| 1 | Major infectious diseases |
| 2 | This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as_compared_to the United States . These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years . The degree of risk is assessed by considering the foreign nature of these infectious diseases , their severity , and the probability of being affected by the diseases present . The diseases listed do not necessarily represent the total disease burden experienced by the local population . |
| 3 | The risk to an individual traveler varies considerably by the specific location , visit duration , type of activities , type of accommodations , time of year , and other factors . |
| 4 | Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such_as vaccines . |
| 5 | Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk . |
| 6 | Note : The sequence of exposure categories listed in individual country entries may vary according_to local conditions . |
| 7 | food or waterborne diseases acquired through eating or drinking on the local economy : |
| 8 | 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 . |
| 9 | 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 . |
| 10 | 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 % . |
| 11 | vectorborne diseases acquired through the bite of an infected arthropod : |
| 12 | 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 . |
| 13 | 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 . |
| 14 | 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 % . |
| 15 | Japanese Encephalitis - mosquito - borne ( Culex tritaeniorhynchus ) viral disease associated with rural areas in Asia ; acute encephalitis can progress to paralysis , coma , and death ; fatality rates 30 % . |
| 16 | African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma ; transmitted to humans via the bite of bloodsucking Tsetse flies ; infection leads to malaise and irregular fevers and , in advanced cases when the parasites invade the central nervous system , coma and death ; endemic in 36 countries of sub_-_Saharan Africa ; cattle and wild animals act as reservoir hosts for the parasites . |
| 17 | Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania ; transmitted to humans via the bite of sandflies ; results in skin lesions that may become chronic ; endemic in 88 countries ; 90 % of cases occur in Iran , Afghanistan , Syria , Saudi Arabia , Brazil , and Peru ; wild and domesticated animals as_well_as humans can act as reservoirs of infection . |
| 18 | Plague - bacterial disease transmitted by fleas normally associated with rats ; person_-_to_-_person airborne transmission also possible ; recent plague epidemics occurred in areas of Asia , Africa , and South America associated with rural areas or small towns and villages ; manifests as fever , headache , and painfully swollen lymph nodes ; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50 % . |
| 19 | Crimean_-_Congo hemorrhagic fever - tick - borne viral disease ; infection may also result from exposure to infected animal blood or tissue ; geographic distribution includes Africa , Asia , the Middle East , and Eastern Europe ; sudden onset of fever , headache , and muscle aches followed by hemorrhaging in the bowels , urine , nose , and gums ; mortality rate is approximately 30 % . |
| 20 | Rift Valley fever - viral disease affecting domesticated animals and humans ; transmission is by mosquito and other biting insects ; infection may also occur through handling of infected meat or contact with blood ; geographic distribution includes eastern and southern Africa where cattle and sheep are raised ; symptoms are generally mild with fever and some liver abnormalities , but the disease may progress to hemorrhagic fever , encephalitis , or ocular disease ; fatality rates are low at about 1 % of cases . |
| 21 | Chikungunya - mosquito - borne ( Aedes aegypti ) viral disease associated with urban environments , similar to Dengue Fever ; characterized by sudden onset of fever , rash , and severe joint pain usually lasting 3 - 7 days , some cases result in persistent arthritis . water contact diseases acquired through swimming or wading in freshwater lakes , streams , and rivers : |
| 22 | Leptospirosis - bacterial disease that affects animals and humans ; infection occurs through contact with water , food , or soil contaminated by animal urine ; symptoms include high fever , severe headache , vomiting , jaundice , and diarrhea ; untreated , the disease can result in kidney damage , liver failure , meningitis , or respiratory distress ; fatality rates are low but left untreated recovery can take months . |
| 23 | Schistosomiasis - caused by parasitic trematode flatworm Schistosoma ; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water ; worms mature and reproduce in the blood vessels , liver , kidneys , and intestines releasing eggs , which become trapped in tissues triggering an immune response ; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity ; mortality , while generally low , may occur in advanced cases usually due to bladder cancer ; endemic in 74 developing countries with 80 % of infected people living in sub_-_Saharan Africa ; humans act as the reservoir for this parasite . |
| 24 | aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine : |
| 25 | Lassa fever - viral disease carried by rats of the genus Mastomys ; endemic in portions of West Africa ; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles ; fatality rate can reach 50 % in epidemic outbreaks . |
| 26 | respiratory disease acquired through close contact with an infectious person : |
| 27 | Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord ; one of the most important bacterial pathogens is Neisseria meningitidis because_of its potential to cause epidemics ; symptoms include stiff neck , high fever , headaches , and vomiting ; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions , often with a seasonal distribution ; death occurs in 5 - 15 % of cases , typically within 24 - 48 hours of onset of symptoms ; highest burden of meningococcal disease occurs in the hyperendemic region of sub_-_Saharan Africa known as the “ Meningitis Belt ” which stretches from Senegal east to Ethiopia . |
| 28 | animal contact disease acquired through direct contact with local animals : |
| 29 | Rabies - viral disease of mammals usually transmitted through the bite of an infected animal , most commonly dogs ; virus affects the central nervous system causing brain alteration and death ; symptoms initially are non_-_specific fever and headache progressing to neurological symptoms ; death occurs within days of the onset of symptoms . |