The World's Worst Travel Diseases
It seemed like a good idea at the time. After an inspiring day at Angkor Wat in Cambodia, I returned to my guesthouse to find locals sharing stories—and homemade rice wine. My instinct told me to stick with bottled beer, but their insistence wore me down. The wine tasted good and complemented their tales of Siem Reap. Feeling in tune with local life, I went to bed happy.
Later in my trip, however, happiness turned to violent illness (I’ll spare you the details). I had contracted giardia, an intestinal parasite—probably from the wine. It took three rounds of antibiotics to get rid of it.
My situation was hardly unique. “In our efforts to have fun while traveling, we often leave our common sense at home,” says Shelly Diaz, traveler’s health spokesperson for the Centers for Disease Control (whose Yellow Book contains an updated list of risks and recommended vaccinations). But finding that balance between experience and safety isn’t always easy. Wrap yourself in a bubble and you can miss out on unforgettable events. Take risks and you can end up with unwelcome surprises like giardia—or worse.
Those surprises don’t always take the form of some exotic disease (sunburns and twisted ankles are common, too). But with a growing number of Americans looking for off-the-beaten-path experiences, the risk of a less pedestrian problem multiplies.
“Travelers are increasingly heading to areas where water isn’t always clean, or where mosquitoes can carry deadly diseases,” says Dr. Phyllis Kozarsky, professor of medicine at Emory University and an expert consultant for the CDC. “And in areas with political destabilization, mosquito control isn’t very high on a government’s to-do list.”
Such areas are definitely on the CDC’s radar, along with places where contaminated food and water can present problems for travelers. The agency is monitoring the growing problem of diseases like malaria, the increasing number of cases involving chikungunya fever, and what Kozarsky calls the “sweeping rise” in dengue fever.
And it’s not just off-the-beaten-path travelers that can be at risk. “West Nile taught us that mosquito-borne viruses can spread, even in our own country,” says Kozarsky. Of course, Americans also face the danger of Lyme disease here at home. And any cruising aficionado has heard about norovirus spreading on ships.
Nevertheless, there are specific actions travelers can take to protect themselves. Here’s what Kozarsky recommends:
- Get the proper vaccinations. Ask your doctor about what protection you’ll need for whatever part of the world you’re traveling to (like yellow fever, for example, for Sub-Saharan Africa and tropical South America. It’s also essential that your basic vaccinations—like diphtheria, tetanus, measles/mumps/rubella, and hepatitis A and B—are up-to-date.
- Bring a traveler’s health kit. Don’t count on being able to find the proper medicine in the region where you’re traveling; counterfeit medication is often rampant. Instead, bring your own pain medication, along with Imodium and an antibiotic for intestinal problems. Of course, if you’re heading to an area affected by malaria, ask your doctor to prescribe the proper prophylaxis.
- Watch what you eat and drink. Let common sense guide you. Drink bottled water or boil it, and make sure fresh vegetables are hot and steaming. (See the CDC’s recommendations on safe food and water.)
Sometimes, even following all these steps won’t be enough. But, says Kozarsky, you shouldn’t let fear stop you from exploring. “We travel because we want to enjoy certain experiences,” she says. “Just remember to take steps to protect yourself.”
What it is: A potentially fatal disease caused by a parasite, usually transmitted by a bite from an infected mosquito. Chills and headaches are just two of its milder symptoms.
How to avoid it: Ask your doctor to prescribe the appropriate prophylaxis before traveling—usually mefloquine or chloroquine, depending where you’re going. And take measures to prevent mosquito bites, like wearing long sleeves and pants and protecting your skin with a repellent containing DEET.
What it is: An intestinal parasite that causes gastroenteritis, it’s usually contracted by travelers by consuming contaminated water or food. And don’t just blame street food—hikers and backpackers have picked up this awful bug in wilderness areas worldwide.
Where it’s found: Everywhere.
How to avoid it: Stick to bottled or boiled water and be wary of uncooked vegetables. (See the CDC’s recommendations on safe food and water.)
What it is: This virus rears its ugly head in many forms, but hepatitis A is the one most travelers should be concerned with. It can be transmitted through contaminated water or uncooked foods, resulting in either a mild illness or a debilitating, months-long disease that includes fever and nausea.
Where it’s found: High-risk areas include most of the developing world—although outbreaks have been known to occur even in parts of the U.S.
How to avoid it: Hepatitis A vaccine and immune globulin are very effective in prevention, so it’s a good idea to be up-to-date on shots. Otherwise, follow the basic rules of consuming clean food and water. (See the CDC’s recommendations on safe food and water.)
What it is: Most of us know all too well.
How to avoid it: Watch what you eat and drink—stick to bottled or boiled drinks and avoid raw foods. However, that may not be enough: up to 50% of travelers to high-risk areas will develop a problem over the course of a week or two, according to the CDC. Taking Pepto-Bismol as a preventive measure can also help. (See the CDC’s recommendations on safe food and water.)
What it is: A viral disease transmitted through mosquito bites that can result in everything from an influenza-like syndrome to severe hepatitis and fever.
How to avoid it: Yellow fever vaccine is effective and relatively safe. Otherwise, follow the rules of avoiding mosquito bites: wear long pants and long sleeves and use repellents containing DEET.
Note: Some countries require proof of vaccination depending on age and where you’re coming from. See the CDC’s chart.
What it is: A viral disease transmitted by a bite from an infected mosquito that can cause severe flu-like illness.
How to avoid it: There’s no vaccine. Follow the rules of avoiding mosquito bites: wearing long pants and long sleeves and using repellents containing DEET.
What it is: A bacterial illness spread by drinking or eating contaminated products. The resulting fever is potentially life-threatening.
How to avoid it: There is a vaccine for typhoid, and the CDC recommends it for travelers going to areas where there is a recognized risk of exposure. However, the Centers also warn that it’s not a substitute for careful food and drink selections. (See the CDC’s recommendations on safe food and water.)
What it is: A viral disease transmitted by mosquito bites that can cause debilitating fever, headache, and worse. First isolated in the 1950s, it has been spreading rapidly of late.
How to avoid it: There’s no vaccine, so take precautions to avoid mosquito bites.
What it is: A disease caused by bacteria from infected tick bites that can cause fever, headaches, rashes, and worse.
Where it’s found: This one hits close to home, since infected ticks are found in the northeastern, north central, and Pacific coastal regions of North America. They also inhabit the temperate, forested regions of Europe and Asia.
How to avoid it: If you can’t avoid spots where ticks live, use repellents, which can reduce the risk. Check your skin and hair for ticks each day.
What it is: A virus spread through inadequately treated food or water that can cause acute gastroenteritis. The CDC attributes an estimated 23 million illnesses each year in the U.S. to norovirus.
Where it’s found: Throughout the world. Outbreaks aboard cruise ships have received lots of publicity, but because it’s easily spread, norovirus can appear anywhere where there are lots of people in close quarters.
How to avoid it: Avoidance can be tough, since norovirus is common and easily transmittable. Keep your hands washed and try to avoid “ready-to-eat” cold foods and raw shellfish. (See the CDC’s recommendations on safe food and water.)