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The Republic of Ecuador has been exposed to a wide range of zoonotic pathogens that have a significant impact on the population's health and the overall economy.

Recent disease outbreaks, such as yellow fever, rabies, hantavirus, and highly pathogenic avian influenza A(H5N1), have disrupted the health system of this South American country.

For example, the number of yellow fever cases reported in South America so far in 2025 represents a threefold increase compared to the cases reported in 2024.

Since the beginning of 2025 and as of early May, four confirmed fatal cases of yellow fever have been reported in Ecuador, from the provinces of Morona Santiago (one fatal case) and Zamora Chinchipe (three fatal cases).

These conditions led Ecuador to establish priority surveillance, prevention, and control strategies for potential outbreaks of animal-borne diseases.

In response to these conditions, with technical support from the Pan American Health Organization/World Health Organization, specialists from the Ecuador Ministry of Public Health, and others announced on June 2, 2025, they are working to prioritize zoonotic and emerging diseases to obtain a list that would provide the country with clarity in the implementation of surveillance and control tasks for these pathologies. 

To alert international visitors, the U.S. CDC has included Ecuador in various disease outbreak alerts. 

The CDC recommends yellow fever vaccination for travelers aged 9 months or older traveling to areas below 7,550 feet in elevation, east of the Andes Mountains, in the provinces of Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos, Tungurahua, and Zamora-Chinchipe.

As of June 3, 2025, the YF-Vax vaccine is generally not recommended for travel to areas with an elevation below 7,550 ft.

The vaccine is required for most travelers arriving from Brazil, the Democratic Republic of the Congo, or Uganda, including those with 12-hour airport transits or layovers in any of these countries. But not those arriving from the U.S.

Located on South America's Pacific Ocean, Ecuador also includes the Galápagos Province, about 600 miles west of the mainland.

This travel vaccine, along with others, is commercially offered at clinics and pharmacies in the U.S.

Vaccine Treats: 
Yellow Fever
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by Fernando Zhiminaicela
Live Blog Update Author: 
Karen McClorey Hackett
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Ecuador
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The Colorado Department of Public Health (CDPH) and Environment, along with El Paso County Public Health, have recently confirmed six measles cases that passed through Denver International Airport, which set an all-time passenger record in 2024, serving 82,358,744 passengers.

In May 2025, measles was confirmed in two unvaccinated residents of El Paso County. These adults are unrelated, but were at Denver around the same time on May 14, 2025.

Both individuals are recovering at home.

In addition, a third Colorado passenger on Turkish Airlines who arrived in Denver on May 13, 2025, has been confirmed positive for measles. The vaccinated adult from Arapahoe County is recovering at home. No public exposures have been identified in connection with this case.

According to a CDPH press release on June 1, 2025, this brings the total number of cases associated with an out-of-state traveler who flew while infectious to six: four passengers on the flight (three Colorado residents and one out-of-state resident) and two El Paso County residents who were at the airport during the exposure period.

Separately, the U.S. CDC published a Global Measles Outbreak Travel Health Advisory on May 28, 2025.

Measles is highly contagious and can sometimes lead to serious health problems, but it is a vaccine-preventable disease. The measles, mumps, and rubella (MMR) vaccine provides strong protection and is generally available at health clinics and pharmacies in the U.S.

Vaccine Treats: 
Measles
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DEN June 3, 2025
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Don Hackett
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Denver
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vaccine 2025

Global Pertussis Outbreak Includes the U.S.

Whooping cough vaccines offered at pharmacies in June 2025
June 3, 2025
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Since April 2024, the Ministry of Health (MOH) of the Republic of Costa Rica has reported an outbreak of Bordetella pertussis (whooping cough) in the Tibas district of San Jose, which has a population of over 70,000 residents.

As of June 2, 2025, the MOH remains on alert for whooping cough cases in local schools, which are primarily transmitted through respiratory droplets from coughing or sneezing, and have an incubation period ranging from 4 to 21 days.

On May 20, 2025, a case of whooping cough was confirmed in a teacher at a school in Golfito and a resident of the Corredores canton. There are now 14 confirmed cases in home isolation, in good general health, and receiving treatment and monitoring from the inter-institutional team.

Following the initial diagnosis, 79 direct contacts were identified, including 72 students, six teachers, and one cleaning staff member. Of these, 31 people presented symptoms.

The MOH recommends that the local population comply with the national vaccination schedule: the Pentavalent vaccine at 2, 4, 6, and 15 months, the Tetravalent vaccine at 4 years old, and the vaccine for pregnant women, indicated from the 20th week of pregnancy.

About 18 years ago, Costa Rico declared a whooping cough emergency and launched a nationwide vaccination program.

While the U.S. CDC advises individuals planning to visit Costa Rica in June 2025 to stay up to date with routine vaccinations, the agency also highlights the presence of Chikungunya and measles in Costa Rica.

These travel vaccines are commercially offered at clinics and pharmacies in the U.S. and should be administered about one month before departure abroad. 

Vaccine Treats: 
Pertussis
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Google Maps June 2, 2025
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Karen McClorey Hackett
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Costa Rica
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After six years without reporting a Zika virus case, the Hawaiʻi Department of Health (DOH) is investigating travel-related cases involving two individuals.

On May 27, 2025, the DOH announced that vector control teams are responding and will continue operations in areas where individuals have spent time, including the Waialua/Haleʻiwa area on the island of Oʻahu.

While Hawaiʻi has mosquito species capable of transmitting Zika, but the virus is not established in the state. As of June 2025, no locally acquired cases have been documented in Hawaiʻi.

The most recent travel-related Zika case in Hawaiʻi was reported in 2019. Travel-associated cases were more frequently reported in Hawai‘i during 2015-2019 when Zika was circulating globally, peaking at 25 cases in 2017.

Over the last few years, there has been a significant increase in Zika cases reported in the Americas, including in Puerto Rico. During 2025, over 12,600 cases have already been reported.

The DOH says Zika can also be transmitted through sex from a person who has Zika. The virus has been found in semen, vaginal fluids, saliva, urine and breast milk.

While most people recover from this mosquito-transmitted disease, pregnant women and their unborn children may become infected, leading to serious health issues. 

A study published in January 2025 found that the mortality rates among 11.4 million children born with a severe Zika virus infection were higher. Young children with congenital Zika syndrome (CZS) had a 13-fold higher risk of death compared with those without CZS.

This study found a cause-specific mortality hazard ratio of 30.28.

As of June 2, 2025, the U.S. Food and Drug Administration has not approved a vaccine that prevents Zika.

The U.S. CDC says, regardless of where you live or visit, if mosquitoes are active in your area, wear long clothing and use insect repellent to reduce the risk of bites. Additionally, travelers returning from an area with a risk of Zika should take steps to prevent mosquito bites for three weeks after their return.

Vaccine Treats: 
Zika
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Google Maps June 2, 2025
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Don Hackett
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Hawaii
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Since being discovered in Lyme, Connecticut, decades ago, Lyme disease has expanded west in the United States, causing significant health risks to people when outdoors.

For example, the Michigan Department of Health and Human Services (MDHHS) recently confirmed Lyme disease is now the most common tick-borne disease in Michigan, and anaplasmosis is increasing across the state.

Lyme disease cases in Michigan have increased by 168% over the last five years.

Michigan recorded 1,215 cases in 2024, as compared to 452 cases in 2020.

Anaplasmosis cases in Michigan have increased by almost fivefold over the last five years, with 82 cases reported in 2024 compared to 17 in 2020.

"Preventing tick bites is the best way to prevent tick-borne diseases, including Lyme disease and anaplasmosis," said Dr. Natasha Bagdasarian, MDHHS's chief medical executive, in a media release on May 21, 2025.

"If you find a tick attached to your body, promptly remove it. Monitor your health, and if you experience fever, rash, muscle or joint aches, or other symptoms, or if you suspect a tick has been attached for more than 24 hours, consult with your medical provider."

As of June 2, 2025, the U.S. Food and Drug Administration has not approved a vaccine for the prevention of Lyme disease. However, an innovative vaccine candidate (VLA15) is progressing in late-stage clinical research.

VLA15 is a multivalent recombinant protein vaccine targeting Borrelia's outer surface protein A (OspA). It is designed for prophylactic, active immunization against Lyme disease. The first data readout of the Phase 3 clinical trial is expected by the end of 2025.

Vaccine Treats: 
Lyme Disease
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US CDC
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Don Hackett
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Michigan
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Through the initial five months of 2025, Zika virus (ZIKV) outbreaks continue as a significant, measurable public health concern worldwide.

In the Region of the Americas, over 12,600 Zika patients have been identified as of June 1, 2025.

Last year, 42,127 ZIka cases and two related fatalities were reported in the Americas in 2024, led by Argentina, Brazil, Bolivia, Colombia.

Foremost among public health leaders' focus is when a pregnant woman becomes infected with this mosquito-transmitted virus. While pregnant, ZIKV can induce severe defects of the fetal brain and, eventually, microcephaly in the infant.

To better understand this health risk, an Ohio State University (OSU) study published in the Proceedings of the National Academy of Sciences on May 23, 2025, reveals the biological secret to the Zika virus's infectious success.

These researchers found that Zika utilizes the host cells' own "self-care" system to clear away useless molecules, thereby suppressing the host proteins that the virus has employed to enter those cells in the first place. 

They wrote in a press release on May 27, 2025, 'While these cell surface proteins are valuable for viral entry, they also have roles in producing an antiviral response. Before that can happen, the virus manipulates a process cells use to keep themselves healthy to lower the proteins' activity, clearing the way for unfettered viral infection.'

'Though other viruses, such as HIV, are known to silence host receptors that let them into cells, Zika is unusual for having at least three of its proteins that can get the job done,' said Shan-Lu Liu, senior author the study and a virology professor in the Department of Veterinary Biosciences at OSU.

"That's the most interesting part: It's amazing that not only one, but several Zika proteins can do this."

"We looked at two Zika virus strains and examined three physiologically relevant cell types. With both strains, we observed downregulation in all three cell types. It looks like this is an important mechanism," added Liu.

Although further research is needed to confirm this, there is a possibility that this mechanism is relevant to the Ebola virus, which utilizes the TIM-1 protein to access host cells, or to other pathogens in the same flavivirus family, including Zika, West Nile, yellow fever, and dengue viruses. 

"The bottom line is this speaks to the co-evolution of viral-host interactions. The more important a host factor is to a virus, the more a virus is going to do to take control of it," Liu said. "Understanding these mechanisms is an important part of being prepared for emerging or reemerging viruses that cause infectious diseases."

As of June 2025, there are no Zika preventive vaccines available, and the U.S. CDC recommends pregnant women avoid visiting areas reporting Zika outbreaks.

Over the last few years, Zika cases have been reported in Puerto Rico, Costa Rica, and other tourist favorite destinations.

Vaccine Treats: 
Zika
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by Jeanette Atherton
Live Blog Update Author: 
Karen McClorey Hackett
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Puerto Rico
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Travel Vaccine Appointment

Travel Vaccine Appointment Request in 2025

Thank you for contacting Vax-Before-Travel. We are forwarding your request for a travel vaccination appointment to a local healthcare provider, such as a travel clinic or pharmacy.

You should receive a response within a few hours. In the meantime, here are a few links to current disease outbreaks impacting various destinations in 2025:

Chikungunya - The mosquito-transmitted virus has been found in over 100 countries, including those in the Americas and the Indian Ocean.

Cholera - The WHO-prequalified oral cholera vaccines, including Dukoral®, are available for international travelers. 

Dengue - Last year, the number of Dengue cases set an unfortunate record, and mid-year reports suggest 2025 may top it.

Malaria - While 90% of malaria cases are reported in Africa, numerous travel-related cases are confirmed each year. Currently, malaria vaccines are offered in Africa.

Mpox - While the number of Mpox cases in the U.S. has diminished in 2025, several African countries are currently reporting outbreaks of Clades 1 and 2. The JYNNEOS vaccine is approved to prevent mpox and is available in most countries.

Urinary Tract Infection - As of 2025, treatments for UTIs and an oral spray vaccine are available globally, but not in the USA.

Yellow Fever - Yellow Fever virus outbreaks have been detected in various countries in 2025. A U.S. FDA-approved Yellow Fever vaccine is available in 2025.

Other travel vaccines are available to protect individuals from various diseases. The U.S. CDC Travel Health Notices recommend that most vaccines be administered about one month before departing for an outbreak area in 2025.

Furthermore, should you need a pre- or post-trip test to detect virus infections such as chikungunya, dengue, or malaria, visit Utla Labtests.

Thank you,

Don Hackett

Vax-Before-Travel, Publisher

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Last Reviewed: 
Thursday, December 11, 2025 - 06:00
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Travel vaccinations are offered at clinics and pharmacies in 2025
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Chikungunya
UTI vaccine

Complicated Urinary Tract Infection Oral Antibiotic Approaches Approval

UTI vaccine and medications available in 2025
May 31, 2025
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With the summer of 2025 cruise ship season getting underway, many passengers are seeking access to a norovirus preventive vaccine.

As of May 14, 2025, the U.S. CDC's Vessel Sanitation Program had reported 17 gastrointestinal (GI) illnesses on cruise ships this year, with over ten classified as norovirus outbreaks, and others still under investigation.

This CDC data compares with 18 GI outbreaks in all of 2024 and just 14 in 2023.

While norovirus vaccine research has been previously unsuccessful, one oral vaccine has published positive news.

Vaxart, Inc. recently announced the publication of complete data from a Phase 2b challenge study of its first-generation oral pill norovirus vaccine candidate. 

This study measured safety, efficacy against infection and symptomatic disease, as well as viral shedding.

Additionally, a machine learning analysis identified statistically significant correlates of protection, which will be incorporated into the development of Vaxart’s second-generation norovirus vaccine candidate.

“Challenge studies provide unique opportunities to identify correlates of protection that can be used to predict vaccine efficacy and support vaccine development,” said James F. Cummings, MD, Chief Medical Officer at Vaxart, in a press release.

“The application of machine learning approaches to the complete data from the Phase 2b challenge study of our first-generation oral pill norovirus vaccine candidate identified two such correlates, functional serum blocking antibody and fecal IgA."

"Evaluation of these endpoints will help inform our understanding and provide an early read on the potential efficacy profile of our second-generation norovirus vaccine candidate as it advances through clinical development."

The single-center, double-blinded Phase 2b challenge study enrolled 165 healthy adults, who were randomized 1:1 to receive Vaxart’s monovalent oral pill vaccine candidate targeting the norovirus GI.1 genotype or placebo. Four weeks after vaccination, subjects were challenged with GI.1 norovirus. The primary objective of the study was to determine the efficacy of the vaccine against norovirus infection and norovirus gastroenteritis (NVG) following gastrointestinal (GI) infection.1 NV challenge.

Secondary objectives were to assess the safety and tolerability of the vaccine candidate. The ability of the vaccine candidate to modify disease severity, the quantity and duration of norovirus shedding, and a set of immunogenicity parameters was also quantified. The primary efficacy endpoints were the proportion of participants showing evidence of NVG, a composite endpoint defined as meeting one or more definitions for acute gastroenteritis and a positive norovirus infection, and the norovirus infection itself.

Key findings from the study include the vaccine was immunogenic and protected against norovirus infection, with a 30% relative reduction for the vaccine group compared with placebo (p=0.003); The vaccine group had a lower incidence of norovirus gastroenteritis (21% relative reduction), but was not statistically different (p=0.178); The vaccine significantly increased serum IgA, IgG, norovirus-blocking antibodies, and antibody-secreting cells (p<0.001 for all endpoints). The vaccine stimulated mucosal-homing B cells and significantly increased norovirus-specific antibodies in saliva, nasal lining fluid, and the intestine.

Steven Lo, Chief Executive Officer of Vaxart, added, “The initiation of the Phase 1 clinical trial comparing our first- and second-generation norovirus vaccine candidates is a key step toward this important goal."

"The Phase 2 challenge study published today for our first-generation norovirus candidate supports our oral pill norovirus vaccine approach, and the preclinical data we have generated to date support our view that our second-generation candidate has the potential to provide improved immunogenicity and protection.”

As of May 30, 3035, the CDC has not recommended any norovirus vaccine.

Vaccine Treats: 
Norovirus
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US CDC May 30, 2025
Live Blog Update Author: 
Don Hackett
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San Francisco
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