Canada, St. Pierre and Miquelon [France], United
States [including Hawaii
NOTE: Please check the
section for important updates on this region.
In 1994, an
international commission certified the eradication of
endemic wild poliovirus from the Americas. Ongoing
surveillance in formerly endemic Central
and South American countries (Tropical
confirms that poliovirus transmission remains
The incidence of
communicable diseases is such that they are unlikely
to prove a hazard for international travelers greater
than that found in their own country. There are, of
course, health risks, but in general, the precautions
required are minimal.
occasionally occur, such as plague,
in wildlife, including bats, Rocky Mountain spotted
fever, tularemia, arthropod-borne encephalitis, and
seasonal outbreaks of influenza.
Rodent-borne hantavirus has been identified,
predominantly in the western states of the United
disease is endemic in the northeastern United
States, Mid-Atlantic, and the upper Midwest and the
southwestern provinces of Canada. Occasional cases
have been reported from the Pacific Northwest.
Recently, cases of West
Nile virus have occurred around the New York City
area. During recent years, the incidence of certain
foodborne diseases, e.g., E.
O157:H7 and salmonellosis, has increased in some
regions. Other hazards include poisonous snakes (see Animal-Associated
Hazards on the Making
Travel Safe page), poison ivy, and poison oak. In
the north, a serious hazard is the very low
temperature in the winter.
In the United States,
proof of immunization against diphtheria,
poliomyelitis, and rubella
is now universally required for entry into school. In
addition, the school entry requirements of most states
include immunization against tetanus
(49 states), pertussis
(44 states), mumps
(46 states), and hepatitis
B (26 states). Haemophilus influenzae type
b (Hib) vaccine is not required for school entry but
is required in 49 states for attendance in day care
(See the Diseases
page for more information on North American diseases
such as hantavirus and Rocky Mountain spotted fever.)
For information on recent U.S. outbreaks, please see
and Mortality Weekly Report).
information on traveling in Canada, please see
Centre for Disease Control, which includes updates
on current Canadian outbreaks.