cdc travel vaccines caribbean

Get Vaccinated Before You Travel

It’s important to plan ahead to get the shots required for all countries you and your family plan to visit.

Protect your child and family when traveling in the United States or abroad by:

• Getting the shots required for all countries you and your family plan to visit during your trip
• Making sure you and your family are up-to-date on all routine U.S. vaccines
• Staying informed about travel notices and alerts and how they can affect your family’s travel plans

Avoid getting sick or coming back home and spreading the disease to others.

Vaccinate at least a month before you travel

See your doctor when you start to plan your trip abroad. It’s important to do this well in advance.

• Your body needs time to build up immunity.
• You may need several weeks to get all the doses of the vaccine.
• Your primary doctor may not stock travel vaccines. Visit a travel medical clinic .
• You’ll need time to prepare for your pre-travel appointment .
• If the country you visit requires a yellow fever vaccine , only a limited number of clinics have the vaccine and will probably be some distance from where you live. You must get it at least 10 days before travel.

Find out which vaccines are recommended or required for the countries you plan to visit .

TIP : Save time by getting routine vaccines during the same doctor visit. Use the Vaccine Self-Assessment Tool and discuss the results with your doctor. It tells you which U.S. recommended vaccines you (19 years and older) or your child (birth – 18 years) might need.

Last-minute travelers

When traveling to another country be aware your doctor may not carry a travel vaccine and you may have to visit a medical clinic.

Many travel vaccines require multiple shots or take time to become fully effective. But some multiple-dose vaccines (like hepatitis A) can still give you partial protection after just one dose. Some can also be given on an “accelerated schedule,” meaning doses are given in a shorter period of time.

• Discover and learn about specific diseases that can affect you while traveling
• What to do if you get sick after traveling
• Vaccines & Immunizations

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The Caribbean Islands Travel Requirements & Vaccinations

The Caribbean is a region located southeast of the Gulf of Mexico and north of South America that is comprised of more than 700 islands in the Caribbean Sea. Some of the more commonly known destinations in the region include Aruba, Barbados, the Cayman Islands, the Bahamas and Antigua. Spanish, English and French are the predominant languages spoken throughout the region.

The geography of the different islands varies greatly – some regions are relatively flat while others are mountainous or volcanic. Most have picturesque coastlines that may feature islets, coral reefs, cays and seagrass meadows in the shallow waters bordering the islands. Climates are generally tropical in the region but can vary from tropical rainforest in some areas to tropical savanna in others.

Tourist attractions in the Caribbean will differ based on the island you are visiting but most destinations will feature:

• Diverse fish and wildlife populations
• Expansive, sandy beaches
• Cultural events and carnivals

Recommended Vaccines When Traveling to the Caribbean

• Hepatitis A

Travelers may also be advised to ensure they have received the routine vaccinations listed below. Some adults may need to receive a booster for some of these diseases:

• Measles, mumps and rubella (MMR)
• Tdap (tetanus, diphtheria and pertussis)

Older adults or those with certain medical conditions may also want to ask about being vaccinated for shingles and/or pneumonia.

This information is not intended to replace the advice of a travel medicine professional. Not all of the vaccines listed here will be necessary for every individual.

Talk to the experts at UH Roe Green Center for Travel Medicine & Global Health to determine how each member of your family can obtain maximum protection against illness, disease and injury while traveling, based on age, health, medical history and travel itinerary.

clock This article was published more than  2 years ago

Traveling to the Caribbean or Bahamas? Here’s what 5 islands require.

How to navigate travel restrictions for island vacations in the Dominican Republic, Puerto Rico and beyond

With its (relatively) nearby beaches, the Caribbean has been a go-to escape for American travelers desperate for R&R during the pandemic. But as with any overseas trip, navigating covid-era travel restrictions from island to island presents a challenge.

Unlike Mexico, which has no entry requirements for travelers, most Caribbean destinations require some testing or proof of vaccination to enter. No matter what’s required for getting away, all Americans flying home from abroad still have to follow U.S. protocol for reentry . All inbound international travelers must show proof of an approved negative coronavirus test taken within a day of their flight to the United States.

Below, By The Way breaks down the rules for five popular islands — including one Atlantic vacation spot just outside the Caribbean — and shares vaccination numbers pulled from The Washington Post’s data tracker, unless otherwise noted.

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Dominican Republic

More than 500,000 travelers visited the Dominican Republic in January , and the country’s tourism minister is hoping to bring more than 7 million tourists to the country in 2022. More than 54 percent of the population has been vaccinated.

CDC travel warning: Level 4 , indicating a “very high” risk of covid exposure

Entry requirements: There are no entry requirements for Americans to visit the Dominican Republic. An aleatory breath test — which can detect covid via “breath print” — is performed on some arriving passengers and anyone who displays symptoms. Visitors who can provide proof of vaccination or a negative coronavirus test taken within 72 hours are exempt from the random test.

Once you’re there: While you don’t need a vaccination card or a negative test to enter the D.R., visitors over 12 must carry their vaccination card with them, because some businesses — like bars, restaurants, gyms and shopping centers — outside of tourism complexes or resorts require proof of full vaccination or a PCR test taken within seven days to enter. Masks are required in indoor public places.

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Aruba began easing its restrictions for international travelers Feb 3. About 72.6 percent of the population has been vaccinated.

CDC warning: Level 4

Entry requirements: All visitors at least 12 years old can either provide proof of vaccination and booster, or take a lab-certified rapid or PCR test before arriving in Aruba. Children under 12 are exempt from testing or vaccination requirements.

People who have recovered from the coronavirus between 10 days and 12 weeks ahead of their trip and do not have any symptoms are also exempt. Instead of uploading proof of vaccination or a negative test result, they must upload proof of their past positive result from the PCR test taken between 10 days and 12 weeks of their trip. An antigen or antibody test, among others, will not be accepted .

Once you’re there: Masks are mandatory in indoor public spaces, including the airport, and recommended in situations when social distancing is difficult. According to the Aruba tourism board website , there are curfews for businesses outside of hotel properties (1 a.m. for most establishments and 2 a.m. for casinos). Restaurants cannot seat more than 10 people per table (children under 12 excluded).

6 questions about travel after recovering from covid, answered

Puerto Rico

Behind Mexico’s Riviera Maya, Puerto Rico is the most booked Caribbean destination for American travelers in 2022, according to data from the flight booking site SkyScanner. The U.S. territory has roughly 79 percent of its population vaccinated.

CDC warning: N/A for U.S. territories

Entry requirements: Fully vaccinated travelers no longer have to present a negative coronavirus test to visit, as of Feb. 2. They must upload proof of vaccination through the country’s travel declaration form portal . Unvaccinated travelers must provide a negative test result to bypass a seven-day quarantine. Alternatively, they can test within 48 hours of arrival and quarantine while waiting for the results.

Travelers who have tested positive for the coronavirus within 90 days of their trip are exempt from testing requirements if they provide a certified medical health certificate from a doctor and proof of a positive test.

For children, those at least 5 years old must show proof of vaccination or a negative test; those between 2 and 4 must show a negative test result; those under 2 are exempt from testing requirements.

Once you’re there: Until at least Feb. 16, Puerto Rico has coronavirus protocols in place that include measures such as limiting event venues and businesses to half-capacity. Important rules for visitors to know include the requirement to provide test results or vaccination status when checking into hotels, paradores (small inns), guesthouses and short-term rentals; and that all food and drink establishments require proof of vaccination or a negative coronavirus test taken within 48 hours to enter. For events indoors and outdoors, attendees must provide proof of vaccination or a negative coronavirus test taken within 48 hours. Children under 5 may not attend mass events.

Masks are required in public indoor places, throughout public transportation and for outdoor activities with at least 50 attendees (excluding public beaches) regardless of age and vaccination status.

U.S. Virgin Islands

The U.S. Virgin Islands is in the Safer-at-Home Phase of its State of Emergency. Over 63 percent of the population has been vaccinated.

CDC warning: N/A

Entry requirements: As of Feb. 2, domestic travelers must submit a negative antigen or PCR test result taken within five days of travel. The rules are different for those visiting the U.S. territory from an international destination. Domestic travelers at least 5 years old must be cleared to travel to the USVI through its travel screening portal . Travelers may be subject to additional screening on arrival.

Once you’re there: The USVI tourism website provides a tool kit for travelers to better understand its coronavirus protocols. The territory requires masks or face coverings in public places for anyone over 2. At hotels and other types of lodging, guests will undergo health screenings and temperature checks. Restaurants and bars have reduced capacity to 75 percent, and no more than six people may sit at one table.

The Bahamas

Across the 700 islands that make up the Bahamas, over 39 percent of the population has been vaccinated.

Entry requirements: In addition to applying for a Bahamas travel health visa, visitors must test within 72 hours of their arrival date. Fully vaccinated travelers and children between ages 2 and 11 can use either a rapid antigen or PCR test, while unvaccinated travelers 12 and older are required to use a PCR test. There are no testing requirements for children under 2.

As of Jan. 4, anyone staying in the Bahamas for more than 48 hours must take a rapid test within their first two nights of their arrival, regardless of vaccination status.

Once you’re there: Protocols may vary on each of the 16 major islands. However, all travelers are required to mask at airports and sea terminals and when traveling by taxi, entering establishments, and checking into hotels. Social distancing is required on beaches.

The Bahamian government may restrict travel into or out of certain islands, and it recommends that travelers watch for updates online . Unvaccinated visitors traveling within the islands of the Bahamas must provide a negative PCR test result taken within 72 hours of their departure date. All unvaccinated visitors must also take a daily questionnaire throughout their trip, up to 14 days.

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New CDC warnings for several Caribbean destinations over COVID-19

The U.S. Centers for Disease Control and Prevention offered its first weekly travel advisory updates of the new year, and it includes a strong warning to "avoid travel" to Aruba due to a "very high risk" of COVID-19.

The CDC also updating its warning levels on several other popular Caribbean destinations including the Bahamas and St. Martin .

To stay up to date on travel news and advice from TPG, sign up for our daily newsletter .

Aruba was added to Level 4, the CDC's highest-risk category when determining COVID risk levels. Countries are moved to Level 4 when more than 500 positive cases per 100,000 residents are detected in the past 28 days.

"Because of the current situation in Aruba, even fully vaccinated travelers may be at risk for getting and spreading COVID-19 variants," the CDC declared on its official website .

Aruba, one of the most popular winter getaways, is still open for travel and airlines are still flying there. It has its own entry requirements for travelers coming from nations deemed high-risk. The U.S. is currently labeled a high-risk country.

Related: Complete reopening guide to Aruba

"Anyone traveling to Aruba from a location classified as high-risk will need to complete the PCR testing requirement 2 days prior to departure to Aruba regardless of vaccination status and will not have the option to test upon arrival in Aruba," states a notice on VisitAruba.com . Travelers must also complete an online Embarkation/Disembarkation card and purchase Aruba Visitors Insurance, according to the Aruba Tourism Authority.

Aruba isn't the only Caribbean destination to have its COVID warning level increased. The CDC also placed The Bahamas and Sint Maarten at Level 3, indicating a "high level" of coronavirus transmission on those islands. It warns that unvaccinated travelers "should avoid nonessential travel" to both Sint Maarten and the Bahamas

Other Caribbean islands have revised their own travel entry requirements due to the continued spread of the omicron variant. This includes the U.S. Virgin Islands, Puerto Rico, and Barbados.

According to the USVI Department of Tourism, all domestic travelers, regardless of vaccination status, must show proof of a negative COVID-19 antigen or PCR test taken within three days of travel. This abbreviates the previous testing window, which had been five days.

Puerto Rico has also cracked down on entry protocols. All domestic travelers to have a negative COVID-19 rapid or PCR test taken within 48 hours of their arrival, regardless of their vaccination status, according to Discover Puerto Rico. Unvaccinated travelers must now quarantine for seven days upon arrival, whether their test is negative or not. Previously, unvaccinated travelers had no mandatory quarantine. You can find full details about travel requirements to Puerto Rico on the Discover Puerto Rico website .

Related: TPG reader story: What it was like to test positive on our way home from vacation

The Bahamas and Barbados have both revised entry regulations with regards to COVID tests.

Barbados now allows travelers to either show proof of a negative COVID-19 rapid test taken within one day of arrival on the island, or proof of a negative PCR test taken within 3 days of arrival, per information on VisitBarbados.org . Unvaccinated visitors must quarantine at pre-approved accommodations for seven days, and take a PCR test on day five.

The Bahamas will now let vaccinated travelers show either a negative rapid antigen test or an RT-PCR test taken no more than 72 hours prior to arrival. Unvaccinated travelers 12 years and older must continue to present a negative RT-PCR test within three days of arrival. Anyone presenting test results older than 72 hours will be denied entry to the islands.

A rapid antigen test now is required for all travelers staying in the Bahamas longer than 48 hours (two nights), regardless of vaccination status.

Featured Image by Nisangha for Getty Images

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Norovirus outbreaks linked to 2 cruise ships with over 150 infected

A total of 161 passengers have reported falling ill during voyages on princess cruises' sapphire princess and royal caribbean international's radiance of the seas.

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The Centers for Disease Control and Prevention are investigating two seemingly separate outbreaks of Norovirus linked to U.S. cruise ships.

Cases have been linked to Princess Cruises' Sapphire Princess and Royal Caribbean International's Radiance of the Seas.

The CDC's Vessel Sanitation Program (VSP) is tracking the "very contagious" outbreaks following reports of passengers in distress .

CARNIVAL FREEDOM PASSENGER ONBOARD DURING FIRE RECOUNTS 'DANGEROUS, TERRIFYING' EXPERIENCE

The Radiance of the Seas, a Royal Caribbean cruise ship, is pictured docked at a port in Seward, Alaska. (iStock)

Approximately 67 out of 1,993 passengers on the Radiance of the Seas reported falling ill during its voyage from Tampa to Los Angeles between Apr. 8 and 22. An additional two crew members also reported illness . 

The predominant symptoms reported from those affected by the Norovirus were diarrhea and vomiting.

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A view of the sign at the Center for Disease Control headquarters is seen in Atlanta, Georgia. (Nathan Posner/Anadolu Agency via Getty Images / Getty Images)

Approximately 94 of 2,532 passengers on the Sapphire Princess reported similar symptoms during its voyage from Los Angeles into the South Pacific that began Apr. 5 and is scheduled to conclude on May 7.

An additional 20 members of the 1,066 crew reported symptoms as well.

Fox Business reached out to both Princess Cruises and Royal Caribbean International for comment on the situation but did not receive a response.

CLICK HERE TO READ MORE ON FOX BUSINESS

This photo shows the Sapphire Princess cruise ship, operated by Princess Cruises, docked at the Marina Cruise center in Singapore. (ROSLAN RAHMAN/AFP via Getty Images / Getty Images)

"Norovirus is a very contagious virus that causes vomiting and diarrhea. Anyone can get infected and sick with Norovirus," the CDC states on its website. "Norovirus is sometimes called the 'stomach flu' or 'stomach bug.' However, norovirus illness is not related to the flu, which is caused by influenza virus."

One of the biggest health risks posed by Norovirus infection is dehydration — the CDC recommends those infected drink plenty of liquids to aid recovering.

The CDC's Vessel Sanitation Program requires cruise lines to report and document cases of illness on their ships in order to facilitate coordinated responses in case of emergency.

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Mexico Traveler View

Travel health notices, vaccines and medicines, non-vaccine-preventable diseases, stay healthy and safe.

• Packing List

After Your Trip

Be aware of current health issues in Mexico. Learn how to protect yourself.

Level 1 Practice Usual Precautions

• Dengue in the Americas April 18, 2024 Dengue is a risk in many parts of Central and South America, Mexico, and the Caribbean. Some countries are reporting increased numbers of cases of the disease. Travelers to the Americas can protect themselves by preventing mosquito bites. Destination List: Argentina, Brazil, Colombia, Costa Rica, Ecuador, including the Galápagos Islands, French Guiana (France), Guadeloupe, Guatemala, Martinique (France), Mexico, Nicaragua, Panama, Paraguay, Peru, Turks and Caicos Islands (U.K.), Uruguay
• Rocky Mountain Spotted Fever in Mexico March 12, 2024 There have been reports of Rocky Mountain spotted fever (RMSF) in people traveling to the United States from Tecate, in the state of Baja California, Mexico.
• Salmonella Newport in Mexico March 29, 2023 Some travelers who have spent time in Mexico have been infected with multidrug-resistant (MDR) Salmonella Newport.

⇧ Top

Check the vaccines and medicines list and visit your doctor at least a month before your trip to get vaccines or medicines you may need. If you or your doctor need help finding a location that provides certain vaccines or medicines, visit the Find a Clinic page.

Routine vaccines

Recommendations.

Make sure you are up-to-date on all routine vaccines before every trip. Some of these vaccines include

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Flu (influenza)
• Measles-Mumps-Rubella (MMR)

Immunization schedules

All eligible travelers should be up to date with their COVID-19 vaccines. Please see  Your COVID-19 Vaccination  for more information. 

COVID-19 vaccine

Hepatitis A

Recommended for unvaccinated travelers one year old or older going to Mexico.

Infants 6 to 11 months old should also be vaccinated against Hepatitis A. The dose does not count toward the routine 2-dose series.

Travelers allergic to a vaccine component or who are younger than 6 months should receive a single dose of immune globulin, which provides effective protection for up to 2 months depending on dosage given.

Unvaccinated travelers who are over 40 years old, immunocompromised, or have chronic medical conditions planning to depart to a risk area in less than 2 weeks should get the initial dose of vaccine and at the same appointment receive immune globulin.

Hepatitis A - CDC Yellow Book

Dosing info - Hep A

Hepatitis B

Recommended for unvaccinated travelers younger than 60 years old traveling to Mexico. Unvaccinated travelers 60 years and older may get vaccinated before traveling to Mexico.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

CDC recommends that travelers going to certain areas of Mexico take prescription medicine to prevent malaria. Depending on the medicine you take, you will need to start taking this medicine multiple days before your trip, as well as during and after your trip. Talk to your doctor about which malaria medication you should take.

Find  country-specific information  about malaria.

Malaria - CDC Yellow Book

Considerations when choosing a drug for malaria prophylaxis (CDC Yellow Book)

Malaria information for Mexico.

Cases of measles are on the rise worldwide. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks prior to departure, or have not had measles in the past, and travel internationally to areas where measles is spreading.

All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, according to  CDC’s measles vaccination recommendations for international travel .

Measles (Rubeola) - CDC Yellow Book

Rabid dogs are commonly found in Mexico. However, if you are bitten or scratched by a dog or other mammal while in Mexico, rabies treatment is often available. 

Consider rabies vaccination before your trip if your activities mean you will be around dogs or wildlife.

Travelers more likely to encounter rabid animals include

• Campers, adventure travelers, or cave explorers (spelunkers)
• Veterinarians, animal handlers, field biologists, or laboratory workers handling animal specimens
• Visitors to rural areas

Since children are more likely to be bitten or scratched by a dog or other animals, consider rabies vaccination for children traveling to Mexico. 

Rabies - CDC Yellow Book

Recommended for most travelers, especially those staying with friends or relatives or visiting smaller cities or rural areas.

Typhoid - CDC Yellow Book

Dosing info - Typhoid

Avoid contaminated water

Leptospirosis

How most people get sick (most common modes of transmission)

• Touching urine or other body fluids from an animal infected with leptospirosis
• Swimming or wading in urine-contaminated fresh water, or contact with urine-contaminated mud
• Drinking water or eating food contaminated with animal urine
• Avoid contaminated water and soil

Clinical Guidance

Avoid bug bites, chagas disease (american trypanosomiasis).

• Accidentally rub feces (poop) of the triatomine bug into the bug bite, other breaks in the skin, your eyes, or mouth
• From pregnant woman to her baby, contaminated blood products (transfusions), or contaminated food or drink.
• Avoid Bug Bites

Chagas disease

• Mosquito bite

Leishmaniasis

• Sand fly bite
• An infected pregnant woman can spread it to her unborn baby

Airborne & droplet

Avian/bird flu.

• Being around, touching, or working with infected poultry, such as visiting poultry farms or live-animal markets
• Avoid domestic and wild poultry
• Breathing in air or accidentally eating food contaminated with the urine, droppings, or saliva of infected rodents
• Bite from an infected rodent
• Less commonly, being around someone sick with hantavirus (only occurs with Andes virus)
• Avoid rodents and areas where they live
• Avoid sick people

Tuberculosis (TB)

• Breathe in TB bacteria that is in the air from an infected and contagious person coughing, speaking, or singing.

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in Mexico, so your behaviors are important.

Eat and drink safely

Food and water standards around the world vary based on the destination. Standards may also differ within a country and risk may change depending on activity type (e.g., hiking versus business trip). You can learn more about safe food and drink choices when traveling by accessing the resources below.

• Choose Safe Food and Drinks When Traveling
• Water Treatment Options When Hiking, Camping or Traveling
• Global Water, Sanitation and Hygiene | Healthy Water
• Avoid Contaminated Water During Travel

You can also visit the Department of State Country Information Pages for additional information about food and water safety.

Prevent bug bites

Bugs (like mosquitoes, ticks, and fleas) can spread a number of diseases in Mexico. Many of these diseases cannot be prevented with a vaccine or medicine. You can reduce your risk by taking steps to prevent bug bites.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). Do not use permethrin directly on skin.
• Stay and sleep in air-conditioned or screened rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
• Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
• 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs .

For more detailed information on avoiding bug bites, see Avoid Bug Bites .

Some diseases in Mexico—such as dengue, Zika, leishmaniasis, and Chagas disease—are spread by bugs and cannot be prevented with a vaccine. Follow the insect avoidance measures described above to prevent these and other illnesses.

Stay safe outdoors

If your travel plans in Mexico include outdoor activities, take these steps to stay safe and healthy during your trip.

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• If you are outside for many hours in heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation : use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if driving a boat, and always wear a life jacket.
• Do not dive into shallow water.
• Do not swim in freshwater in developing areas or where sanitation is poor.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• To prevent infections, wear shoes on beaches where there may be animal waste.

Leptospirosis, a bacterial infection that can be spread in fresh water, is found in Mexico. Avoid swimming in fresh, unchlorinated water, such as lakes, ponds, or rivers.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately. Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Consider buying medical evacuation insurance. Rabies is a deadly disease that must be treated quickly, and treatment may not be available in some countries.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medications you take.
• Some prescription drugs may be illegal in other countries. Call Mexico’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website ( www.jointcommissioninternational.org ).

In some countries, medicine (prescription and over-the-counter) may be substandard or counterfeit. Bring the medicines you will need from the United States to avoid having to buy them at your destination.

Malaria is a risk in some parts of Mexico. If you are going to a risk area, fill your malaria prescription before you leave, and take enough with you for the entire length of your trip. Follow your doctor’s instructions for taking the pills; some need to be started before you leave.

Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

In many places cars, buses, large trucks, rickshaws, bikes, people on foot, and even animals share the same lanes of traffic, increasing the risk for crashes.

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Ride only in cars that have seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Avoid driving at night; street lighting in certain parts of Mexico may be poor.
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in Mexico, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.
• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Medical Evacuation Insurance

If you are seriously injured, emergency care may not be available or may not meet US standards. Trauma care centers are uncommon outside urban areas. Having medical evacuation insurance can be helpful for these reasons.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

For information traffic safety and road conditions in Mexico, see Travel and Transportation on US Department of State's country-specific information for Mexico .

Maintain personal security

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel advisories and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP) .
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate .
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

To call for emergency services while in Mexico, dial 066, 060, or 080. Write these numbers down to carry with you during your trip.

Learn as much as you can about Mexico before you travel there. A good place to start is the country-specific information on Mexico from the US Department of State.

Americans in Mexico have been arrested for purchasing souvenirs that were, or looked like, antiques and that local customs authorities believed were national treasures. Familiarize yourself with any local regulations for antiques and follow these tips:

• When you are considering purchasing an authentic antique or a reproduction, ask if you are allowed to export these items before you purchase them.
• If you buy a reproduction, document on the customs form that it is a reproduction.
• If you buy an authentic antique, obtain the necessary export permit (often from the national museum).

Healthy Travel Packing List

Use the Healthy Travel Packing List for Mexico for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.

Why does CDC recommend packing these health-related items?

It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.

If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic . Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.

If your doctor prescribed antimalarial medicine for your trip, keep taking the rest of your pills after you return home. If you stop taking your medicine too soon, you could still get sick.

Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the doctor about your travel history.

For more information on what to do if you are sick after your trip, see Getting Sick after Travel .

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Norovirus: Nearly 200 sick in outbreaks on Princess, Royal Caribbean ships, CDC says

FILE - Tourists crowd upper decks and stateroom balconies as the Anthem of the Seas owned by Royal Caribbean International on Aug. 9, 2023, in Lisbon, Portugal. (Photo by Horacio Villalobos#Corbis/Corbis via Getty Images)

Nearly 200 passengers on U.S. cruise ships suffered from diarrhea and vomiting in norovirus outbreaks in April, according to the U.S. Centers for Disease Control and Prevention.

The CDC reported that 94 of the 2,532 (3.71%) passengers on Princess Cruises’ Sapphire Princess ship reported getting sick during its current voyage. The 32-day, roundtrip cruise began on April 5 and ends on May 7, according to the cruise tracking and information site CruiseMapper . 

Another 20 of the 1,066 crew members on board also reported getting sick, the CDC said.

Cruise ship rescued 14 stranded at sea for over a week

This was the scene from the lunch buffet during the first full day of cruising for the Icon of the Seas. The crew rescued all 14 from the distressed boat which was dwarfed by the largest cruise ship in the world.

On Royal Caribbean’s Radiance of the Seas ship, 67 of the 1,993 (3.36%) total passengers on board became ill during a voyage that began on April 8 and ended on April 22, according to the agency. Two crew members aboard also got sick. 

In both of the norovirus outbreaks, the main symptoms were diarrhea and vomiting, the CDC said.

Princess Cruises told FOX Television Stations that "at the first sign" of an increase in passengers reporting gastrointestinal illnesses, "we immediately initiated additional enhanced sanitization procedures to interrupt the person-to-person spread of this virus."

"Our sanitization program, includes disinfection measures, isolation of ill passengers and communication to passengers about steps they can take to stay well while onboard," the company told FOX Television Stations.

Royal Caribbean International did not immediately return a request for comment, but the CDC said in its notice that the company also took several steps in response to the outbreak – including isolating the sick passengers and crew members and "increased cleaning and disinfection procedures." 

RELATED: 'Vampire facials' at unlicensed spa likely resulted in HIV infections: CDC

Cruise ships expose passengers to high volumes of people and new environments, which can "create the risk for illness from contaminated food, or water or, more commonly, through person-to-person contact," the CDC says. 

The agency recommends that anyone feeling sick should report their illness. If it happens before the voyage, travelers can ask their cruise line about any possible alternative cruising options. 

Those on board should wash their hands often to prevent illness, as well as get plenty of rest and stay hydrated. 

This story was reported from Cincinnati.

Travel Vaccines and Advice for the Caribbean and Northern America

The Caribbean and Northern America offer a wide variety of experiences for all kinds of travellers. From the snows of Greenland to the beaches of Jamaica, there is something for everyone.

Passport Health offers all the vaccinations and medications you may need to travel safely throughout the region. See our What Vaccines… section to learn more.

Countries in this region include:

What Vaccines Do I Need for the Caribbean and Northern America?

The PHAC and WHO recommend the following vaccinations for travellers to the Caribbean and Northern America: hepatitis A , hepatitis B , typhoid , cholera , yellow fever and rabies .

Some routine vaccinations are also recommended, this includes: measles, mumps and rubella (MMR) , tetanus, diphtheria and pertussis (Tdap) , influenza , chickenpox , shingles , pneumonia , meningitis and polio .

Proof of yellow fever vaccination may be required for some travellers, based on the countries they have recently visited.

See the tables below for more information:

Are There Other Health Concerns in the Caribbean and Northern America?

A few different types of infections are present in the Caribbean and Northern America region.

Dengue , Zika and malaria are found in various parts of the region. Most cases are in the Caribbean but some infections can be found in the Southern United States. Be sure to take precautions with mosquito repellents and netting. Your Passport Health travel health specialist can advise you on the need for antimalarials.

Travellers’ diarrhea can affect travellers to any region. Be sure to have a travellers’ diarrhea prevention kit with you for your trip.

What Are the Entry Requirements in the Caribbean and Northern America?

Visas are only required for a few countries within the Caribbean and Northern America region. Passports are required to travel to all regions.

See the below table for more information:

Embassy information for each country is available on its own destination advice page.

Travelling to Another Destination?

Travelling outside of the Caribbean and Northern America? Learn more about your destination with our full compliment of destination advice pages!

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• Burkina Faso
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• Cayman Islands
• Central African Republic
• Christmas Island
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• Equatorial Guinea
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• Norfolk Island
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• Philippines
• Pitcairn Islands
• Puerto Rico
• Republic of the Congo
• Saint Barthelemy
• Saint Helena
• Saint Kitts and Nevis
• Saint Lucia
• Saint Martin
• Saint Pierre-et-Miquelon
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• Saudi Arabia
• Sierra Leone
• Sint Eustatius
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• South Africa
• South Georgia and the South Sandwich Islands
• South Korea
• South Sudan
• Switzerland
• Trinidad and Tobago
• Turkmenistan
• Turks and Caicos Islands
• U.S. Virgin Islands
• United Arab Emirates
• United Kingdom
• United States
• Wake Island
• Western Sahara

On This Page: What Vaccines Do I Need for the Caribbean and Northern America? Are There Other Health Concerns in the Caribbean and Northern America? What Are the Entry Requirements in the Caribbean and Northern America? Travelling to Another Destination?

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USDA Actions to Protect Livestock Health From Highly Pathogenic H5N1 Avian Influenza

Federal Order to assist with developing a baseline of critical information and limiting the spread of H5N1 in dairy cattle

WASHINGTON, April 24, 2024 – To further protect the U.S. livestock industry from the threat posed by highly pathogenic H5N1 avian influenza, USDA is sharing a number of actions that we are taking with our federal partners to help us get ahead of this disease and limit its spread.

Today, USDA’s Animal and Plant Health Inspection Service (APHIS) announced a Federal Order requiring the following measures, effective Monday, April 29, 2024:

Mandatory Testing for Interstate Movement of Dairy Cattle

• Prior to interstate movement, dairy cattle are required to receive a negative test for Influenza A virus at an approved National Animal Health Laboratory Network (NAHLN) laboratory.
• Owners of herds in which dairy cattle test positive for interstate movement will be required to provide epidemiological information, including animal movement tracing.
• Dairy cattle moving interstate must adhere to conditions specified by APHIS.
• As will be described in forthcoming guidance, these steps will be immediately required for lactating dairy cattle, while these requirements for other classes of dairy cattle will be based on scientific factors concerning the virus and its evolving risk profile.

Mandatory Reporting

• Laboratories and state veterinarians must report positive Influenza A nucleic acid detection diagnostic results (e.g. PCR or genetic sequencing) in livestock to USDA APHIS.
• Laboratories and state veterinarians must report positive Influenza A serology diagnostic results in livestock to USDA APHIS.

USDA has identified spread between cows within the same herd, spread from cows to poultry, spread between dairies associated with cattle movements, and cows without clinical signs that have tested positive. On April 16, APHIS microbiologists identified a shift in an H5N1 sample from a cow in Kansas that could indicate that the virus has an adaptation to mammals. Centers for Disease Control and Prevention (CDC) conducted further analysis of the specimen sequence, which did not change their overall risk assessment for the general public, because the substitution has been seen previously in other mammalian infections and does not impact viral transmission. Additionally, APHIS’ National Veterinary Services Laboratories found H5N1 in a lung tissue sample from an asymptomatic cull dairy cow that originated from an affected herd and did not enter the food supply.

The novel movement of H5N1 between wild birds and dairy cows requires further testing and time to develop a critical understanding to support any future courses of action. This Federal Order is critical to increasing the information available for USDA. Requiring positive test reporting will help USDA better under this disease and testing before interstate movement will limit its spread.

While we are taking this action today, it is important to remember that thus far, we have not found changes to the virus that would make it more transmissible to humans and between people. While cases among humans in direct contact with infected animals are possible, our partners at the U.S. Centers for Disease Control and Prevention (CDC) believe that the current risk to the public remains low.

Additionally, we continue to see affected cows recover after supported care with little to no associated mortality. We also continue to work with our partners in the states and industry to emphasize the critical importance biosecurity plays in limiting disease spread for all livestock and poultry.

You may view the Federal Order , which is effective on Monday, April 29, 2024.

Further, in an effort to maximize understanding and research on H5N1 in dairy cattle, on April 21, APHIS made publicly available 239 genetic sequences from the U.S. H5N1 clade 2.3.4.4b influenza virus recently found in samples associated with the ongoing HPAI outbreak in poultry and wild birds, and the recent H5N1 event in dairy cattle. APHIS has also offered virus samples to interested researchers to facilitate epidemiological study. Increasing our understanding of this disease and how it spreads is critical to stopping it. This is why APHIS is urging dairy cattle producers and those who work in or with the industry to share epidemiological information from affected farms, even if they are not planning to move cattle interstate. APHIS further urges producer participation in public health assessments to continue to confirm worker safety and monitor for any potential changes in the virus that could impact transmissibility.

In addition, our partners in the U.S. Food and Drug Administration released an update on the ongoing work to ensure continued effectiveness of the federal-state milk safety system. It is important to emphasize that, based on the information and research available to us at this time, the U.S. Food and Drug Administration and USDA believe that our commercial milk supply is safe because of both the pasteurization process and the required diversion or destruction of milk from sick cows. Pasteurization has continuously proven to inactivate bacteria and viruses in milk. The FDA and USDA continue to work closely to collect and evaluate additional data and information specific to avian influenza in dairy cattle and to support state counterparts as this emerging disease in dairy cattle is managed.

As USDA continues to take steps to protect the health of livestock, the Department continues to work closely with federal partners at the CDC on protecting the health of people and FDA on protecting the safety of the food supply. The U.S. government is committed to addressing this situation with urgency.

To learn more about USDA’s response to HPAI in dairy cattle, visit www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/livestock .

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