9 Worst Travel Diseases and How to Avoid Them

As travelers are increasingly heading into areas where the water isn’t always clean or where mosquitos carry deadly diseases, it’s important to become familiar with the risks before you go and take every preventative measure possible.

First and foremost, travelers are warned to take precautions to protect themselves. The following recommendations apply to all travelers:

• Get your vaccinations up to date. Tell your doctor where you’ll be traveling, and you may need specific vaccinations, but it’s also important that your basic vaccinations – measles/mumps/rubella, tetanus, and diphtheria as well as hepatitis A and B – are up to date.
• Carry a traveler’s medical kit. You can’t count on being able to find proper medications where you’re traveling, and the risk of counterfeit medications is rampant in many countries. See What’s in your Travel Medical Kit for more details.
• Watch what you eat and drink and where it came from. Drink safely bottled water or boil your own. See Safe Drinking Water Tips for Travelers for more information. Make sure fresh vegetables are hot and steaming and avoid uncooked seafood.
• Wash your hands frequently and carefully with soap and water. In case you don’t have access to soap and water, carry antiseptic wipes and hand sanitizer.

The risk isn’t just to those who are traveling off the beaten path either. When travelers head to disaster-stricken areas to volunteer with aid efforts, they also put themselves at risk, and here at home we face E. coli outbreaks, West Nile, and Lyme disease.

1. Giardiasis

Giardia is a microscopic parasite causing the diarrheal illness known as giardiasis. Giardia is protected by a thin outer shell that allows it to survive outside a host for long periods of time and makes it resistant to chlorine disinfection. Symptoms vary and include diarrhea, abdominal cramps, vomiting, nausea, dehydration and may last a week, two, or longer.

Where you’ll find it: everywhere. It is the most frequently diagnosed intestinal parasitic disease in the U.S. and among travelers. We put it first on our list for that reason alone.

Steps to avoid it: the steps to avoid giardiasis are focused entirely on basic hygiene and clean food and water consumption.

1. Wash your hands often and thoroughly with soap and water.
2. Shower before and after being in the water at beaches, pools, and fountains.
3. Avoid drinking contaminated water and ice made from local water.
4. Avoid foods that are raw or that may be washed in contaminated water.

2. Typhoid

Typhoid is a bacterial illness spread through contaminated water and foods washed in contaminated water. The resulting illness and fever is life-threatening.

Where you’ll find it: in high-risk areas like South Asia and in developing countries in Asia, Africa, the Caribbean, and Central and South America. Haiti has been fighting an outbreak since the January 2010 earthquake destroyed much of their infrastructure.

Steps to avoid it: the steps to avoid typhoid focus primarily on clean food and water consumption.

1. Check the CDC Traveler’s Health Map before you go so you know the current risk at your destination.
2. See your doctor (preferably one specializing in travel medicine) before you go and determine whether a typhoid vaccine is right for you.
3. Avoid drinking contaminated water and ice made from local water.
4. Avoid foods that are raw or that may be washed in contaminated water.

3. Norovirus

Norovirus is an extremely contagious virus that can infect anyone. It’s spread by person-to-person contact, consuming contaminated food or water, or touching contaminated surfaces. Symptoms include severe stomach pain, nausea, diarrhea and vomiting and outbreaks typically occur from November to April.

Where you’ll find it: everywhere. This one is really hard to escape.

Steps to avoid it: the steps to avoid norovirus are focuses primarily on good personal hygiene.

1. Wash your hands often and thoroughly with soap and water.
2. Clean and disinfect surfaces such as handles, countertops, sinks, and more with a chlorine bleach solution.
3. Carefully wash fruits and vegetables in clean water before peeling them.
4. Cook seafood thoroughly before eating them.
5. Isolate those that are ill and keep them away from areas where food is being prepared.

See Avoiding Norovirus on Vacation – It’s not Just a Cruise Ship Problem for more details.

4. Malaria

Malaria is a potentially fatal disease caused by a tiny parasite that is transmitted through a bite from an infected mosquito. Travelers who contract malaria experience fever, chills, and flu-like symptoms, which if left untreated can cause severe complications and death. In 2010, an estimated 216 million cases of malaria occurred and 655,000 people died (most in Africa).

Where you’ll find it: in South and Central America, Haiti, the Dominican Republic, parts of Africa, Asia, Eastern Europe and the South Pacific.

Steps to avoid it: The steps to avoid malaria are primarily focused on preventing mosquito bites.

1. Check the CDC Traveler’s Health Map before you go so you know the current risk at your destination.
2. See your doctor (preferably one specializing in travel medicine) before you go and determine whether taking antimalaria medication, typically mefloquine or chloroquine, is right for you.
3. If you will be taking malaria prevention medications, obtain the supply you’ll need before you go. Many countries – even those where malaria is common – have a problem with counterfeit drugs, so you should always purchase your antimalarial drugs at home before you travel.
4. Be prepared to take preventive measures to guard against mosquito bites (even if you decide to take the antimalarial drugs). This includes wearing long sleeves and pants to protect your skin and using mosquito repellent with DEET. It also means sleeping in safely screened or mosquito netted quarters.

See the CDC recommendations for Malaria and Travelers.

5. Hepatitis A

While hepatitis comes in many forms, Hep A is the one travelers should be most concerned about. Easily transmitted through contaminated water and uncooked foods, it has an incubation period of approximately 28 days, so a traveler may well have returned to work after a trip before the symptoms develop. Symptoms include fever, nausea, and exhaustion, and relapses can occur.

Where you’ll find it: high-risk areas include most of the developing world, but outbreaks can and do occur anywhere.

Steps to avoid it: the steps to avoid Hep A are primarily focused on the basic rules of consuming clean food and water.

1. Consider the Hepatitis A vaccine and immune globulin, which are very effective.
2. Avoid drinking contaminated water and ice made from local water.
3. Avoid foods that are raw or that may be washed in contaminated water.

See the Most Common Vaccine-Preventable Traveler’s Disease – Hepatitis A for more details.

6. Yellow Fever

Yellow Fever is a viral disease also transmitted through mosquito bites and results in a range of uncomfortable flu-like symptoms.

Where you’ll find it: in tropical South America and Sub-Saharan Africa.

Steps to avoid it: the steps to avoid Yellow Fever focus on preventing mosquito bites.

1. Check the CDC Traveler’s Health Map before you go so you know the current risk at your destination.
2. See your doctor (preferably one specializing in travel medicine) before you go and get a yellow fever vaccine.
3. Take precautions to prevent mosquito bites, including wearing long clothing, using repellents with DEET, and sleeping in mosquito-safe quarters.

Some countries require proof of vaccination – see the CDC recommendations by country.

7. Dengue Fever

Another viral disease transmitted through mosquito bites and causing severe flu-like illness. There is no vaccine.

Where you’ll find it: in the South Pacific, Asia, the Caribbean, Central and South America, and Africa. It is endemic in Puerto Rico and many popular tourist destinations. Outbreaks periodically occur in Samoa and Guam.

Steps to avoid it: the steps to avoid Dengue focus on preventing mosquito bites although early treatment is known to reduce the risk of developing serious complications.

1. Check the CDC Traveler’s Health Map before you go so you know the current risk at your destination.
2. Take precautions to prevent mosquito bites, including wearing long clothing, using repellents with DEET, and sleeping in mosquito-safe quarters.

8. Chikungunya

A viral disease also spread through mosquito bites and causing debilitating fever, headache, joint swelling, and more. Acute chikungunya fever typically lasts a few days up to a few weeks, but some patients experience prolonged fatigue and pain lasting several weeks. The incubation time is typically 3 to 7 days.

Where you’ll find it: in Africa, Asia, and even in Europe. First discovered in the 1950s, it has been spreading more rapidly lately.

Steps to avoid it: the steps to avoid chikungunya virus are focused on preventing mosquito bites, especially since the risk of importing it into new areas seems to be through infected travelers.

1. Check the CDC Traveler’s Health Map before you go so you know the current risk at your destination. See also the geographic distribution of chikungunya virus.
2. Take precautions to prevent mosquito bites, including wearing long clothing, using repellents with DEET, and sleeping in mosquito-safe quarters.

9. Lyme Disease

Lyme disease is caused by a bacteria that is released in the system after a tick bite. Symptoms include fever, headaches, rashes, chills, joint pain and more. The incubation time can be from 3 to 30 days after a tick bite. If left untreated, the infection can spread to other parts of the body and cause severe complications.

Where you’ll find it: this disease hits closer to home than most of these diseases listed here because infected ticks are found in northeastern, north central, and the Pacific coastal regions of North America. It’s also found in temperate and forested regions of Europe and Asia.

Steps to avoid it: the steps to avoid Lyme disease are focused on avoiding tick bites.

1. Take precautions to avoid tick bites in areas where ticks are prevalent.
2. Use repellents and check your skin and hair for ticks each day.
3. Know the signs and symptoms and seek early treatment.

See the CDC signs and symptoms of Lyme disease to be able to recognize it.