Field Listing

Major infectious diseases

This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as compared to the United States. These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years. The degree of risk is assessed by considering the foreign nature of these infectious diseases, their severity, and the probability of being affected by the diseases present. The diseases listed do not necessarily represent the total disease burden experienced by the local population.
The risk to an individual traveler varies considerably by the specific location, visit duration, type of activities, type of accommodations, time of year, and other factors. Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such as vaccines.
Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk. Note: The sequence of exposure categories listed in individual country entries may vary according to local conditions.

food or waterborne diseases acquired through eating or drinking on the local economy:
Hepatitis A - viral disease that interferes with the functioning of the liver; spread through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea; 15% of victims will experience prolonged symptoms over 6-9 months; vaccine available.
Hepatitis E - water-borne viral disease that interferes with the functioning of the liver; most commonly spread through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine.
Typhoid fever - bacterial disease spread through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated, mortality rates can reach 20%.

vectorborne diseases acquired through the bite of an infected arthropod:
Malaria - caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats accompanied by anemia; death due to damage to vital organs and interruption of blood supply to the brain; endemic in 100, mostly tropical, countries with 90% of cases and the majority of 0.4-0.8 million estimated annual deaths occurring in sub-Saharan Africa.
Dengue fever - mosquito-borne (Aedes aegypti) viral disease associated with urban environments; manifests as sudden onset of fever and severe headache; occasionally produces shock and hemorrhage leading to death in 5% of cases.
Yellow fever - mosquito-borne (in urban areas Aedes aegypti) viral disease; severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever; occurs only in tropical South America and sub-Saharan Africa, where most cases are reported; fatality rate is less than 20%.
Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus) viral disease associated with rural areas in Asia; acute encephalitis can progress to paralysis, coma, and death; fatality rates 30%.
African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma; transmitted to humans via the bite of bloodsucking Tsetse flies; infection leads to malaise and irregular fevers and, in advanced cases when the parasites invade the central nervous system, coma and death; endemic in 36 countries of sub-Saharan Africa; cattle and wild animals act as reservoir hosts for the parasites.
Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania; transmitted to humans via the bite of sandflies; results in skin lesions that may become chronic; endemic in 88 countries; 90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia, Brazil, and Peru; wild and domesticated animals as well as humans can act as reservoirs of infection.
Plague - bacterial disease transmitted by fleas normally associated with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in areas of Asia, Africa, and South America associated with rural areas or small towns and villages; manifests as fever, headache, and painfully swollen lymph nodes; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50%.
Crimean-Congo hemorrhagic fever - tick-borne viral disease; infection may also result from exposure to infected animal blood or tissue; geographic distribution includes Africa, Asia, the Middle East, and Eastern Europe; sudden onset of fever, headache, and muscle aches followed by hemorrhaging in the bowels, urine, nose, and gums; mortality rate is approximately 30%.
Rift Valley fever - viral disease affecting domesticated animals and humans; transmission is by mosquito and other biting insects; infection may also occur through handling of infected meat or contact with blood; geographic distribution includes eastern and southern Africa where cattle and sheep are raised; symptoms are generally mild with fever and some liver abnormalities, but the disease may progress to hemorrhagic fever, encephalitis, or ocular disease; fatality rates are low at about 1% of cases.
Chikungunya - mosquito-borne (Aedes aegypti) viral disease associated with urban environments, similar to Dengue Fever; characterized by sudden onset of fever, rash, and severe joint pain usually lasting 3-7 days, some cases result in persistent arthritis.

water contact diseases acquired through swimming or wading in freshwater lakes, streams, and rivers:
Leptospirosis - bacterial disease that affects animals and humans; infection occurs through contact with water, food, or soil contaminated by animal urine; symptoms include high fever, severe headache, vomiting, jaundice, and diarrhea; untreated, the disease can result in kidney damage, liver failure, meningitis, or respiratory distress; fatality rates are low but left untreated recovery can take months.
Schistosomiasis - caused by parasitic trematode flatworm Schistosoma; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water; worms mature and reproduce in the blood vessels, liver, kidneys, and intestines releasing eggs, which become trapped in tissues triggering an immune response; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity; mortality, while generally low, may occur in advanced cases usually due to bladder cancer; endemic in 74 developing countries with 80% of infected people living in sub-Saharan Africa; humans act as the reservoir for this parasite.

aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine:
Lassa fever - viral disease carried by rats of the genus Mastomys; endemic in portions of West Africa; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles; fatality rate can reach 50% in epidemic outbreaks.

respiratory disease acquired through close contact with an infectious person:
Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord; one of the most important bacterial pathogens is Neisseria meningitidis because of its potential to cause epidemics; symptoms include stiff neck, high fever, headaches, and vomiting; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions, often with a seasonal distribution; death occurs in 5-15% of cases, typically within 24-48 hours of onset of symptoms; highest burden of meningococcal disease occurs in the hyperendemic region of sub-Saharan Africa known as the "Meningitis Belt" which stretches from Senegal east to Ethiopia.

animal contact disease acquired through direct contact with local animals:
Rabies - viral disease of mammals usually transmitted through the bite of an infected animal, most commonly dogs; virus affects the central nervous system causing brain alteration and death; symptoms initially are non-specific fever and headache progressing to neurological symptoms; death occurs within days of the onset of symptoms.

  • Afghanistan

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: Crimea-Congo hemorrhagic fever, malaria

  • Angola

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, typhoid fever

    vectorborne diseases: dengue fever, malaria

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Argentina

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Argentina; as of 24 January 2021, Argentina has reported a total of 1,853,830 cases of COVID-19 or 4,101.8 cumulative cases of COVID-19 per 100,000 population with 103.1 cumulative deaths per 100,000 population

  • Bangladesh

    degree of risk: high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: dengue fever and malaria are high risks in some locations

    water contact diseases: leptospirosis

    animal contact diseases: rabies

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Bangladesh; as of 24 January 2021, Bangladesh has reported a total of 531,326 cases of COVID-19 or 322.6 cumulative cases of COVID-19 per 100,000 population with 4.9 cumulative deaths per 100,000 population

  • Benin

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Bolivia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea and hepatitis A

    vectorborne diseases: dengue fever and malaria

  • Botswana

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria

  • Brazil

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea and hepatitis A

    vectorborne diseases: dengue fever and malaria

    water contact diseases: schistosomiasis

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Brazil; as of 24 January 2021, Brazil has reported a total of 8,753,920 cases of COVID-19 or 4,118.3 cumulative cases of COVID-19 per 100,000 population with 101.3 cumulative deaths per 100,000 population; the Department of Homeland Security has issued instructions requiring US passengers who have been in Brazil to travel through select airports where the US Government has implemented enhanced screening procedures

  • Burkina Faso

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Burma

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever, malaria, and Japanese encephalitis

    animal contact diseases: rabies

  • Burundi

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Cambodia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever, Japanese encephalitis, and malaria

  • Cameroon

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Central African Republic

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Chad

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • China

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: Crimean-Congo hemorrhagic fever, Japanese encephalitis

    soil contact diseases: hantaviral hemorrhagic fever with renal syndrome (HFRS)

    note: a new coronavirus is causing an outbreak of respiratory illness (COVID-19) in China; illness with this virus has ranged from mild to severe with fatalities reported; the US Department of State has issued a do not travel advisory for China due to COVID-19; the Centers for Disease Control and Prevention has also recommended against travel to China and published additional guidance at https://wwwnc.cdc.gov/travel/notices/warning/novel-coronavirus-china; the US Department of Homeland Security has issued instructions requiring US passengers who have been in China to travel through select airports where the US Government has implemented enhanced screening procedures; as of 24 January 2021, China has reported a total of 99,931 cases of COVID-19 or 6.8 cumulative cases of COVID-19 per 100,000 population with 0.3 cumulative deaths per 100,000 population

  • Colombia

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: dengue fever, malaria, and yellow fever

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Colombia; as of 24 January 2021, Columbia has reported a total of 1,987,418 cases of COVID-19 or 3,905.9 cumulative cases of COVID-19 per 100,000 population with 99.4 cumulative deaths per 100,000 population

  • Congo, Democratic Republic of the

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and trypanosomiasis-gambiense (African sleeping sickness)

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    note - on 18 October 2019, the Centers for Disease Control and Prevention issued a Travel Health Notice for an Ebola outbreak in the South Kivu (Kivu Sud), North Kivu (Kivu Nord), and Ituri provinces in the northeastern part of the Democratic Republic of the Congo; travelers to this area could be infected with Ebola if they come into contact with an infected person’s blood or other body fluids; travelers should seek medical care immediately if they develop fever, muscle pain, sore throat, diarrhea, weakness, vomiting, stomach pain, or unexplained bleeding or bruising during or after travel

  • Congo, Republic of the

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Cook Islands

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Costa Rica

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: dengue fever

  • Cote d'Ivoire

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Croatia

    degree of risk: intermediate (2020)

    vectorborne diseases: tickborne encephalitis

  • Cuba

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea and hepatitis A

    vectorborne diseases: dengue fever

  • Djibouti

    degree of risk: high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever

  • Dominican Republic

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever

  • Ecuador

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Egypt

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    water contact diseases: schistosomiasis

    note: clusters of cases of a respiratory illness caused by the novel coronavirus (COVID-19) are occurring throughout Egypt; as of 24 January 2021, Egypt has reported a total of 161,143 cases of COVID-19 or 157.5 cumulative cases of COVID-19 per 100,000 population with 8.7 cumulative deaths per 100,000 population

  • El Salvador

    degree of risk: high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea

    vectorborne diseases: dengue fever

  • Equatorial Guinea

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    animal contact diseases: rabies

  • Eritrea

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

  • Estonia

    degree of risk: intermediate (2020)

    vectorborne diseases: tickborne encephalitis

  • Eswatini

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria

    water contact diseases: schistosomiasis

  • Ethiopia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • European Union

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring regionally; the US Department of Homeland Security has issued instructions requiring US passengers who have been in the European Union’s Schengen Area (comprised of the following 26 European states: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland) to travel through select airports where the US Government has implemented enhanced screening procedures

  • Fiji

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • France

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout France; as of 24 January 2021, France has reported a total of 2,985,259 cases of COVID-19 or 4,573.5 cumulative cases of COVID-19 per 100,000 population with 111.0 cumulative deaths per 100,000 population

  • French Polynesia

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Gabon

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Gambia, The

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Ghana

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Guatemala

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Guinea

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    aerosolized dust or soil contact diseases: Lassa fever (2016)

  • Guinea-Bissau

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Guyana

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Haiti

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Honduras

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Hungary

    degree of risk: intermediate (2016)

    vectorborne diseases: tickborne encephalitis (2016)

  • India

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: dengue fever, Crimean-Congo hemorrhagic fever, Japanese encephalitis, and malaria

    water contact diseases: leptospirosis

    animal contact diseases: rabies

    note: clusters of cases of a respiratory illness caused by the novel coronavirus (COVID-19) are being reported across 27 States and Union Territories in India; as of 24 January 2021, India has reported a total of 10,654,533 cases of COVID-19 or 772.1 cumulative cases of COVID-19 per 100,000 population with 11.1 cumulative deaths per 100,000 population; on 16 March 2020, the government proposed extensive social distancing measures, including closure of all schools, museums, and cultural and social centers; prohibited gatherings of more than 50 people; and called on the public to avoid all non-essential travel; international commercial passenger flights remain suspended

  • Indonesia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Iran

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: Crimean-Congo hemorrhagic fever

    note: a new coronavirus is causing sustained community spread of respiratory illness (COVID-19) in Iran; sustained community spread means that people have been infected with the virus, but how or where they became infected is not known, and the spread is ongoing; illness with this virus has ranged from mild to severe with fatalities reported; as of 24 January 2021, Iran has reported a total of 1,367,032 cases of COVID-19 or 1,627.6 cumulative cases of COVID-19 per 100,000 population with 68.2 cumulative deaths per 100,000 population

  • Iraq

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Iraq; as of 24 January 2021, Iraq has reported a total of 612,870 cases of COVID-19 or 1,523.7 cumulative cases of COVID-19 per 100,000 population with 32.3 cumulative deaths per 100,000 population

  • Italy

    respiratory diseases: Covid-19 (see note) (2020)

    note: a new coronavirus is causing sustained community spread of respiratory illness (COVID-19) in Italy; sustained community spread means that people have been infected with the virus, but how or where they became infected is not known, and the spread is ongoing; illness with this virus has ranged from mild to severe with fatalities reported; as of 24 January 2021, Italy has reported a total of 2,455,185 cases of COVID-19 or 4,060.7 cumulative cases of COVID-19 per 100,000 population with 140.9 cumulative deaths per 100,000 population; the US Department of State has issued a Travel Advisory to reconsider travel to Italy due to the recent outbreak of COVID-19; the Centers for Disease Control and Prevention has also recommended postponing nonessential travel to Italy at this time and published additional guidance at https://wwwnc.cdc.gov/travel/notices/alert/coronavirus-italy; the US Department of Homeland Security has issued instructions requiring US passengers who have been in Italy to travel through select airports where the US Government has implemented enhanced screening procedures

  • Japan

    respiratory diseases: Covid-19 (see note) (2020)

    note: clusters of cases of respiratory illness caused by a new coronavirus (COVID-19) in Japan; illness with this virus has ranged from mild to severe with fatalities reported; as of 24 January 2021, Japan has reported a total of 360,661 cases of COVID-19 or 285.2 cumulative cases of COVID-19 per 100,000 population with 4.0 cumulative deaths per 100,000 population; the US Department of State has issued a Travel Advisory recommending increased caution in Japan due to the recent outbreak of COVID-19; the Centers for Disease Control and Prevention has recommended postponing nonessential international travel at this time and published additional guidance at https://wwwnc.cdc.gov/travel/notices/alert/ ; on 25 May 2020, Japan ended its state of emergency

  • Kenya

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and Rift Valley fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Kiribati

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Korea, South

    respiratory diseases: Covid-19 (see note) (2020)

    note: a novel coronavirus is causing an outbreak of respiratory illness (COVID-19) in South Korea; illness with this virus has ranged from mild to severe with fatalities reported; the US Department of State has issued a Travel Advisory recommending avoiding all international travel due to COVID-19; the Centers for Disease Control and Prevention has recommended against all international travel and published additional guidance at https://wwwnc.cdc.gov/travel/notices/warning/ ; as of 24 January 2021, South Korea has reported a total of 75,084 cases of COVID-19 or 146.5 cumulative cases of COVID-19 per 100,000 population with 2.6 cumulative deaths per 100,000 population

  • Laos

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Latvia

    degree of risk: intermediate (2020)

    vectorborne diseases: tickborne encephalitis

  • Lesotho

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

  • Liberia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    aerosolized dust or soil contact diseases: Lassa fever

  • Lithuania

    degree of risk: intermediate (2020)

    vectorborne diseases: tickborne encephalitis

  • Madagascar

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Malawi

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Malaysia

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: dengue fever

    water contact diseases: leptospirosis

  • Mali

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Marshall Islands

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Mauritania

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Mexico

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea and hepatitis A

    vectorborne diseases: dengue fever

    note: a new coronavirus is causing sustained community spread of respiratory illness (COVID-19) in Mexico; sustained community spread means that people have been infected with the virus, but how or where they became infected is not known, and the spread is ongoing; illness with this virus has ranged from mild to severe with fatalities reported; as of 24 January 2021, Mexico has reported a total of 1,732,290 cases of COVID-19 or 1,343.6 cumulative cases of COVID-19 per 100,000 population with 114.5 cumulative deaths per 100,000 population

  • Micronesia, Federated States of

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Montenegro

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: Crimean-Congo hemorrhagic fever

  • Morocco

    note: clusters of cases of a respiratory illness caused by the novel coronavirus (COVID-19) are occurring in Morocco; as of 24 January 2021, Morocco has reported a total of 465,769 cases of COVID-19 or 1,261.9 cumulative cases of COVID-19 per 100,000 population with 22.0 cumulative deaths per 100,000 population

  • Mozambique

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Namibia

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria

    water contact diseases: schistosomiasis

  • Nauru

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Nepal

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: Japanese encephalitis, malaria, and dengue fever

  • New Caledonia

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Nicaragua

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Niger

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Nigeria

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: leptospirosis and schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

    aerosolized dust or soil contact diseases: Lassa fever

    note: on 7 October 2019, the Centers for Disease Control and Prevention issued a Travel Health Notice for a Yellow Fever outbreak in Nigeria; a large, ongoing outbreak of yellow fever in Nigeria began in September 2017; the outbreak is now spread throughout the country with the Nigerian Ministry of Health reporting cases of the disease in all 36 states and the Federal Capital Territory; the CDC recommends travelers going to Nigeria should receive vaccination against yellow fever at least 10 days before travel and should take steps to prevent mosquito bites while there; those never vaccinated against yellow fever should avoid travel to Nigeria during the outbreak
    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Nigeria; as of 24 January 2021, Nigeria has reported a total of 120,602 cases of COVID-19 or 58.5 cumulative cases of COVID-19 per 100,000 population with 0.7 cumulative deaths per 100,000 population; as of 19 March 2020, the Government of Nigeria has restricted entry into Nigeria for travelers from the following high incidence countries: China, Italy, Iran, Norway, South Korea, Spain, Japan, France, Germany, US, UK, Netherlands, and Switzerland

  • Niue

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Pakistan

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: dengue fever and malaria

    animal contact diseases: rabies

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Pakistan; as of 24 January 2021, Pakistan has reported a total of 530,818 cases of COVID-19 or 240.3 cumulative cases of COVID-19 per 100,000 population with 5.1 cumulative deaths per 100,000 population; the Government of Pakistan will permit commercial outbound passenger flights from all international airports except Gwadar and Turbat effective 30 May 2020, but inbound passenger flights remain suspended; limited domestic flight operations from five major airports – Islamabad, Karachi, Lahore, Peshawar, and Quetta are available; on 7 May 2020, the Government of Pakistan announced an ease in some of the nationwide lockdown restrictions; additionally, the Islamabad Capital Territory and Sindh, Punjab, Balochistan, and Khyber Pakhtunkhwa provinces have varying degrees of lockdowns

  • Palau

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Panama

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: dengue fever

  • Papua New Guinea

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Paraguay

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever

  • Peru

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever, malaria, and Bartonellosis (Oroya fever)

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Peru; as of 24 January 2021, Peru has reported a total of 1,088,096 cases of COVID-19 or 3,300.1 cumulative cases of COVID-19 per 100,000 population with 119.6 cumulative deaths per 100,000 population; at this time, there are no specific limitations or quarantine requirements for US citizens and Lawful Permanent Residents entering the US from Peru; on 3 June 2020, Peruvian President Martín VIZCARRA signed a supreme decree extending Peru’s Health State of Emergency for 90 days beginning Wednesday, 10 June 2020; this is not an extension of the national quarantine, although social distancing and the use of facemasks will be required for the foreseeable future

  • Philippines

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

    water contact diseases: leptospirosis

    note - on 8 October 2019, the Centers for Disease Control and Prevention issued a Travel Health Notice regarding a polio outbreak in the Philippines; CDC recommends that all travelers to the Philippines be vaccinated fully against polio; before traveling to the Philippines, adults who completed their routine polio vaccine series as children should receive a single, lifetime adult booster dose of polio vaccine

  • Pitcairn Islands

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Poland

    degree of risk: intermediate (2016)

    vectorborne diseases: tickborne encephalitis (2016)

  • Russia

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: Crimean-Congo hemorrhagic fever, tickborne encephalitis

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout the Russia; as of 24 January 2021, Russia has reported a total of 3,719,400 cases of COVID-19 or 2,548.7 cumulative cases of COVID-19 per 100,000 population with 47.6 cumulative deaths per 100,000 population

  • Rwanda

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    animal contact diseases: rabies

  • Samoa

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Sao Tome and Principe

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

  • Saudi Arabia

    note: sporadic cases of a respiratory illness caused by the novel coronavirus (COVID-19) are occurring throughout Saudi Arabia; as of 24 January 2021, Saudi Arabia has reported a total of 366,185 cases of COVID-19 or 1,051.8 cumulative cases of COVID-19 per 100,000 population with 18.2 cumulative deaths per 100,000 population

  • Senegal

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Serbia

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea

  • Sierra Leone

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    aerosolized dust or soil contact diseases: Lassa fever

  • Solomon Islands

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Somalia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: dengue fever, malaria, and Rift Valley fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • South Africa

    degree of risk: intermediate (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    water contact diseases: schistosomiasis

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout South Africa; as of 24 January 2021, South Africa has reported a total of 1,404,839 cases of COVID-19 or 2,368.7 cumulative cases of COVID-19 per 100,000 population with 68.4 cumulative deaths per 100,000 population; on 24 May 2020, the Government of South Africa announced the lockdown alert level for South Africa will be lowered to level 3 with effect on 1 June 2020, except for some areas designated as “coronavirus hotspots”; per the lockdown, all airports in South Africa are closed to commercial traffic

  • South Sudan

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: malaria, dengue fever, Trypanosomiasis-Gambiense (African sleeping sickness)

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Spain

    respiratory diseases: Covid-19 (see note) (2020)

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Spain; as of 24 January 2021, Spain has reported a total of 2,456,675 cases of COVID-19 or 5,254.4 cumulative cases of COVID-19 per 100,000 population with 117.7 cumulative deaths per 100,000 population; the Spanish Government is gradually relaxing confinement measures in phases over the next several weeks; these measures will vary from region to region within Spain; the Department of Homeland Security has issued instructions requiring US passengers who have been in Spain to travel through select airports where the US Government has implemented enhanced screening procedures

  • Sri Lanka

    degree of risk:

    intermediate

    (2020)

    vectorborne diseases: dengue fever

    water contact diseases: leptospirosis

    animal contact diseases: rabies

  • Sudan

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and Rift Valley fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Suriname

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Tajikistan

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria

  • Tanzania

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and Rift Valley fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Thailand

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: dengue fever, Japanese encephalitis, and malaria

  • Timor-Leste

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

  • Togo

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and yellow fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

    respiratory diseases: meningococcal meningitis

  • Tokelau

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Tonga

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Turkey

    respiratory diseases: Covid-19 (2020)

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Turkey; as of 24 January 2021, Turkey has reported a total of 2,424,328 cases of COVID-19 or 2,874.5 cumulative cases of COVID-19 per 100,000 population with 29.6 cumulative deaths per 100,000 population

  • Uganda

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever

    vectorborne diseases: malaria, dengue fever, and Trypanosomiasis-Gambiense (African sleeping sickness)

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • United Kingdom

    respiratory diseases: Covid-19 (see note) (2020)

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout the UK; as of 24 January 2021, the UK has reported a total of 3,617,463 cases of COVID-19 or 5,328.7 cumulative cases of COVID-19 per 100,000 population with 143.4 cumulative deaths per 100,000 population; individuals arriving in the UK must self-isolate for 14 days and may be contacted to verify compliance; new arrivals will be required to provide UK officials with contact and travel information prior to arrival; the US Department of Homeland Security has issued instructions requiring US passengers who have been in the UK to travel through select airports where the US Government has implemented enhanced screening procedures

  • Vanuatu

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • Venezuela

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea and hepatitis A

    vectorborne diseases: dengue fever and malaria

  • Vietnam

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever, malaria, and Japanese encephalitis

  • Wallis and Futuna

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea

    vectorborne diseases: malaria

  • World

    note: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring globally; older adults and people of any age with serious chronic medical conditions are at increased risk for severe disease; some health care systems are becoming overwhelmed and there may be limited access to adequate medical care in affected areas; many countries are implementing travel restrictions and mandatory quarantines, closing borders, and prohibiting non-citizens from entry with little advance notice; US residents may have difficulty returning to the United States; as of 24 January 2021, 98,280,844 confirmed cases of COVID-19 and 2,112,759 deaths have been reported to the World Health Organization

  • Yemen

    degree of risk: high (2020)

    food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: dengue fever and malaria

    water contact diseases: schistosomiasis

  • Zambia

    degree of risk: very high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies

  • Zimbabwe

    degree of risk: high (2020)

    food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever

    vectorborne diseases: malaria and dengue fever

    water contact diseases: schistosomiasis

    animal contact diseases: rabies