiasis.

 

Vaccinations

Which vaccination is mandatory for Indonesia and what should I do?

YELLOW FEVER if…..

• the YELLOW FEVER vaccine
  – it is not mandatory for all those who come from Europe, North America and Australia and have not passed through Africa or Central and South America in the last 6 months.
  – it is obligatory for every person (with the exception of children under six months), arriving by air or sea; without the vaccinationcertificate the person is isolated for a maximum of 6 days
  (i) if he left an area where there is a risk of disease transmission less than 6 days before his arrival, or
  (ii) if he passed in transit in one of those areas, with the exception of those passengers and crew members who, for the duration of their transit through an airport located in aarea where there is a risk of disease transmission, are staying in the airport buildings, provided the airport doctor allows this derogation, or
  (iii) if they arrived on a vessel which left or called a port located in an area where there is risk of disease transmission less than 30 days prior to its arrival in India, unless this vessel has been disinfected in accordance with the procedure established by WHO.
  (iv) if you have arrived in an aircraft which, having been in an area where there is a risk of transmission of disease, has not been disinfected in accordance with the provisions of the Air Navigation (Public Health) Regulations of India, 1954 or to the provisions recommended by the WHO.The following countries and areas are considered to be at risk of transmission:
• – Africa : Angola, Benin, Burkina Faso, Burundi, Cameroon, Chad, Congo, Ivory Coast, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea Bissau, Equatorial Guinea, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria , Central African Republic, Democratic Republic of Congo, Rwanda, Senegal, Sierra Leone, Sudan, South Sudan, Togo, Uganda.
• – America : Argentina, Bolivia, Brazil, Colombia, Ecuador, Guyana, French Guiana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago, Venezuela. Note: When a case of yellow fever is reported in a country other than those mentioned above, that country is considered by the Government of India as an area where there is a risk ofdisease transmission and is added to this list.
  This country considers the Yellow Fever vaccination certificate valid for life (amendment 0MS 11.07.2016). However, we recommend direct verification before leaving, considering the continuous changes in the regulations of the individual countries. (Updated March 2023)

 What vaccinations are recommended for INDONESIA, and what should be done?

Recommended vaccinations:

I have to get YELLOW FEVER vaccination to go to Indonesia  (click here)

Vaccination is neither required nor recommended for any traveler from Italy, Europe, North America, Australia as the virus is not present in Asia and there is no risk of contagion.

DENGUE vaccination  (click here)

Vaccination is recommended for all travelers over 9 years of age, for entry to the various islands of the country. Dengue is particularly prevalent during and after the rainy season. It is essential to request the vaccine for prolonged stays in areas at risk of arbovirus.  WHERE IS IT CARRIED OUT? Click here

Other recommended vaccinations:

HEPATITIS A – read more….
TYPHOID FEVER – read more….
Vaccines essential for the protection against “food” infections, i.e. transmitted by “contaminated food and drink”; “dirty hands”; contaminated crockery, dishes, glasses: (valid everywhere, in Italy and in most countries of the world)
DIARRHOIC AND COLERIFORM SYNDROMES
essential vaccination for effective protection from “Colera Vibrio” and other intestinal pathogenic bacteria, even aggressive ones, cause of “diarrhea of the traveler”. It should always be regarded as protective of the intestine. It can be taken into consideration depending on the type of trip and stay. The “oral” formulation of the cholera vaccineit also protects against intestinal infections caused by many enterotoxic agents. The vaccine is therefore recommended for travel to many countries around the world.
HEPATITIS B  read more….
Protection from contact with infected blood: in the event of medication due to an accident during the trip (in clinics or local EDs) for infections due to medication irons; syringes in health care facilities with poor hygiene; sexual transmission unprotected sex; other contacts with blood; (valid everywhere, in Italy and in most countries of the world)
MENINGOCOCCAL MENINGITIS to find out more…
Protection from infections transmitted by saliva droplets, breathing and coughing, through the air, in airplanes, crowded places, buses and trains, offices and schools, poorly ventilated environments; (For your personal protection and for the protection of the people close to you (family – work) – possibility of becoming a healthy carrier of the meningitis bacterium.) (valid everywhere, in Italy and in most countries of the world)
TETANUS    for learn more…
POLIOMYELITIS
Following the latest epidemiological data and related recommendations issued by the WHO, travelers are recommended a vaccine booster (IPV-injection) best done together with (tetanus-diphtheria-pertussis-quadrivalent vaccine) to be boosted every 10 years. The effectiveness of the vaccine, being a reminder of vaccinations made in the past, is immediate.
Protection from infections transmitted by faecal micro-particles present in the soil, contact and ingestion; (valid everywhere, in Italy and in most countries of the world)
ROUTINE VACCINATIONS
Make sure you have carried out all the vaccinations required by the National Health System . These include: tetanus, diphtheria, polio, pertussis, haemophilus B, hepatitis B, measles, mumps, rubella, chicken pox.

Malaria: situation and prevention

Is there malaria in the country and what needs to be done in order not to get sick?

What is it

Malaria is an infectious disease, (All about Malaria – CESMET – Traveller’s Clinic), acute, caused by a parasite, Plasmodium, which enters the body through the bite of the Anopheles mosquito, immediately attacks the liver cells, creating liver damage, and then parasitising the red blood cells, with even severe anaemia. Present in the country, it is a disease very much linked to wet environments, rainy seasons, and weather and environmental conditions favourable to mosquito breeding. The advice I can give you is to check before you leave the itinerary of your trip, the current weather conditions in the areas where you are staying. Do not trust ‘hearsay – there is no malaria! ” Malaria is present where you don’t expect it, and with climate change the Anopheles mosquito has come to colonise even high altitude territories, previously not hospitable for the insect.
Remember that Malaria is a potentially serious and even fatal disease. Do not underestimate it! It can be prevented by using, as a first line of defence, effective repellents (SEE NOZETA – NEEM OIL ); It is also useful to use the fangs to carry with you at all times;
as a second line of defence it is essential to use appropriate chemo prophylaxis drugs, which are safe and effective, to be taken particularly in the seasons of higher risk and in areas with a high risk of encountering the Anopheles mosquito;
a third line of defence is to pay attention to suitable clothing that covers your uncovered parts at dusk and at night, a defence that is effective but often difficult in certain latitudes and climates. Although we must remember that the more you cover yourself the less you suffer from the heat, and the less you drink ice-cold drinks and the less thirsty you are.  For more information, read the fact sheet on malaria

In the country

• The risk of malaria exists throughout the year in all areas of East Indonesia (Maluku, North Maluku Utara, East Nusa Tenggara, Papua and West Papua provinces), including the city of Labuan Bajo and the Komodo islands in the region of Nusa Tenggara. Rural areas of Kalimantan (Borneo), West Nusa Tenggara (including the island of Lombok), Sulawesi and Sumatra. Low transmission in rural areas of Java including Pangandaran, Sukalumi and Ujung Kulong. None in the cities of Jakarta and Ubud, the resort areas of Bali and Java, and the Gili Islands and Thousand Islands (Pulau Seribu).
  Resistance to chloroquine and sulfadoxine-pyrimethamine reported. Resistance of P. vivax to chloroquine reported. (Updated January 2023)

 

Prophylaxis

Doxycycline 100 mg (BASSADO – MIRACLIN lactose-free), https://www.clinicadelviaggiatore.com/il-bassado-un-vecchio-antibiotico-per-una-ottima-prevenzione-della-malaria/
is an excellent drug, which I personally consider to be the first choice for stays in safe tourist areas than for adventurous trips, during trekking and when using tents or poorly controlled residences. Medication for stays in protected residences or mild risk areas, but also for stays in high risk areas. You should know that ‘doxycycline 100 mg’ is a first-choice drug not only for the ‘prevention of malaria infection’ but also for the ‘prevention and treatment of intestinal and skin bacterial infections’ and towards ‘infections caused by tick bites – the dreaded typhus exanthematica’.
Because of its characteristics, the drug is very versatile; it can be taken for very short or short stays, a few days or weeks, but also in the long term, i.e. for many months. I would remind you in this regard that tetracycline-based drugs, including doxycycline, are taken for months and months, even over a year, by young people suffering from acne, i.e. infections on the face or trunk. A safe, effective drug with no or few side effects. Remember that at prophylactic doses of 100 mg a day, the effects of sensitisation to the sun’s rays are practically minimal. The effect is weighted, i.e. directly related to the amount of substance present in the drug. In any case, always remember to use protective sun creams. The drug is cheap and cannot be used under the age of 10. In pregnancy, taking doxycycline 100 mg is possible in the very first weeks of pregnancy, before the 16th week, as studies and clinical practice have shown that it poses no risk to the foetus. The rule remains that it is important to consult your doctor before taking any medication during pregnancy to assess the potential risks and benefits.
The drug should be avoided in case of allergy or intolerance to tetracyclines. In malaria prophylaxis it is taken daily, during lunch with a large glass of water, from the time of entry into the risk area, during the stay and for one week after leaving the malaria risk area. (although the half-life of the is short the evidence points to one week of continued intake of the drug).
Atovaquone-Proguanil (MALARONE drug on the market for over 20 years. Until a few years ago a drug of first choice in both prophylaxis and therapy, it was abandoned in clinical practice because it was becoming less and less effective. It has been replaced in therapy for years now by compounds based on Artemisia Annua. Just as it no longer works for the treatment of malaria, the drug is also increasingly less effective in prophylaxis. In fact, its efficacy against malaria has been declining in recent years, partly following the fate of the chloroquine-resistant forms. For several years, forms of resistance have been described starting in the East, in the Golden Triangle countries (Thailand, Laos Myanmar) and then spreading to Africa and even the Americas. The drug is still useful and effective in paediatric use. It was used for periods of no more than 30 days, but can be used for up to 60 days. One tablet is taken every day from 2/3 days before leaving to 1 week on return. It is no longer a drug to be recommended in these areas except in paediatric age.
Mefloquine (LARIAM 250),
a drug that has been used for over 40 years, once effective in therapy and prophylaxis, currently has very low efficacy in prophylaxis and zero efficacy in therapy. It is no longer to be used in adults and also in paediatrics. The same reasoning as for MALARONE also applies to LARIAM. Mefloquine has been discontinued in malaria therapy because it is no longer effective. Strong resistance started in the Far East and then spread throughout the East, the Middle East, Africa and finally the Americas. The safety of the drug in pregnant women, with whom it could possibly still be used, was demonstrated from the outset because of its still low efficacy.
The drug was used in subjects in good health. It was not to be used in heart patients, arrhythmic, neuro and psychopathic subjects, and in those suffering from insomnia. Reported symptoms of irritability of the peripheral nervous system and central. Absolutely to be avoided in those who dive, stay at high altitude, and take repeated and prolonged flights. The mode of intake is very favourable, with a weekly dose from one week before leaving to three to four weeks on return. But many years’ experience tells us that the drug is highly ineffective given the high resistance of plasmodia, which have been developed over many years. Dr. Paolo Meo – tropical doctor – Cesmet director

 

Local traditions, foods, drinks

What are some curiosities and what are the major traditions of the country?
Indonesia is a country full of unique traditions and curiosities. [1] An interesting tradition is that of large kites flying in the sky in the Sanur region of Bali, which are considered to be of great religious importance to the Balinese. Another tradition is the cultivation of a seaweed in Lembongan , near Bali, which is rich in carrageenan and used to make ice cream and other products. Indonesian cuisine is also a very important aspect of local culture , with rice as the staple foodand the widely used spices. The Galungan festival is an important celebration in Bali where all the gods are believed to descend to earth. [2] In addition, Subak, a traditional irrigation system, is essential for rice cultivation in Indonesia. [3] Finally, in Indonesia the civet is bred, an animal similar to the cat. A very valuable product is the coffee grown in many Indonesian islands.

What are the 10 most interesting traditional foods?

Ten of Indonesia’s most famous traditional foods:

There are many traditional dishes in Indonesia that are worth trying. Some of the more popular ones are listed below:

• Rendang beef
• Indonesian satay
• Bakso
• Nasi Goreng
• Mie Goreng
• Gudeg
• Gado Gado

These are traditional dishes typical of the archipelago. In addition to these dishes, there are many others worth trying. Indonesian cuisine is known for the use of fresh herbs and spices, which make the food delicious and unique .
Some popular dishes worth trying are sate ayam/kambing, sate padang, and ayam bakar taliwang. Sate ayam/kambing is grilled with kecap manis sweet soy sauce over hot charcoal fire, sate padang is originally from Padang, Sumatra and is known for its spice mix, while ayam bakar taliwang is a dish of Spicy grilled chicken originally from Lombok.

 

What are the traditional drinks that we can try and taste during our stay?

Indonesia’s many delicious dishes are gaining popularity in Asian countries and globally. But we often forget the equally refreshing and culturally significant local drinks that have accompanied local life for decades, if not centuries. Discover the local drinks that all Indonesians love (and you will too!)

Bajigur
Bajigur is a traditional hot drink of the Sundanese people of West Java, Indonesia. The drink is made from coconut milk, Aren sugar, ginger, a little salt, and sometimes pandan leaves or coffee. This traditional drink is particularly popular in the highlands of West Java, where the temperature is often freezing, as the drink’s ingredients have a natural warming effect. Bajigur is also consumed as a medicinal drink, known to help reduce the pain of arthritis, improve blood circulation and treat digestive problems.

Fresh Bajigur Jamu
This traditional herbal drink originates from the ancient civilizations of Java and has a wide variety of recipes. Its effectiveness in treating various diseases has stood the test of time, making this drink widely consumed by the local population. Jamu can be formulated with combinations of natural ingredients, from seeds, roots, flowers, fruits and leaves, depending on the expected benefits. Today Jamu can still be bought in some traditional markets. Some extracts are produced in powder form and can be prepared comfortably at home. Many Indonesian modern medicines are also based on the ingredients and concept of Jamu.

Temulawak
Long before American sodas entered the Indonesian archipelago, the nation already appreciated its own traditional carbonated drink in the early 1980s. Carbonated temulawak is obtained from the Java ginger plant (Curcuma xanthorrhiza), a rhizome known for its anti-inflammatory and diuretic properties. This sweet-tasting drink is still found in traditional restaurants, usually served over ice for a cooling effect.

Arak Bali
Arak is the traditional brandy of Bali fermented from white rice. This alcoholic beverage was originally used for traditional rituals and ceremonies, before being widely consumed and brewed modernly. Today, this drink is a popular souvenir among international tourists to take home, due to its unique taste and cultural significance. More than a recreational alcoholic beverage, Bali arak is also consumed to warm the body during cold weather and to relieve nausea.

Brem
A traditional alcoholic beverage loved for its sweet taste, Brem is originally an offering used for ceremonies in Balinese temples, sometimes as a substitute for blood. The drink is formulated using fermented black and/or white ketan (glutinous rice). Brem is also eaten as a solid snack in some areas of Java. It has an alcohol content ranging from 10 to 25%, lower than that of its counterpart arak Bali.

uwak coffee Es Cendol o Dawet
This refreshing cold drink is not only a favorite in Indonesia but also in other Southeast Asian countries. The drink features worm-like green jellies made of rice flour and pandan leaves. To prepare the drink, the jellies are dipped in coconut milk mixed with palm sugar and ice. The cold drink can be served as a dessert or a snack, preferably at noon when the temperature is high.

Wedang Ronde
Wedang ronde is a traditional hot dessert suitable for cold nights or rainy days. It contains glutinous rice balls stuffed with peanuts and soaked in ginger and lemongrass juices mixed with sugar. Some studies suggest that this drink originated from an ancient Chinese dynasty before being brought to the archipelago and modified to taste by the locals. wedang ronde hot

Es Kelapa Muda
Es Kelapa Muda (young coconut ice) is a popular beach drink in many tropical countries, but the Indonesian coconut drink has unique characteristics. Coconut ice is often served with palm sugar or white sugar, orange juice, lemon, or sweet condensed milk. Young coconut also has thick flesh that you can scrape off the inside of the coconut.

Young coconut ice on Es Doger beach

This colorful dessert consists of red tapioca pearls, avocado, fermented cassava, black glutinous rice, jackfruit, pink syrup, and cubed bread. The main liquid is refreshing ice made from coconut milk. Customers can choose which ingredients to include or opt for all. This dessert is found in many Indonesian cities, sold in vendor carts or even in restaurants.

 

What are the cultural and tourist destinations of greatest interest in the destination country of my trip?

What general info is useful to me during the trip?

Capital: Jakarta

Weather http://it.weather.yahoo.com/asia/Indonesia/ http://www.tv5.org http://www.ssec.wisc.edu

Language : Bahasa Indonesia (official), Javanese, English

Currency: Indonesian rupiah

Time zone: GMT +6 +7 +8

History, Economy, Culture: https://www.cia.gov http://www.britannica.com

Security : www.viaggiaresicuri.it www.dovesiamonelmondo.it

 

Some useful health information to keep you healthy on the go

What are the main rules and how should I prepare for the trip?

Give your body time to adjust to the new climate and new environment. Before the trip, if possible, dedicate a few hours to physical activity, and get your body used to the new rhythms during the trip …read more

How should I protect myself from the bites of mosquitoes and other insects?

 

Mosquitoes & co. – How to protect yourself: mosquitoes that transmit diseases other than malaria are active during the day and wherever there is a collection of fresh water: wear light-coloured, long clothes with wide sleeves, long and wide, light-coloured trousers, T-shirts or shirts with long and wide sleeves and light color to be tucked into the belt of the trousers ……read more

But is it really dangerous to swim in some lakes or rivers in tropical countries? And why?

To prevent the possible transmission of infectious diseases, it is advisable to swim only in pools with chlorinated water. The sea water is safe.
Bathing in contaminated water can be dangerous for the skin, eyes, ears, mucous membranes of the mouth, especially if  … read more

How can I avoid altitude sickness?

It is a set of symptoms that can occur when the human organism, having exceeded 2500 meters of altitude, has not yet adapted to the new environmental situation. We can define high altitude as follows … read more

How to travel safely? Who should I notify before leaving on a trip, especially to distant, unsafe countries?

Safety: www.viaggiaresicuri.it www.dovesiamonelmondo.it

In the suitcase

Mountain or sea, safari and adventure or relaxing holiday, hot or cold: you must prepare your luggage with care, attention, without exaggeration and above all by foreseeing the unpredictable. Clothing appropriate to the climate and never forgetting a small travel pharmacy.

 

 

Brief advice for those traveling in the country 

Brazil is a country rich in natural beauty and unique environments. You can choose to visit the Brazilian Amazon, an unmissable experience if you love nature. You can explore the rainforest, take boat trips along the rivers, and observe a diverse array of one-of-a- kind flora and fauna . Discover the Iguazu Park on the border between Brazil, Argentina and Paraguay , home to the majestic Iguazu Falls . Discover the Pantanal, one of the largest wetlands in the world full of the most diverse species of animals If you love the sea plan a trip to Fernando de Noronha , a volcanic archipelago located in the Atlantic Ocean, a true paradise for its crystalline waters. In northeastern Brazil go to Jericoacoara , a charming coastal village surrounded by sand dunes, lagoons and beautiful beaches.

The immense cities among which Rio de Janeiro and São Paulo stand out will fill you with a kaleidoscope of experiences and sensations.
Enjoy the journey to the end while protecting your health. Follow the preventive advice and prepare the trip correctly . Consult with those who can provide you with the right information and travel with peace of mind. Feel free to ask me for information and advice by writing here and entering the requested data. (click here https://www.clinicadelviaggiatore.com/modulo-consulenze-online/ ) The first thing to do is protect yourself from mosquito bites . These insects can transmit
viruses , bacteria and parasites, including malaria in some areas . Use effective repellents, even natural ones. This indicated product is very effective and has a series of very useful properties during travel.
Dengue virus fevers are the main health problem, along with other viruses of the thick family, in the country. In the post covid period, since 2022, dengue cases in the country have increased significantly, exponentially in certain areas. In large cities in particular, disease has become a problem. It is transmitted by mosquito bites and therefore it is important to protect yourself from bites to avoid a form that can become heavy and disabling.
Use repellents, protect yourself from bites and consult with a specialist if it is necessary to get vaccinated against the disease with the new QDENGA vaccine (click here https://www.clinicadelviaggiatore.com/qdenga-il-nuovo-vaccino-against-la-dengue/ .
Use mosquito nets and insect repellents. You can use small stoves or the classic coils.
During the journey, diarrhea from food and water contamination is frequent. Be careful and follow the advice I give you later.
Even if many say the opposite, denying the presence of the disease , malaria is present in various areas described below, in particular, in the Amazon area.
After the great epidemic of 2016-2020, which developed in different areas of the country, it is useful and wise to carry out vaccination against yellow fever . The virus is present in some types of monkeys, the disease is a zoonosis, and these can be healthy carriers of the same, and can transmit it to humans through mosquito bites.

Always trust in your immune strength , but help your body by strengthening it with effective preventive practices.

– Dr. Paolo Meo, tropical infectious disease doctor

Health alerts

MAY 2023 : DENGUE in Rio de Janeiro:
cases in the city have increased by 600% compared to previous years . In 2023, infections increased by 46% across the country. In large cities and especially in Rio, there was an exponential increase in dengue cases. The Dengue epidemic has rarely been so widespread. Aedes A egypti mosquitoes maintain transmission with a 600% increase in the number of confirmed diagnoses since the beginning of the year 2023 .
Given the seriousness of the situation, the municipal administration of Rio has reported that it is “monitoring” various areas of the metropolis, especially in the western area, where the greatest number of infected people has been recorded. The Pan American Health Organization reported that in all of Brazil, dengue cases increased by 46% in the first two months of 2023, when 158,310 infected were detected. Between January and February, there was an increase in the presence of the Aedes aegypti mosquito . The symptoms manifested were fever, skin rashes and muscle and joint pain.
The state of Espirito Santo is experiencing the most serious epidemic in 2023 with 29,000 infections and nine deaths.
In Minas Geraisthere were 7 thousand cases with six deaths.
In Rondonia, more than a thousand patients were confirmed in January alone, 40 percent more than in the whole of 2022.
There were 987 deaths caused by diseases attributable to the infection , an increase of 301 percent in one year.

MARCH 2022 : Approval in Brazil of the new vaccine against Dengue: the QUDENGA from the Takeda company . On March 2, Brazil’s National Health Surveillance Agency ( Anvisa ) approved the registration of the new dengue vaccine, Qdenga ,

MAY 2023: YELLOW FEVER
Cases of the disease have been reported in the state of Minas Gerais, Also in the first months of 2023 there are some suspected cases of the disease . Patients presented with fever, jaundice, body aches, and feverish pains . Several monkeys have been identified as healthy carriers of the virus. Monkeys are the reservoir and cause of new cases, even if they are sporadic. Vaccination coverage is important.

MARCH 2023: CHIKUNGUNYA Up to February 20, the increase in cases of the disease was 110%, from 16,971 to 35,569 probable cases. The highest percentage increases were observed in the southeast region, with emphasis on the states of Minas Gerais and Espírito Santo. Others on the rise are Tocantins, Mato Grosso do Sul, Bahia and Sergipe.
Essential attention to mosquito bites with the use of effective repellents.

FEBRUARY 2023: MALARIA

The increase in temperatures and humidity , the rains lead to the increase in the spread of different types of mosquitoes (Aedes and Anopheles), with the spread of diseases of viral and parasitic origin. This is what has occurred in an anomalous way, with the increase in cases of malaria, even fatal ones, in areas of the country even at altitudes above 1800 metres. This confirms the need for correct and updated information on the real epidemiological situations in the country, in order to implement the best preventive protocol and the most adequate prophylaxis.

MARCH 2023 Measles

A measles epidemic has been going on for several months. the number of cases remains high and is growing. Measles cases are present in most provinces of the country.

Climate, weather, health and environment

Current weather situation

Click here for the weather situation and forecasts coming soon: Weather Forecast in real time
https://www.3bmeteo.com/previsioni-meteo/brazil

What are the different seasons in the country and how are they characterized and how does the climate influence the spread of diseases?

In Brazil, the seasons are not very defined as we are in a predominantly tropical climate area . An example Rio de Janeiro where we have a warm climate almost all year round.
These are the characteristic seasons of the great country of Brazil (1) Outono / Autumn : From March 21 to June 20 we have Outono , which is very popular because of the leaves that fall on the ground. Outono is also known in Brazil as Estação das Frutas
(Fruit Season), because it is the harvest season and some of the most popular fruits in Brazil are easy to find during this season, such as: banana, apple and lemon. 

(2) Winter/Winter : June 21st to September 23rd is Winter, and in Brazil, especially Rio de Janeiro, it’s a bit different. Since we have a warm climate all year round, during this season the temperature drops but not much. People call it Friozinho Carioca and surely it’s the best time to have a cup of coffee and eat some sweets at Confeitaria Colombo!
(3) Primavera / Spring : From September 23rd to December 21st it is Primavera in Brazil, also known as Estação dasFlores (Season of Flowers), the best time to find flowers for your loved one. Most people prefer this season to walk around the city, get in touch with nature and visit many different places, Jardim Botânico is one such place.
(4) Verão /Summer from December to March. , the peak of the rainy season usually corresponds to the austral summer, which runs from December to March
However, it is important to note that climatic characteristics can vary greatly from one region to another within Brazil due to its size and geographical diversity. Some regions, such as the Amazon, are characterized byheavy rainfall throughout the year, while others, such as southern Brazil, may have more distinct seasons with colder winters and hotter summers.

In Brazil, there are generally two main seasons:
(A) the dry season
(B) the rainy season.

The country is very extensive and is divided into three climatic areas:

–the equatorial area characterized by constant rains, in the Amazon area and a small coastal area;

–the inter- tropical area characterized by a dry season in the vast intermediate zone and in a small northern stretch;

–the almost Mediterranean area in the extreme south of the country characterized by mild winters and hot summers , with the average temperature in June and July dropping to 12 °C and above .

Precipitation typically exceeds 1,000 millimeters (40 inches) per year in most parts of the country . However , there is an arid area in the north-east , where they also drop below 500mm a year. The rainiest area is the Amazon rainforest , where 2,000 to 2,500 mm of rain typically fall per year. The amount of sunshine is particularly strong on the north-eastern coast (Natal, Fortaleza), where there are almost 3,000 hours of sunshine per year. In the south (São Paulo), there are typically 1,800 to 2,100 hours of sunshine per year . No
n the rainiest areas (Santos) it goes down to 1,650 hours. The least sunny area of ​​Brazil is the western Amazon, where there are typically 1,600 to 1,800 hours of sunshine per year.

What consequences does climate change have on the seasons and the climate?

In Brazil, climate change, which affects the climate and seasons around the world , is having a significant impact on the seasons and climate . A major impact concerns agricultural production and the availability of drinking water. Here are some issues arising from this situation:

–Increase in temperatures: Climate change has led to an increase in average temperatures. Heat waves have become more intense and frequent, influencing the summer seasons and leading to greater exposure to the risk of heatstroke and dehydration ;

–Heavy and prolonged rains: Many territories are experiencing changes in precipitation patterns, with more intense and prolonged rains in some regions. This can cause flooding, crop damage, landslides, and water management problems ;

–Drought: Some regions are facing longer and more intense droughts. This can affect the availability of fresh water, damage crops and cause water supply problems for the population ;

–Sea level rise: Climate change contributes to sea level rise, which can have significant effects on Brazilian coasts . Coastal areas are vulnerable to erosion, coastal flooding, and saltwater intrusion into groundwater ;

–Extreme Weather: Brazil continues to experience more frequent and intense extreme weather events due to climate change. These events include storms, hurricanes, floods and droughts, which can cause damage to infrastructure, loss of life and negative impacts on agriculture ;

(sandstorm in São Paulo)

–Biodiversity loss: Climate change threatens land biodiversity . Natural habitats are under threat from changes in temperatures and precipitation patterns, putting many unique plant and animal species at risk ;

–Impacts on agriculture: Climate change can negatively affect agriculture. Changes in rainfall and temperature patterns can affect the production of key crops such as soybeans and coffee, jeopardizing food security and the country’s agricultural economy

–Areas affected by desertification : Some regions of Brazil are at risk of desertification due to climate change. Areas already facing drought and land degradation could become increasingly arid, threatening agricultural productivity and the livelihoods of local communities.

What are the characteristics of Brazil ‘s environment ?

Brazil is a country rich in natural beauty and unique environments. Here are some indications of natural environments to consider for your trip to Brazil:

–Amazonia: A visit to the Brazilian Amazon is an unmissable experience for the natural beauties present. It is possible to explore the rainforest, hike along the rivers and observe a wide range of flora and fauna unique in the world .

–Iguazú National Park : Located on the border between Brazil, Argentina and Paraguay, this national park is home to the majestic namesake waterfalls . You can in various ways admire the spectacular waterfalls and go hiking in the surrounding jungle.

–Pantanal: The Pantanal is one of the largest wetlands in the world and an outstanding destination for viewing and researching unique bird , wildlife and tree species. The area is rich in thousands of plant and animal species. Among the animals it is possible to come across caimans, anacondas, jaguars and many other rare species .

–Fernando de Noronha: A volcanic archipelago located in the Atlantic Ocean . A true paradise for those who love the sea. Its crystal clear waters are a feature and offer excellent opportunities for snorkelling, scuba diving and spotting marine life such as dolphins, sea turtles and sharks.

–Chapada dos Veadeiros : A national park in the Cerrado region famous for its amazing rock formations, spectacular waterfalls and natural pools. Particular are the paths that run through the unique ecosystem of the Cerrado . Located in the central plateau of Brazil, the Cerrado is the largest tropical savanna outside Africa, occupying 24% of the national territory, second only to the Amazon biome

–Jericoacoara : It is a particular coastal village in northeastern Brazil surrounded by sand dunes, lagoons and enchanting beaches. The ideal place to practice water sports such as windsurfing and kite surfing.

–Ecuadorian Amazonia: It is special to discover the territories of the Amazon from a different perspective, by visiting the Ecuadorian Amazon. Wonderful and unique hikes in the forest, navigations along the rivers and contacts with the local indigenous communities.

It is fundamental, when visiting the different territories of Brazil, to respect the natural environment . You need to be aware of the impact you can have on the ecosystem . It is advisable to follow the local rules and indications for the conservation of the natural environment . Enjoy the beauty of Brazilian nature and treasure these unique experiences!

What diseases can I find in Brazil and what are the risk assessments to face this trip? What are the preventive practices and vaccinations to do?

Both the WHO “World Health Organization” and the American CDC “Centers for Disease Control and Prevention” constantly monitor and report the various diseases present in Brazil. We confirm the presence of a number of diseases and endemics on most of the territory, including large cities.

Malaria – Malaria risk is present year-round in forested areas below 1500 meters in several Amazonian states. (see chapter dedicated to the malaria situation). Transmission is higher in some peripheral urban areas and this is due to the fact that the reservoir of the malarial parasite is man. Minimal risk in the Iguazu Falls location. The main species present are Plasmodium vivax (85% of cases) and P. falciparum (15% of cases). See below how to avoid the risk of malaria.

Dengue – Brazil has the highest number of cases ofdengueviral̴About70% of all cases are reportedin the countryand of this total, 17% are concentrated in the Amazon region of Brazil. Frequent outbreaks also in the state of Rio de Janeiroand in particular in the megalopolis.
the disease isspread almost throughout the country. Dengue is a viral disease transmitted by the bite of Aedes mosquitoes. AND’very common in urban areas. Frequent outbreaks occur in the cities of Rio de Janeiro. Prevention consists in paying attention to insect bites and protection with repellents. We recommend NOZETA – NEEM oil, very effective and with repellent and soothing characteristics.
click here https://www.clinicadelviaggiatore.com/nozeta-la-nuova-formlazione-dellolio-di-neem/
A safe and effective vaccine has also been present in Europe for a few months. Request vaccination from your trusted international vaccination centre.
(click here: https://www.clinicadelviaggiatore.com/qdenga-vaccinazione-against-la-dengue-presso-il-cesmet/ )
Vaccination should be considered in some areas and for some types of travel. Always inquire with your reference specialist for advice . Request information here: (click here https://www.clinicadelviaggiatore.com/modulo-consulenze-online/ )

Chikungunya – Frequent outbreaksin many states but particularlyin the state of Rio de Janeiroand in the northern states of the country. Epidemic outbreaks of thisarbovirusare occurring with exponential increase in the country.
The disease is characterized by high fever and severe joint pain. It is transmitted by the Aedes mosquito. Joint pain, much more intense inchikungunya, mainly affects the feet and hands, usually in the ankles and wrists.

The diagnosis is clinical but confirmed by specific laboratory tests. Since the disease is transmitted by mosquitoes, it is essential that people strengthen measures to eliminate breeding sites in homes and neighborhoods.

• Make sure water tanks and other tanks are properly covered;
• Remove leaves or other types of dirt that can cause water to accumulate in the gutters;
• Store the tires in covered places;
• Store the bottles with the mouth facing downwards;
• Periodically clean drains, gutters and other types of drains;

Treatment of chikungunya is done according to the symptoms. There is currently no specific antiviral treatment for the disease. Hydration and rest are essential measures for recovery. Symptoms usually disappear after the acute phase of the disease. Pain and fatigue can last for months.

Zika-virus – Indigenous transmission of the virus has been confirmed in the following states: Alagoas, Bahia, Ceará, Maranhao, Mato Grosso, Pará, Paraíba, Paraná, Pernambuco, Piauí, Rio de Janeiro, Rio Grande do Norte, Roraima and São Paulo .

Yellow Fever –
Yellow fever is a mosquito-borne viral disease of the genus Aedes. Low incidence in humans, it can be found in monkeys as healthy carriers of the virus. If the virus infects the person via mosquito bite, it can cause severe liver, kidney damage with severe overall symptoms.
Although vaccination against yellow fever is not mandatory to enter Brazil and is not considered useful by many, we strongly recommend for travelers visiting the country, and particularly in the highland areas, in the parks but in general, also in the areas urban.
Vaccination is recommended for all travelers over 9 months of age, due to the real risk of infection.The state of Goias, in central Brazil, represents the area where there is the greatest risk of transmission of the yellow fever virus. This is also due to the high presence of monkeys, reservoir of the virus, healthy carriers of the disease.

Traveler’s diarrhea – Traveler’s diarrhea is one of the most common illnesses during stays in Brazil. About 60% of travelers to the country suffer from these annoying intestinal infectious forms. It can be caused by various pathogens, including bacteria, viruses and parasites. Contaminated food, drinks, ice, dirty unwashed hands, water with which you take a shower, all this can be the origin of annoying diarrhea in many travellers. It may be appropriate to use some drugs in prevention and consider useful some vaccines that protect against foodborne infections. Use saline replenishers and also ferments to help rehydrate and maintain the intestinal microbial environment.

In most cases, strains of a bacterium called Escherichia coli and known as ETEC (Enterotoxigenic E. coli) strains are responsible. Other enterobacteria also cause diarrhea. Useful use of the Dukoral vaccine, oral anti-choleric, which covers different forms caused by different enterobacteria.

Hepatitis B – In the country there is a high prevalence (>25%) of carriers of the HBV virus, responsible for hepatitis B. It is advisable, as a preventive measure, to carry out the recall of the disease.

Onchocerciasis – Sporadic outbreaks in the South-West region of the country.

HIV/AIDS : Also in Brazil HIV/AIDS is a serious public health problem in the country. According to the CDC, the HIV prevalence rate is quite high, meaning that approximately several million people are living with HIV/AIDS. It is important to be careful in sexual intercourse with several random partners and the protection and use of condoms is recommended.

Rabies : (click here) , There are cases of rabies in the country. Wild animals and some domestic animals with the virus have been isolated . It is advisable to evaluate the risks in order to carry out a possible vaccination practice.

Vaccinations

What vaccination is mandatory for Brazil and what should we do?

YELLOW FEVER if…..

A Yellow Fever vaccination certificate is required of all travelers over one year of age from areas where there is a risk of disease transmission. The international certificate valid throughout the world is issued only by vaccination centers authorized by WHO and by the member states.

What vaccinations are recommended for Brazil   and what should I do?

Recommended vaccinations:

YELLOW FEVER (click here)
Vaccination is strongly recommended for travelers over 1 year of age who go to the center of the country, to the Amazonian areas and to the territories south of the Queen of São Paulo. Vaccination is recommended regardless of the international or local regulations in force for entry into the country. Before leaving, obtain information from specialized centers about the areas of the country at greatest risk.

Other recommended vaccinations:

HEPATITIS A – read more….
TYPHOID FEVER – read more….
Vaccines essential for the protection against “food” infections, i.e. transmitted by “contaminated food and drink”; “dirty hands”; contaminated crockery, dishes, glasses: (valid everywhere, in Italy and in most countries of the world)
DIARRHOIC AND COLERIFORM SYNDROMES
essential vaccination for effective protection from “Colera Vibrio” and other intestinal pathogenic bacteria, even aggressive ones, cause of “diarrhea of the traveler”. It should always be regarded as protective of the intestine. It can be taken into consideration depending on the type of trip and stay. The “oral” formulation of the cholera vaccineit also protects against intestinal infections caused by many enterotoxic agents . The vaccine is therefore recommended for travel to many countries around the world.

HEPATITIS B read more…. Protection from contact with infected blood: in the event of medication due to an accident during the trip (in clinics or local EDs) for infections due to medication irons; syringes in health care facilities with poor hygiene; sexual transmission unprotected sex; other contacts with blood; (valid everywhere, in Italy and in most countries of the world)

MENINGOCOCCAL MENINGITIS for more information…
Protection from infections transmitted by saliva droplets, breathing and coughing, through the air, in airplanes, crowded places, buses and trains, offices and schools, poorly ventilated environments; (For your personal protection and for the protection of the people close to you (family – work) – possibility of becoming a healthy carrier of the meningitis bacterium.) (valid everywhere, in Italy and in most countries of the world)

TETANUS to find out more… POLIOMYELITIS Following the latest epidemiological data and related recommendations issued by the WHO, travelers are recommended a vaccine booster (IPV-injection) better to be carried out together with (tetanus-diphtheria-pertussis- quadrivalent vaccine) from call back every 10 years. The effectiveness of the vaccine, being a reminder of vaccinations made in the past, is immediate. Protection from infections transmitted by faecal micro-particles present in the soil, contact and ingestion; (valid everywhere, in Italy and in most countries of the world)  

ROUTINE VACCINATIONS
Make sure you have carried out all the vaccinations required by the National Health System . These include: tetanus, diphtheria, polio, pertussis, haemophilus B, hepatitis B, measles, mumps, rubella, chicken pox.

Malaria: situation and prevention

Is there malaria in the country and what needs to be done in order not to get sick?
What it is
Malaria is an acute infectious disease present in the country, closely linked to humid, rainy environments, seasons and meteorological conditions. Check before leaving the itinerary of your trip and the weather conditions of the areas of your stays. Remember that Malaria is a potentially serious and even fatal disease. Don’t underestimate her. It is possible to prevent it by paying attention to clothing that covers the exposed parts at sunset and at night, by using repellents and by using suitable prophylaxis drugs, in the seasons of greatest risk. For more information, read the fact sheet on malaria

In the country
The risk of malaria is present throughout the year in forested areas below 1500 meters in nine Amazon states: Acre, Amape , Amazonas, Maranhao (western part), Mato Grosso (northern part), Para (except the city of Belem), Rondonia, Roraima and Tocantis (western part). Transmission is highest in some peripheral urban areas of Cruzeiro do sol, Manaus and Porto Velho . The disease is also endemic in the suburbs of large cities such as Boa Vista, Macapa, Maraba , Rio Branco and Santarem.
The risk is minimal in the resort town of Iguazu Falls. There is a risk for those taking an Amazon River cruise, as there may be infected mosquitoes on board. Most cruises end or depart from the city of Manaus where the risk of malaria is high . The risk is minimal in all states outside the Amazon, including the east coast from Fortaleza to Rio de Janeiro. The main species present are Plasmodium vivax (85% of cases) and P. falciparum (15% of cases).
Small towns and large cities present a risk of infection sometimes equal if not greater than remote and wild areas. The transmission, through the bite of the Anopheles mosquito takes place from man toman.
Notified resistance to chloroquine but also to mefloquine and partly to atovaquone . Reduced resistance to Doxycycline which may be a first choice for prophylaxis .
(Updated May 2023 )

Prophylaxis
Doxycycline is an excellent drug of choice for stays both in tourist areas and on adventurous trips, during trekking and in case of use of poorly supervised tents or residences. Drug for stays in protected residences or low-risk areas, as well as for high-risk stays. You should know that “doxycycline 100 mg” is a drug of choice not only for the prevention of malarial infection but also for the prevention of intestinal and skin bacterial infections and against infections caused by tick bites. Due to its characteristics, the drug is very versatile, it can in fact be taken for very short or short stays, a few days or weeks, but also in the long term, that is, for many months. We remind you that tetracycline-based drugs, including doxycycline, are taken for over 1 year by children who experience acne, i.e. infections on the face or trunk. A safe, effective drug, with no or few side effects. We remind you that at prophylaxis doses, 100 mg per day, the effects of sensitization to sunlight are practically absent. In any case, remember the use of sunscreens. Low cost drug. It cannot be used under the age of 12 or during pregnancy, or in case of allergy or intolerance to tetracyclines. It is taken every day, during lunch, from entering the risk area, for one week from leaving the malaria risk area.
Atovaquone- Proguanil, a drug on the market for almost 20 years, still has a good antimalarial coverage for the forms resistant to chloroquine, even if forms of resistance and poor efficacy have been described for several years. Useful for pediatric use, used for periods not exceeding 30 days, but usable up to 60 days. One tablet is taken every day from 2/3 days before leaving to 1 week after returning.
Mefloquine , a drug used by over 40 years, Effective in prophylaxis and in therapy. Effective both in adults and also in children. Efficacy and safety also demonstrated in pregnant women. Usable in subjects in good health conditions. Not to be used in heart patients, arrhythmic subjects, neuro and psychopaths, in people suffering from insomnia. Peripheral and central nervous system irritability symptoms reported. To be avoided in those who carry out diving, stays at high altitudes, repeated and prolonged air flights. The method of recruitment which provides for a weekly dose from one week before leaving to 3/4 weeks upon return is favorable.

What should I do if I return with health problems from the trip?

In case of fever, diarrhea or in any case if you feel unwell, it is essential to consult a doctor without delay (in case of fever, possibly within 24 hours, due to the possibility of having contracted malaria, if you are returning from an area at risk) . Specialist or expert in Tropical Diseases. Read everything…

Local traditions, foods, drinks

What are the traditional foods of greatest interest in Brazil ?

1.Feijoada : the Brazilian national dish, prepared with black beans, rice, pork and beef

2.Coxinha : a sort of chicken nugget, stuffed with cheese and other ingredients, and fried

3.Pão de queijo : a cheese sandwich, made with cassava flour and cheese.

4.Moqueca : a fish stew, prepared with coconut milk, tomatoes, onions and other ingredients.

5.Churrasco: A grilled mixed meat, often served with rice and beans.

6.Bacalhau bolinhos : fried cod croquettes.

7.Brigadeiros : chocolate sweets, made with condensed milk, butter and cocoa.

8.Bombocado : a coconut dessert, made with condensed milk, egg, and grated coconut.

9.Salpiçao de frango: a chicken salad, with vegetables and other ingredients.

10.Pastel de queijo : a pastry filled with cheese, fried.

These dishes are just a few of the many traditional foods of Brazil, which vary according to regions and cultural influences.

What traditional drinks can we enjoy during our stay in Brazil ?

–Caipirinha: a cocktail made with cachaça , lime, water, refined brown sugar and ice. It tastes herbaceous and fresh.

–Cachaça : a Brazilian distillate made from sugar cane, used as the main ingredient of the caipirinha. It has a strong and intense flavour.

–Guarana: a soft drink made from guarana, a plant native to Brazil. It tastes sweet and fizzy.

–Mate: a drink made from yerba mate leaves, a plant native to South America. It has a bitter and slightly herbaceous taste.

–Batida: a soft drink made from condensed milk, fruit and ice. It tastes sweet and creamy.

–Quentão : a hot drink made with cachaça , brown sugar, cinnamon and cloves. It has a sweet and spicy taste.

–Cajuína : a soft drink made from the juice of caju , a typical fruit of Brazil. It has a sweet and fruity taste.

–Cerveja : Brazilian beer, produced in different variations. It tastes bitter and fizzy.

–Catuaba : an alcoholic drink made from cachaça and catuaba bark , a typical plant from Brazil. It has a sweet and slightly bitter taste.

–Chimarrão : a yerba mate -based drink , served in a gourd with a straw. It has a bitter and slightly herbaceous taste.

–Cachaça com mel: an alcoholic drink made from cachaça and honey. It has a sweet and intense flavour.

–Caldo de cana : a soft drink made from sugar cane juice. It tastes sweet and fresh.

–Licor de jenipapo : a liqueur made from jenipapo , a typical fruit from Brazil. It has a sweet and fruity taste.

–Licor de cacao: a cocoa-based liqueur, used as an ingredient in many Brazilian cocktails. It has a sweet and intense flavour.

–Cachaça com limão : An alcoholic beverage made from cachaça and lemon juice. It has a fresh and sour taste.

What are the cultural and tourist destinations of greatest interest in the destination country of my trip?

Brazil , in its vastness and diversity is famous for its national parks and nature reserves, where you can spot wild animals of all kinds. It is rich in natural beauty and unique environments. This is a small description and naturalistic advice and natural environments that you could consider for your trip to Brazil:

–Amazonia: A visit to the Brazilian Amazon is an unmissable experience for nature lovers. T he rainforest provides incredible thrills. Take boat trips along the rivers and observe unique and infinite flora and fauna .

–Iguazú National Park : Located on the border between Brazil, Argentina and Paraguay, this national park is home to the majestic Iguazú Falls . You can hike to admire the spectacular waterfalls and immerse yourself in the beauty of the surrounding jungle.

–Pantanal: The Pantanal is one of the largest wetlands in the world and an outstanding destination for bird and wildlife lovers. You can observe caimans, anacondas, jaguars and many other animal species.

–Fernando de Noronha: This volcanic archipelago located in the Atlantic Ocean is a paradise for sea lovers. Its crystal clear waters offer excellent opportunities for snorkelling, scuba diving and spotting of dolphins, sea turtles and sharks.

–Chapada dos Veadeiros : This national park in the Cerrado region is famous for its amazing rock formations, spectacular waterfalls and natural pools . The Cerrado ecosystem is one of a kind . It is one of the most fascinating naturalistic destinations .

–Jericoacoara : This coastal village in northeastern Brazil is surrounded by sand dunes, lagoons, and lovely beaches. It is an ideal place to practice water sports such as windsurfing and kite surfing.

–Ecuadorian Amazonia: it is a particular exploration of the Amazon . Excursions in the forest allow still untouched landscapes. It is possible to tackle navigation along the rivers by meeting and learning from the local indigenous communities.

When traveling through the immense Brazilian land, one must always respect the natural environment. Unknowingly you can have a negative impact on the ecosystem that is crossed. For this reason it is necessary to follow the local rules for the conservation of the environment. T he beauty of Brazilian nature is to be enjoyed, it is good to treasure these unique experiences, but it is essential to adopt those rules of prevention and attention in order not to fall ill during the trip and risk showing results that can last for months even after returning from the trip. Prevention, balanced behaviour, preventive vaccinations and caution allow us to fully enjoy the country’s nature.

What general info is useful to me during the trip?

Capital: Brasilia
Language: Portuguese
Currency: Real
Time Zone: GMT-3
History, Economy, Culture : http://www.britannica.com https://www.cia.gov

Some useful health information to keep you healthy on the go

What are the main rules and how should I prepare for the trip?

Give your body time to adjust to the new climate and new environment. Before the trip, if possible, dedicate a few hours to physical activity, and get your body used to the new rhythms during the trip …read more

Who should get vaccinated for yellow fever? And is the vaccine mandatory? And where?

Vaccination against Yellow Fever or Amaryllis Vaccine, an acute viral disease, which is transmitted by mosquito bite, is the only preventive practice that can be compulsorily requested by the health authorities of a country in order to enter through the border crossings …  . Read everything

How should I protect myself from the bites of mosquitoes and other insects?

Mosquitoes & co. – How to protect yourself: mosquitoes that transmit diseases other than malaria are active during the day and wherever there is a collection of fresh water: wear light-coloured, long clothes with wide sleeves, long and wide, light-coloured trousers, T-shirts or shirts with long and wide sleeves and light color to be tucked into the belt of the trousers ……read more

But is it really dangerous to swim in some lakes or rivers in tropical countries? And why?

To prevent the possible transmission of infectious diseases, it is advisable to swim only in pools with chlorinated water. The sea water is safe.
Bathing in contaminated water can be dangerous for the skin, eyes, ears, mucous membranes of the mouth, especially if  … read more

How can I avoid altitude sickness?

It is a set of symptoms that can occur when the human organism, having exceeded 2500 meters of altitude, has not yet adapted to the new environmental situation. We can define high altitude as follows … read more

How to travel safely? Who should I notify before leaving on a trip, especially to distant, unsafe countries?

Safety: www.viaggiaresicuri.it www.dovesiamonelmondo.it

In the suitcase

Mountain or sea, safari and adventure or relaxing holiday, hot or cold: you must prepare your luggage with care, attention, without exaggeration and above all by foreseeing the unpredictable. Clothing appropriate to the climate and never forgetting a small travel pharmacy.

 

 Brief advice for those traveling in the country
What should I do when I go to Cuba?

If you are looking for a destination with a unique culture, breathtaking natural beauty, interesting history and warm people, then Cuba is the right destination. A vibrant and unique culture, with Spanish, African and Caribbean influences reflected in the island’s music, dance, architecture and cuisine. Incredible natural beauty, with white sand beaches and crystal clear waters, lush tropical forests and majestic mountains. Valle de Viñales , for example, is an Area of ​​Outstanding Natural Beauty, a UNESCO World Heritage Site, with tobacco fields and limestone mountains soaring into the sky. And few know that Cuba, in the middle of the Caribbean area, is an island state of Central America which includesthe homonymous island (about 105,007 square km and the Isla de la Juventud (about 2500 square km) and about 1600 islands and islets immersed in a fantastic and uncontaminated nature. Among these thousands of islands the Camagüey archipelago and that of the Canarreos constitute a set of islands to discover and visit.

In Cuba, for travellers, the main problem is characterized by forms of traveler’s diarrhea , spread through the intake of contaminated food and drink.  It is important to protect yourself from mosquito and insect bites . These carry diseases, first of all Dengue Viral Fever and also other Arboviruses. Use effective repellents, even natural ones. (Nozeta – Neem is an effective and advisable product) . Cuba is considered “malaria free” , ie the presence of the malarial parasite is not reported on the main island nor on the other thousands of small islands of the archipelago.
There is no presence of the yellow fever virus “Yellow Fever free” etherefore there is no need to carry out vaccination against the disease. But if you come from endemic or infected countries (Africa and Latin America) it is mandatory to get vaccinated.  Cholera is not officially present in the islands, but in the Caribbean, even via maritime transport, the cholera vibrio circulates almost everywhere. For years it has been fed by a circulation that developed from Haiti and from there spreads to many Caribbean and Central American islands and countries. The oral vaccine is recommended, which also covers forms of enterobacteria, especially E. Coli. Beware of tick bites with the possibility of developing a disease called exanthematous typhus.
Correct information, good preventive preparation before the trip, and shrewd behavior allow us to fully enjoy this trip.

How do I get correct health information to go to Cuba

Feel free to ask for advice to get to know problems and solutions   – dr. Paolo Meo, tropical infectious disease doctor

Health alerts
What are the current epidemics in Cuba?

COVID-19  Follow the daily case situation in the country (click here)

MARCH 2023: DENGUE 

Cases of viral haemorrhagic fever, particularly acute, were reported to increase already in the last quarter of 2022 in Cuba. Cases increased in the first quarter of 2023. They are increasing especially during the rainy season. It is possible to request the new dengue vaccine from the beginning of 2023. Particularly for those wishing to stay for an extended period.
At cesmet it is possible to book and get the vaccine against dengue.

 

Climate, weather, health and environment

What is the weather and upcoming weather forecast in Cuba?:

Weather forecast in real time

What are the different seasons in the country and how are they characterized and how does the climate influence the spread of diseases?

Cuba is located in the northern part of the vast Caribbean archipelago  and is its largest island. To the north lies the United States, separated from Cuba by the  only 180 km wide Strait of Florida  and the North Atlantic Ocean . To the west is the  Yucatán channel  which divides it from the Central American continent, to the south the  Caribbean Sea  and to the east the  Windward channel which separates it from Haiti. The Republic of Cuba occupies the entire island, and the more than 1,600 surrounding islets, such as the Isle of Youth  (Isla de la Juventud), with the exception of  Guantánamo Bay , a naval base that has been “loaned” garlic United States  in  1903 .

The elongated shape of the island on the east-west axis and therefore its irrelevant difference in latitude between its north and south ends , make the island uniform from a climatic point of view, characterized by the constant blowing of the trade winds that come from the ocean Atlantic.
The  tropical climate  is divided into two seasons,
the dry season in winter (November to April)    and the dry season in  Cubait coincides with the winter one and is characterized by a pleasant climate with temperatures ranging between 26° and 28° C. The rains are notably reduced, although still possible on the northern slopes, more exposed to the fresh irruptions of the States. On these occasions, in particular, from December to March, temperatures can drop as low as 10°C, especially in the northwestern part of the island, where both the capital Havana and Varadero are located. The southern coast, on the other hand, is more rarely affected by the cold. The winter season is the most suitable for visiting the city and enjoying various excursions, but in any case on fine days, you can also experience beach life, especially in the south-east, which is more sheltered from the north winds and with temperatures reaching 30°C all year round.

Wet and rainy season from May to October.  The rainy season in  Cuba  is very hot everywhere, with the heat only partially tempered by the trade winds. Especially between July and August temperatures reach 33-34°C and the high humidity makes the heat more oppressive. The rains are intense throughout the period, except for a relative lull in the month of July, but they manifest themselves in the form of intense and short thunderstorms that arrive during the afternoon hours, leaving space for the sun immediately afterwards.

During the wet season, especially between September and October, hurricanes can occur, very deep depression systems, with a variable extension between  150 and 600  km  in diameter, which manage to develop winds of extraordinary intensity (up to  300  km/h ) and flooding torrential rains, which cause serious problems for the population with a certain regularity. In terms of extreme weather phenomena, Cuba is prone to hurricanes which can be characterized by winds exceeding 250km/h and torrential rains. However, these events do not pose a threat to the lives of people who can shelter in modern buildings

Average temperatures on an annual scale are between 20 and 30  °C and rainfall is abundant and intense in the summer. The temperature of the sea water, also due to the presence of the nearby  Gulf stream , fluctuates between  26  °C  in winter and  28-30°C in summer.

Ambient climate and climate change. How does it influence life in Cuba?

Climate change has affected Cuba’s climate and seasons in several ways. First, Cuba’s tropical climate has become warmer and more humid, with the winter seasons getting hotter.
Extreme weather events, such as more intense storms and longer dry spells, are becoming more frequent, affecting the country’s agriculture and food production as well as tourism this season.
Sea level rise due to climate change also has a negative impact on Cuba’s coastal areas and fisheries. These climate changes are affecting the health of the Cuban population, increasing vulnerability to climate-sensitive diseases, such as an exponential increase in cases of dengue fever. THEClimate change has also caused significant economic damage to Cuba, with a loss of $65.85 billion in GDP between 1990 and 2019. These factors, combined with political and economic crises, are contributing to the emigration of a large number of Cubans.

Climate and environment What is the best time to travel to Cuba?

The temperatures are pleasant all year round, with oscillations between 20 and 30° C, on average throughout the country: in fact, there are no great variations between one area and another and also the sea is always warm , registering an average , even during the winter, about 25°C in Havana and 26-27°C on the southern coast. The island can therefore be perfectly visited in every season , although for those who want to avoid the risk of rain it is preferable to organize the trip in winter.
During the summer, on the other hand, it is easy to come across the typical tropical thunderstorms , even if they are short-lived rains that occur mainly in the late afternoon. Furthermore, from June to November, qTherefore, throughout the rainy season, Cuba can be hit by hurricanes: tropical storms and cyclones, coming from the east, affect the eastern part more, in any case.

When to find the best climate?

In Cuba, for those who want to live on the beach, the best period is undoubtedly the one that goes from May to October. However, this period has a couple of drawbacks: sultry heat (with peaks of 35° C even in Havana and Varadero) and high humidity which causes annoying thunderstorms in the afternoon. Moreover, remember, from June to November there is the danger of hurricanes, therefore it is advisable to consult the weather forecast in the days preceding departure to travel in safety.

For those who, on the other hand, want to dedicate themselves to an “itinerant” holiday , go on excursions and wander around the cities and the beauties of the island, the ideal period is undoubtedly the winter, from November to April. In fact, in this period of time, the rains are extremely rare and the temperatures are pleasant but not very hot. The more “adventurous” will be able to enjoy the beaches and the sea, perhaps moving to the eastern part of the island, where the climate is a little warmer and even the water allows for pleasant swimming

When is it not advisable to go to Cuba?

Even if there isn’t a really bad time to visit Cuba, you have to deal with the hurricane season which, although unlikely, can still reach the island in the months from June to November and especially from August to October. In July and August then, despite being in a low season, coinciding with the rains, heat and high humidity, crowds of visitors are not lacking and the Cubans themselves flock to the local beaches. So those traveling in these months will have to take into account, however, a strong tourist turnout.

What are the characteristics of the environment of the destination country of your trip?

What environments and what natural resources do we find in Cuba?

Cuba hosts an important biodiversity and a large number of endemic species, ranging from the smallest bird on the planet ( Elena’s hummingbird ) to the  Cuban crocodile  which can measure up to six meters in length. Other species include land iguanas, the  hutia , 370 species of birds, 26 bats and snails of the genus  Polymita . The country is one of the few where bee populations have not declined, thanks to the promotion of organic agriculture .

The island has so far managed to keep its natural beauty intact and is considered the green lung of the Caribbean . The Cuban authorities have made the protection of natural heritage a priority and have created more than 250 protected natural areas, covering 22% of the country. The “Queen’s Garden” nature reserve, which includes almost 150 kilometers of islands, reefs and mangroves, is home to one of the best preserved coral reefs in the world. However, the development of mass tourism and global warming are causing some concern.
Its territory is mostly flat , with a cordillera that stretches parallel to the coast. Here the landscape is characterized by the  Mogotes de Jumagua , limestone formations covered with vegetation.
The remarkable coastal development offers a wide variety of seascapes, from the rocky coast to the high and craggy ones, but above all a huge expanse of beaches. The reef extends outside the Camagüey archipelago . In the development of the coast there are deep and wide inlets that constitute natural port basins of exceptional value and beauty, locations of the historic commercial ports of Cuba such as  Havana ,  Santiago de Cuba  and  Cienfuegos.
The rivers are characterized by having a short course , given the narrow shape of the island. However, they are rich in water, even if their regime is determined by the rains: some have underground stretches due to the karst formation of the land. The longest is the  Rio Cauto  (343  km )  which, unlike the others, flows longitudinally.

Beaches in Cuba

Sol de Cuba

The beaches of Cuba  are an attraction for their particularity. Ideal places to relax, have fun or practice various water activities such as  scuba diving and snorkelling. However, deciding which beach to visit is not always easy. Around this large island there are many spectacular small beaches , with their  natural landscapes  .  The Cuban archipelago  is made up of two  islands , Cuba Island  and Juventud Island , which have a large number of beaches. Thousands of keys (small islands) form part of this archipelago, in which, even if not all habitable, there are the most beautiful and luxuriant beaches. Many little frequented and known. In Cuba  Varadero must be a mandatory destination. This wonderful Cuban city  is the most famous destination internationally for its  paradisiacal beaches . Of its 30 km of extension, 22

Playa Santa Maria del Mar, Cuba

km are  beaches.  The famous Blue Beach  is also the largest, and its fame is not only given by its idyllic landscape with colors such as blue and turquoise that contrast with the colors of nature, but it is also given by the many leisure  activities that it is possible to accomplish. There is no shortage of attractions of the   cayos , small  islands  located on the  Atlantic coast  and in the  Caribbean sea. A true spectacle of nature and beauty. Crystal clear and warm waters , an extraordinary fauna  with its  exotic animals that share their habitat with the vegetation; the great coral reef  with its huge variety of  colorful fish . Even in Havana , the beaches  are close and easily accessible. The best known set of  beaches  is called  Playas del Este ,  made up of seven beaches where you will meet the authentic Cuban spirit . Of these beaches, the most famous is  Santa María del Mar. Of this group of beaches, Playa Jibacoa  and  Playa Trópico also stand out , perfect for diving into  the seabed .

What are the most interesting Natural Parks in Cuba?
Cuba  differs from the rest of the island Caribbean countries by its wonderful natural landscapes, as it has numerous natural parks which constitute one of the most popular attractions of the country.

Vinales Valley, Pinar Del Rio

Some of its parks have international fame, while others are essential places for any tourist who wants to get to know Cuba in the slightest.
Among these are the   Parque Nacional de Viñales , famous for its sugar, tobacco and coffee crops;
the Valle de Viñale , with its impressive  mogotes  (hills) full of vegetation;
the surprising   Mural de la Prehistoria , a place which together with the   Cueva del Indio  constitute one of the most visited points of  Pinar del Río , the westernmost province of Cuba.
Furthermore, this province also offers two stupendous and paradisiacal natural islets where the impact of man has been reduced to a minimum: Cayo Levisa  and  Cayo Jutías .

In the provinces of Artemisa and Mayabeque, around Havana, are the  Parque Natural de Soroa  and the ecological complex of  Las Terrazas , both located within the  Reserva de la Biosfera Sierra del Rosario , a stupendous place endowed with an incredible beauty whose main attractions are the famous  Salto del Arcoíris , an impressive natural waterfall, the towns of Soroa and Las Terrazas and the Orquideario de Soroa, a botanical garden where you can admire more than 20,000 specimens of 700 species of orchids.

In the province of Matanzas is the  Parque Nacional Península de Zapata , famous for hosting the exuberant  Ciénaga de Zapata  and the  Gran  Parque Natural de Montemar , where you can find the beautiful  Laguna del Tesoro ,  Boca Guamá ,  the Taíno village and the historic  Bahía de Cochinos .

Topes de Collantes, Sancti Spiritus

In the most central part of Cuba is the  Sierra del Escambray , which forms the  Gran Parque Natural de  Topes de Collantes , where the famous waterfalls of  Topes de Collantes  and  El Nicho are located , located near  Cienfuegos and Trinidad .

Another important natural park in the central area of ​​Cuba is the  Parque Nacional de Caguanes , which with its 10 small islets is considered as part of the Biosfera de Buenavista reserve.

In eastern Cuba, the  Parque Nacional Alejandro de Humboldt stands out , shared by the provinces of   Holguín  and  Guantánamo . The park offers various tourist centers, trails, paths, rural accommodation and camping areas.

Even the small Isla de la Juventud hosts important natural parks such as that of Punta Francés or the Parque Nacional Ciénaga de Lanier, considered as the third most important swamp in all of Cuba.

What are the diseases present in Cuba? What are the real risks (March 2023)

Malaria, yellow fever, cholera, meningitis are diseases present in Cuba?

Both the WHO “World Health Organization” and the American CDC “Centers for Disease Control and Prevention” constantly monitor and report the various diseases present in Cuba. Our direct experience in different areas of the country confirms the presence of a series of diseases endemic to most of the territory, including large cities.

Is malaria present in Cuba?

The risk of malaria infection in Cuba is practically absent. Cases of malaria have not been described for a long time, and even the places where the Anopheles is present are free from the disease. Mosquitoes do not carry the parasite and cannot transmit the disease.

Are there any risks in Cuba for traveler’s diarrhea?
Traveler’s diarrhea : (click here)
Traveler’s diarrhea is one of the most common diseases during a stay in Cuba. More than 60% of travelers to the country suffer from these annoying intestinal infectious forms. It can be caused by various pathogens, including bacteria, viruses and parasites. It may be appropriate to use some drugs in prevention.

Is Yellow Fever in Cuba and do I need to get vaccinated?
Yellow fever : (click here)
Yellow fever, a viral disease transmitted by mosquitoes of the genus Aedes, is not present in all of Cuba.

Are there cholera outbreaks in Cuba? How do we protect ourselves?

As indicated by the Cuban health authorities, there are localized outbreaks of cholera (click here)   in different areas of the country and on different islands. The disease circulates throughout the Caribbean area and is endemic. Cholera is an acute intestinal infectious disease. Always present on the island, it grew further after the epidemic that developed in Haiti. It was developed by being transmitted through contaminated water and food.

Is there a risk of AIDS in case of unprotected intercourse?
HIV/AIDS :
HIV/AIDS is a major public health problem in the country. The virus continues to circulate in an important part of the population even if for several years the control of the disease has led to excellent results. It is important to be careful in sexual intercourse with several random partners and the protection and use of condoms is recommended.

Are arboviruses such as Dengue, Chikungunja or Zika present in Cuba?

Dengue and arbovirus : (click here)

Briefly, dengue is an acute viral disease transmitted by the Aedes aegypti mosquito. The reservoir is the infected man; for this reason it developed mainly in large cities. Symptoms can include high fever, headache, muscle and joint pain, nausea, and skin rashes. Dengue can progress to hemorrhagic dengue, a more severe form of the disease that can be fatal. Since the beginning of 2023 it has been possible to have a vaccine for this disease.
Outbreaks of dengue hemorrhagic feverthey are present in almost all the country, but especially in the big cities and in various humid parts of the island. Dengue is a viral disease transmitted by the bite of Aedes mosquitoes. The disease is widespread in urban areas. Frequent outbreaks occur in cities and in particular in the capital. Prevention consists in paying attention to insect bites and protection with repellents. We recommend NOZETA – NEEM oil, very effective and with repellent and soothing characteristics.

It is important to evaluate the inoculation of the new vaccine for Dengue, called QDENGA

For information and reservations of the DENGUE vaccine (CLICK HERE)

Chikungunya and Zika viruses :

There are some outbreaks of these arboviruses, similar to dengue, which occur sporadically in many of the islands of the Cuban archipelago.

The Cuban government has taken several measures to control and prevent the spread of dengue and other arboviruses in the country, including:

1. Information and awareness campaigns to educate the population about the risks of dengue and other viruses and how to prevent them.
2. Mosquito control through the elimination of breeding sites, the use of insecticides and the distribution of insecticide-treated bed nets.
3. Surveillance and monitoring of cases of dengue and other viruses to quickly identify outbreaks and take timely action.
4. Treatment and care of dengue patients in health centres.

Are there outbreaks of tuberculosis in Cuba and what is the risk of contagion? (TB) :
TB is another infectious disease present in high incidence in several populated areas of the island. It is particularly developed in the suburbs of the big city. It has a low mortality rate.

Are there any cases of canine or other animal rabies?
Rabies : (click here)
There are widespread cases of rabies in the country due to the presence of animals carrying the virus, both dogs and wild animals. Monkeys and bats can also spread the virus. It is advisable to evaluate the risks for any vaccination practice.

Is heartworm present, or schistosomiasis (bylarthia) or onchocerca, the blindness of rivers?

Neglected Tropical Diseases (NTD) : (click here)
NTDs are a group of neglected diseases that affect people living in poverty and rural areas. In Cuba, NTDs include lymphatic filariasis, and schistosomiasis in well-localized areas.
These are some of the major diseases found in Cuba, but there are also other diseases that have been reported in the island by WHO and the CDC.

Schistosomiasis is a parasitic infection with Schistosoma (Bilarzia) fluke worms, it is present in some areas of the country. The parasitesinfect humans by entering the bloodstream transcutaneously from contact with contaminated freshwater (baths or diving). The larvae of these microorganisms infect the vascular system and are transferred via capillaries in the gastrointestinal and genitourinary systems. To avoid schistosomiasis, contact with contaminated fresh water must be avoided, as the disease is transmitted through direct contact with these waters and not by ingestion. Also, it is important to avoid swimming, bathing, or walking in fresh water known to contain schistosomes. Using toilets for urination and defecation Using snail-killing chemicals (molluscicides) in freshwater bodies known to contain schistosomes is a disease control system”

 

Vaccinations

Which vaccination is mandatory for Cuba and how should we behave?

YELLOW FEVER if…..  

Cuba is a country where yellow fever is not present, there is no risk of becoming infected and ill, but the Cuban government requires yellow fever vaccination for travelers from countries endemic or infected with the disease, such as parts of Africa and Latin America.  If you are from one of these countries or have spent time in an area with a high yellow fever risk in the six weeks prior to your trip to Cuba, you are required to present your yellow fever vaccination certificate upon arrival at the airport . You must get the yellow fever vaccination before traveling to Cuba.

(Updated March 2023)

What vaccinations are recommended for Cuba and what should be done?

Recommended vaccinations:
do I need to get the yellow fever vaccination for Cuba? The certificate of vaccination against Yellow Fever except for those arriving from countries endemic or infected with the disease. Vaccination is not recommended for travelers from virus-free countries. (Updated March 2023)
 

Other recommended vaccinations:

Is vaccination for DENGUE recommended?. 
Given the presence of widespread outbreaks in the country, especially in the rainy season, it is advisable to evaluate the possibility of carrying out the new vaccine for DENGUE. Prevention consists in paying attention to insect bites and protection with repellents. We recommend NOZETA – NEEM oil, very effective and with repellent and soothing characteristics.
The main prophylaxis consists in the inoculation of the new vaccine. Important is the assessment of environmental and biological risk, and deciding for the inoculation of the new vaccine for Dengue, called QDENGA

For information and reservations of the DENGUE vaccine (CLICK HERE)

Hepatitis A vaccination is recommended

to know more….

Vaccination for TYPHOID FEVER is recommended – to know more….

DIARRHOIC AND COLERIFORM SYNDROMES    
Is vaccination for cholera recommended? Vaccination is essential for effective protection against “Vibrio del Cholera” and other intestinal pathogenic bacteria, even aggressive ones, which cause “traveller’s diarrhea”. It should always be regarded as protective of the intestine. It can be taken into consideration depending on the type of trip and stay. The “oral” formulation of thecholera vaccinealso protects against intestinal infections caused by many enterotoxic agents. The vaccine is therefore recommended for travel to many countries around the world.

These are essential vaccines for protection against “food” infections, i.e. transmitted by “contaminated food and drink”; “dirty hands”; contaminated dishes, plates, glasses: (valid everywhere, in Italy and in most countries of the world)

Is vaccination for HEPATITIS B recommended ? to know more….
Protection from contact with infected blood: in the event of medication due to an accident during the trip (in clinics or local EDs) for infections due to medication irons; syringes in health care facilities with poor hygiene; sexual transmission unprotected sex; other contacts with blood; (valid everywhere, in Italy and in most countries of the world)

Is vaccination for MENINGOCOCCAL MENINGITIS recommended? to know more…
Protection from infections transmitted by saliva droplets, breathing and coughing, through the air, in airplanes, crowded places, buses and trains, offices and schools, poorly ventilated environments; (For your personal protection and for the protection of the people close to you (family – work) – possibility of becoming a healthy carrier of the meningitis bacterium.) (valid everywhere, in Italy and in most countries of the world) It
is Is tetanus vaccination recommended ?   to learn more…
Is vaccination for POLIOMELITE recommended?
Following the latest epidemiological data and related recommendations issued by the WHO, travelers are recommended a vaccine booster (IPV-injection) best done together with (tetanus-diphtheria-pertussis-quadrivalent vaccine) to be boosted every 10 years. The effectiveness of the vaccine, being a reminder of vaccinations made in the past, is immediate.
Protection from infections transmitted by faecal micro-particles present in the soil, contact and ingestion; (valid everywhere, in Italy and in most countries of the world)
ROUTINE VACCINATIONS
Make sure you have carried out all the vaccinations required by the National Health System . These include: tetanus, diphtheria, polio, pertussis, haemophilus B, hepatitis B, measles, mumps, rubella, chicken pox.

Malaria: situation and prevention

What is the malaria situation in Cuba?

The risk of malaria infection in Cuba is practically non-existent. Cases of malaria have not been described for a long time, and even the places where the Anopheles is present are free from the disease. Mosquitoes do not carry the parasite and cannot transmit the disease.

What should I do if I return from the trip with health problems?

In case of fever, diarrhea or in any case if you feel unwell, it is essential to consult a doctor without delay (in case of fever, possibly within 24 hours, due to the possibility of having contracted malaria, if you are returning from an area at risk) . Specialist or expert in Tropical Diseases. Read everything…

Local traditions, foods, drinks

What are some curiosities and what are the major traditions in Cuba?

Some of the topics to explore related to the most important traditions in Cuba:
In Cuba, there are several curiosities and traditions that characterize its unique culture. One of the most famous traditions is the story of the Giraldilla, a small bronze sculpture that represents a flag and which has become a symbol of the city of Havana[1].

 GIRALDILLA AND THE LOVE STORY The Giraldilla is the name given to a weather vane located on the bell tower of the castle of la Real Fuerza in Havana, a small bronze sculpture that has become the symbol of the city of Havana. The story of its origins is lost in the legend of a love story.   It is said that the beautiful  Doña Isabel of Bobadilla , married to  Hernando de Soto appointed Captain General of Cuba by the King of Spain Carlos I, she used to wait for her husband spending many hours in the watchtower of the Castello de la Real Fuerza waiting to spot the ships that would bring her husband home from a long exploratory voyage to the continent American (present-day Georgia, Alabama and Florida). Unfortunately Hernando de Soto died in those lands due to an uncontrollable fever (probable malaria), it is said that her wife died of love when she knew her husband’s fate.
A few years later, the artist Gerónimo Martin Chaffinch (1607-1649), was inspired by Doña Isabel of Bobadilla taking her as a reference and symbol of marriage by sculpting a figure of her in her memory.
The governor of the city at that time, Don Juan Bitrián Viamonte, had the brass sculpture cast into a bronze weather vane and then fixed atop the tallest tower of the newly built castle. Governor Bitrán christened this weather vane Giraldilla, after the Giralda in his hometown of Seville. The original statuette is kept in the city museum, a copy is placed on the highest point of the castle.

The Guayabera shirt , originally created for farmers in Sancti Spiritus, is now a popular, fresh and elegant garment with four large pockets on the front, two pleats on the chest and three on the back. GUAYABERA, TYPICAL CUBAN SHIRT
It is said that a farmer in the province of Sancti Spiritus asked his wife to make a comfortable shirt for working in the fields. His wife made a new shirt that was comfortable and practical but she could not imagine that its original design will subsequently make it so popular, first among the residents of the area and then all over the world.
The name of this shirt was  yayabera , because she was born in the region near the Yayabo River. It is also said that the farmers of that area, when harvesting the guavas (local fruit), left some fruits in the pockets of the yayabera and for this reason the name was soon transformed into  guayabera . Generally in white fabric, it is a fresh, comfortable and elegant dress and can have long or short sleeves. It usually has four large pockets at the front, two rows of pleats at the chest and three at the back ending in two buttons.
Another hypothesis on the origin of the guayabera is attributed to a Spanish immigrant who became a tailor in the village of Sancti Spiritus in the 18th century. He made and sold large shirts with comfortable pockets to hold cigars, in other words, a garment similar to the current guayabera.

Whether the origins can be attributed to the hands of the farmer’s wife or to the Spanish tailor, the guayabera has become very popular, so much so that in 1880 the town hall of Sancti Spiritus authorized its use in official events. In the second half of the 20th century, Cuban politicians began to wear it on their electoral tours across the island, in the hope of being more pleasing to the peasant population.

In the 1950s, a modification was introduced to the garment by adding a lace around the neck to give a more formal character to the guayabera so that it was introduced in large living rooms and even in official government meetings. When Ramón Grau San Martin assumed the first judiciary in 1944, he elevated it to the rank of law courts.

NEW YEAR’S EVE IN LAS CHARANGAS DE BEJUCAL Anyone who decides to go to Cuba to celebrate the end of the year in the name of sun and sea will find themselves in the midst of one of the oldest festivals in Havana, Las Charangas de Bejucal.  During the fiesta, the city is divided into two parts, one blue and one red, which revives a past rivalry between Creoles and Spaniards on one side and Africans on the other, to the sound of music.

The performances of  Los Tambores de Bejucal  (a typical Cuban percussion band of high international prestige) ignite the traditional rivalry between two conga groups. The  Ceibistas  (members of the Ceiba de Plata group, characterized by the color blue and a scorpion as their symbol) compete with the  Espinistas  (members of Espina de Oro, who wear red and have a rooster as their symbol), to see who can play the drums with the highest and most impressive sound. Typical food at  Charangas it includes pan con lechón (pork sandwich), popcorn, churros (fried sweet pastry strips) and cotton candy. The origin of the Charangas is very similar to that of the Parrandas de Remedios and dates back to 1830. At the beginning the The feast had a purely religious character and according to tradition it took place on December 24, the date on which the slaves were freed to then join the free blacks and the Creoles. During the festival, black Africans worshiped the Orishas (African deities), playing their drums, saying prayers and dancing along the main streets of Bejucal. Their rites had particular characteristics depending on the ethnic group they came from, the Congo, Carabalíes, Ararás, Mandigas and Lucimíes who, inevitably, had different spiritual traditions and formed their own cabildos.

The Spaniards and Creoles who lived in Bejucal, allowed the party, baptized a group of black and mixed people with the name of Musicanga (which meant disgusting and poor music) while another group of black people took the name of Malayos (which meant red-roosters). The Musicangai adopted the color blue and a scorpion as their representative animal while the Malayos chose the color red and the rooster as their favorite animal. Thanks to the fusion of cultures that characterize the Cuban identity, racial and class differences have been lost over time. At the beginning of the 20th century, the rival groups renamed themselves: the Musicanga was called Ceiba de Plata (the silver of silk-cotton) and the Malayos took the name of Espina de Oro (the golden thorn).

The Santiago de Cuba Carnival is the largest and most famous in Cuba, where different cultures mix evident in the richness of music and dance[1]. The extras, groups of costumed performers who perform music and dance, are one of the main attractions of the carnival[1]. Music in Cuba is an important artistic expression and part of daily life, often accompanied by rhythmic and vital dances such as mambo, salsa and cha-cha-cha[2]. Dance styles such as Rumba, Son and Salsa are the result of African and Spanish influence[2].

Finally, some food and drink traditions include the Mojito, the Cuba-libre and the Daiquiri, as well as the famous Cuban rum[3]. Cuban cigars are also an important part of the country’s culture and identity[3]. The Santiago de Cuba Carnival is an iconic and traditional celebration that dates back to at least the 17th century[2]. This annual event takes place from July 21 to 28, attracting thousands of people from all over the country and around the world[3]. Festivities include night processions, parties and street concerts, as well as daytime performances involving music, dance and song[3].

Sappadas are a staple of the carnival, with groups of musicians and dancers performing in the streets, wearing colorful traditional costumes[1]. These groups of artists help create an electrifying and engaging atmosphere during the celebrations.

During the Santiago de Cuba Carnival, music is omnipresent and plays a crucial role in creating the festive atmosphere[3]. Typical carnival musical styles include Cuban son, cha-cha-cha, mambo and rumba, all influenced by African, European and indigenous traditions.

The Carnival coincides with Cuba’s National Day and the anniversary of the attack on the Moncada Barracks, which falls on July 26 [3]. This historic date is an important moment for the nation and adds another layer of meaning to carnival celebrations.

If you wish to visit Santiago de Cuba during Carnival, it is advisable to plan ahead, as transport and accommodation can be difficult to find due to the high influx of people[3]. Being part of this cultural celebration is a unique and memorable experience that will allow you to immerse yourself in Cuban traditions and history.

 

Tribes and Cultures:

In Cuba, originally, there were several Amerindian populations, including the Taíno, the Siboney and the Guanajatabey [1]. However, after the arrival of the Spanish in 1492, these indigenous populations suffered a drastic decline due to disease, slavery and warfare [1]. Today, the Cuban population is mainly composed of descendants of Spaniards, Africans and mestizos, with predominant religions such as Roman Catholicism and Santeria [2]. There are also Christian-Protestant communities present on the island [2].

Population and culture

According to the 2019 census, Cuba has a population of approximately 11.2 million. Of these, over two million live in the capital Havana and surrounding areas. By Latin American standards, Cuba has a high life expectancy of 78.66 years, even slightly higher than the life expectancy in the United States (78.54 years). Due to the increase in life expectancy and the reduction of infant mortality at birth to 5.5 cases per 1,000 births (for comparison, 3 cases in Italy and 6.5 cases in the United States per 1,000 births), the population of Cuba has experienced a steady increase until 2016. From 2016 onwards the population remained unchanged or even decreased slightly.

Cuba’s population is multi-ethnic, due to its complex colonial origins and slave economy. Marriages between ethnic groups are widespread, thus favoring the great variety, despite a certain discrepancy in the census of the country’s population: if the Institute of Cuban and Cuban-American Studies at the University of Miami found that 62% of Cubans are black, the 2002 Cuban census showed that 65.05% of Cuba’s population is white. These results can be influenced by socially desirable factors and by formulations that hide political motivations.

Cuba is officially a secular state. Prior to the 1992 constitutional amendment, Cuba classified itself as an atheist state. With the new constitution, freedom of religion has increased. Cuba’s main religions are Catholicism and Santeria, a religion based on the traditional religion of the Yoruba people of West Africa, which is heavily mixed with Christian elements.

Spanish is spoken in Cuba. Minority languages, such as the Indian languages ​​spoken in other Latin American countries, are almost non-existent. Despite the many tourists, it is usually difficult to find signs in English in museums and other tourist places in Cuba. English is a language that was not usually learned or taught in Cuba, given the long and famous conflicts between Cuba and the United States . Even though more and more young people are learning it privately and English is also taught in schools, the diffusion of the language is still limited. Most of the teachers are low qualified and the supply is by no means sufficient. Travelers who book a package holiday with an all-inclusive hotel or a fully organized trip with an Italian or English-speaking guide do not need to speak Spanish, but other than the hotel staff they will have almost no contact with the locals which is a pity. A good idea for those planning to travel to Cuba is therefore to learn some Spanish beforehand.

 

Dances and music: the enthralling Cuban rhythms

Cuba is home to  Caribbean rhythms : the notes of mambo, rumba, salsa and cha-cha-cha (which originated here) will be the soundtrack of your trip to the island. Also not to be missed are the Afro-Latin jazz big bands, brought to the fore in recent years by the Buena Vista Social Club.

In Cuba music is not only an artistic expression, but  a companion of daily life , often accompanied by rhythmic and vital dances. Cuban dances represent   the love for life that characterizes the people of Cuba, here every dance has its music, and music does not exist without dance! Cuban music developed from the influences of African slaves deported to the island and from the influences of Spanish immigrants.

There were three original styles :   the son, of Spanish and African origin, the danzon, which draws on the French tradition and with more sedate rhythms, the third trend, totally deriving from African culture. The three styles then mixed together and gave birth to  different strands  such as Rumba, Son, Salsa, Reggaeton, Bachata and obviously Cha Cha Cha.

In Cuba, you’ll find a diverse range of musical genres that reflect the island’s rich cultural diversity. Some of the main Cuban musical genres include Rumba, Danzon, Son, Danzon-mambo and Cha cha cha [1]. Rumba, for example, is a genre of Afro-Cuban music and dance that combines drumming, singing, and energetic dance movements. Son, on the other hand, is a musical style characterized by the fusion of African and Spanish elements, often considered the heart of Cuban music.

Santiago de Cuba, in particular, has been the cradle of many Cuban musical genres and is the center of the country’s Afro-Cuban culture [2]. The influence of Cuban music has also spread beyond the borders of the island, as evidenced by the Salsa genre, which originated in New York City and was heavily influenced by Cuban music [1]. Tito Puente, known as the King of Salsa and the King of Latin Jazz, was an icon of Latin music who helped spread these genres around the world [1].

In addition to traditional musical genres, more modern and international styles can also be found in Cuba, such as Rap and Hip-Hop [3]

 

What traditional foods can I find in Cuba?

The 10 most sought-after traditional dishes in Cuba are:

Arroz con Pollo (Chicken and Rice) 

Moros y Cristianos (rice and black beans)

Ropa vieja (pulled beef stew)

Masitas de Puerco Fritas (fried pork) 

Ajiaco Criollo (meat and vegetable stew)

Cuban Sandwich (sandwich with roast pork, ham, cheese and mustard)

Fufu (plantain puree) 

Picadillo a la Habanera (minced meat with onions, peppers and spices)

Tamales (corn dough with meat and vegetables)

Casabe (Cassava Flour-Based Flatbread) 

These dishes reflect Cuban cuisine, with Spanish and African influences, and the use of spices, meats such as pork and chicken, and vegetables such as peppers, cucumbers, onions and potatoes.

What are the 10 traditional drinks that I can try while staying in Cuba?

What you definitely drink in Cuba is rum. Very high quality and cheap. Traditional Cuban drinks usually still contain Cuban rum and most often Havana Club. Cuba Libre, the signature alcoholic drink without Coca-Cola. There is no coca as an American product in Cuba. So the traditional drink Cuba Libre is served with a cola drink, but not with Coca-Cola and lime juice. Other drinks include Piña Coladas, Daiquiris, Mojitos, Havana Loco, Cuban beers like Crystal and Buchanero and, of course, fresh coconut juice.
Among the most popular drinks:

Mojito: a refreshing cocktail made with rum, mint, sugar, lime juice and sparkling water.

Cuba Libre: a classic cocktail made with rum, Coca-Cola and lime juice.

Daiquiri: a cocktail made with rum, lime juice and sugar syrup.

Piña Colada: a creamy cocktail made with rum, pineapple juice and coconut milk.

Canchánchara: a historic cocktail made with rum, honey, lime juice and hot water.

El Presidente: an elegant cocktail made with rum, vermouth, curaçao and grenadine.

Saoco: A refreshing cocktail made with rum, coconut water and lime juice.

Guarapo: A soft drink made from fresh sugar cane juice.

Malojillo: A soft drink made from lemonade and malojillo leaves, a plant similar to lemongrass.

Café Cubano: A strong, sweet espresso often served in small cups.

Cerveza: The local beer, with popular brands like Cristal and Bucanero.

Ron Collins: A cocktail similar to the Tom Collins, but with rum instead of gin.

Batido: a blended drink made from fresh fruit, milk and sugar.

Crema de Vie: a sweet liqueur similar to Irish liqueur, made from milk, sugar, eggs, rum and spices.

Jugo de Tamarindo: A soft drink made from tamarind juice and sugar

What general info is useful to me during the trip?

General informations

Language: Spanish

Capital: Havana

Currency: Cuban peso

Time zone: GMT -5

History, Economy, Culture: https://www.cia.gov http://www.britannica.com

Safety: – www.viaggiaresicuri.it – www.dovesiamonelmondo.it

Some useful health information to keep you healthy on the go

What are the main rules and how should I prepare for the trip?

Give your body time to adjust to the new climate and new environment. Before the trip, if possible, dedicate a few hours to physical activity, and get your body used to the new rhythms during the trip …read more

Who should get vaccinated for yellow fever? And is the vaccine mandatory? And where?

Vaccination against Yellow Fever or Amaryllis Vaccine, an acute viral disease, which is transmitted by mosquito bite, is the only preventive practice that can be compulsorily requested by the health authorities of a country in order to enter through the border crossings …  . Read everything

How should I protect myself from the bites of mosquitoes and other insects?

Mosquitoes & co. – How to protect yourself: mosquitoes that transmit diseases other than malaria are active during the day and wherever there is a collection of fresh water: wear light-coloured, long clothes with wide sleeves, long and wide, light-coloured trousers, T-shirts or shirts with long and wide sleeves and light color to be tucked into the belt of the trousers ……read more

But is it really dangerous to swim in some lakes or rivers in tropical countries? And why?

To prevent the possible transmission of infectious diseases, it is advisable to swim only in pools with chlorinated water. The sea water is safe.
Bathing in contaminated water can be dangerous for the skin, eyes, ears, mucous membranes of the mouth, especially if  … read more

How can I avoid altitude sickness?

It is a set of symptoms that can occur when the human organism, having exceeded 2500 meters of altitude, has not yet adapted to the new environmental situation. We can define high altitude as follows … read more

How to travel safely? Who should I notify before leaving on a trip, especially to distant, unsafe countries?

Safety: www.viaggiaresicuri.it www.dovesiamonelmondo.it

 

Brief advice for those traveling in the country
What should I do when I go to Cuba?

If you are looking for a destination with a unique culture, breathtaking natural beauty, interesting history and warm people, then Cuba is the right destination. A vibrant and unique culture, with Spanish, African and Caribbean influences reflected in the island’s music, dance, architecture and cuisine. Incredible natural beauty, with white sand beaches and crystal clear waters, lush tropical forests and majestic mountains. Valle de Viñales , for example, is an Area of ​​Outstanding Natural Beauty, a UNESCO World Heritage Site, with tobacco fields and limestone mountains soaring into the sky. And few know that Cuba, in the middle of the Caribbean area, is an island state of Central America which includesthe homonymous island (about 105,007 square km and the Isla de la Juventud (about 2500 square km) and about 1600 islands and islets immersed in a fantastic and uncontaminated nature. Among these thousands of islands the Camagüey archipelago and that of the Canarreos constitute a set of islands to discover and visit.

In Cuba, for travellers, the main problem is characterized by forms of traveler’s diarrhea , spread through the intake of contaminated food and drink.  It is important to protect yourself from mosquito and insect bites . These carry diseases, first of all Dengue Viral Fever and also other Arboviruses. Use effective repellents, even natural ones. (Nozeta – Neem is an effective and advisable product) . Cuba is considered “malaria free” , ie the presence of the malarial parasite is not reported on the main island nor on the other thousands of small islands of the archipelago.
There is no presence of the yellow fever virus “Yellow Fever free” etherefore there is no need to carry out vaccination against the disease. But if you come from endemic or infected countries (Africa and Latin America) it is mandatory to get vaccinated.  Cholera is not officially present in the islands, but in the Caribbean, even via maritime transport, the cholera vibrio circulates almost everywhere. For years it has been fed by a circulation that developed from Haiti and from there spreads to many Caribbean and Central American islands and countries. The oral vaccine is recommended, which also covers forms of enterobacteria, especially E. Coli. Beware of tick bites with the possibility of developing a disease called exanthematous typhus.
Correct information, good preventive preparation before the trip, and shrewd behavior allow us to fully enjoy this trip.

How do I get correct health information to go to Cuba

Feel free to ask for advice to get to know problems and solutions   – dr. Paolo Meo, tropical infectious disease doctor

Health alerts
What are the current epidemics in Cuba?

COVID-19  Follow the daily case situation in the country (click here)

MARCH 2023: DENGUE 

Cases of viral haemorrhagic fever, particularly acute, were reported to increase already in the last quarter of 2022 in Cuba. Cases increased in the first quarter of 2023. They are increasing especially during the rainy season. It is possible to request the new dengue vaccine from the beginning of 2023. Particularly for those wishing to stay for an extended period.
At cesmet it is possible to book and get the vaccine against dengue.

 

Climate, weather, health and environment

What is the weather and upcoming weather forecast in Cuba?

Weather forecast in real time

What are the different seasons in the country and how are they characterized and how does the climate influence the spread of diseases?

Cuba is located in the northern part of the vast Caribbean archipelago  and is its largest island. To the north lies the United States, separated from Cuba by the  only 180 km wide Strait of Florida  and the North Atlantic Ocean . To the west is the  Yucatán channel  which divides it from the Central American continent, to the south the  Caribbean Sea  and to the east the  Windward channel which separates it from Haiti. The Republic of Cuba occupies the entire island, and the more than 1,600 surrounding islets, such as the Isle of Youth  (Isla de la Juventud), with the exception of  Guantánamo Bay , a naval base that has been “loaned” garlic United States  in  1903 .

The elongated shape of the island on the east-west axis and therefore its irrelevant difference in latitude between its north and south ends , make the island uniform from a climatic point of view, characterized by the constant blowing of the trade winds that come from the ocean Atlantic.
The  tropical climate  is divided into two seasons,
the dry season in winter (November to April)    and the dry season in  Cubait coincides with the winter one and is characterized by a pleasant climate with temperatures ranging between 26° and 28° C. The rains are notably reduced, although still possible on the northern slopes, more exposed to the fresh irruptions of the States. On these occasions, in particular, from December to March, temperatures can drop as low as 10°C, especially in the northwestern part of the island, where both the capital Havana and Varadero are located. The southern coast, on the other hand, is more rarely affected by the cold. The winter season is the most suitable for visiting the city and enjoying various excursions, but in any case on fine days, you can also experience beach life, especially in the south-east, which is more sheltered from the north winds and with temperatures reaching 30°C all year round.

Wet and rainy season from May to October.  The rainy season in  Cuba  is very hot everywhere, with the heat only partially tempered by the trade winds. Especially between July and August temperatures reach 33-34°C and the high humidity makes the heat more oppressive. The rains are intense throughout the period, except for a relative lull in the month of July, but they manifest themselves in the form of intense and short thunderstorms that arrive during the afternoon hours, leaving space for the sun immediately afterwards.

During the wet season, especially between September and October, hurricanes can occur, very deep depression systems, with a variable extension between  150 and 600  km  in diameter, which manage to develop winds of extraordinary intensity (up to  300  km/h ) and flooding torrential rains, which cause serious problems for the population with a certain regularity. In terms of extreme weather phenomena, Cuba is prone to hurricanes which can be characterized by winds exceeding 250km/h and torrential rains. However, these events do not pose a threat to the lives of people who can shelter in modern buildings

Average temperatures on an annual scale are between 20 and 30  °C and rainfall is abundant and intense in the summer. The temperature of the sea water, also due to the presence of the nearby  Gulf stream , fluctuates between  26  °C  in winter and  28-30°C in summer.

Ambient climate and climate change. How does it influence life in Cuba?

Climate change has affected Cuba’s climate and seasons in several ways. First, Cuba’s tropical climate has become warmer and more humid, with the winter seasons getting hotter.
Extreme weather events, such as more intense storms and longer dry spells, are becoming more frequent, affecting the country’s agriculture and food production as well as tourism this season.
Sea level rise due to climate change also has a negative impact on Cuba’s coastal areas and fisheries. These climate changes are affecting the health of the Cuban population, increasing vulnerability to climate-sensitive diseases, such as an exponential increase in cases of dengue fever. THEClimate change has also caused significant economic damage to Cuba, with a loss of $65.85 billion in GDP between 1990 and 2019. These factors, combined with political and economic crises, are contributing to the emigration of a large number of Cubans.

Climate and environment What is the best time to travel to Cuba?

The temperatures are pleasant all year round, with oscillations between 20 and 30° C, on average throughout the country: in fact, there are no great variations between one area and another and also the sea is always warm , registering an average , even during the winter, about 25°C in Havana and 26-27°C on the southern coast. The island can therefore be perfectly visited in every season , although for those who want to avoid the risk of rain it is preferable to organize the trip in winter.
During the summer, on the other hand, it is easy to come across the typical tropical thunderstorms , even if they are short-lived rains that occur mainly in the late afternoon. Furthermore, from June to November, qTherefore, throughout the rainy season, Cuba can be hit by hurricanes: tropical storms and cyclones, coming from the east, affect the eastern part more, in any case.

When to find the best climate?

In Cuba, for those who want to live on the beach, the best period is undoubtedly the one that goes from May to October. However, this period has a couple of drawbacks: sultry heat (with peaks of 35° C even in Havana and Varadero) and high humidity which causes annoying thunderstorms in the afternoon. Moreover, remember, from June to November there is the danger of hurricanes, therefore it is advisable to consult the weather forecast in the days preceding departure to travel in safety.

For those who, on the other hand, want to dedicate themselves to an “itinerant” holiday , go on excursions and wander around the cities and the beauties of the island, the ideal period is undoubtedly the winter, from November to April. In fact, in this period of time, the rains are extremely rare and the temperatures are pleasant but not very hot. The more “adventurous” will be able to enjoy the beaches and the sea, perhaps moving to the eastern part of the island, where the climate is a little warmer and even the water allows for pleasant swimming

When is it not advisable to go to Cuba?

Even if there isn’t a really bad time to visit Cuba, you have to deal with the hurricane season which, although unlikely, can still reach the island in the months from June to November and especially from August to October. In July and August then, despite being in a low season, coinciding with the rains, heat and high humidity, crowds of visitors are not lacking and the Cubans themselves flock to the local beaches. So those traveling in these months will have to take into account, however, a strong tourist turnout.

What are the characteristics of the environment of the destination country of your trip?

What environments and what natural resources do we find in Cuba?

Cuba hosts an important biodiversity and a large number of endemic species, ranging from the smallest bird on the planet ( Elena’s hummingbird ) to the  Cuban crocodile  which can measure up to six meters in length. Other species include land iguanas, the  hutia , 370 species of birds, 26 bats and snails of the genus  Polymita . The country is one of the few where bee populations have not declined, thanks to the promotion of organic agriculture .

The island has so far managed to keep its natural beauty intact and is considered the green lung of the Caribbean . The Cuban authorities have made the protection of natural heritage a priority and have created more than 250 protected natural areas, covering 22% of the country. The “Queen’s Garden” nature reserve, which includes almost 150 kilometers of islands, reefs and mangroves, is home to one of the best preserved coral reefs in the world. However, the development of mass tourism and global warming are causing some concern.
Its territory is mostly flat , with a cordillera that stretches parallel to the coast. Here the landscape is characterized by the  Mogotes de Jumagua , limestone formations covered with vegetation.
The remarkable coastal development offers a wide variety of seascapes, from the rocky coast to the high and craggy ones, but above all a huge expanse of beaches. The reef extends outside the Camagüey archipelago . In the development of the coast there are deep and wide inlets that constitute natural port basins of exceptional value and beauty, locations of the historic commercial ports of Cuba such as  Havana ,  Santiago de Cuba  and  Cienfuegos.
The rivers are characterized by having a short course , given the narrow shape of the island. However, they are rich in water, even if their regime is determined by the rains: some have underground stretches due to the karst formation of the land. The longest is the  Rio Cauto  (343  km )  which, unlike the others, flows longitudinally.

Beaches in Cuba

Sol de Cuba

The beaches of Cuba  are an attraction for their particularity. Ideal places to relax, have fun or practice various water activities such as  scuba diving and snorkelling. However, deciding which beach to visit is not always easy. Around this large island there are many spectacular small beaches , with their  natural landscapes  .  The Cuban archipelago  is made up of two  islands , Cuba Island  and Juventud Island , which have a large number of beaches. Thousands of keys (small islands) form part of this archipelago, in which, even if not all habitable, there are the most beautiful and luxuriant beaches. Many little frequented and known. In Cuba  Varadero must be a mandatory destination. This wonderful Cuban city  is the most famous destination internationally for its  paradisiacal beaches . Of its 30 km of extension, 22

Playa Santa Maria del Mar, Cuba

km are  beaches.  The famous Blue Beach  is also the largest, and its fame is not only given by its idyllic landscape with colors such as blue and turquoise that contrast with the colors of nature, but it is also given by the many leisure  activities that it is possible to accomplish. There is no shortage of attractions of the   cayos , small  islands  located on the  Atlantic coast  and in the  Caribbean sea. A true spectacle of nature and beauty. Crystal clear and warm waters , an extraordinary fauna  with its  exotic animals that share their habitat with the vegetation; the great coral reef  with its huge variety of  colorful fish . Even in Havana , the beaches  are close and easily accessible. The best known set of  beaches  is called  Playas del Este ,  made up of seven beaches where you will meet the authentic Cuban spirit . Of these beaches, the most famous is  Santa María del Mar. Of this group of beaches, Playa Jibacoa  and  Playa Trópico also stand out , perfect for diving into  the seabed .

What are the most interesting Natural Parks in Cuba?
Cuba  differs from the rest of the island Caribbean countries by its wonderful natural landscapes, as it has numerous natural parks which constitute one of the most popular attractions of the country.

Vinales Valley, Pinar Del Rio

Some of its parks have international fame, while others are essential places for any tourist who wants to get to know Cuba in the slightest.
Among these are the   Parque Nacional de Viñales , famous for its sugar, tobacco and coffee crops;
the Valle de Viñale , with its impressive  mogotes  (hills) full of vegetation;
the surprising   Mural de la Prehistoria , a place which together with the   Cueva del Indio  constitute one of the most visited points of  Pinar del Río , the westernmost province of Cuba.
Furthermore, this province also offers two stupendous and paradisiacal natural islets where the impact of man has been reduced to a minimum: Cayo Levisa  and  Cayo Jutías .

In the provinces of Artemisa and Mayabeque, around Havana, are the  Parque Natural de Soroa  and the ecological complex of  Las Terrazas , both located within the  Reserva de la Biosfera Sierra del Rosario , a stupendous place endowed with an incredible beauty whose main attractions are the famous  Salto del Arcoíris , an impressive natural waterfall, the towns of Soroa and Las Terrazas and the Orquideario de Soroa, a botanical garden where you can admire more than 20,000 specimens of 700 species of orchids.

In the province of Matanzas is the  Parque Nacional Península de Zapata , famous for hosting the exuberant  Ciénaga de Zapata  and the  Gran  Parque Natural de Montemar , where you can find the beautiful  Laguna del Tesoro ,  Boca Guamá ,  the Taíno village and the historic  Bahía de Cochinos .

Topes de Collantes, Sancti Spiritus

In the most central part of Cuba is the  Sierra del Escambray , which forms the  Gran Parque Natural de  Topes de Collantes , where the famous waterfalls of  Topes de Collantes  and  El Nicho are located , located near  Cienfuegos and Trinidad .

Another important natural park in the central area of ​​Cuba is the  Parque Nacional de Caguanes , which with its 10 small islets is considered as part of the Biosfera de Buenavista reserve.

In eastern Cuba, the  Parque Nacional Alejandro de Humboldt stands out , shared by the provinces of   Holguín  and  Guantánamo . The park offers various tourist centers, trails, paths, rural accommodation and camping areas.

Even the small Isla de la Juventud hosts important natural parks such as that of Punta Francés or the Parque Nacional Ciénaga de Lanier, considered as the third most important swamp in all of Cuba.

What are the diseases present in Cuba? What are the real risks

Malaria, yellow fever, cholera, meningitis are diseases present in Cuba?

Both the WHO “World Health Organization” and the American CDC “Centers for Disease Control and Prevention” constantly monitor and report the various diseases present in Cuba. Our direct experience in different areas of the country confirms the presence of a series of diseases endemic to most of the territory, including large cities.

Is malaria present in Cuba?

The risk of malaria infection in Cuba is practically absent. Cases of malaria have not been described for a long time, and even the places where the Anopheles is present are free from the disease. Mosquitoes do not carry the parasite and cannot transmit the disease.

Are there any risks in Cuba for traveler’s diarrhea?
Traveler’s diarrhea : (click here)
Traveler’s diarrhea is one of the most common diseases during a stay in Cuba. More than 60% of travelers to the country suffer from these annoying intestinal infectious forms. It can be caused by various pathogens, including bacteria, viruses and parasites. It may be appropriate to use some drugs in prevention.

Is Yellow Fever in Cuba and do I need to get vaccinated?
Yellow fever : (click here)
Yellow fever, a viral disease transmitted by mosquitoes of the genus Aedes, is not present in all of Cuba.

Are there cholera outbreaks in Cuba? How do we protect ourselves?

As indicated by the Cuban health authorities, there are localized outbreaks of cholera (click here)   in different areas of the country and on different islands. The disease circulates throughout the Caribbean area and is endemic. Cholera is an acute intestinal infectious disease. Always present on the island, it grew further after the epidemic that developed in Haiti. It was developed by being transmitted through contaminated water and food.

Is there a risk of AIDS in case of unprotected intercourse?
HIV/AIDS :
HIV/AIDS is a major public health problem in the country. The virus continues to circulate in an important part of the population even if for several years the control of the disease has led to excellent results. It is important to be careful in sexual intercourse with several random partners and the protection and use of condoms is recommended.

Are arboviruses such as Dengue, Chikungunja or Zika present in Cuba?

Dengue and arbovirus : (click here)

Briefly, dengue is an acute viral disease transmitted by the Aedes aegypti mosquito. The reservoir is the infected man; for this reason it developed mainly in large cities. Symptoms can include high fever, headache, muscle and joint pain, nausea, and skin rashes. Dengue can progress to hemorrhagic dengue, a more severe form of the disease that can be fatal. Since the beginning of 2023 it has been possible to have a vaccine for this disease.
Outbreaks of dengue hemorrhagic feverthey are present in almost all the country, but especially in the big cities and in various humid parts of the island. Dengue is a viral disease transmitted by the bite of Aedes mosquitoes. The disease is widespread in urban areas. Frequent outbreaks occur in cities and in particular in the capital. Prevention consists in paying attention to insect bites and protection with repellents. We recommend NOZETA – NEEM oil, very effective and with repellent and soothing characteristics.

It is important to evaluate the inoculation of the new vaccine for Dengue, called QDENGA

For information and reservations of the DENGUE vaccine (CLICK HERE)

Chikungunya and Zika viruses :

There are some outbreaks of these arboviruses, similar to dengue, which occur sporadically in many of the islands of the Cuban archipelago.

The Cuban government has taken several measures to control and prevent the spread of dengue and other arboviruses in the country, including:

1. Information and awareness campaigns to educate the population about the risks of dengue and other viruses and how to prevent them.
2. Mosquito control through the elimination of breeding sites, the use of insecticides and the distribution of insecticide-treated bed nets.
3. Surveillance and monitoring of cases of dengue and other viruses to quickly identify outbreaks and take timely action.
4. Treatment and care of dengue patients in health centres.

Are there outbreaks of tuberculosis in Cuba and what is the risk of contagion? (TB) :
TB is another infectious disease present in high incidence in several populated areas of the island. It is particularly developed in the suburbs of the big city. It has a low mortality rate.

Are there any cases of canine or other animal rabies?
Rabies : (click here)
There are widespread cases of rabies in the country due to the presence of animals carrying the virus, both dogs and wild animals. Monkeys and bats can also spread the virus. It is advisable to evaluate the risks for any vaccination practice.

Is heartworm present, or schistosomiasis (bylarthia) or onchocerca, the blindness of rivers?

Neglected Tropical Diseases (NTD) : (click here)
NTDs are a group of neglected diseases that affect people living in poverty and rural areas. In Cuba, NTDs include lymphatic filariasis, and schistosomiasis in well-localized areas.
These are some of the major diseases found in Cuba, but there are also other diseases that have been reported in the island by WHO and the CDC.

Schistosomiasis is a parasitic infection with Schistosoma (Bilarzia) fluke worms, it is present in some areas of the country. The parasitesinfect humans by entering the bloodstream transcutaneously from contact with contaminated freshwater (baths or diving). The larvae of these microorganisms infect the vascular system and are transferred via capillaries in the gastrointestinal and genitourinary systems. To avoid schistosomiasis, contact with contaminated fresh water must be avoided, as the disease is transmitted through direct contact with these waters and not by ingestion. Also, it is important to avoid swimming, bathing, or walking in fresh water known to contain schistosomes. Using toilets for urination and defecation Using snail-killing chemicals (molluscicides) in freshwater bodies known to contain schistosomes is a disease control system”

 

Vaccinations

Which vaccination is mandatory for Cuba and how should we behave?

YELLOW FEVER if…..  

Cuba is a country where yellow fever is not present, there is no risk of becoming infected and ill, but the Cuban government requires yellow fever vaccination for travelers from countries endemic or infected with the disease, such as parts of Africa and Latin America.  If you are from one of these countries or have spent time in an area with a high yellow fever risk in the six weeks prior to your trip to Cuba, you are required to present your yellow fever vaccination certificate upon arrival at the airport . You must get the yellow fever vaccination before traveling to Cuba.

 

What vaccinations are recommended for Cuba and what should be done?

Recommended vaccinations:
do I need to get the yellow fever vaccination for Cuba? The certificate of vaccination against Yellow Fever except for those arriving from countries endemic or infected with the disease. Vaccination is not recommended for travelers from virus-free countries. (Updated March 2023)
 

Other recommended vaccinations:

Is vaccination for DENGUE recommended?. 
Given the presence of widespread outbreaks in the country, especially in the rainy season, it is advisable to evaluate the possibility of carrying out the new vaccine for DENGUE. Prevention consists in paying attention to insect bites and protection with repellents. We recommend NOZETA – NEEM oil, very effective and with repellent and soothing characteristics.
The main prophylaxis consists in the inoculation of the new vaccine. Important is the assessment of environmental and biological risk, and deciding for the inoculation of the new vaccine for Dengue, called QDENGA

For information and reservations of the DENGUE vaccine (CLICK HERE)

Hepatitis A vaccination is recommended

to know more….

Vaccination for TYPHOID FEVER is recommended – to know more….

DIARRHOIC AND COLERIFORM SYNDROMES    
Is vaccination for cholera recommended? Vaccination is essential for effective protection against “Vibrio del Cholera” and other intestinal pathogenic bacteria, even aggressive ones, which cause “traveller’s diarrhea”. It should always be regarded as protective of the intestine. It can be taken into consideration depending on the type of trip and stay. The “oral” formulation of thecholera vaccinealso protects against intestinal infections caused by many enterotoxic agents. The vaccine is therefore recommended for travel to many countries around the world.

These are essential vaccines for protection against “food” infections, i.e. transmitted by “contaminated food and drink”; “dirty hands”; contaminated dishes, plates, glasses: (valid everywhere, in Italy and in most countries of the world)

Is vaccination for HEPATITIS B recommended ? to know more….
Protection from contact with infected blood: in the event of medication due to an accident during the trip (in clinics or local EDs) for infections due to medication irons; syringes in health care facilities with poor hygiene; sexual transmission unprotected sex; other contacts with blood; (valid everywhere, in Italy and in most countries of the world)

Is vaccination for MENINGOCOCCAL MENINGITIS recommended? to know more…
Protection from infections transmitted by saliva droplets, breathing and coughing, through the air, in airplanes, crowded places, buses and trains, offices and schools, poorly ventilated environments; (For your personal protection and for the protection of the people close to you (family – work) – possibility of becoming a healthy carrier of the meningitis bacterium.) (valid everywhere, in Italy and in most countries of the world) It
is Is tetanus vaccination recommended ?   to learn more…
Is vaccination for POLIOMELITE recommended?
Following the latest epidemiological data and related recommendations issued by the WHO, travelers are recommended a vaccine booster (IPV-injection) best done together with (tetanus-diphtheria-pertussis-quadrivalent vaccine) to be boosted every 10 years. The effectiveness of the vaccine, being a reminder of vaccinations made in the past, is immediate.
Protection from infections transmitted by faecal micro-particles present in the soil, contact and ingestion; (valid everywhere, in Italy and in most countries of the world)
ROUTINE VACCINATIONS
Make sure you have carried out all the vaccinations required by the National Health System . These include: tetanus, diphtheria, polio, pertussis, haemophilus B, hepatitis B, measles, mumps, rubella, chicken pox.

Malaria: situation and prevention

What is the malaria situation in Cuba?

The risk of malaria infection in Cuba is practically non-existent. Cases of malaria have not been described for a long time, and even the places where the Anopheles is present are free from the disease. Mosquitoes do not carry the parasite and cannot transmit the disease.

What should I do if I return from the trip with health problems?

In case of fever, diarrhea or in any case if you feel unwell, it is essential to consult a doctor without delay (in case of fever, possibly within 24 hours, due to the possibility of having contracted malaria, if you are returning from an area at risk) . Specialist or expert in Tropical Diseases. Read everything…

Local traditions, foods, drinks

What are some curiosities and what are the major traditions in Cuba?

Some of the topics to explore related to the most important traditions in Cuba:
In Cuba, there are several curiosities and traditions that characterize its unique culture. One of the most famous traditions is the story of the Giraldilla, a small bronze sculpture that represents a flag and which has become a symbol of the city of Havana[1].

 GIRALDILLA AND THE LOVE STORY The Giraldilla is the name given to a weather vane located on the bell tower of the castle of la Real Fuerza in Havana, a small bronze sculpture that has become the symbol of the city of Havana. The story of its origins is lost in the legend of a love story.   It is said that the beautiful  Doña Isabel of Bobadilla , married to  Hernando de Soto appointed Captain General of Cuba by the King of Spain Carlos I, she used to wait for her husband spending many hours in the watchtower of the Castello de la Real Fuerza waiting to spot the ships that would bring her husband home from a long exploratory voyage to the continent American (present-day Georgia, Alabama and Florida). Unfortunately Hernando de Soto died in those lands due to an uncontrollable fever (probable malaria), it is said that her wife died of love when she knew her husband’s fate.
A few years later, the artist Gerónimo Martin Chaffinch (1607-1649), was inspired by Doña Isabel of Bobadilla taking her as a reference and symbol of marriage by sculpting a figure of her in her memory.
The governor of the city at that time, Don Juan Bitrián Viamonte, had the brass sculpture cast into a bronze weather vane and then fixed atop the tallest tower of the newly built castle. Governor Bitrán christened this weather vane Giraldilla, after the Giralda in his hometown of Seville. The original statuette is kept in the city museum, a copy is placed on the highest point of the castle.

The Guayabera shirt , originally created for farmers in Sancti Spiritus, is now a popular, fresh and elegant garment with four large pockets on the front, two pleats on the chest and three on the back. GUAYABERA, TYPICAL CUBAN SHIRT
It is said that a farmer in the province of Sancti Spiritus asked his wife to make a comfortable shirt for working in the fields. His wife made a new shirt that was comfortable and practical but she could not imagine that its original design will subsequently make it so popular, first among the residents of the area and then all over the world.
The name of this shirt was  yayabera , because she was born in the region near the Yayabo River. It is also said that the farmers of that area, when harvesting the guavas (local fruit), left some fruits in the pockets of the yayabera and for this reason the name was soon transformed into  guayabera . Generally in white fabric, it is a fresh, comfortable and elegant dress and can have long or short sleeves. It usually has four large pockets at the front, two rows of pleats at the chest and three at the back ending in two buttons.
Another hypothesis on the origin of the guayabera is attributed to a Spanish immigrant who became a tailor in the village of Sancti Spiritus in the 18th century. He made and sold large shirts with comfortable pockets to hold cigars, in other words, a garment similar to the current guayabera.

Whether the origins can be attributed to the hands of the farmer’s wife or to the Spanish tailor, the guayabera has become very popular, so much so that in 1880 the town hall of Sancti Spiritus authorized its use in official events. In the second half of the 20th century, Cuban politicians began to wear it on their electoral tours across the island, in the hope of being more pleasing to the peasant population.

In the 1950s, a modification was introduced to the garment by adding a lace around the neck to give a more formal character to the guayabera so that it was introduced in large living rooms and even in official government meetings. When Ramón Grau San Martin assumed the first judiciary in 1944, he elevated it to the rank of law courts.

NEW YEAR’S EVE IN LAS CHARANGAS DE BEJUCAL Anyone who decides to go to Cuba to celebrate the end of the year in the name of sun and sea will find themselves in the midst of one of the oldest festivals in Havana, Las Charangas de Bejucal.  During the fiesta, the city is divided into two parts, one blue and one red, which revives a past rivalry between Creoles and Spaniards on one side and Africans on the other, to the sound of music.

The performances of  Los Tambores de Bejucal  (a typical Cuban percussion band of high international prestige) ignite the traditional rivalry between two conga groups. The  Ceibistas  (members of the Ceiba de Plata group, characterized by the color blue and a scorpion as their symbol) compete with the  Espinistas  (members of Espina de Oro, who wear red and have a rooster as their symbol), to see who can play the drums with the highest and most impressive sound. Typical food at  Charangas it includes pan con lechón (pork sandwich), popcorn, churros (fried sweet pastry strips) and cotton candy. The origin of the Charangas is very similar to that of the Parrandas de Remedios and dates back to 1830. At the beginning the The feast had a purely religious character and according to tradition it took place on December 24, the date on which the slaves were freed to then join the free blacks and the Creoles. During the festival, black Africans worshiped the Orishas (African deities), playing their drums, saying prayers and dancing along the main streets of Bejucal. Their rites had particular characteristics depending on the ethnic group they came from, the Congo, Carabalíes, Ararás, Mandigas and Lucimíes who, inevitably, had different spiritual traditions and formed their own cabildos.

The Spaniards and Creoles who lived in Bejucal, allowed the party, baptized a group of black and mixed people with the name of Musicanga (which meant disgusting and poor music) while another group of black people took the name of Malayos (which meant red-roosters). The Musicangai adopted the color blue and a scorpion as their representative animal while the Malayos chose the color red and the rooster as their favorite animal. Thanks to the fusion of cultures that characterize the Cuban identity, racial and class differences have been lost over time. At the beginning of the 20th century, the rival groups renamed themselves: the Musicanga was called Ceiba de Plata (the silver of silk-cotton) and the Malayos took the name of Espina de Oro (the golden thorn).

The Santiago de Cuba Carnival is the largest and most famous in Cuba, where different cultures mix evident in the richness of music and dance[1]. The extras, groups of costumed performers who perform music and dance, are one of the main attractions of the carnival[1]. Music in Cuba is an important artistic expression and part of daily life, often accompanied by rhythmic and vital dances such as mambo, salsa and cha-cha-cha[2]. Dance styles such as Rumba, Son and Salsa are the result of African and Spanish influence[2].

Finally, some food and drink traditions include the Mojito, the Cuba-libre and the Daiquiri, as well as the famous Cuban rum[3]. Cuban cigars are also an important part of the country’s culture and identity[3]. The Santiago de Cuba Carnival is an iconic and traditional celebration that dates back to at least the 17th century[2]. This annual event takes place from July 21 to 28, attracting thousands of people from all over the country and around the world[3]. Festivities include night processions, parties and street concerts, as well as daytime performances involving music, dance and song[3].

Sappadas are a staple of the carnival, with groups of musicians and dancers performing in the streets, wearing colorful traditional costumes[1]. These groups of artists help create an electrifying and engaging atmosphere during the celebrations.

During the Santiago de Cuba Carnival, music is omnipresent and plays a crucial role in creating the festive atmosphere[3]. Typical carnival musical styles include Cuban son, cha-cha-cha, mambo and rumba, all influenced by African, European and indigenous traditions.

The Carnival coincides with Cuba’s National Day and the anniversary of the attack on the Moncada Barracks, which falls on July 26 [3]. This historic date is an important moment for the nation and adds another layer of meaning to carnival celebrations.

If you wish to visit Santiago de Cuba during Carnival, it is advisable to plan ahead, as transport and accommodation can be difficult to find due to the high influx of people[3]. Being part of this cultural celebration is a unique and memorable experience that will allow you to immerse yourself in Cuban traditions and history.

 

Tribes and Cultures:

In Cuba, originally, there were several Amerindian populations, including the Taíno, the Siboney and the Guanajatabey [1]. However, after the arrival of the Spanish in 1492, these indigenous populations suffered a drastic decline due to disease, slavery and warfare [1]. Today, the Cuban population is mainly composed of descendants of Spaniards, Africans and mestizos, with predominant religions such as Roman Catholicism and Santeria [2]. There are also Christian-Protestant communities present on the island [2].

Population and culture

According to the 2019 census, Cuba has a population of approximately 11.2 million. Of these, over two million live in the capital Havana and surrounding areas. By Latin American standards, Cuba has a high life expectancy of 78.66 years, even slightly higher than the life expectancy in the United States (78.54 years). Due to the increase in life expectancy and the reduction of infant mortality at birth to 5.5 cases per 1,000 births (for comparison, 3 cases in Italy and 6.5 cases in the United States per 1,000 births), the population of Cuba has experienced a steady increase until 2016. From 2016 onwards the population remained unchanged or even decreased slightly.

Cuba’s population is multi-ethnic, due to its complex colonial origins and slave economy. Marriages between ethnic groups are widespread, thus favoring the great variety, despite a certain discrepancy in the census of the country’s population: if the Institute of Cuban and Cuban-American Studies at the University of Miami found that 62% of Cubans are black, the 2002 Cuban census showed that 65.05% of Cuba’s population is white. These results can be influenced by socially desirable factors and by formulations that hide political motivations.

Cuba is officially a secular state. Prior to the 1992 constitutional amendment, Cuba classified itself as an atheist state. With the new constitution, freedom of religion has increased. Cuba’s main religions are Catholicism and Santeria, a religion based on the traditional religion of the Yoruba people of West Africa, which is heavily mixed with Christian elements.

Spanish is spoken in Cuba. Minority languages, such as the Indian languages ​​spoken in other Latin American countries, are almost non-existent. Despite the many tourists, it is usually difficult to find signs in English in museums and other tourist places in Cuba. English is a language that was not usually learned or taught in Cuba, given the long and famous conflicts between Cuba and the United States . Even though more and more young people are learning it privately and English is also taught in schools, the diffusion of the language is still limited. Most of the teachers are low qualified and the supply is by no means sufficient. Travelers who book a package holiday with an all-inclusive hotel or a fully organized trip with an Italian or English-speaking guide do not need to speak Spanish, but other than the hotel staff they will have almost no contact with the locals which is a pity. A good idea for those planning to travel to Cuba is therefore to learn some Spanish beforehand.

 

Dances and music: the enthralling Cuban rhythms

Cuba is home to  Caribbean rhythms : the notes of mambo, rumba, salsa and cha-cha-cha (which originated here) will be the soundtrack of your trip to the island. Also not to be missed are the Afro-Latin jazz big bands, brought to the fore in recent years by the Buena Vista Social Club.

In Cuba music is not only an artistic expression, but  a companion of daily life , often accompanied by rhythmic and vital dances. Cuban dances represent   the love for life that characterizes the people of Cuba, here every dance has its music, and music does not exist without dance! Cuban music developed from the influences of African slaves deported to the island and from the influences of Spanish immigrants.

There were three original styles :   the son, of Spanish and African origin, the danzon, which draws on the French tradition and with more sedate rhythms, the third trend, totally deriving from African culture. The three styles then mixed together and gave birth to  different strands  such as Rumba, Son, Salsa, Reggaeton, Bachata and obviously Cha Cha Cha.

In Cuba, you’ll find a diverse range of musical genres that reflect the island’s rich cultural diversity. Some of the main Cuban musical genres include Rumba, Danzon, Son, Danzon-mambo and Cha cha cha [1]. Rumba, for example, is a genre of Afro-Cuban music and dance that combines drumming, singing, and energetic dance movements. Son, on the other hand, is a musical style characterized by the fusion of African and Spanish elements, often considered the heart of Cuban music.

Santiago de Cuba, in particular, has been the cradle of many Cuban musical genres and is the center of the country’s Afro-Cuban culture [2]. The influence of Cuban music has also spread beyond the borders of the island, as evidenced by the Salsa genre, which originated in New York City and was heavily influenced by Cuban music [1]. Tito Puente, known as the King of Salsa and the King of Latin Jazz, was an icon of Latin music who helped spread these genres around the world [1].

In addition to traditional musical genres, more modern and international styles can also be found in Cuba, such as Rap and Hip-Hop [3]

 

What traditional foods can I find in Cuba?

The 10 most sought-after traditional dishes in Cuba are:

Arroz con Pollo (Chicken and Rice) 

Moros y Cristianos (rice and black beans)

Ropa vieja (pulled beef stew)

Masitas de Puerco Fritas (fried pork) 

Ajiaco Criollo (meat and vegetable stew)

Cuban Sandwich (sandwich with roast pork, ham, cheese and mustard)

Fufu (plantain puree) 

Picadillo a la Habanera (minced meat with onions, peppers and spices)

Tamales (corn dough with meat and vegetables)

Casabe (Cassava Flour-Based Flatbread) 

These dishes reflect Cuban cuisine, with Spanish and African influences, and the use of spices, meats such as pork and chicken, and vegetables such as peppers, cucumbers, onions and potatoes.

What are the 10 traditional drinks that I can try while staying in Cuba?

What you definitely drink in Cuba is rum. Very high quality and cheap. Traditional Cuban drinks usually still contain Cuban rum and most often Havana Club. Cuba Libre, the signature alcoholic drink without Coca-Cola. There is no coca as an American product in Cuba. So the traditional drink Cuba Libre is served with a cola drink, but not with Coca-Cola and lime juice. Other drinks include Piña Coladas, Daiquiris, Mojitos, Havana Loco, Cuban beers like Crystal and Buchanero and, of course, fresh coconut juice.
Among the most popular drinks:

Mojito: a refreshing cocktail made with rum, mint, sugar, lime juice and sparkling water.

Cuba Libre: a classic cocktail made with rum, Coca-Cola and lime juice.

Daiquiri: a cocktail made with rum, lime juice and sugar syrup.

Piña Colada: a creamy cocktail made with rum, pineapple juice and coconut milk.

Canchánchara: a historic cocktail made with rum, honey, lime juice and hot water.

El Presidente: an elegant cocktail made with rum, vermouth, curaçao and grenadine.

Saoco: A refreshing cocktail made with rum, coconut water and lime juice.

Guarapo: A soft drink made from fresh sugar cane juice.

Malojillo: A soft drink made from lemonade and malojillo leaves, a plant similar to lemongrass.

Café Cubano: A strong, sweet espresso often served in small cups.

Cerveza: The local beer, with popular brands like Cristal and Bucanero.

Ron Collins: A cocktail similar to the Tom Collins, but with rum instead of gin.

Batido: a blended drink made from fresh fruit, milk and sugar.

Crema de Vie: a sweet liqueur similar to Irish liqueur, made from milk, sugar, eggs, rum and spices.

Jugo de Tamarindo: A soft drink made from tamarind juice and sugar

What general info is useful to me during the trip?

General informations

Language: Spanish

Capital: Havana

Currency: Cuban peso

Time zone: GMT -5

History, Economy, Culture: https://www.cia.gov http://www.britannica.com

Safety: – www.viaggiaresicuri.it – www.dovesiamonelmondo.it

Some useful health information to keep you healthy on the go

What are the main rules and how should I prepare for the trip?

Give your body time to adjust to the new climate and new environment. Before the trip, if possible, dedicate a few hours to physical activity, and get your body used to the new rhythms during the trip …read more

Who should get vaccinated for yellow fever? And is the vaccine mandatory? And where?

Vaccination against Yellow Fever or Amaryllis Vaccine, an acute viral disease, which is transmitted by mosquito bite, is the only preventive practice that can be compulsorily requested by the health authorities of a country in order to enter through the border crossings …  . Read everything

How should I protect myself from the bites of mosquitoes and other insects?

Mosquitoes & co. – How to protect yourself: mosquitoes that transmit diseases other than malaria are active during the day and wherever there is a collection of fresh water: wear light-coloured, long clothes with wide sleeves, long and wide, light-coloured trousers, T-shirts or shirts with long and wide sleeves and light color to be tucked into the belt of the trousers ……read more

But is it really dangerous to swim in some lakes or rivers in tropical countries? And why?

To prevent the possible transmission of infectious diseases, it is advisable to swim only in pools with chlorinated water. The sea water is safe.
Bathing in contaminated water can be dangerous for the skin, eyes, ears, mucous membranes of the mouth, especially if  … read more

How can I avoid altitude sickness?

It is a set of symptoms that can occur when the human organism, having exceeded 2500 meters of altitude, has not yet adapted to the new environmental situation. We can define high altitude as follows … read more

How to travel safely? Who should I notify before leaving on a trip, especially to distant, unsafe countries?

Safety: www.viaggiaresicuri.it www.dovesiamonelmondo.it

 

Information, safety, prevention.

These are the key words for safe and healthy travel. Travelling is now the norm, all over the world. That is why it is normal to prepare for your trip. These are the golden rules, but there are more tips and advice from Dr Paolo Meo, a specialist in infectious and tropical diseases and a travel health expert.

Always ask for advice, talk to an expert and get informed;
Choose and buy your travel health insurance;
Prepare a ‘small travel pharmacy’;
Choose some ‘supplements’ or natural products to keep you healthy and energetic;
Check if you need any vaccinations or preventative measures;
Prepare the right documents;
Set off relaxed
Seek advice
Go to a ‘travel medicine centre’ near your home and ask for information from an experienced and knowledgeable doctor. Listen to him or her and dispel any doubts you may have. Assess together the risks, behaviour, medicines and possible vaccines for your health; are you in Rome? We are waiting for you at the Cesmet Traveller’s Clinic. Everything you need for your trip. To book your consultation in the clinic, click here; we will get back to you quickly. You can also request an online consultation:
– Consult the “health on the road” expert doctor to whom you can email, whatsapp video or skype all your questions to receive information, resolve doubts, prepare yourself adequately; buy the consultation directly.

The QDENGA vaccination for protection against DENGUE viral fever has been available in several European countries since early 2023. In Italy too, the effective and safe QDENGA vaccine, approved by both the American FDA and the EMA in Europe, is available in several centres.

Where is it possible to get the dengue vaccine in Italy?

From April 2023, at Cesmet’s international vaccination centre, it is possible to get the vaccine for Dengue Virus Fever, trade name QDENGA.

To book the vaccination you can

– write a request e-mail immediately to seg.cesmet@gmail.com
– fill in your request on the “CONTACT US” form
– write a whatsapp to 3466000899.
Provide your personal details, destination and date of travel, and the number of doses required.
In view of the small number of doses currently available and the high demand, please submit your request quickly. You will be provided with all information. An advance payment of 50€ is required upon confirmation of the booking, after receiving all the information . There are 2 doses in a vaccination cycle, 3/6 months apart. The first dose already induces good levels of protection.

What is DENGUE virus disease? (click)

1.Short tips for travelling in the country
Tanzania is a country rich in natural beauty, including national parks, reserves, endless savannahs, lakes and islands with dream beaches. Organising a trip in search of animals in Tanzania can be a unique and unforgettable experience. What are the important rules for organising a trip in search of animals or natural beauty in Tanzania: first choose the right period, i.e. the dry season from June to October, this is the best time to spot wild animals; in these months, animals concentrate around water sources and are easier to spot.

Then choose the best areas to observe wildlife in a spectacular setting. The parks, famous for their wildlife, environments and animals are located in the northern territories and are the Serengeti; Ngorongoro, Tarangire and Lake Manyara. The Tarangire National Park with its 2,850 square kilometres is the sixth largest park in Tanzania.

You can travel around the vast Tanzanian territories in many ways: using a jeep; travelling some stretches on foot, with a good guide, even in a hot-air balloon, and even using internal transport. Choose your safari and your way of travelling carefully.

Enjoy the trip you have planned until the end while always keeping your health in mind. Follow the preventive advice given by those who know the situation and prepare your trip properly. Consult with those who can give you the right advice and travel with peace of mind. If you wish, ask me for information and advice by writing here and putting in the required data. (click here https://www.clinicadelviaggiatore.com/modulo-consulenze-online/).
The first thing to do while travelling is to protect yourself from mosquito bites and other insects. These insects (vectors) can transmit viruses, bacteria and parasites, including malaria almost everywhere. As a first line of protection, use effective repellents, including natural ones. This indicated product, NOZETA, is very effective, harmless, and can also be used by babies, pregnant women, and people with delicate skin. It has a number of properties that are very useful when travelling.

Beware of tick bites. The problem is real, especially where wild animals are concentrated. The disease is serious, sometimes dangerous if undiagnosed, transmitted by ticks. It is called exanthematous typhus. You have to prevent it with unwelcome substances such as Neem oil, and you have to have the right drugs to treat it.

Dengue virus fever is particularly widespread along the coasts but is present almost everywhere.

In recent years, it has spread and is a major health problem even and especially in large cities. Use effective repellents for this disease, too, and protect yourself from bites, and advise your specialist if you should be vaccinated for the disease with the new QDENGA vaccine (click here https://www.clinicadelviaggiatore.com/qdenga-il-nuovo-vaccino-contro-la-dengue/.

Use mosquito nets and insect repellents.You can use insect repellents or classic mosquito nets. Diarrhoea from food and water contamination is common during travel.Be careful and follow the advice given below.

Malaria is widespread throughout the country and several risk areas are described below. The disease occurs particularly during the rainy season.Yellow Fever, a zoonosis particularly of primates (certain types of monkeys), which constitute the reservoir and may be healthy carriers of the virus.Get vaccinated against Yellow Fever, which I recommend as a connoisseur of the area.The virus is transmitted to humans through the bite of mosquitoes.
Always trust in your immune strength and good health, but help your body by strengthening it with effective preventive practices.

Dr. Paolo Meo, infectious tropicalist physician

2.Health alert
-Cholera in Tanzania and other African countries (June 23): the epidemic of cholera cases, which has always been present in the area but has been on the upswing for several months in the north-west, continues. Cases reported in Arusha and in villages in the area of the great parks. Cases in the Dodoma area and suburbs of Dar Es Salaam.
The cholera epidemic in the WHO African region continues to evolve. Cases reported in 13 countries.Five countries (Burundi, Ethiopia, Kenya, Mozambique and Tanzania) recorded a significant increase in cases in May 23. In week 10 (6 to 13 March 2023), a total of 4110 cholera cases were reported from 11 countries.In the first quarter of 2023, however, 40,563 cholera cases with 818 deaths were reported.The disease exists and is endemic in most countries.Ask to be vaccinated with the effective and safe oral vaccine.
-Dengue (July 23):The disease that has been present in the country for more than a decade, has been on the rise since March ’23 and reported cases have increased. An interesting study, published in the Lancet, explains the reason for the low aggressiveness and also for the rather mild symptoms that the population in Tanzania, and in the African continent in general, has.
The study shows that in several countries on the continent, although all patients tested were infected with the same genotype of the dengue virus, black individuals were protected from aggravating dengue disease, suggesting the presence of protective genetic or environmental factors among people of African descent. The milder clinical manifestations of dengue in African patients would explain why dengue epidemics in Africa are small and milder than in Asia and Latin America.And clinical forms are often mistaken for symptoms attributable to malaria.Disease-specific tests need to be introduced in many countries, alongside malaria tests, to detect outbreaks of the virosis and guide diagnosis. Indeed, local patients have a lower incidence of severe dengue.However, the disease has spread like wildfire.Important to request the Qdenga vaccine.

– Ticks – exanthematous typhus

A small tick to pull out

The presence of people in densely populated areas facilitates the occurrence of tick-bite-related diseases.Arthropods, order Ixodidae, are included in the class Arachnidae, the same class as spiders, mites and scorpions. Ticks are external parasites ranging in size from a few millimetres to about 1 centimetre, depending on species and stage of development.

Ticks suck various microorganisms, including viruses and bacteria, from the blood of animals. In particular, Rickettsia mooseri is present.Exanthematous typhus is the disease that can develop, and this bacterium is able to spread via the lymphatic system.Diagnosis must be swift and treatment prompt.In 2023 in different areas of the country and also in Zanzibar we saw the spread of ticks and consequently the disease.

-Marburg virus (March – June 2023)

On 21 March 2023, an outbreak of Marburg virus disease, a particularly aggressive virosis causing haemorrhaging and even death, was first reported by the Tanzanian Ministry of Health. On 2 June 2023, the Ministry of Health of the United Republic of Tanzania declared the end of its first documented outbreak of Marburg virus disease (MVD). A total of nine cases (eight laboratory confirmed and one probable) were reported between 21 March and 31 May. All cases were reported from Bukoba district, Kagera region.A total of six deaths were reported during the outbreak (case fatality ratio 67%).Following WHO recommendations, the declaration was made 42 days (twice the maximum incubation period for Marburg virus infection) after the last possible exposure to a probable or confirmed case of MVD.The outbreak appears to have been resolved.

3.Climate, weather health and environment
a.Current weather situation https://www.3bmeteo.com/previsioni-meteo/tanzania

b.What are the different seasons in the country and how does the climate influence the spread of diseases?

Tanzania is characterised by a tropical climate, which is greatly influenced by the altitude of the different areas.
The rainy season runs from October to May, with the two different rainy seasons occurring between January and February in the far northern part of Tanzania.
In general, the climate is hot and humid on the coast, while the north-western highlands are cooler. There are no major differences between winter and summer temperatures, a characteristic of equatorial countries.

Therefore, the seasons are divided into:
– Rainy season: October to May, with the two rainy seasons combined in January and February.

– Dry season: June to September;

During the rainy season, the landscape changes considerably.They may vary in intensity and distribution depending on the area, but the rains bring lush vegetation and the growth of rivers and lakes.This leads to an increase in vegetation, with many plants flowering and fruiting, and an increase in wildlife, with many animals feeding on the flowering plants and new leaves.

During the rainy season in Tanzania, the landscape becomes greener and more lush, with an increase in vegetation and wildlife, and an increase in rivers and lakes.

During the rainy season, many animals can find more food and water, and it can be easier to identify them. Many species of animals reproduce because of the abundance of food and water. The vegetation is denser and animals do not need to move as much to find food and water. During rainfall, major flooding and widespread landslides often occur. These phenomena damage the habitats of wild animals.
In general, areas in north-western Tanzania, such as the Serengeti and Ngorongoro Crater, are still accessible during the rainy season, but some roads are closed due to flooding.

4.What impact does climate change have on the seasons and the environment?

Climate change in recent years has had a significant impact on the country’s environment. The main effects of climate change in Tanzania include:
– Decreased agricultural productivity: a large part of the population lives in rural areas that depend on rain-fed agriculture, which is threatened by rising temperatures, prolonged droughts and intense and sudden rains.

– Increased diseases: there are several climate-sensitive diseases that tend to spread during droughts and floods.The tendency

The increasing trend and spread of water-related diseases such as cholera, soil fertilisation and malaria is an indicator of how climate change is affecting the increase of many forms.
– Increased vulnerability: agriculture and livestock are the dominant sectors of the Tanzanian economy, providing livelihoods, income and employment. A temperature increase of 2°C – 4°C could alter the distribution of Tanzania’s seven agro-ecological zones. Areas that used to cultivate perennial crops would only be suitable for annual crops.
– Increased economic costs: Tanzania’s economy is highly dependent on sectors affected by climate variability and change. It is estimated that climate change will lead to large additional future economic costs ranging between 1% and 2% of annual GDP by 2030.
On the other hand, climate change is having a significant impact on Tanzania’s fauna and flora, creating the conditions for a drastic decrease in the territory. These include:
– “the Drought: Frequent and severe droughts in many parts of the country are affecting food production and water availability, threatening the survival of many animal species.

– “Habitat Loss”: Poorly planned agricultural expansion, fencing, settlements, urban centres, roads and other human activities are causing the loss of natural habitats

for many animal species.
– “Declining animal populations”: many animal species are seeing their populations decline. For example, in the Serengeti-Mara, the dominant species, the wildebeest, has seen a 9% decline in land occupancy, corresponding to 36 fewer days in a year.
– “Loss of food resources”: Drought, erosion, desiccation and consequent loss of food resources are threatening the survival of important animal species.
– ‘Ecosystem degradation’: Illegal exploitation of riparian sands for the needs of construction companies is causing resource depletion and degradation of the Lake Victoria ecosystem.

Thus, the current climate changes, characterised by changing temperatures, long periods of drought with sudden flooding rains, are causing a number of problems for the country’s fauna and flora, including loss of habitat, dwindling animal populations, loss of food resources and ecosystem degradation.

Among the most notable animal species are:
– ” the Lions”: according to a Wired article, climate change is endangering the lions that inhabit the Serengeti National Park, East Africa’s main and largest wildlife reserve.
– “Animal species in general”: An article by AGI reports that 27% of animal species are also at risk of extinction in Tanzania, due to the sudden changes in the climate.

for many spRemove DIV Tags from HTML with this Simple Web Tool – DIY Danielleecie animals.
– “Declining animal populations”: many animal species are seeing their populations decline. For example, in the Serengeti-Mara, the dominant species, the wildebeest, has seen a 9% decline in territory occupancy, corresponding to 36 fewer days in a year.
– “Loss of food resources”: Drought, erosion, drying up and cons risk extinction also in Tanzania, due to sudden climate change and loss of biodiversity.

5.What are the characteristics of the environment of the country you are travelling to?
Tanzania has a number of different environments with their own particular geography and characteristics:

-‘Central Tanzanian Plateau’: This region is characterised by a vast plateau with plains and arable areas. Devoted to agriculture and pastoralism. The expansion of these human activities has resulted in the disappearance of immense areas of forest and scrubland. The expanses of woodland are increasingly shrinking.
-‘East Coast’: It faces the Indian Ocean and is hot and humid. It is about 800 kilometres long and stretches from the border with Kenya in the north to the border with Mozambique in the south. It is characterised by a vast alluvial plain that extends up to 80 kilometres inland. Rich in mangrove forests and swamps, the coastal region is also famous for its white sandy beaches and crystal clear waters of the Indian Ocean. Dar es Salaam, the capital of Tanzania is the largest city and is located on the east coast of the country. Ports in the coastal region include the port of Dar es Salaam and the port of Tanga.

In summary, the east coast of Tanzania is a region of great economic and tourist importance, characterised by a hot and humid climate, mangrove forests, white sandy beaches and important trading ports.

-‘Mountainous northeast – Kilimanjaro region’: This region is mountainous and includes the volcanoes Meru and Kilimanjaro, it is the highest point on the African continent.
-‘Savannah areas’: The central regions of the country have huge areas of shrub savannah, while in the wetter areas in the north-west of the country, towards Lake Victoria, park-like wet savannah prevails.
-National Parks: Tanzania has several national parks, including the Serengeti National Park, Ngorongoro Crater and Arusha National Park. These parks are famous for their wildlife, including the African ‘big five’: lion, elephant, buffalo, leopard and rhinoceros.

As we all know, Tanzania is famous for its national parks, which are home to a wide range of wildlife and offer you the opportunity to go on unforgettable safaris. Here are some of Tanzania’s most famous national parks and where they are located:

– “Serengeti National Park”: Located in northern Tanzania, east of Lake Victoria, the   Serengeti National Park is famous for its vast plains, which stretch as far as the eye can see, and for the annual migration of more than a million wildebeest and zebra. It is migration and settlement territory for thousands of animal species.

– Ngorongoro Crater: Located in northern Tanzania, it is an immense volcanic crater that is home to a wide range of wildlife, including elephants, rhinos, lions and cheetahs. It is a migratory territory for hundreds of species that come to quench their thirst, particularly in the hot and dry seasons.

– “Arusha National Park”: Also located in the north of Tanzania, close to the great volcanoes, first and foremost Kilimanjaro, it is famous for its wildlife, including giraffes, zebras and colobus.

– Selous Wildlife Reserve: Located in southern Tanzania in the Great Parks area, it is the largest wildlife reserve in Africa and is home to a wide range of wildlife. Thousands of different species of mammals, birds, reptiles and all kinds of insects. Famous are the herds of dozens of different species of monkeys, elephants, rhinos, lions and cheetahs.

– ‘Ruaha National Park’: The park is located in the centre of Tanzania, and is home to a wide range of wildlife, including elephants, buffalo, lions and cheetahs.

The beautiful and immense Tanzania is famous for its national parks, but attracts for the vast expanses of savan ,

for the highest mountains in Africa and a coastline characterised by beaches with crystal-clear and particularly hospitable sea. The coral reef continues to attract divers.

6.What diseases can I find in Tanzania? What are the real risks

In this list, we list the diseases that are most prevalent in the different parts of the country. The incidence of individual diseases is linked to the seasons, rainy periods and humidity, which favours both forms of transmission by insect bites and those spread by micro faecal particles.

Anthrax

It is endemic throughout the country. It is a zoonosis (animal disease) and can involve humans in small outbreaks. It is present all year round throughout the country.

Cholera

Cholera outbreaks have always been reported in the country. Present more in the city suburbs and in villages of a certain size where the fertilisation of the environment favours the spread of the disease. Currently, the risk is increasing after the Covid-19 years,
It is reported in the following regions (districts): Arusha, Coast [Pwani], Dar es Salaam (Ilala, Kinondoni), Dodoma, Kigoma, Kilimanjaro, Lindi, Mara, Mbeya, Morogoro, Mtwara, Mwanza, Rukwa, Shinyanga, Tanga, Zanzibar (Ladysmith area, particularly the Umhlumayo areas in the east and Watersmeet in the north).

Dengue

The mosquito-borne viral disease has been endemic for more than a decade, from data provided by the WHO and personal experience of the writer. The risk is lower and therefore low in the highlands, in park areas, and is present up to 2500 m.a.s.l. but it grows along the coast, in Dar Es Salham and is also present in Zanzibar.

Present on the coast and islands throughout the year, the endemic tends to decline particularly in the northern, highland and park areas during the dry periods with milder temperatures between May and October.

Hepatitis A

The country is considered hyperendemic with ‘high risk’ for all unvaccinated receptive individuals. Vaccination is good protection for the disease.

Hepatitis B

Medium-high risk (HBsAg prevalence in 5-7% of the population).

Yellow fever

The country is at risk due to the presence of the virus (flavivirus) in monkeys, healthy carriers. Yellow Fever is in fact a zoonosis, an animal disease, and is transmitted by mosquito bites. Vaccination is strongly recommended, particularly in inland areas, central savannahs and parks.

Typhoid fever

The country has a high salmonella endemic. The type of salmonella characterised by the Vi. antigen is present (injection vaccine recommended).

Malaria

Malaria is present in most territories. There are endemic areas in the country with a high risk of P.falciparum. The risk is therefore present throughout the country, including urban areas, below 2,500 m, throughout the year.

The risk decreases considerably between May and October/November. P.falciparum is present in > 85%, resistant to chloroquine and sulfadoxine-pyrimethamine and also to Atovaquone throughout the country. Rare cases of Pl. Vivax.

 

These are some of the provinces in Tanzania where malaria is particularly present:

– Muheza; – Lushoto; – Babati; – Hanang; – Loliondo

According to estimates in recent years, malaria is now also present in some previously malaria-free mountainous areas no higher than 2500 metres above sea level.

Prophylaxis

The first protection to avoid the onset of malaria is to watch out for mosquito bites. The following precautions should be taken:

a.Sleep under ‘treated mosquito nets’ with dedicated insecticide products;
b.Wear, if you can, long-sleeved clothes and long trousers, particularly during the ‘evening and night hours’.
c.Apply insect repellents to exposed skin that are effective. I recommend NOZETA – NEEM oil, which is very effective and has repellent and soothing properties.
d.Take antimalarial drugs in chemoprophylaxis, effective, safe, not resistant to plasmodium, evaluated by the specialist doctor through counselling or controls before, during and after the trip to Tanzania. (see the specific malaria chapter)
e.avoid being bitten by mosquitoes, as malaria is transmitted through their bites. Mosquitoes are most active during the evening and night hours, so it is important to take precautions during these hours.

For chemoprophylaxis I recommend:
Doxycycline 100 mg: it is an excellent drug of choice for stays in both tourist areas and adventurous travels, during trekking, and in the case of using tents or less controlled accommodations. It is suitable for stays in protected residences or areas of low risk, as well as for high-risk stays. You should know that “doxycycline 100 mg” is a drug of choice not only for the prevention of malaria infection but also for the prevention of bacterial intestinal and skin infections and infections caused by tick bites. Due to its characteristics, the drug is very versatile and can be taken for very short or brief stays, a few days or weeks, but also for a long period, i.e., for several months. It is worth noting that drugs based on tetracyclines, including doxycycline, are taken for over 1 year by individuals with acne, i.e., infections on the face or trunk. It is a safe, effective drug with few or minimal side effects. We remind you that at prophylactic doses (100 mg per day), the effects of photosensitivity to sunlight are practically absent. Nevertheless, we recommend the use of sunscreen. It is an affordable drug. It is not suitable for use in children under 12 years of age or during pregnancy, or in case of allergy or intolerance to tetracyclines. It should be taken every day during lunch, starting from the entrance to the malaria-risk area, for one week after leaving the malaria-risk area.

Atovaquone-Proguanil, a drug on the market for almost 20 years, still provides good antimalarial coverage for chloroquine-resistant forms, although forms of resistance and reduced efficacy have been reported for several years. It is suitable for pediatric use and can be taken for periods not exceeding 30 days, but it can also be used for up to 60 days. The recommended dosage is one tablet daily, starting 2-3 days before the trip and continuing for 1 week after returning.

Mefloquine, a drug used for over 30 years, is effective for both prophylaxis and treatment. It works well for adults and also in pediatric populations. Its efficacy and safety have been demonstrated in pregnant women as well. It is suitable for use in individuals in good health but should be avoided in patients with heart conditions, arrhythmias, neurological or psychiatric disorders, and those suffering from insomnia. Side effects may include symptoms of peripheral and central nervous system irritation. It should be avoided by individuals engaging in activities like diving, high-altitude stays, repeated and prolonged air travel. The recommended dosage is once a week, starting 1 week before the trip and continuing for 3-4 weeks after returning.

11. What to do if I experience health problems after the trip?

Upon returning from a trip, in case of illness, fever, diarrhea, or any other symptoms, even mild, it is essential to consult promptly (in case of fever, preferably within 24 hours due to the possibility of having contracted malaria if returning from a high-risk area) a Specialist or an expert in Tropical Diseases. If malaria is suspected, request a malaria test without delay. Always remember that infections can manifest even months after traveling to tropical areas. Inform the attending doctors about your travel history to tropical areas, especially if you experience any unusual symptoms.

12. Some useful health information for maintaining wellness during the journey

The main rules to prepare for the trip and maintain good health are:

• Give your body time to adapt to the new climate and environment. Engage in physical activity before the trip if possible, and acclimate your body to the new rhythms during the journey.
• Vaccinate against Yellow Fever if required by the health authorities of the country you are visiting.
• Protect yourself from mosquito and insect bites by wearing appropriate clothing, using mosquito repellents, and sleeping under mosquito nets.
• Avoid swimming in contaminated lakes or rivers to prevent the transmission of infectious diseases.
• Take precautions to avoid altitude sickness if traveling to high-altitude areas.
• Inform someone reliable, especially in remote or less secure areas, about your travel plans and keep them updated about your whereabouts.
• Carry essential medicines and a small travel pharmacy, taking into consideration the specific health risks of the destination.

13.In the suitcase What should I pack and what medicines should I bring?

Mountain or sea, safari and adventure, or a relaxing vacation, hot or cold: you must carefully prepare your luggage, pay attention, not overpack, and above all, anticipate… the unexpected. Bring appropriate clothing for the climate and never forget a small travel pharmacy.

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In conclusion, traveling to Tanzania offers an opportunity to explore a country rich in cultural diversity and natural beauty. To fully enjoy the experience and stay healthy, it is crucial to be aware of health risks, take necessary precautions, and seek medical attention promptly if any health issues arise.

Matthew died at the age of 14 at the end of a stay in his grandparents’ country. The stay in a familiar environment gave many happy days. The days spent with his cousins and many friends. Then the illness, the aggravation and death.

It is now clear to everyone, haemorrhagic fevers caused by infection with one of the 4 types of the Dengue virus can kill even during an organised holiday trip. This virus, which is now widespread in most tropical and equatorial countries, is transmitted to humans by a type of mosquito, the Aedes, which is now widespread everywhere, even in Europe, and we are talking about the very common and widespread tiger mosquito.

from Messaggero Veneto of 30 July ’23

Matteo, a young Friulian boy of 14, had finished school and had flown with his mother to Brazil to spend a holiday, to meet his grandparents and aunt and uncle in the state of Parà, in Brazil. He had been living in the country since mid-June and was due to return to Italy at the end of July. During his stay, like many others, he had been bitten by those pesky mosquitoes, and at some point, for more than 10 days, he had begun to feel increasingly ill. First he was bedridden, at home, and then, his symptoms worsening, he was admitted to a hospital, where he was put under treatment. Within a few days, the situation rapidly deteriorated until his death on 29 July.

This dramatic event unfortunately confirms the dangerous nature of the disease and the need to pay great attention to insect bites, vectors (transporters) of the virus. Until now, controlling the territory and the presence of mosquitoes was the first and only prevention against the disease. We now have a preventive vaccine that works both in controlling the outbreak of the disease and also modulates the often dangerous secondary immune response in individuals who have already had the disease. The vaccine was approved by the US FDA, in December 22 by the European EMA, in February 23 by the AIFA in Italy.

To find out about the vaccine’s characteristics click here.
To find out where to get the Dengue vaccine in Italy click here.

AEDES

The dengue virus, transmitted through the bite of the Aedes mosquito, most of the time remains asymptomatic, without manifesting itself in any way. And this is what happens in most people, both locals and travellers. Sometimes it can manifest itself with increasingly aggressive symptoms and forms until, in rare cases, death occurs. Treatment is aimed at resolving the symptoms of this immune response and inflammation, which can be particularly violent. Sometimes the disease is characterised by the impairment and collapse of platelets in the blood, with the risk of severe haemorrhaging. In these cases, transfusions and control of probable shock states become essential.
In Latin America, the first half of 2023 was a period of exponential and uncontrolled growth of this disease. In all states, the presence and reproduction of Aedes and the consequent spread of the virus, from human to human through the bite of these insects, was surprisingly high.
Brazil has had the highest levels of spread of this disease for years, but Argentina, Peru and Colombia have also recorded a significant increase in cases and, unfortunately, an important increase in the mortality rate, particularly in the first months of the year. However, Dengue with the other diseases, such as Chickungunija and Zika, are present in all the other countries of Latin and Central America and in all the Caribbean islands.

The drama of Matteo and his family brings us back in a stark way to the need to inform oneself seriously and consciously before a trip. Not to underestimate indications and advice. To know the real risks and the ways to avoid them. Our organism is capable of overcoming anything, but let us help it strengthen itself.

QDENGA of TAKEDA

For the Dengue virus disease I would like to remind you again that there is now an effective and safe vaccine that is worth considering before travelling to endemic areas. FOR INFORMATION AND RESERVATIONS CLICK HERE.