Search API
India has recently increased in popularity as a destination for United States travelers. Last year, the U.S. National Travel and Tourism Office tanked India as the second most popular international travelers destination.
While tourism has increased, so has the number of Chikungunya virus outbreaks in India.
On December 19, 2024, the U.S. CDC reported an outbreak of Chikungunya in India's Maharashtra and Telangana states.
According to India's National Center for Vector-Borne Diseases Control, 192,343 CHIKV cases were reported in 2024. Those infected with this mosquito-transmitted disease develop some symptoms and many report long-term symptoms.
Pune's National Institute of Virology has indicated that Chikungunya virus variants are causing more cases and lingering symptoms in 2024.
A study published on October 19, 2024, determined that the incidence of post-chikungunya chronic rheumatism and fatigue and the impact on quality of life and chronic fatigue in adults seven years after infections were significant.
These experts have identified Chikungunya's "Indian Ocean lineage," first identified in 2006, as the primary cause of the recent surge in cases and lingering symptoms. This novel lineage has also spread globally.
"India's ongoing Chikungunya outbreak is a good reminder for international travelers about this often forgotten mosquito illness and the importance of vaccination. Infection can lead to long-term health issues such as chronic joint pain, and people 65 years and older are especially at risk for complications," Jeri Beales, MSN, RN, informed Vax-Before-Travel.
"The approved vaccine is given as a single dose, and studies show it is highly effective for at least several years after receiving. The U.S. CDC does not recommend every traveler to India get the vaccine. It is only approved for people 18 years and older in the U.S., so be sure to talk to your local travel clinic or physician," added Beales, who leads Destination Health Clinic, a Boston, Massachusets area travel health provider specializing in health education and vaccination for international travelers.
Since 2013, the Asian genotype has led to Chikungyna outbreaks in the Region of the Americas, which will continue in 2026.
Last year, the Pan American Health Organization reported over 421,018 Chikungunya cases and 211 related deaths in the Americas.
The CDC's Level 2—Practice Enhanced Precautions Travel Health Advisory recommends the FDA-approved Chikungunya vaccine for certain visitors and long-term residents in India and other areas reporting outbreaks.
As of January 2025, Valneva SE's IXCHIQ® (VLA1553) vaccine is offered at many travel clinics and pharmacies in the U.S.
According to local media reports, India is establishing 13 new quarantine centers at major international airports to isolate travelers with infectious disease symptoms that could potentially trigger an outbreak.
On January 1, 2024, SeaandJob reported, "The program focuses on strengthening health system capacities at all levels—primary, secondary, and tertiary—and enhancing preparedness for effectively managing current and future pandemics or health emergencies."
In the United States, international airports have become essential screening centers for disease risks.
For example, in October 2024, the U.S. Government initiated health screening for air travelers arriving from the Republic of Rwanda during its recent Marbug disease outbreak.
In 2025, the U.S. CDC will continue publishing Travel Health Advisories Assessments, including guidance for cruise ships. This will enable international travelers to confirm travel vaccine recommendations by country.
Additionally. the Transportation Security Administration is prepared to screen holiday travelers during the end-of-year travel period. The TSA adjusts processes and procedures to meet the evolving threat and achieve the highest transportation security levels. Because of this, you may notice changes in our procedures occasionally.
In the Region of the Americas, 2024 has been marked as the worst year ever for dengue virus infections, 12.8 million, and related fatalities, 7,855.
From a country perspective, the United States has experienced a significant impact, with dengue cases increasing by approximately 43%. According to the U.S. CDC, 8,863 dengue cases were reported as of mid-December 2024, compared to 6,164 cases in 2023.
Within the U.S., the Florida Department of Health recently reported some unsettling news.
As of late December 2024, 911 travel-associated dengue cases had been reported, mainly by visitors to Brazil (61), Cuba (506), and Puerto Rico (41). Additionally, 85 locally acquired dengue cases were reported from ten counties, led by Miami-Dade (47).
In 2023, 609 travel-associated dengue cases were reported, and 186 humans contracted dengue while in Florida.
With international travel expected to increase in 2025, this CDC data suggests that more international visitors may unintentionally introduce one of the four dengue viruses in Florida next year.
Furthermore, since mosquitoes transmit dengue, locally acquired infections will likely increase next year.
From a disease prevention perspective, there is hope that access to dengue vaccines may improve in 2025 as approved vaccines increase production and vaccine candidates seek approvals.
The Costa Rican Ministry of Health published a notice in December 2024 regarding changes to yellow fever certificate requirements for travelers, effective January 11, 2025.
The countries that are now considered at risk and for which yellow fever vaccination against yellow fever is required are the following: Bolivia, Brazil, Colombia, Ecuador, Guyana, French Guiana, Paraguay, Peru, Suriname, Venezuela, and Trinidad and Tobago. Additionally, countries in Africa have been added to Costa Rica's list.
When visiting Costa Rica, a yellow fever vaccination (YF-VAX or Stamaril) certificate may be required at the airport. Foreigners who arrive in Costa Rica and do not present the International Certificate of Vaccination against Yellow Fever to the immigration authority will not be allowed to enter the territory.
As of December 31, 2024, the YF vaccine is not part of the mandatory vaccination schedule, so it must be purchased at private pharmacies.
In addition to YF, Costa Rica has reported Chikungunya (45), Dengue, and Zika (25) cases in 2024.
Most of this year's Dengue cases (30,000) have been detected near San Jose in the mountains, not at Costa Rica's beaches.
Previously, in early December 2024, the U.S. State Department issued a Level 2: Exercise Increased Caution, Travel Advisory, for the Republic of Costa Rica. This U.S. advisory says visitors to Costa Rica should exercise increased caution due to various civil unrest targeting tourists.
Last year, about 2.4 million people visited Costa Rica, many traveling from the United States.
As 2024 draws to a close, the World Health Organization (WHO) published an in-depth update on malaria burden and trends at global, regional, and country levels. As of December 19, 2024, the WHO reported malaria outbreaks remain a formidable public health challenge.
In 2023 alone, there were an estimated 597,000 malaria-related fatalities and 263 million new cases, an increase of 11 million cases over 2022.
The WHO wrote, 'Given current trends, progress towards critical targets of the WHO global malaria strategy is off track.'
As the WHO Director-General stated: "No one should die of malaria.... An expanded package of lifesaving tools now offers better protection against the disease, but stepped-up investments and action in high-burden African countries are needed to curb the threat."
The WHO African Region continues to be most impacted, accounting for an estimated 94% of global cases, led by Nigeria and the Democratic Republic of the Congo.
When visiting these countries, the WHO recommends international travelers speak with a travel vaccine expert one month before departure. In November 2024, the WHO published a revised version of the consolidated Guidelines for malaria with an updated vaccine recommendation.
While malaria vaccines are available in Africa, they are unavailable in the USA in 2024.
In the U.S., most malaria cases are travel-related.
The U.S. Centers for Disease Control and Prevention reported that as of the week ending November 23, 2024 (#47), 1,772 malaria cases had been confirmed in 2024, mostly among international travelers arriving in New York City (232), Texas, Miami, Florida, and Los Angeles, California. In 2023, there were 2,013 travel-related malaria cases in the U.S.
A recent study published by the JAMA Network measured antibody response to Respiratory syncytial virus (RSV) vaccinations in immunocompromised individuals.
This Research Letter, published on December 30, 2024, disclosed a heterogeneous antibody response to RSV vaccines among immunocompromised persons.
In contrast to universal seroconversion and preF IgG fold rises greater than 10 in immunocompetent persons, approximately 40% of immunocompromised participants did not seroconvert or achieve a conservative neutralization threshold postvaccination.
Better neutralization was seen among RSVA-AS01E (AREXVY™) recipients, suggesting possible augmentation by the vaccine adjuvant.
These researchers wrote, 'Low antibody titers may indicate a role for additional vaccine doses to enhance immune response among immunocompromised persons.
As of December 31, 2024, various RSV vaccines are offered at local pharmacies, and monoclonal antibody passive immunization is approved.
The U.S. Centers for Disease Control and Prevention (CDC) today announced active person-to-person transmission of mpox clade 1 in Burundi, Central African Republic, Democratic Republic of the Congo, Kenya, the Republic of the Congo, Rwanda, and Uganda.
As of December 30, 2024, the CDC's Level 2 Travel Health Advisory says person-to-person transmission has occurred through various means during this mpox outbreak. Historically, clade I have been associated with a higher percentage of people with mpox developing severe illness or dying, compared to clade II.
The mpox clade II outbreak began in the United States in late May 2022.
As of November 2024, there have been 2,455 confirmed clade II mpox cases this year, which has exceeded the 1,407 confirmed cases in 2023.
Furthermore, the CDC says mpox vaccination is recommended for certain people traveling to countries with ongoing person-to-person transmission of clade I mpox.
In the U.S., the JYNNEOS® (MVA-BN, IMVANEX®, IMVAMUNE®) Smallpox and Mpox Vaccine has been approved by the U.S. FDA since September 2019. Other mpox vaccines and vaccine candidates are actively seeking regulatory approvals in 2025.
