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After being named by Travel + Leasure as 'Destination of the Year' in 2024, when Costa Rica welcomed about 2.6 million tourists, a few headwinds have confronted this Central American country.
A spokesman for the business group Turismo por Costa Rica recently estimated that tourist arrivals could drop by 15% to 20% by the end of 2025.
"The decline is multifactorial," Bary Roberts noted in a news article by the Tico Times on March 21, 2025.
Price competitiveness is one hurdle.
The appreciation of the Republic of Costa Rican colón has further eroded purchasing power. Each U.S. dollar now converts to fewer colones, making Costa Rica a pricier destination compared to regional peers.
Another tourism challenge is an increase in health alerts.
On March 18, 2025, the U.S. Embassy in San José issued an alert on the spike in histoplasmosis associated with caving activities in Costa Rica.
Histoplasmosis is a lung infection caused by a fungus in soil contaminated with bat or bird droppings. If left untreated, it can lead to serious and potentially life-threatening complications.
Additionally, over the past few years, local cases of mosquito-transmitted Chikungunya, Dengue, Malaria, and Zika have been confirmed at Costa Rica's beaches and mountain destinations.
Furthermore, from a safety perspective, the U.S. Embassy remains committed to ensuring the well-being of U.S. citizens when visiting Costa Rica. The State Department's Level 2 Travel Advisory issued in December 2024 says visitors should exercise increased caution due to crime.
In February 2025, The U.S. Embassy announced it had received reports regarding travel incidents near the Juan Santamaría International Airport.
Please take appropriate precautions and stay informed when visiting Costa Rica. To receive alerts, you can enroll in the Smart Traveler Enrollment Program, making locating you in an emergency easier.
The Chikungunya outbreak on La Réunion Island recently reached Level 4 of the ORSEC plan of this French overseas department and region.
The Director General of the Regional Health Agency (ARS) stated in a media release on March 19, 2025, stated Réunion is experiencing a "medium-intensity epidemic," with 2,888 cases reported in early March.
On March 21, 2025, local media reported two Chikungunya-related fatalities.
ARS wrote, 'Although there is no current tension in the hospital environment, 77 patients were admitted to the emergency room between March 3 and 9, 2025.'
'Faced with the increase and spread of cases across the country, the ARS vector control service is adapting its system to optimize the effectiveness of interventions.'
The southern municipalities are the most affected by this mosquito-transmitted virus, particularly Le Tampon, located in the south-central part of the island and home to about 80,000 residents.
To alert international travelers, the U.S. CDC issued a Travel Health Advisory in February 2025, confirming that people can protect themselves by preventing mosquito bites and that vaccination against Chikungunya is recommended for most people traveling to a destination with a current Chikungunya outbreak.
In the United States, various Chikynunga vaccines are available at most travel clinics and pharmacies as of March 22, 2025.
While the Texas Department of Health and Human Services (DSHS) has reported 317 measles cases this year, the state's overall vaccination rate is very positive.
As of March 22, 2025, Texas says, 'Texas schools have reported high coverage rates for each vaccine included in the survey.'
For example, the Texas Kindergarten Annual Report of Immunization Status for the School Year 2023-2024 shows 94.34% of children were vaccinated with the MMR vaccine.
In seventh grade, immunization coverage was above 95% for all vaccines except Tdap and meningococcal MCWY vaccines.
Furthermore, vaccinations appear to be increasing in Texas.
According to DSHS, about 173,000 MMR doses were administered in 2025, compared to at least 158,000 over the same timeframe last year. Media reporting indicates that MMR access has increased at national and community pharmacies as of March 2025.
An unanswered question is why the DSHS's unvaccinated/unknown category lists 307 people with no documented doses of measles vaccine more than 14 days before symptom onset when the state has an immunization registry.
Public health leaders would better understand this measles outbreak if this innovative technology were adequately utilized.
To inform everyone, the U.S. Centers for Disease Control and Prevention (CDC) issued a Health Advisory notifying clinicians, public health officials, and potential travelers to Texas about this year's measles outbreak.
The CDC recommends anyone visiting measles outbreak areas to protect against this highly transmissible virus.
The U.S. Department of Health and Human Services today filed a [Docket No. CDC-2025-0017] notice regarding a meeting of the Advisory Committee on Immunization Practices (ACIP), the vaccine advisory committee of the Centers for Disease Control and Prevention (CDC).
The ACIP advises the Director of the CDC on the use of immunizing agents.
As of March 21, 2025, this newly scheduled ACIP meeting will be held on April 15 and April 16, 2025, and will be digitally open to the public.
The agenda will include discussions on chikungunya, COVID-19, cytomegalovirus, Human papillomavirus, influenza, Lyme disease, meningococcal, mpox, pneumococcal, Respiratory Syncytial Virus vaccines for adults, and maternal and pediatric populations.
An update on the current measles outbreak in the U.S. will also be provided.
ACIP recommendation votes are scheduled for meningococcal, chikungunya, and RSV vaccines for adults.
Of note, VIMKUNYA® became the first chikungunya vaccine approved in the U.S. for people aged 12 and older as of March 18, 2025, without an ACIP recommendation.
A Vaccines for Children vote is also scheduled for meningococcal vaccines.
The agenda for this ACIP meeting is similar to the rescheduled February 2025 session.
To increase trust in the vaccine authorization process, the CDC launched a website in early March 2025 identifying ACIP member conflicts of interest, if any. Revealed on March 7, 2025, people can use this free CDC digital tool to quickly find previous conflicts of interest by ACIP members from 2000 to 2024.
The Philippines Department of Health has reported acute watery diarrhea cases in various provinces in 2025, where typhoid fever has become endemic.
As of March 19, 2025, local media reported that the Province of Negros Occidental, located in the Negros Island Region, 344 typhoid fever cases and three related deaths have been confirmed this year.
An estimated 11–21 million cases of typhoid fever occur worldwide each year.
To alert international travelers visiting the Philippines, the U.S. CDC recommends typhoid vaccination for most people, especially those staying with friends or relatives or visiting smaller cities or rural areas.
About 5.5 million people visited the Philippines last year.
In the United States, travel clinics and pharmacies offer typhoid vaccines in 2025. The CDC says that typhoid vaccines protect 50%–80% of recipients and reinforce safe food and water precautions.
Furthermore, the CDC has included the Philippines in recent Dengue and Measles Travel Health Advisories.
According to the World Health Organization (WHO), the seven cholera epidemic is considered to have started in 1961 and continues in March 2025.
So far, in 2025, a cumulative total of 70,488 cholera cases and 808 deaths were reported from 23 countries across three WHO regions.
In February 2025 alone, 459 cholera-related fatalities were confirmed, representing a 32% increase in January.
To help reduce cholera outbreaks, Oral Cholera Vaccine (OCV) production has remained high, reflecting significant efforts by the supplier and partners. The average OCV stockpile has recently stabilized at 5.5 million doses in February.
However, the WHO's external situation report #24 stated on March 20, 205, that the growing global demand continues to exceed supply, hindering efforts to control cholera outbreaks, respond rapidly to the disease’s spread, and implement preventative campaigns.
Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from feces.
While cholera vaccination is not generally recommended for all international travelers, it is what the U.S. CDC suggested when visiting cholera outbreak zones.
In the United States, travel clinics and pharmacies currently have an ample supply of OCVs.
Since the Mpox virus swept around the world in May 2022, Germany's Standing Commission on Vaccination has recommended that people at an elevated risk of infection receive a preventive vaccination.
After millions of JYNNEOS® (MVA-BN®, IMVAMUNE®) doses were administered, an observational study published positive effectiveness data today.
The Lancet Infectious Diseases published results from a study conducted at Charité – Universitätsmedizin Berlin on March 18, 2025, that found one dose of the JYNNEOS was 84% in people without HIV and 58% effective against mpox infection overall.
However, due to the significant drop in Mpox infections in the second half of 2022, the study could not determine the additional effect of a second vaccine dose.
Furthermore, Breakthrough infections were associated with reduced symptoms, compared with infections in unvaccinated individuals.
In a related press release, Prof. Leif Erik Sander, Director of the Department of Infectious Diseases and Critical Care Medicine at Charité and a research group leader at the Berlin Institute of Health at Charité, stated, "Our results confirm that a single dose of the vaccine provides good protection against Mpox, at least for a short time."
"That is a very good figure, which is likely increased further by the second vaccine dose."
"The reason is that developing immune protection after vaccination presumably requires specific immune cells called T cells. These T cells often appear at lower levels in people with HIV and are not fully functional, which translates to a weaker immune response. This also corresponds to our observation that these participants experienced fewer local and systemic side effects after receiving the vaccine."
"We assume that people living with HIV develop protection against Mpox after the second vaccine dose, and urgently advise these people to receive the two vaccine doses."
"The immune system typically develops longer-lasting immune protection when exposed to the vaccine on more than one occasion."
Further studies will be required to determine the precise extent of the protective effect in different groups following two vaccine doses.
As of March 29, 2025, the JYNNEOS vaccine is commercially available at many clinics and pharmacies in the United States.
