idual 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 1.5-2.5 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 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