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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.
By Country Listing of the values for the Major infectious diseases field
Country Major infectious diseases
Afghanistan
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria (2016)
American Samoa

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Angola
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, typhoid fever (2016)
vectorborne diseases: dengue fever, malaria (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Anguilla

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Antigua and Barbuda

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Argentina

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Aruba

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Bangladesh
degree of risk: high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria are high risks in some locations (2016)
water contact diseases: leptospirosis (2016)
animal contact diseases: rabies (2016)
Barbados

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Belize
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Benin
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever, malaria, and yellow fever (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Bhutan
degree of risk: high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever (2016)
Bolivia
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea and hepatitis A (2016)
vectorborne diseases: dengue fever, malaria, and yellow fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Botswana
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria (2016)
Brazil
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea and hepatitis A (2016)
vectorborne diseases: dengue fever and malaria (2016)
water contact diseases: schistosomiasis (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Burkina Faso
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever, malaria, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Burma
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever, malaria, and Japanese encephalitis (2016)
water contact diseases: leptospirosis (2016)
animal contact diseases: rabies (2016)
Burundi
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Cabo Verde

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Cambodia
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever, Japanese encephalitis, and malaria (2016)
Cameroon
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Cayman Islands

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Central African Republic
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Chad
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
China
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: Japanese encephalitis (2016)
soil contact diseases: hantaviral hemorrhagic fever with renal syndrome (HFRS) (2016)
Colombia
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: dengue fever, malaria, and yellow fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Congo, Democratic Republic of the
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and trypanosomiasis-gambiense (African sleeping sickness) (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Congo, Republic of the
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Costa Rica
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Cote d'Ivoire
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Croatia
degree of risk: intermediate (2016)
vectorborne diseases: tickborne encephalitis (2016)
Cuba
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea and hepatitis A (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Curacao

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Djibouti
degree of risk: high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever (2016)
Dominica

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Dominican Republic
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Ecuador
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Egypt
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
water contact diseases: schistosomiasis (2016)
El Salvador
degree of risk: high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Equatorial Guinea
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
animal contact diseases: rabies (2016)
Eritrea
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
Estonia
degree of risk: intermediate (2016)
vectorborne diseases: tickborne encephalitis (2016)
Eswatini
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria (2016)
water contact diseases: schistosomiasis (2016)
Ethiopia
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Fiji

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Gabon
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Gambia, The
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Ghana
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Grenada

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Guatemala
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Guinea
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
aerosolized dust or soil contact diseases: Lassa fever (2016)
Guinea-Bissau
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Guyana
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Haiti
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Honduras
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Hungary
degree of risk: intermediate (2016)
vectorborne diseases: tickborne encephalitis (2016)
India
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: dengue fever, Japanese encephalitis, and malaria (2016)
water contact diseases: leptospirosis (2016)
animal contact diseases: rabies (2016)
Indonesia
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)
Iran
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: Crimean-Congo hemorrhagic fever (2016)
Iraq
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
Jamaica

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Kenya
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and Rift Valley fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Laos
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)
Latvia
degree of risk: intermediate (2016)
vectorborne diseases: tickborne encephalitis (2016)
Liberia
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
aerosolized dust or soil contact diseases: Lassa fever (2016)
Lithuania
degree of risk: intermediate (2016)
vectorborne diseases: tickborne encephalitis (2016)
Madagascar
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Malawi
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Malaysia
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: dengue fever (2016)
water contact diseases: leptospirosis (2016)
Mali
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Marshall Islands

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Mauritania
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Mexico
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea and hepatitis A (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Micronesia, Federated States of

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Montenegro
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: Crimean-Congo hemorrhagic fever (2016)
Mozambique
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Namibia
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria (2016)
water contact diseases: schistosomiasis (2016)
Nepal
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: Japanese encephalitis, malaria, and dengue fever (2016)
New Caledonia

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Nicaragua
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Niger
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Nigeria
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: leptospirosis and schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
aerosolized dust or soil contact diseases: Lassa fever (2016)
Pakistan
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)
animal contact diseases: rabies (2016)
Panama
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Papua New Guinea
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Paraguay
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Peru
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever, malaria, and Bartonellosis (Oroya fever) (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Philippines
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)
water contact diseases: leptospirosis (2016)
Poland
degree of risk: intermediate (2016)
vectorborne diseases: tickborne encephalitis (2016)
Puerto Rico

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Russia
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: tickborne encephalitis (2016)
Rwanda
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
animal contact diseases: rabies (2016)
Saint Barthelemy

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Saint Lucia

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Saint Martin

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Saint Vincent and the Grenadines

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Samoa

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Sao Tome and Principe
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
Senegal
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Serbia
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea (2016)
Sierra Leone
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
aerosolized dust or soil contact diseases: Lassa fever (2016)
Singapore

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Sint Maarten

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Somalia
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: dengue fever, malaria, and Rift Valley fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
South Africa
degree of risk: intermediate (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
water contact diseases: schistosomiasis (2016)
South Sudan
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, trypanosomiasis-Gambiense (African sleeping sickness) (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Sri Lanka
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea and hepatitis A (2016)
vectorborne diseases: dengue fever (2016)
water contact diseases: leptospirosis (2016)
animal contact diseases: rabies (2016)
Sudan
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and Rift Valley fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Suriname
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Tajikistan
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria (2016)
Tanzania
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and Rift Valley fever (2016)
water contact diseases: schistosomiasis and leptospirosis (2016)
animal contact diseases: rabies (2016)
Thailand
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea (2016)
vectorborne diseases: dengue fever, Japanese encephalitis, and malaria (2016)
Timor-Leste
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)
Togo
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and yellow fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
respiratory diseases: meningococcal meningitis (2016)
Tonga

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Trinidad and Tobago

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Turks and Caicos Islands

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Uganda
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A and E, and typhoid fever (2016)
vectorborne diseases: malaria, dengue fever, and trypanosomiasis-Gambiense (African sleeping sickness) (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Venezuela
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea and hepatitis A (2016)
vectorborne diseases: dengue fever and malaria (2016)

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Vietnam
degree of risk: very high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever, malaria, and Japanese encephalitis (2016)
Virgin Islands

note: active local transmission of Zika virus by Aedes species mosquitoes has been identified in this country (as of August 2016); it poses an important risk (a large number of cases possible) among US citizens if bitten by an infective mosquito; other less common ways to get Zika are through sex, via blood transfusion, or during pregnancy, in which the pregnant woman passes Zika virus to her fetus

Yemen
degree of risk: high (2016)
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: dengue fever and malaria (2016)
water contact diseases: schistosomiasis (2016)
Zambia
degree of risk: very high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)
Zimbabwe
degree of risk: high (2016)
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever (2016)
vectorborne diseases: malaria and dengue fever (2016)
water contact diseases: schistosomiasis (2016)
animal contact diseases: rabies (2016)