Ms. Fierz,

Which diseases are particularly dangerous during pregnancy? 

Basically, it is necessary to distinguish between diseases that are dangerous for the pregnancy (e.g. malaria) and diseases that have a specifically negative effect on the childs developement (e.g. the Zika virus). Diseases such as measles, yellow fever, malaria or dengue can present much more severely during pregnancy. This is mainly because the immune system is slightly weakened while pregnant.

How does Zika affect pregnancies? 

The Zika virus is particularly widespread in Central and South America as well as in Southeast Asia. Infection with the Zika virus is rarely symptomatic in adults. However, the Zika virus can cause malformation in the fetus, especially in the first two months of pregnancy when the fetal organs are formed. The most apparent malformation is microcephaly, which is when the brain doesn't fully develop and the head is too small. Microcephaly can lead to developmental delays and intellectual impairment among other things. A Zika infection is all the more insidious because its so often asymptomatic, meaning someone could have the virus but not know it. Tests are unfortunately not very reliable which is why we generally advise those who are pregnant, or those who may soon become pregnant, to not travel to at-risk areas in the first place. Apart from mosquito protection, there are unfortunately no other preventative options. 

What about malaria? Can pregnant people take malaria prophylaxis? Is it recommended? 

Malaria, like Zika, is a mosquito-borne disease that presents with high fever and flu-like symptoms. It is a potentially fatal disease that is very physically demanding on those who are pregnant. There are malaria prophylaxis drugs that are approved in pregnancy, namely Mephaquin (Mefloquine ®). In general it provides good protection against malaria (about 96%) but there are malaria parasites resistant to Mephaquin in Southeast Asia. Unfortunately, among all malaria prophylaxis there is no drug that protects 100% against malaria. Therefore, we generally recommend that pregnant people not travel to a malaria risk area. 

Are mosquito sprays pregnancy compatible? 

Yes, mosquito sprays available our Travel Clinic are compatible with pregnancy. However, care should be taken to only apply superficially and not ingest them. 

Are there any restrictions during pregnancy when it comes to air travel? 

It should be noted that flying is not recommended later in pregnancy, i.e. from week 35 onward. Many airlines ask for a doctor`s statement declaring that it is safe for the person to fly. There are even airlines that do not accept pregnant humans as passengers at all. When flying, there is always a risk of thrombosis (blood clots) which is increased during pregnancy. We therefore recommend preventive measures such as well-fit compression stockings and aisle seats with the possibility to move around. 

Independent of traveling: Which vaccinations are especially important for those who are pregnant and why? 

It should be noted that live vaccines (such as that for yellow fever) should be administered before pregnancy, as they must not be done during pregnancy. However it is recommended to be vaccinated against tetanus, diphtheria and pertussis in the second trimester (our Boostrix vaccine, for example, provides protection against all three of these diseases in one convenient vaccine). The antibodies produced by the pregant human will then later protect the newborn. The COVID vaccination is also recommended in the second trimester as it ensures that the baby is already born with some protection against COVID. 

Which vaccinations may become relevant when traveling and what should be considered? 

Travel vaccinations (except live vaccines) can also be administered during pregnancy. However, these are also recommended only from the second trimester onward because in the first trimester the delicate and vulnerable organ formation of the embryos takes place. Therefore, as few medical interventions as possible are recommended during this period. 

What should be considered when preparing for a trip? 

In addition to the passport, you should certainly also pack the maternity pass. All important data and examination results about the course of pregnancy are noted in there. Before starting your trip, a medical travel consultation is certainly essential. During a travel consultation, your vaccination status is discussed as well as the most important pathogens abroad. However, it must also be considered whether the trip should not be postponed until after the pregnancy. 

What should be considered during the trip? 

If you decide to travel despite pregnancy, there are some things to consider. Raw and undercooked meat and fish should be avoided. The rule is: cook it, boil it, peel it or leave it! Dairy products or desserts with raw eggs should also be avoided. Be sure to drink enough water and avoid long exposure to the sun. To prevent altitude sickness, altitudes of more than 2500 meters should be avoided, as well as great physical exertion in general. As is the case in Switzerland, pregnant women abroad should keep a distance from cats to avoid contracting toxoplasmosis through contact with feces or scratches. Toxoplasmosis is a disease that is often asymptomatic in adults but can impact the fetus and care should therefore be taken to avoid it during pregnancy.

What should be considered after the trip? 

It is important to think about tropical diseases such as malaria or tropical diarrhea if symptoms occur in the first weeks to months after the trip. These can often only break out after the trip. Symptoms such as fever and diarrhea should therefore be examined medically if they persist.

In a nutshell:

As a pregnant human traveling, be sure to keep this in mind: 

• Take your maternity passport with you.
• Make sure your vaccination status is up to date and seek advice from a travel medicine professional regarding additional vaccinations and medications. 
• Excessive heat, altitudes above 2,500 meters and great exertion should be avoided. 
• Make sure to drink enough water.
• In warm countries, avoid undercooked meat, raw fish and foods with raw eggs (tiramisu, mayonnaises, ice cream etc.).
• When it comes to food: Cook it, boil it, peel it or leave it!
• Avoid glaring sunlight and make sure you use a high sun protection factor when protecting yourself from the sun.

To be optimally prepared for your trip, it is worth scheduling an appointment at the travel medicine center.