An Ebola outbreak caused by Bundibugyo ebolavirus — a strain for which no approved vaccine or treatment currently exists — is actively spreading in the Democratic Republic of the Congo and has now reached Uganda. On May 16, the World Health Organization declared the outbreak a Public Health Emergency of International Concern (PHEIC), the highest international health alert available.

Where and how many

The outbreak began April 24, 2026, with the suspected index case a healthcare worker at a medical center in Bunia, Ituri Province, whose source of infection remains unknown. As of May 19:

• 513 total cases, including 131 deaths
• Active transmission across multiple health zones in Ituri Province
• Two laboratory-confirmed cases in North Kivu Province – one each in Butembo and Goma
• At least four healthcare workers have died
• Contact tracing is ongoing

It has now reached Uganda

Two imported cases have been confirmed in Kampala, both travelers who arrived separately from the DRC. The first was hospitalized May 11 and died May 14. The second was confirmed May 16. The cases are not believed to be linked to each other, and no secondary spread in Uganda has been reported to date.

Why this outbreak is especially difficult to contain

The response in the DRC is significantly complicated by regional insecurity, restricted access for health workers, civil unrest, and ongoing population movement across affected areas — all of which make detection and isolation of new cases harder and slower.

What travelers need to know about this strain

Bundibugyo ebolavirus is distinct from the more widely known Zaire ebolavirus. The existing Ebola vaccines, including Ervebo, do not protect against this strain, and no therapeutics have been approved for it.

Symptoms to watch for

Symptoms typically appear 2–21 days after exposure. Watch for:

• Sudden fever, severe headache, and intense fatigue
• Muscle pain, vomiting, diarrhea, or abdominal cramping
• Unexplained bleeding or bruising in later stages of illness

If you develop these symptoms within 21 days of returning from the DRC or Kampala, do not go directly to a clinic or emergency room. Call ahead so your provider can prepare isolation precautions and protect staff and other patients from potential exposure.

How to protect yourself

• Avoid all non-essential travel to Ituri and North Kivu provinces in the DRC until the outbreak is declared over
• If travel to Kampala is necessary, avoid hospitals and crowded healthcare settings unless urgently needed
• Ebola does not spread through the air – it requires direct contact with the blood or body fluids of someone who is symptomatic. Standard precautions and awareness go a long way
• There is currently no approved vaccine or treatment for the Bundibugyo strain responsible for this outbreak

Questions or concerns? Contact us at TravelBug Health – we’re happy to talk through your travel plans and help you stay safe.

Resources:

• CDC – Ebola Disease Information
• WHO – Ebola Disease Outbreak News
• CDC – Uganda Travel Health Notice

The post Ebola Outbreak in DRC and Uganda – WHO Declares Global Health Emergency appeared first on TravelBug Health.

A rare outbreak of hantavirus pulmonary syndrome (HPS) has been confirmed among passengers and crew aboard the expedition cruise ship MV Hondius, reported to the World Health Organization on May 2, 2026. The ship departed Ushuaia, Argentina on April 1 carrying 147 passengers and crew from 23 countries, traveling through some of the world’s most remote locations – Antarctica, South Georgia Island, Tristan da Cunha, Saint Helena, and Ascension Island before arriving in the Netherlands on May 18.

Where and how many

As of mid-May:

• At least 10 confirmed or suspected cases, including 3 deaths
• Cases span passengers and crew from 23 countries
• Former passengers are currently quarantined or under medical monitoring in more than 12 countries
• The CDC has classified this as a Level 3 emergency response

Why this outbreak is unusual

The Andes virus is the only hantavirus known to spread from person to person making a confined ship environment a uniquely risky setting. Most hantavirus infections occur through contact with infected rodent droppings or urine. The leading hypothesis is that the index case, a Dutch passenger, contracted the virus during a four-month road trip through South America before boarding, with subsequent spread on the ship occurring through close, prolonged contact. Airborne transmission remains under investigation.

What travelers need to know about this strain

There is no approved antiviral treatment for Andes virus, care is supportive only. The WHO, CDC, and European health agencies all assess the risk to the general public as very low. As of May 18, no confirmed cases have been reported among the U.S. general public.

Symptoms to watch for:

Symptoms typically appear 1–8 weeks after exposure. Watch for:

• Fever, chills, and muscle aches especially in the thighs, hips, and back
• Headache, nausea, vomiting, or abdominal pain
• As the illness progresses: shortness of breath, cough, and a feeling of tightness in the chest

If you develop these symptoms and were aboard the MV Hondius or had close contact with a confirmed case, do not go directly to an emergency room or urgent care. Call your healthcare provider first so they can prepare appropriate precautions and protect other patients.

How to protect yourself

• If you were aboard the MV Hondius or had close, prolonged contact with a symptomatic passenger, self-monitor for symptoms for a full 8 weeks from your last exposure
• If you are traveling to Andean South America, avoid contact with rodents and their droppings – in cabins, camping areas, and rural settings where rodent exposure is likely
• There is currently no vaccine for Andes virus – prevention is your best tool

Questions or concerns? Contact us at TravelBug Health – we’re here to help you assess your risk and navigate next steps.

Resources:

• CDC – Hantavirus Situation Summary
• WHO – Disease Outbreak News: Hantavirus, Multi-country
• Johns Hopkins – Hantavirus Outbreak 2026

The post Andes Hantavirus Outbreak Linked to Cruise Ship Travel appeared first on TravelBug Health.

The EU Entry/Exit System (EES) reaches full implementation today – here’s what every traveler headed to Europe this summer needs to know.

What changed today (April 10, 2026)

The post New Europe Border Controls In Place. More Coming. appeared first on TravelBug Health.

Measles Circulating in Maricopa County. Were You Exposed?

Issued April 9, 2026 · Maricopa County Department of Public Health

Measles is spreading in Maricopa County. A new case has been confirmed in a resident with no known travel or contact with prior cases, which means measles is circulating locally. If you visited any of the locations below during the times listed, you may have been exposed.

Were you at any of these locations?

The post Measles Circulating in Maricopa County. Were You Exposed? appeared first on TravelBug Health.

A cluster of meningococcal meningitis cases has emerged in Kent, England, predominantly among university students. The UK Health Security Agency has confirmed the majority are serogroup B. Given the epidemiological links between cases, health authorities are treating this as an active outbreak. The outbreak in Canterbury, Kent consists of 22 cases now confirmed with required hospitalization, and two deaths reported.

Health officials have been working quickly to contain the spread – over 2,300 people have already been vaccinated and more than 9,000 antibiotic doses distributed to those who may have been exposed.

Travelers, students, and anyone planning an extended stay in the affected area should consult their provider about receiving the the MenB vaccine before visiting. As a travel health resource, feel free to contact us if you have any questions.

Resources:

• NHS – Meningitis Information
• CDC – Meningococcal B VIS

The post UK Meningitis Outbreak in Kent, England appeared first on TravelBug Health.

A marked increase in chikungunya virus (CHIKV) infections has been observed globally since 2025, with over 502,000 cases across 40 countries in the Americas, Africa, Asia, and Europe, including local transmission in France and Italy.

Six countries are currently experiencing above-average incidence:

• Bolivia (6,600+ cases, mainly in Cochabamba and Santa Cruz)
• Cuba (115+ cases throughout the country)
• French Guiana (500+ cases, mainly in western coastal areas)
• Mayotte (3,600+ cases throughout the country — outbreak has yet to peak)
• Seychelles (cases increasing but undisclosed, with 70+ cases reported in travelers)
• Suriname (1,360+ cases throughout the country — outbreak has yet to peak, with case numbers likely underestimated)

Notably, Bolivia has recorded 6 deaths and Mayotte 230 deaths, representing the highest mortality among affected destinations. The Americas continue to carry the highest overall burden, with Suriname alone reporting over 1,700 new cases in the past 30 days.

What This Means for Travelers

Vaccination against chikungunya (VIMKUNYA) is recommended for travelers aged 12 years and older visiting Bolivia, Cuba, French Guiana, Mauritius, Mayotte, Seychelles, or Suriname. For destinations with sporadic cases, vaccination may be considered for those planning stays of six months or longer. Regardless of destination, all travelers should practice strict mosquito bite prevention — Aedes mosquitoes bite primarily during daylight hours, with peak activity at dawn and dusk. Book a consultation with TravelBug before your trip to ensure you have the most current recommendations for your itinerary.

For more information, see the resources below:

• CDC Chikungunya Areas at Risk – March 2026
• PAHO Epidemiological Alert – February 2026
• WHO Chikungunya Global Situation Report
• ECDC Chikungunya Monthly Overview

The post Multi-Country Chikungunya Outbreak – 6 Destinations on High Alert appeared first on TravelBug Health.

Temporary polio booster recommendations have been updated to reflect the latest case and environmental surveillance data. Travelers should be aware that Germany, Togo, the United Kingdom, and Zambia have been added to the list of destinations for which a polio booster is recommended prior to travel.

If you are traveling to any of these newly added destinations, ensure your polio vaccination is up to date before departure. Adults who completed a primary polio vaccine series in childhood should consider receiving a one-time adult booster dose of IPV (inactivated polio vaccine) if they have not already done so. Travelers who are immuno-compromised, working in healthcare or humanitarian settings, or planning extended stays may face elevated risk and are strongly encouraged to seek personalized medical guidance.

Polio vaccine recommendations can change quickly as new case and surveillance data emerge, so it is important to verify current requirements close to your travel date. Before your next trip, book a consultation with a travel medicine specialist from TravelBug Health to confirm that your vaccinations are current — planning ahead is strongly encouraged.

Additional resources for travelers:

• CDC Global Polio Level 2 Travel Notice
• WHO Polio IHR Emergency Committee Statement
• CDC Polio Vaccination for International Travelers

The post Polio Booster Recommendations Updated appeared first on TravelBug Health.

Measles activity in the United States has increased dramatically in late 2025 and early 2026. According to the US Centers for Disease Control and Prevention (CDC), the country has reported hundreds of confirmed cases so far in 2026, including large outbreaks in South Carolina and other states, and several new outbreak clusters across multiple jurisdictions. Weeks with more than 80 confirmed cases have occurred since late January 2026, and total confirmed cases for 2025 exceeded 2,200, the highest annual figure in decades. The majority of cases have been in individuals who were unvaccinated or had incomplete vaccine histories. This surge represents a significant rise over typical baseline levels seen prior to this period.

Measles Status – Mexico

Mexico continues to experience ongoing measles transmission, with thousands of confirmed cases reported since late 2025, especially in western states such as Jalisco, where incidence remains elevated. Outbreaks have not yet peaked in all areas.

Recommendations for Travelers and Residents

To reduce the risk of infection with measles, vaccination remains the most effective strategy. Public health guidance aligns with established immunization criteria:
• Persons aged 12 months and older without documentation of two valid doses of measles-containing vaccine (MMR) should complete a two-dose series spaced by at least 28 days.
• Infants aged 6–11 months traveling to areas with active transmission should receive a dose of MMR before travel.
• Adults born before 1970 without evidence of immunity should receive at least one dose of MMR.

Measles Elimination Status – North America

The Pan American Health Organization (PAHO) has confirmed that Canada has lost its measles elimination status after more than 12 months of continuous transmission during a large nationwide outbreak. As a result, North America no longer holds the measles-free designation previously verified by PAHO. Canada’s outbreak began in late 2024 and expanded across multiple provinces, leading to sustained endemic transmission.

The United States and Mexico are also at risk of having individual elimination statuses revoked if uninterrupted measles transmission continues for 12 months. Ongoing outbreaks in under-vaccinated communities are being closely evaluated by health authorities.

Key Point:

Measles is a highly contagious disease preventable with vaccination. Travelers and residents should ensure up-to-date immunization before travel or participation in large gatherings.

The post Measles Outbreaks in North America appeared first on TravelBug Health.

Public health officials are identifying and notifying potentially exposed individuals. Anyone present at the following locations during these times should monitor for measles symptoms for 21 days post-exposure.

Exposure Location: Hale Theatre Arizona, 50 W. Page Ave., Gilbert, AZ 85233

Exposure Dates/Times:

• January 5-7: 6:30 p.m. to 11:30 p.m.
• January 8-9: 3:00 p.m. to 11:30 p.m.
• Monitor for symptoms through January 30, 2026

Three New Exposure Locations:

1. EOS Fitness, 3025 S. Val Vista Dr., Gilbert, AZ 85295
   • January 13 & 15: 4:45 a.m. to 7:45 a.m.
   • Monitor for symptoms through February 5, 2026
2. Target, 1515 E Warner Rd., Gilbert, AZ 85296
   • January 13: 3:30 p.m. to 5:45 p.m.
   • Monitor for symptoms through February 3, 2026
3. Sam’s Club, 1225 N Gilbert Rd., Gilbert, AZ 85234
   • January 15: 9:00 a.m. to 11:30 a.m.
   • Monitor for symptoms through February 5, 2026

Measles Presentation and Symptoms

Measles typically presents as an acute viral illness with:

• Prodrome (early phase): High fever (>101°F), cough, coryza (runny nose), and conjunctivitis (red, watery eyes)
• Rash: Generalized maculopapular rash appearing several days after prodrome
  • Starts on the face at the hairline
  • Proceeds down the body, may include palms and soles
  • Appears discrete but may become confluent
  • Lasts several days, fades in the same order it appeared
• Koplik spots: Small white spots with bluish-white centers inside the mouth (occasionally seen)

Atypical presentations:

• Symptoms may be mild, absent, or atypical in persons with some degree of immunity (previously vaccinated with waning immunity, or children who passively acquired maternal antibodies)
• Those vaccinated between 1963-1967 and immunocompromised individuals may present with atypical rash (typically begins on extremities rather than face)

Vaccination and Prevention

The MMR vaccine is 97% effective at preventing measles with two doses.

All individuals should ensure they have evidence of immunity:

• Two doses of MMR vaccine, at least 28 days apart
• Laboratory confirmation of immunity
• Laboratory confirmation of previous measles infection
• Born before 1957 (generally considered immune, though healthcare workers should still receive two MMR doses regardless of birth year)

Vaccination recommendations for Arizona residents and travelers:

• Recommendation: Infants aged 6-11 months should receive early MMR vaccination (per CDC outbreak guidance)
• Children: First dose at 12-15 months, second dose at 4-6 years
• Adults born in 1957 or later: Should have documentation of two doses of MMR vaccine
• Healthcare workers: Should receive two doses of MMR regardless of year of birth
• International travelers (6 months and older): Should receive MMR before travel

For individuals who may have been exposed:

• Post-exposure vaccination: MMR vaccine given within 72 hours of exposure may provide protection or reduce disease severity
• Immune globulin (IG): Can be given within 6 days of exposure for high-risk individuals who cannot be vaccinated (infants under 12 months, pregnant women, severely immunocompromised persons)

What to do if you were at an exposure location:

1. Verify your MMR vaccination status (2 doses for most people)
2. Watch for symptoms through November 27, 2025 (21 days after last potential exposure)
3. If symptoms develop:
   • Call ahead before visiting any healthcare facility to minimize exposures
   • Isolate immediately—stay home and away from others
   • Do not use public transportation or visit public places
   • Seek medical evaluation for testing and care

Arizona residents seeking vaccination:

• TravelBug Health: Book online or Call to schedule an appointment at (480) 435-2774
  • Location: 8603 E Royal Palm Rd, Ste 120, Scottsdale, AZ 85258
  • Hours: Monday-Friday, 9 AM – 5 PM

TravelBug Health is a full-service travel medicine clinic, and we provide everything you need in one visit to stay healthy and safe on your journey.

Learn more about travel health risks on our website.

References:

Maricopa County Department of Public Health. Public Health Measles Health Alert Notice. January, 2026.

The post Measles Cases Confirmed in Gilbert, AZ appeared first on TravelBug Health.

Paraguay’s Ministry of Health has revised its yellow fever vaccination entry requirements, now requiring proof of vaccination from travelers coming from specific risk zones in just 5 countries: Bolivia, Brazil, Colombia, Guyana, and Peru. This is stricter than WHO’s standard recommendations and applies even to airport transit stops longer than 24 hours.

Who This Affects and What You Need

The new requirement targets travelers aged 1-59 years arriving from designated high-risk areas, including Santa Cruz Department in Bolivia, five specific states in Brazil (Amazonas, Minas Gerais, São Paulo, Rio Grande do Sul, and Roraima), six departments in Colombia, all of Guyana, and five regions in Peru. Notably, this also applies to Paraguayan citizens and residents traveling TO these risk zones.

Understanding Yellow Fever

Yellow fever is a serious mosquito-borne viral disease that can cause severe illness and death. While Paraguay has remained yellow fever-free since 2008, neighboring countries continue to report outbreaks. The vaccine is highly effective and provides lifelong protection with a single dose—but it must be given at least 10 days before travel to be valid for entry.

What Travelers Should Do

To ensure smooth entry into Paraguay and protect yourself against yellow fever, verify whether your departure location is in a designated risk zone. If so, get vaccinated at least 10 days before your trip and keep your International Certificate of Vaccination (yellow card) with your passport. No certificate means you may be denied entry or face mandatory health monitoring for up to 10 days.

TravelBug Health offers yellow fever vaccination along with expert travel health guidance to keep you safe on your journey. Contact us to ensure you have all the vaccines and documentation you need before you travel.

Related Travel Health Resources

Learn more about the Yellow Fever vaccination on our website or book an appointment here.

References:

Paraguay Ministry of Public Health and Social Welfare. Yellow Fever Entry Requirements. January 2026.

The Rio Times. Paraguay’s New Health Entry Requirements: What You Need to Know. July 8, 2025.

U.S. CDC Yellow Book 2026. Paraguay Yellow Fever Information.

The post Paraguay Updates Yellow Fever Vaccine Requirements for Entry appeared first on TravelBug Health.

Understanding Typhoid Risk

Typhoid is a significant global health issue that affects millions of people each year, especially in regions with inadequate sanitation and water quality. Typhoid fever is a serious bacterial infection spread through contaminated food and water, causing prolonged high fever, severe headache, and stomach pain. It is especially prevalent in the Indian subcontinent and is also a risk throughout Asia, Africa and regions of South and Central America.

Essential Prevention Measures

While authorities are responding to this incident, travelers must take their own precautions. Never drink tap water—even for brushing teeth. Use only bottled, boiled, or filtered water, avoid ice made from tap water, eat thoroughly cooked food, and skip street vendor meals. Practice frequent, thorough handwashing regardless of vaccination status.

Vaccination Recommendations

Typhoid vaccination is recommended for ALL travelers to India. Even with vaccination, strict food and water precautions remain essential. The vaccine (available as an injection lasting 2 years or oral capsules lasting 5 years) should be given at least 2 weeks before travel for maximum protection.

TravelBug Health offers typhoid vaccination and comprehensive travel health consultations to keep you safe in India and destinations worldwide. Schedule your pre-travel appointment to ensure you have all necessary vaccines and advice before you go.

Learn more about typhoid vaccination options on our website or book an appointment here.

References:

Outbreak News Today. India: Typhoid outbreak in Gandhinagar, Gujarat. January 2026.

Business Standard. Amit Shah orders ‘war-footing’ response to typhoid outbreak in Gandhinagar. January 5, 2026.

The Wire. Gujarat Typhoid Outbreak: Sewage Contaminates Drinking Water Network. January 2026.

The post Typhoid Outbreak in Gandhinagar, India appeared first on TravelBug Health.

Affected regions:

• South Ethiopia Regional State
• Sidama Region

Current status:

• 13 confirmed cases
• 8 deaths (62% mortality rate)
• No secondary cases reported outside Ethiopia
• Active investigations ongoing to determine timeline, transmission chains, and outbreak source

Keep in Mind:

MVD is caused by Marburg virus or Ravn virus (both in the Filoviridae family, which also includes Ebola virus). The virus is zoonotic, with Egyptian rousette bats (Rousettus aegyptiacus) being the natural reservoir. Previous MVD outbreaks have occurred in other African countries including Uganda, Kenya, Angola, Democratic Republic of Congo, and Ghana. This is the first recorded outbreak in Ethiopia.

• Marburg virus disease (MVD) is a rare but highly fatal viral hemorrhagic fever with mortality rates of 23-90%, depending on virus strain and level of case management
• The actual number of infections may be higher than confirmed cases, as investigations are ongoing
• A person infected with Marburg virus is not contagious until after symptoms appear
• Incubation period ranges from 2-21 days after exposure
• Early intensive supportive care and fluid replacement can lower mortality rates
• Marburg virus is NOT spread through airborne transmission—it requires direct contact with body fluids of infected persons or animals
• There are currently no FDA-approved vaccines or treatments for MVD, though investigational vaccines and treatments are in development

Symptoms and Transmission

Early “dry” symptoms (first 2-5 days):

• Sudden onset of high fever
• Severe headache
• Muscle aches and pains
• Chest pains
• Severe fatigue

Later “wet” symptoms (days 5-7 onward):

• Vomiting
• Diarrhea
• Unexplained bleeding or bruising (from nose, gums, injection sites, or in vomit/stool)
• Rash may appear
• Severe weight loss
• Multi-organ dysfunction

Transmission occurs through:

• Direct contact (through broken skin or mucous membranes) with body fluids of infected persons: blood, urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, or semen
• Contact with objects contaminated with body fluids (needles, medical equipment, bedding)
• Contact with infected animals, particularly bats or non-human primates
• Handling or eating bushmeat
• Entering caves or mines where bats live

NOT transmitted through:

• Casual contact (sitting near someone)
• Airborne transmission
• Contact with asymptomatic persons

Travel Recommendations

CDC Travel Health Notice:

On November 17, 2025, CDC issued a Level 1 Travel Health Notice (Practice Usual Precautions) for Ethiopia. The risk to travelers is low, but travelers should be aware of MVD and take preventive measures.

Prevention measures for travelers to Ethiopia:

• Avoid contact with blood and body fluids of people who are sick
• Avoid contact with semen from a person who recovered from MVD until testing shows virus is no longer present
• Do not touch the body of someone who died from suspected or confirmed MVD, including during funeral or burial practices
• Avoid contact with cave-dwelling bats, bat urine or droppings, forest antelopes, non-human primates (monkeys, chimpanzees, gorillas)
• Do not eat or handle blood, fluids, or raw meat from these or unknown animals (bushmeat)
• Do not enter areas known to be inhabited by bats, such as mines or caves
• Practice good hand hygiene

Healthcare workers traveling to Ethiopia:

• Be aware of increased risk of MVD exposure in clinical settings
• Follow strict infection prevention and control precautions
• Use appropriate personal protective equipment (PPE)
• Monitor yourself for symptoms for 21 days after returning to your home country

While in outbreak areas:

• Monitor your health daily
• Check for signs or symptoms of MVD while in affected regions and for 21 days after leaving
• If you develop symptoms:
  • Isolate immediately from others
  • Do not travel
  • Contact local health authorities or healthcare facility for guidance
  • Alert healthcare providers of your recent presence in MVD-affected area BEFORE entering facility

If symptoms develop after returning home:

• Seek immediate medical attention
• Call ahead before visiting healthcare facility
• Inform healthcare providers of your travel to Ethiopia
• Isolate from others until assessed by medical professionals

Ethiopian national response:

Ethiopian authorities are implementing comprehensive response measures including screening, isolation of cases, contact tracing, airport exit screening, and public awareness campaigns. As of December 3, 2025, CDC is not recommending additional assessments or monitoring of travelers arriving from Ethiopia by U.S. health departments.

Related Travel Health Resources

Travel Vaccines and Health Tips for Visiting Africa in 2025

East Africa Travel Guide: Safari Experiences in Kenya and Tanzania

Learn more about travel health risks on our website.

References:

U.S. Centers for Disease Control and Prevention (CDC). Health Alert Network (HAN): First Reported Outbreak Caused by Marburg Virus in Ethiopia. December 3, 2025.

CDC. Marburg in Ethiopia – Level 1, Practice Usual Precautions. November 17, 2025.

CDC. About Marburg Disease.

CDC. Clinical Overview of Marburg Virus Disease.

World Health Organization (WHO). Marburg virus disease outbreak in Ethiopia. November 2025.

National Emerging Special Pathogens Training and Education Center (NETEC) Resource Library.

UK Health Security Agency (UKHSA) / TravelHealthPro. Marburg virus disease outbreak in Ethiopia. November 24, 2025.

The post Ethiopia: First Reported Marburg Virus Disease Outbreak appeared first on TravelBug Health.

Affected cities (confirmed):

• Delhi
• Mumbai
• Ahmedabad
• Lucknow
• Extent of distribution to other areas unknown

Key concerns:

• Counterfeit vaccine may contain ineffective substances (saline, distilled water) or harmful, unregulated ingredients
• Vaccine circulated without maintaining required cold chain (2-8°C), further compromising any potential efficacy
• Treatment failure could result in rabies deaths, as the disease is nearly always fatal once symptoms develop

Keep in Mind:

• The actual extent of counterfeit vaccine distribution is unknown and may be more widespread than reported
• India accounts for 36% of the world’s rabies deaths, with an estimated 18,000-20,000 deaths annually
• About 30-60% of reported rabies cases and deaths occur in children under 15 years, as bites often go unrecognized and unreported
• A human rabies case was reported in the U.S. in 2025 in a traveler from India who received a dog bite and subsequently died
• Rabies is preventable with proper wound care and timely vaccination, but once symptoms develop, it is nearly always fatal
• Travelers who received rabies vaccine in India between November 2023 and present should verify the vaccine source and consider revaccination if uncertain

Rabies Risk in India

India is endemic for rabies, with rabid dogs being the primary source of human infections. The true burden of rabies is not fully known due to underreporting, but available data indicates:

• 18,000-20,000 rabies deaths annually
• Dog bites are common, especially to children
• Stray dogs and puppies roaming freely on streets pose significant risk
• Rabies affects the central nervous system (brain and spinal cord)

Transmission:

• Through saliva of infected animals via bites, scratches, or fresh wounds licked by rabid animals
• Dogs account for vast majority of human rabies cases in India
• Other mammals (cats, monkeys, bats) can also transmit rabies

Symptoms:

First symptoms appear weeks or months after exposure and include weakness, discomfort, fever, headache, and itching/prickling at bite site. Severe disease symptoms follow, including anxiety, confusion, agitation, hallucinations, difficulty swallowing, excessive salivation, paralysis, and coma. Death typically occurs within days of symptom onset.

Recommendations for Travelers

Prevention is critical:

• Avoid all contact with dogs (including puppies), cats (including kittens), and wild mammals while in India
• Be especially cautious of animals roaming freely on streets
• Do not attempt to pet, feed, or touch any animals
• Supervise children closely around animals

Pre-exposure vaccination:

Travelers should be vaccinated prior to travel if they:

• Might come in contact with dogs, cats, or wildlife
• Plan to work with animals during travel
• Will be in rural or remote areas where medical care may be delayed
• Plan extended stays in India
• Are children (at higher risk due to proximity to animals and potential to not report bites)

Pre-exposure vaccination consists of 2 doses given 7 days apart. This does NOT eliminate the need for post-exposure treatment if bitten, but it simplifies treatment and provides protection if treatment is delayed.

If bitten, scratched, or licked on broken skin:

1. Immediately wash the wound thoroughly with soap and running water for at least 15 minutes
2. Seek immediate medical care at an established, reputable healthcare facility
3. Request verification of the vaccine product name, batch number, and manufacturer
4. Take a photo of the vaccine vial/packaging if possible
5. Keep written records of all vaccines received, including:
   • Vaccine name and manufacturer
   • Batch/lot number
   • Date administered
   • Healthcare facility name and location
   • Vaccinator’s name/credentials

For post-exposure prophylaxis in India:

• Seek care at established, reputable healthcare facilities (major hospitals, international clinics)
• Ask for verification that genuine vaccine is being used
• Genuine Abhayrab will have proper cold chain documentation and packaging
• If uncertain about vaccine authenticity, travel to another country (Nepal, Thailand, UAE) to access reliable rabies vaccine
• Contact your embassy or consulate for recommendations on reliable medical facilities

Upon returning home:

• Contact your healthcare provider immediately if you:
  • Received rabies vaccine in India
  • Are uncertain about the vaccine source or authenticity
  • Did not complete full post-exposure prophylaxis series
  • Had a potential rabies exposure but did not seek treatment
• Healthcare provider will assess need for additional vaccination
• If you have confirmation you received a different brand of rabies vaccine (not Abhayrab), you likely do not require additional vaccine

Identifying Genuine vs. Counterfeit Vaccine

Red flags for counterfeit vaccine:

• Purchased from unauthorized sources (pharmacies without proper licensure, street vendors)
• Significantly cheaper than market rate
• Packaging differences from genuine product
• No cold chain documentation
• Unusual or suspicious labeling
• Healthcare facility cannot provide detailed product information

Genuine Abhayrab characteristics:

• Manufactured by Indian Immunologicals Limited (Govt. of India Enterprise)
• Proper cold chain maintenance (2-8°C)
• Clear, professional packaging and labeling
• Available through licensed, reputable healthcare facilities
• Healthcare provider can provide batch documentation

Related Travel Health Resources

Get Your Rabies Vaccine in Phoenix

Rabies: Why Pre-Travel Vaccination is Your Best Defense

Learn more about travel health risks on our website.

References:

U.S. Centers for Disease Control and Prevention (CDC). Rabies in India – Level 1, Practice Usual Precautions. November 25, 2025.

UK Health Security Agency (UKHSA) / TravelHealthPro. Falsified rabies vaccine: India. Updated November 27, 2025.

Drug Controller General of India / Delhi Drugs Control Department. Alert on Counterfeit Abhayrab Vaccine. January-March 2025.

Vax-Before-Travel. India’s Rabies Situation Concerns the U.S. CDC. December 1, 2025.

Vax-Before-Travel. False Rabies Vaccinations in India. November 12, 2025.

Outbreak News Today. Rabies travel notice for India: Human case in US traveler, counterfeit vaccines. November 30, 2025.

Nomad Health. Counterfeit medication abroad. Know the risks! November 13, 2025.

World Health Organization (WHO). Substandard and falsified medical products.

The post India: Counterfeit Rabies Vaccine Circulating appeared first on TravelBug Health.

Most affected areas include:

• Budapest (highest number of cases)
• Borsod-Abaúj-Zemplén County
• Szabolcs-Szatmár-Bereg County
• Pest and Fejér Counties

Demographics:

• 56% male, 44% female
• Infections most frequently detected among children aged 3-14 years
• Cases also reported in adults, particularly those experiencing homelessness and people who inject drugs

Keep in Mind:

• Many who contract hepatitis A remain symptom-free but can still transmit the virus, meaning actual infections in Hungary likely exceed the 1,648 confirmed cases
• The average incubation period is one month (range: 15-50 days)
• Symptoms typically appear about one week after infection and include fatigue, weakness, nausea, diarrhea, abdominal pain, dark urine, light or clay-colored stools, loss of appetite, fever, itchy skin, and jaundice (yellowing of skin/eyes)
• While usually mild with symptoms resolving within a few weeks, prolonged and more severe forms can occur
• Liver failure can rarely occur in the elderly, pregnant women, and people with chronic diseases, which may require hospitalization and, in severe cases, a liver transplant
• Unlike other types of hepatitis (B and C), hepatitis A does not lead to chronic liver disease
• Hepatitis A is highly contagious—in the absence of proper hygiene, an infected person can pass the virus to 8-10 other people

Multi-country outbreak:

Between January and May 2025, Austria, Czechia, Hungary, and Slovakia reported 2,097 hepatitis A cases. As of November 2025, the Czech Republic has reported approximately 2,600 cases with 29 deaths—the highest number since 1989. Slovakia reported 880 cases (January-May 2025), and Austria recorded 87 confirmed cases including 3 deaths. The outbreaks primarily affect vulnerable populations including adults experiencing homelessness, people who inject drugs, those living in poor sanitary conditions, and members of Roma communities in Czechia and Slovakia.

Transmission and Risk Factors

Hepatitis A virus (HAV) is transmitted primarily through the fecal-oral route:

• Consuming food or water contaminated with fecal matter containing the virus
• Close contact with an infected person
• Less commonly, through blood contact or sexual contact
• Risk of infection is greater in places with poor hygiene and unsafe drinking water

The virus thrives in conditions of inadequate sanitation and lack of access to safe water. European health officials attribute the outbreak surge to poor hygiene conditions, unsafe drinking water in some areas, and potential introduction by travelers from developing countries where hepatitis A is endemic.

Vaccination and Prevention

Hepatitis A vaccination is recommended for travelers aged ≥ 1 year going to Hungary. Close contacts of hepatitis A cases can get vaccinated against the virus free of charge in Hungary.

Post-exposure prophylaxis: Because of the long incubation period of hepatitis A (up to 50 days), vaccination should be considered—ideally within 2 weeks of potential exposure—for any unvaccinated or incompletely vaccinated traveler who had been in Hungary in the past 2 months. Active immunization is effective if administered within 2 weeks of exposure.

All travelers should observe strict prevention measures:

• Practice frequent, thorough handwashing (the most effective prevention method)
• Observe food and beverage precautions:
• Practice safer-sex measures
• Avoid sharing eating utensils, towels, or personal items
• Maintain good personal hygiene

If you develop symptoms:

Even if symptoms are mild, see a doctor if you suspect hepatitis A to rule out other similar conditions. There is no specific drug therapy; the body will fight off the virus itself. Most patients are advised to rest, drink plenty of fluids, and avoid alcohol and other substances that put strain on the liver.

Learn more about travel health risks on our website. 

or read more about recommended vaccines for travel to Europe,

Do I Need any Vaccines to Travel to Europe in 2025?

References:

National Centre for Public Health and Pharmacy (NNGYK), Hungary. Weekly Epidemiological Summary. November 2025.

European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment: Multi-country outbreak of hepatitis A in the EU/EEA. June 24, 2025.

ECDC. Multi-country outbreak of hepatitis A in the EU/EEA. June 2025.

Portfolio.hu. Exceptionally severe hepatitis A epidemic in Hungary. November 20, 2025.

XpatLoop. Health Authority Warns of Rise in Hepatitis A Cases in Hungary. November 24, 2025.

The Lancet Microbe. Hepatitis A outbreak in Europe. September 3, 2025.

Travelvax. HUNGARY: Hepatitis A outbreak continues. November 26, 2025.

Medscape. Europe’s Hepatitis A Outbreak: What You Need to Know. June 26, 2025.

The post Hungary: Significant Hepatitis A Increase appeared first on TravelBug Health.

Public exposure locations:

Maricopa County (Phoenix):

• Mortgage Matchup Center (201 E Jefferson St, Phoenix, AZ 85004)
  • November 5 at 6:00 PM through November 6 at 12:30 AM
  • Tate McRae concert (sold-out show)
  • Watch for symptoms through November 27
• Home2 Suites by Hilton Phoenix Downtown (125 E Jackson St, Phoenix, AZ 85004)
  • November 5 at 3:00 PM through November 6 at 1:00 PM
  • Watch for symptoms through November 27

Coconino County (Flagstaff):

• Flagstaff Mall (4650 U.S. 89, Flagstaff, AZ 86004)
  • November 6 at 10:00 AM through 2:30 PM
  • Watch for symptoms through November 27

These are separate incidents involving two different infected individuals—one who visited Phoenix locations and another who visited Flagstaff. Neither infected person is a resident of their respective county. As of November 13, 2025, no secondary cases have been reported from these exposures in either Maricopa or Coconino counties.

Keep in Mind:

• Measles is one of the most contagious diseases known—approximately 90% of unvaccinated people exposed to measles will become infected
• The virus can remain infectious in the air for up to 2 hours after an infected person leaves an area
• Potentially multiple people may have been exposed at the Tate McRae concert alone
• Infected individuals are contagious from 4 days before rash onset through 4 days after rash appears (9 days total)
• Many measles cases can be mild or atypical in previously vaccinated individuals with waning immunity, meaning actual infections may exceed reported cases
• Symptoms typically appear 7-21 days after exposure, with most people developing symptoms 7-12 days post-exposure
• Adults who received only 1 MMR vaccine as a child are considered fully vaccinated but may have waning immunity

Arizona Measles Cases:

These Phoenix and Flagstaff exposures occur amid Arizona’s worst measles year since 1991. As of November 13, 2025, Arizona has confirmed 128 measles cases statewide:

• Mohave County: 124 cases (Colorado City/Arizona-Utah border outbreak—second-largest U.S. outbreak in 2025)
• Navajo County: 4 cases (reported earlier in 2025)
• Maricopa County: These recent exposures represent the first public measles notification in Maricopa County during the current nationwide outbreak
• 3 hospitalizations statewide; no deaths reported

Nationally, the CDC reports over 1,618 measles cases across 42 jurisdictions in 2025—the highest annual total since measles was declared eliminated in the U.S. in 2000.

Measles Presentation and Symptoms

Measles typically presents as an acute viral illness with:

• Prodrome (early phase): High fever (>101°F), cough, coryza (runny nose), and conjunctivitis (red, watery eyes)
• Rash: Generalized maculopapular rash appearing several days after prodrome
  • Starts on the face at the hairline
  • Proceeds down the body, may include palms and soles
  • Appears discrete but may become confluent
  • Lasts several days, fades in the same order it appeared
• Koplik spots: Small white spots with bluish-white centers inside the mouth (occasionally seen)

Atypical presentations:

• Symptoms may be mild, absent, or atypical in persons with some degree of immunity (previously vaccinated with waning immunity, or children who passively acquired maternal antibodies)
• Those vaccinated between 1963-1967 and immunocompromised individuals may present with atypical rash (typically begins on extremities rather than face)

Vaccination and Prevention

The MMR vaccine is 97% effective at preventing measles with two doses.

All individuals should ensure they have evidence of immunity:

• Two doses of MMR vaccine, at least 28 days apart
• Laboratory confirmation of immunity
• Laboratory confirmation of previous measles infection
• Born before 1957 (generally considered immune, though healthcare workers should still receive two MMR doses regardless of birth year)

Vaccination recommendations for Arizona residents and travelers:

• Children: First dose at 12-15 months, second dose at 4-6 years
• Adults born in 1957 or later: Should have documentation of two doses of MMR vaccine
• Healthcare workers: Should receive two doses of MMR regardless of year of birth
• International travelers (6 months and older): Should receive MMR before travel

For individuals who may have been exposed:

• Post-exposure vaccination: MMR vaccine given within 72 hours of exposure may provide protection or reduce disease severity
• Immune globulin (IG): Can be given within 6 days of exposure for high-risk individuals who cannot be vaccinated (infants under 12 months, pregnant women, severely immunocompromised persons)

What to do if you were at an exposure location:

1. Verify your MMR vaccination status (2 doses for most people)
2. Watch for symptoms through November 27, 2025 (21 days after last potential exposure)
3. If symptoms develop:
   • Call ahead before visiting any healthcare facility to minimize exposures
   • Isolate immediately—stay home and away from others
   • Do not use public transportation or visit public places
   • Seek medical evaluation for testing and care

Arizona residents seeking vaccination:

• TravelBug Health: Call to schedule an appointment at (480) 435-2774
  • Location: 8603 E Royal Palm Rd, Ste 120, Scottsdale, AZ 85258
  • Hours: Monday-Friday, 9 AM – 5 PM

TravelBug Health is a full-service travel medicine clinic, and we provide everything you need in one visit to stay healthy and safe on your journey.

Learn more about travel health risks on our website.

References:

Maricopa County Department of Public Health. Public Health Measles Health Alert Notice. November 12, 2025.

Maricopa County Department of Public Health. Press Release: Measles exposures at two public locations. November 12, 2025.

Coconino County Health and Human Services. Measles Exposure at Flagstaff Mall Confirmed. November 12, 2025.

Arizona Department of Health Services. Measles Information and Updates.

Centers for Disease Control and Prevention. Measles Cases and Outbreaks. Updated November 4, 2025.

KJZZ. Public measles exposures identified in Flagstaff, downtown Phoenix last week. November 12, 2025.

Phoenix New Times. Phoenix Tate McCrae concert site of measles exposure. November 12, 2025.

KNAU Arizona Public Radio. Measles case confirmed at Flagstaff Mall. November 12, 2025.

The post Arizona: Measles Exposures in Phoenix and Flagstaff appeared first on TravelBug Health.

Most affected provinces:

• Western Cape: 162 cases (34% of all cases)
• Gauteng: 111 cases (23% of all cases)
• Additional cases in Free State and Northern Cape

Age distribution:

• Over half (273/483, 56%) of cases are children under 5 years
• Approximately one in four (128/483, 26%) cases are infants 6 months or younger
• Infants under 3 months face highest risk for severe complications

Keep in Mind:

• Many pertussis cases go unrecognized and unreported, meaning actual infections in South Africa likely exceed the 483 confirmed cases
• One confirmed case often represents multiple undetected infections in the community
• Pertussis is highly contagious—an infected person can spread it to 12-17 other unvaccinated individuals
• About 90% of unvaccinated people exposed to pertussis will become infected
• Symptoms begin like a common cold but progress to severe, prolonged coughing fits lasting weeks or months (the “100-day cough”)
• Infants may not cough at all but can stop breathing (apnea)
• About 1 in 5 unvaccinated people with pertussis is hospitalized
• Complications include pneumonia (1 in 20 children), seizures, brain damage, and death (1-3 per 1,000 children)
• The outbreak has yet to peak, meaning case numbers are expected to continue rising

Global Outlook on Pertussis

South Africa’s outbreak is part of a significant global pertussis resurgence in 2025. According to the Pan American Health Organization (PAHO), World Health Organization (WHO), and the U.S. Centers for Disease Control and Prevention (CDC), multiple countries worldwide are reporting substantial increases:

• Americas Region: 7 countries reporting outbreaks with 14,201 cases and 93 deaths (Brazil, Colombia, Ecuador, United States, Mexico, Paraguay, Peru)
• United States: 10,062 cases including 5 deaths through mid-May 2025
• Argentina: 180+ cases since mid-July 2025

Declining vaccination coverage is a major factor—in South Africa and globally, coverage for pertussis-containing vaccines dropped during the COVID-19 pandemic and has not fully recovered.

Vaccination and Prevention for Travelers to South Africa

All adult travelers to South Africa should receive 1 dose of Tdap (adult acellular pertussis-containing vaccine) every 10 years, assuming they previously received an adequate primary series.

Booster considerations:

• A booster dose should be considered if it has been at least 3 years since the last acellular pertussis-containing vaccine (e.g., Tdap) dose for persons aged > 65 years or those with immunocompromising conditions or underlying lung disease (off-label use)
• Those who received Td or TT for their most recent dose should receive an immediate dose of Tdap, regardless of the interval since the last tetanus dose

For families traveling to South Africa with infants:

• Parents of infants who have not yet completed a 3-dose series of a pertussis-containing vaccine may want to consider postponing travel to South Africa until the infant has received the third dose
• Infants receive DTaP vaccines at 2, 4, and 6 months of age, with boosters at 15-18 months and 4-6 years
• Infants under 6 months are at greatest risk and have the highest hospitalization and death rates

Pregnant travelers to South Africa:

• Maternal vaccination during pregnancy is highly effective at protecting newborns
• Pregnant women should receive Tdap vaccination during the third trimester (27-36 weeks) of each pregnancy
• Vaccination during pregnancy provides passive immunity to infants during the first weeks of life before they can be vaccinated
• Babies born to vaccinated mothers have a 90% decreased risk of getting pertussis in the first 3 months of life

Healthcare workers and caregivers traveling to or working in South Africa:

• Should ensure they are up-to-date on Tdap vaccination to prevent transmission to vulnerable patients and infants
• Vaccination of close contacts of pregnant women and newborns is essential

Travelers to Western Cape and Gauteng provinces should be especially vigilant, as these areas account for 57% of all confirmed cases.

Learn more about travel health risks on our website.

Learn more about the TDAP vaccine.

Schedule a pre-travel consult before your trip.

References:

National Institute for Communicable Diseases (NICD), South Africa. Increase in pertussis cases in South Africa. November 6, 2025.

The Conversation. Measles and whooping cough outbreaks in South Africa: a sign of low vaccination coverage. September 26, 2025.

Pan American Health Organization (PAHO/WHO). Epidemiological Alert: Increased pertussis (Whooping Cough) in the Americas Region. May 31, 2025.

PAHO/WHO. PAHO urges strengthened surveillance and childhood vaccination amid rising pertussis cases. June 4, 2025.

Centers for Disease Control and Prevention (CDC). Pertussis Surveillance and Trends. October 27, 2025.

The post South Africa: Pertussis (Whooping Cough) Outbreak appeared first on TravelBug Health.

Most affected districts:

– Wong Tai Sin (Fung Tak Estate area)
– Kwai Tsing (Tsing Yi – Mount Haven area)
– Connections to Sheung Wan

Keep in Mind:

– Many chikungunya infections are asymptomatic or mild, meaning the actual number of people infected is likely higher than the confirmed case count
– Chikungunya-transmitting mosquitoes can bite throughout the day
– Peak mosquito activity occurs in the early morning, late afternoon, and evening
– Symptoms typically include sudden onset of fever and severe joint pain, often accompanied by muscle pain, headache, nausea, fatigue, and rash
– Joint pain can persist for weeks or months in some cases

Vaccination and Prevention

VIMKUNYA Chikungunya Vaccination should be considered for travelers aged ≥ 12 years with a prolonged stay ≥ 6 months in Hong Kong or affected areas.

All travelers should observe strict insect precautions:

– Use EPA-registered insect repellents containing DEET, picaridin, or oil of lemon eucalyptus
– Wear long sleeves and pants, especially during peak mosquito activity hours (early morning, late afternoon, and evening)
– Stay in accommodations with air conditioning or window screens if possible
– Use mosquito nets if sleeping in areas without screens
– Apply permethrin to clothing and gear for added protection
– Be vigilant throughout the entire day, as mosquitoes that transmit chikungunya are active during daylight hours

Travelers visiting Wong Tai Sin, Kwai Tsing (particularly Tsing Yi), or Sheung Wan districts should be especially diligent with mosquito protection throughout the day.

Learn more about Chikungunya and Travel Health Risks.

The post Hong Kong Confirms First-Ever Local Chikungunya Cases appeared first on TravelBug Health.

57% protection against hospitalization and death at 4 weeks after vaccination
45% protection against ER visits and infections
Protection drops over 5 months — strongest early on
Durable defense against the most serious complications

Researchers studied more than 237,000 Nebraskans during last year’s respiratory virus season — including multiple Omicron strains — and found similar protection across variants.

Big takeaway:
Even with waning immunity, annual vaccination remains critical, especially for people at higher risk.

Experts warn that with low vaccination rates heading into fall and winter, the combination of COVID-19, flu, and RSV could challenge hospitals again.

—
Protect yourself, protect your community: stay up to date on COVID-19 and seasonal vaccines. Go. Explore. Safely.

The post Last Year’s COVID Vaccines Did Their Job — Especially Against the Worst Outcomes appeared first on TravelBug Health.

West Nile Virus Outbreak

According to Italy’s Ministry of Health, as of early October 2025, Italy has reported 718 confirmed cases of West Nile virus, including 49 fatalities. More than 70 confirmed cases per week have been reported since mid-August 2025, representing a 2-fold increase over average incidence. The outbreak has now peaked.

Most affected regions:

– Lazio: 252 cases
– Campania: 124 cases
– Veneto: 91 cases
– Cases reported across most other regions

Keep in Mind:

– One clinical case of WNV often represents 10 or more asymptomatic infections in the population
– WNV-transmitting mosquitoes are generally night biters with peak activity at dusk and dawn
– Most infections are asymptomatic, but about 1 in 5 people develop fever, headache, body aches, and other flu-like symptoms
– Severe neurological illness occurs in less than 1% of cases but can be serious, particularly in older adults

Chikungunya Virus Outbreak

According to the European Centre for Disease Prevention and Control (ECDC) and Italy’s National Institute of Health, Italy is among six countries globally experiencing above-average chikungunya incidence in 2025. As of early October 2025, 364 cases have been registered with the outbreak appearing to have peaked.

Most affected regions:

– Emilia-Romagna
– Veneto

This is part of a larger global surge. According to ECDC, PAHO, WHO, and international health authorities, between January 1 and September 30, 2025, approximately 445,271 suspected and confirmed chikungunya cases (including 155 deaths) were reported across 40 countries/territories worldwide. Local transmission has been confirmed in multiple European locations, including both France and Italy.

Keep in Mind:

– Chikungunya-transmitting mosquitoes can bite throughout the day
– Peak mosquito activity occurs in the early morning, late afternoon, and evening
– Symptoms typically include sudden onset of fever and severe joint pain, often accompanied by muscle pain, headache, nausea, fatigue, and rash
– Joint pain can persist for weeks or months in some cases

Vaccination and Prevention

VIMKUNYA Chikungunya Vaccination recommended for travelers aged ≥ 12 years going to Italy or affected areas.

All travelers should observe strict insect precautions:

– Use EPA-registered insect repellents containing DEET, picaridin, or oil of lemon eucalyptus
– Wear long sleeves and pants, especially during high-risk hours (dawn/dusk for WNV; early morning, late afternoon, and evening for chikungunya)
– Stay in accommodations with air conditioning or window screens
– Use mosquito nets if sleeping in areas without screens
– Apply permethrin to clothing and gear for added protection
– Be vigilant throughout the entire day and night, as different mosquito species are active at different times

Given the overlap of both diseases and their different mosquito activity patterns, consistent all-day and all-night mosquito protection is essential for travelers to Italy.

Learn more about travel health risks on our website.

References:

Italian National Institute of Health (ISS). West Nile Virus Surveillance.
European Food Safety Authority (EFSA). West Nile virus surveillance, October 2025.
European Centre for Disease Prevention and Control (ECDC). West Nile fever surveillance.
ECDC. Chikungunya seasonal surveillance 2025.
ECDC. Chikungunya worldwide overview.
PAHO/WHO. Global Chikungunya Surveillance, September 2025.

The post Italy Outbreaks: West Nile Virus and Chikungunya appeared first on TravelBug Health.

While absolute risk to international travelers remains low due to short exposure periods, the current outbreak elevates risk levels, particularly for certain travel profiles. Travelers at highest risk include those visiting rural agricultural areas, staying in basic accommodations without mosquito screening, or participating in outdoor activities during peak mosquito activity periods.

Early symptoms include fever, headache, and altered mental status, progressing rapidly to encephalitis with seizures, coma, and focal neurological deficits. The rapid progression and lack of specific antiviral treatments make prevention through vaccination and mosquito control the primary defense strategies.

Japanese Encephalitis Vaccination Considerations

The IXIARO® Japanese Encephalitis(JE) vaccine series can protect travelers from the disease caused by Japanese encephalitis virus, approved for use in individuals 2 months of age and older. The vaccine series requires advance planning, as protection develops 1-2 weeks after the final dose. Two doses are administered 7 or 28 days apart, providing protection, with booster doses extending immunity.

Comprehensive Mosquito Protection Strategy

Given that JE mosquitoes (primarily Culex species) are most active during nighttime hours, protection measures should focus on evening and overnight periods. Travelers visiting rural areas below 1,500 meters (5,000 feet) elevation should consider Japanese encephalitis vaccination. All visitors should practice strict mosquito protection, using EPA-approved repellents, protective clothing, and screened accommodations.

Medical Preparedness

Travelers should ensure comprehensive travel health insurance that covers medical evacuation, as severe JE cases may require intensive care not available in rural areas. Seek immediate medical attention for fever, headache, or altered mental status during or after travel to affected areas, informing healthcare providers about potential JE exposure. Preventive measures through vaccination and mosquito protection remain the most effective strategies for travelers to affected regions.

Schedule a consult with TravelBug Health to discuss whether the Japanese Encephalitis vaccine is right for you.

To learn more about the JE vaccine series, visit our Japanese Encephalitis vaccination page.

For more information about JE disease, visit the CDC’s Japanese Encephalitis website.

The post Japanese Encephalitis Outbreak in Nepal appeared first on TravelBug Health.

The post Antibiotic-Resistant Pertussis on the Rise in Brazil, Mexico, Peru and the US. appeared first on TravelBug Health.

Singapore is experiencing an outbreak of chikungunya cases, with over 20 reported infections since January 2025—double the typical rate. The outbreak continues to escalate with more than one case per week since early August, but health officials say it has not yet peaked.

France Experiences First Chikungunya Outbreak

According to Santé Publique France, approximately 70 locally acquired cases of chikungunya have been reported since mid-June 2025—a significant increase over average incidence. This marks the first chikungunya outbreak in France. Health officials have reported cases distributed across multiple regions including Provence-Alpes-Côte d’Azur (22 cases), Corsica (13 cases), Occitanie (16 cases), Nouvelle-Aquitaine (3 cases), Auvergne-Rhône-Alpes (7 cases), and Grand Est (1 case) regions.

Italy Reports Local Transmission Clusters

Italy has confirmed four local transmission events of chikungunya virus in the northern regions of Emilia-Romagna and Veneto, with 29 locally acquired cases reported by August 20, 2025. This represents a concerning development as it demonstrates active local transmission in two separate outbreak clusters in northern Italy.

What Travelers Need to Know and Protection Measures

Travelers should be aware that chikungunya is a mosquito-borne viral infection causing fever, severe joint pain, and muscle aches that can persist for weeks or months.

All travelers to areas endemic for chikungunya should take comprehensive mosquito protection measures, including using EPA-approved insect repellents, wearing light-colored long sleeves and pants when possible, and staying in air-conditioned or screened accommodations. Be especially vigilant during peak mosquito activity times: early morning, late afternoon, and evening, though the Aedes mosquitoes that transmit chikungunya can bite throughout the day. Travelers aged 12 and older should consult their healthcare provider about chikungunya vaccination before departure. Seek immediate medical attention if you develop sudden fever, joint pain, or rash during or after your trip.

Important Update on Chikungunya Vaccination:

The Ixchiq® chikungunya vaccine, developed by Valneva, has recently been withdrawn from the U.S. market following reports of rare but serious vaccine-related side effects. While this may seem concerning, it also demonstrates that the U.S. vaccine safety monitoring system is working effectively to protect public health.

At TravelBug Health, your safety is our top priority. We offer Vimkunya®—an alternative chikungunya vaccine option with a safer side effect profile and strong protection for international travelers visiting regions where there is a Chikungunya outbreak.

Schedule a consult with TravelBug Health to have a discussion about whether the Chikungunya vaccine is right for you.

To learn more about Chikungunya, visit our Chikungunya vaccination page.

The post Chikungunya Outbreak in Singapore, ongoing in France and Italy, Ixchiq® vaccine recalled. appeared first on TravelBug Health.

The risk to general travelers remains MINIMAL. However, certain groups should take additional precautions and consider vaccination.

Who Should Consider Cholera Vaccination for Uganda –
Aid and refugee workers traveling to affected areas, medically vulnerable persons visiting affected regions, and travelers visiting friends and relatives in Amaru or Lamwo districts should consider cholera vaccination.

Regardless of vaccination status, all travelers should observe strict food and beverage precautions. Eat only fully cooked, hot food and drink bottled or properly boiled water. Avoid ice, raw vegetables, salads, and street vendor food. Always peel fruits yourself and skip any raw or undercooked seafood.

Maintain rigorous hand hygiene by washing hands frequently and thoroughly with soap, especially before eating and after using the bathroom. Use alcohol-based hand sanitizer when soap is unavailable.

Travel Health Kit Essentials –
Carry azithromycin for empiric antibiotic therapy and oral rehydration solution (ORS) packets for self-treatment if moderate-to-severe diarrhea develops. Also pack alcohol-based hand sanitizer and water purification tablets or a portable filter.

If You Develop Watery Diarrhea –
Ensure adequate intake of clean water and avoid high-sugar beverages. Use oral rehydration solution (ORS) if available and oral fluids are tolerated. Seek immediate medical attention for severe symptoms and consider antibiotic treatment as advised by your healthcare provider.

Emergency Symptoms Requiring Immediate Medical Care –
Seek immediate medical attention if you experience severe, persistent watery diarrhea, signs of dehydration such as dizziness or dry mouth, vomiting that prevents keeping fluids down, high fever, or severe abdominal cramping.

Prevention is Key – Remember: COOK IT, BOIL IT, PEEL IT, or FORGET IT

For personalized travel health advice, consult TravelBug Health – Your trusted source for global travel health information!

The post Uganda Cholera Outbreak appeared first on TravelBug Health.

While no human infections have been documented in connection with this outbreak, health officials emphasize that travelers to the region should exercise caution. The primary recommendation involves avoiding direct contact with poultry, wild birds, and their droppings at high-risk locations such as live markets, poultry farms, and rural agricultural areas where birds are kept or processed.

Additionally, consumption of poultry products should be avoided in affected areas due to difficulty ensuring proper cooking temperatures that would eliminate the virus. This precaution extends to other bird-derived products that may not undergo adequate heat treatment during preparation.
Health authorities stress the importance of symptom monitoring for anyone who has visited the affected region. Any traveler developing respiratory symptoms within 10 days of visiting avian influenza affected regions should seek immediate medical attention and inform healthcare providers of their recent travel history, including specific locations visited and any potential exposure to birds or poultry.

The post Avian Influenza in Botswana appeared first on TravelBug Health.

As of today (July 7, 2025), The Honduras Ministry of Health has now rescinded the measles vaccination entry requirement for travelers coming from measles-affected countries. Proof of vaccination is only required for Honduran citizens aged 12 months through 10 years traveling to measles-affected countries.

However, the incidence of measles is on the rise worldwide, including here in the U.S. and in Europe. `Measles is one of the most contagious diseases in the world, it can cause serious harm or death and is preventable with the MMR vaccine.

The CDC and TravelBug Health recommend you ensure your MMR vaccinations are up to date, especially if you are unvaccinated or planning international travel. Stay alert for symptoms if exposed and avoid public spaces if symptomatic.

Schedule a consult with TravelBug Health or contact us now to get your MMR(Measles, Mumps, and Rubella) Vaccine

The post (Updated) Honduras Measles Vaccination Entry Requirement appeared first on TravelBug Health.

Israel’s main international hub, Ben Gurion Airport, remains closed to all civilian flights until further notice. Israeli airline EL AL has suspended all flights through June 19 and announced additional cancellations through June 23 to several destinations including Berlin, Barcelona, Warsaw, Tokyo, Krakow, Venice, Belgrade, and Moscow.

Several European carriers, including Lufthansa and Air France, have halted all service to Tel Aviv and Tehran. British Airways, easyJet, and Ryanair have also suspended flights to Israel. U.S. airlines such as United Airlines and Delta have paused operations to Tel Aviv as well.

Major Middle Eastern carriers, including Emirates, Etihad, and Qatar Airways, have suspended select routes and are rerouting others to avoid affected airspace.

These widespread flight disruptions come as the UK, France, Germany, and other European nations have issued official travel warnings for both Israel and Iran.

If you’re planning travel to the region:
Check your airline’s website regularly for updates, enroll in your country’s traveler safety programs (such as STEP for U.S. citizens), and consider adjusting your itinerary until the situation stabilizes. We highly recommend travel insurance that includes trip interruption and security evacuation coverage for this region.

The post Middle East Flights Disrupted Amid Israel–Iran Conflict appeared first on TravelBug Health.

Four unvaccinated individuals in Navajo County, Arizona, have been diagnosed with measles—the first confirmed cases in the state for 2025. These individuals recently traveled internationally and were exposed to the virus from a single source. Public health officials are tracing contacts, and identifying locations where exposure may have occurred between May 17–28, 2025. Officials are working to pinpoint possible exposure sites and are notifying individuals who may have been in contact with the virus. Those affected are being advised to watch for symptoms over a 21-day period and limit time in public or high-risk areas.

Symptoms to Watch For (7–14 days post-exposure):

• High fever (>101°F)
• Cough, runny nose
• Red, watery eyes
• Rash that starts on the head and spreads downward

Call ahead. If you believe you may have measles, contact your healthcare provider before visiting to avoid exposing others.
No primary care provider? Call your nearest hospital emergency department or urgent care center before arriving.

Vaccination is critical: Measles is highly contagious but preventable. The MMR vaccine offers over 99% protection with two doses.

Measles complications can be serious: Roughly 1 in 5 infected people in the U.S. require hospitalization.

Public Health Resources:

For vaccination or symptom guidance:
Navajo County Public Health Services District
https://www.navajocountyaz.gov/309/Public-Health-Services
Phone: 928-532-6050

For more information on measles cases in Arizona:
azhealth.gov/measles

Measles Vaccine (MMR): Your Questions Answered

MMR (Mumps, Measles, Rubella)

Recommendation for Travelers and Residents:
Ensure your MMR vaccinations are up to date, especially if you are unvaccinated or planning international travel. Stay alert for symptoms if exposed and avoid public spaces if symptomatic.

Schedule a consult with TravelBug Health or contact us now to get your MMR Vaccine.

The post First Confirmed Measles Cases in Arizona – June 9, 2025 appeared first on TravelBug Health.

Angola: Over 24,800 cases since January mainly affecting Luanda, Benguela, and Bengo. Outbreak has peaked; trend is stable.

Democratic Republic of the Congo: Over 26,500 cases widespread, especially in Haut-Katanga, Haut-Lomami, Nord Kivu, South Kivu, and Tanganyika. Outbreak is still growing.

South Sudan: Over 49,400 cases nationwide. Outbreak has peaked; case numbers declining.

Sudan: Over 14,300 cases nationwide. Outbreak past peak but cases are increasing again.

Cholera remains a concern in regions with limited healthcare access or conflict, including Burundi, Mozambique, Syria, the Palestinian Territories, and Yemen.

Advice for Travelers
Risk for routine travelers remains low. However, cholera vaccination is recommended for aid workers, medically vulnerable individuals, and those visiting friends and relatives in outbreak areas. All travelers should maintain strict food and water safety, practice good hand hygiene, and consider carrying oral rehydration salts (ORS) and azithromycin for self-treatment in case of moderate or severe diarrhea.

The post Multi-Country Cholera Outbreak appeared first on TravelBug Health.

Travelers should ensure they are fully vaccinated against COVID-19. Those who received their last dose more than six months ago may have reduced immunity and should consider getting a booster shot if eligible. Individuals at higher risk for severe illness or who are not fully vaccinated may want to carry antiviral medication for self-treatment, if appropriate. All travelers are advised to comply with local guidelines, including mask use and physical distancing measures.

The post COVID-19 Update for Travelers to Thailand appeared first on TravelBug Health.

Proof of vaccination (administered ≥ 10 days prior to travel) is also required for persons using public transportation services in Colombia; however, a signed declaration assuming direct responsibility for any possible infection of themselves and/or others is acceptable if a vaccination certificate is not available or not yet valid. Proof of vaccination (or a signed declaration) should be carried at all times.

The post Colombia Now Requires Yellow Fever Vaccine for Public Transportation and National Parks appeared first on TravelBug Health.

The post Ecuador: Revised Yellow Fever Entry Requirements appeared first on TravelBug Health.

Protests have the potential to turn violent without warning. Police may use riot control agents (e.g., tear gas) and water cannons/rubber or live bullets. The presence of heavily armed security forces should be expected. Travelers should avoid areas of demonstrations and crowd gatherings, maintain a high level of security awareness, carry a fully charged communication device, and check in frequently with local media and embassy communications.

The post Protests: Chile, Nepal, Turkey, Serbia appeared first on TravelBug Health.

The post Peru: State of Emergency appeared first on TravelBug Health.

Global dengue activity remains high, with major outbreaks in the Americas, including Puerto Rico and the U.S. Virgin Islands, leading to record travel-associated and locally acquired cases in the U.S.

In 2024, the Americas reported 13 million dengue cases and 8,200 deaths, with early 2025 data showing a continued rise. Puerto Rico remains under a public health emergency, while Florida, California, and Texas have recorded locally acquired infections. The CDC urges healthcare providers to remain vigilant for dengue in patients with fever and recent travel history and to educate travelers on mosquito bite prevention before, during, and after trips.

Public Recommendations

• Familiarize yourself with the guidance provided in the June 2024 HAN (CDCHAN-00511) on dengue in the United States and CDC’s current Travel Health Notice on global dengue.

• When traveling to regions with ongoing or frequent dengue transmission, take precautions to prevent mosquito bites during travel, particularly if traveling to an area with frequent or continuous dengue transmission.

• Additionally, after returning from your trip, continue mosquito bite prevention measures for at least 3 weeks to reduce the risk of transmitting the virus to others in areas where mosquitoes are present. These precautions also help minimize the risk of other vector-borne illnesses.

With spring and summer travel coinciding with peak dengue season, the CDC warns that local transmission may increase in mosquito-prone U.S. regions. Travelers and healthcare providers should take proactive measures to prevent the spread of the virus.

The post CDC Issues Health Alert on Rising Dengue Cases appeared first on TravelBug Health.

Over the past 2 weeks, flu deaths have outpaced fatalities from COVID and now make up 2.6% of all deaths for the most recent week, compared to 1.5% for COVID.

Outpatient visits for flulike illness are highest in people ages 24 years old and younger.

11 more pediatric flu deaths

The CDC received reports of 11 more pediatric flu deaths, raising the season’s total to 68.

The post US flu reaches high severity status as deaths outpace COVID appeared first on TravelBug Health.

In unrelated news, the attorney general for the neighboring state of Louisiana and his deputy said yesterday in a news release and on social media, that the Louisiana Department of Health (LDH) will no longer encourage mass vaccination. LDH has banned vaccine events and ordered staff not to promote vaccination, New Orleans Public Radio (NOPR) reported today, citing an internal memo to staff yesterday, the same day as the confirmation of Robert F. Kennedy, Jr, as secretary of the US Department of Health and Human Services.

The post Texas measles outbreak doubles, to 48 cases. appeared first on TravelBug Health.

Measles outbreaks occur when community immunization levels drop below a critical threshold. As one of the most contagious diseases in the world, measles can be especially dangerous for children. Fortunately, two doses of the MMR vaccine provide lifelong protection against the disease.

Click here to learn more about measles and how the MMR vaccine can keep you safe.

The post Measles Outbreak in Texas up to 24 cases appeared first on TravelBug Health.

Last week alone, 48,661 people were hospitalized due to the flu, and 57 children have died from flu-related illness so far this season.

There’s still time to protect yourself—get your flu shot today. Vaccination can help reduce your risk of severe illness, hospitalization, and even death in the weeks ahead.

The post Flu Activity at Highest Levels in 15 Years appeared first on TravelBug Health.

The post Brazil: Significant Yellow Fever Increase in São Paulo State appeared first on TravelBug Health.

The post UK Travel Alert: Electronic Travel Authorization Required for U.S. Travelers in 2025 appeared first on TravelBug Health.