Traveling in the United States

The overall health risks of traveling in the United States are low. There are no vaccination requirements for visitors to the U.S. The high standard of living, high level of sanitation, high vaccination rate and well-organized public health systems contribute to the overall safety of traveling here.

Foodborne diseases may occur, but the risk is low. Fresh fruit and vegetables are safe despite rare contamination outbreaks, mostly of salmonella. Seafood poisoning is possible, but the risk is also low. Most seafood poisonings result from imported seafood. Periodic red tide events in Atlantic coastal waters may render locally harvested seafood toxic, but a monitoring system effectively prevents contaminated seafood from being sold. Water in the U.S. is generally safe for drinking with the possible exception of well water in some rural areas that may not be treated or adequately controlled.

Vector-borne diseases represent a small to moderate risk. Mosquitos are present all over the U.S., but human reservoirs of mosquito-transmitted diseases are small or nonexistent. Ticks are present throughout the country and may transmit a range of diseases. The most significant tickborne disease is Lyme disease, with 96 percent of reported cases in the Northeast and upper Midwest (around the Great Lakes). The risk of infection is limited to areas with trees, bushes and high grass inhabited by deer. People are most at risk for contracting Lyme disease in spring and summer.

Another tickborne disease to be aware of in the U.S. is Rocky Mountain spotted fever. Most tickborne diseases are seasonal but may be present year-round in temperate and warm climates. American trypanosomiasis (Chagas disease) is a neglected tropical disease transmitted by kissing bugs (triatomines). Vector-borne transmission of Chagas disease occurs in the Americas, including the southern half of North America. This could be a risk for campers in the U.S. southern states where triatomines are endemic.

Contagious diseases that spread from person to person are rare except for the seasonal flu and more recently COVID-19. Outbreaks of hepatitis A may occur among drug users and homeless people. Traveling internationally increases your risk of coming in contact with contagious diseases in general, so vaccinations for measles and influenza are recommended.

Risk of injury is relatively low in the U.S., but traffic accidents are a significant cause of injury for travelers. Drowning is a risk for recreational swimmers, due in part to rip currents present off some beaches. Hurricanes can be a threat along the Atlantic coast from June through November, so watch for storm warnings and follow the instructions issued by authorities.

Adventure sports and wilderness activities expose participants to various risks; additional training may be warranted to keep these risks under control.

Popular weekend and vacation destinations for Americans are the American and Caribbean tropics. Overall health risks for traveling in the American and Caribbean tropics are moderate to high. The warm and humid climate contributes to risks of both foodborne and vector-borne diseases. Sanitation levels vary and with it the risk of travelers’ diarrhea and other foodborne diseases. Dengue and chikungunya are endemic in some areas. Seafood poisoning is common, with ciguatera being the most prevalent cause.

Health care services in the United States are excellent, but in rural areas health care is not always readily available. Emergency medical services are not free, and health care in the United States can be very expensive, so health insurance is highly recommended.