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International travelers visiting countries in Africa in 2025 should be aware of the health risks associated with the ongoing cholera outbreak.
Cholera is a potentially fatal infection that causes severe diarrhea but can be prevented with vaccination.
While cholera is no longer a health risk in the United Kingdom (UK), it is sometimes reported in returning travellers from three WHO regions.
For example, the UK's Travel Health Pro reported on March 7, 2025, that four cases of cholera (toxigenic Vibrio cholerae serogroup O1) were locally diagnosed in mid-February 2025.
Three UK travellers were recently diagnosed with cholera after visiting the Federal Democratic Republic of Ethiopia.
A fourth UK cholera case did not travel but reported consuming water from Ethiopia by one of the returned travellers before experiencing symptoms.
Ethiopia is just one of 22 areas the WHO currently identifies as a risk for cholera.
A cholera vaccine can be considered for travellers departing from the UK following a full risk assessment and those with limited access to safe water and/or underlying health problems.
According to the U.S. CDC, cholera remains a global health risk.
And when leaving the United States in March 2025, the U.S. CDC recommends that travelers speak with a travel vaccine expert about cholera prevention options. Following increased production, cholera vaccines have become more available this year.
Since early 2025, New Mexico and Texas have reported an unexpected number of measles cases, mainly in rural counties.
As of March 11, 2025, the state of Oklahoma was added to this geographic health outbreak.
The Oklahoma State Department of Health (OSDH) confirmed two measles cases in a press release but did not disclose the actual locations.
“These cases highlight the importance of being aware of measles activity as people travel or host visitors,” Kendra Dougherty, Director of Infectious Disease Prevention and Response at OSDH said.
As of March 6, 2025, the U.S. CDC reported 222 measles cases in 12 jurisdictions this year.
These measles cases may be related to the ongoing global measles outbreak in 2025.
In a recent CDC Health Alert Network, the agency wrote that the risk for widespread measles in the United States remains low due to robust U.S. immunization and surveillance programs.
The CDC says healthcare providers should ensure all patients without other evidence of immunity, especially those planning international travel, are up to date on the MMR vaccine, which is offered at most pharmacies in the U.S.
Brazil's Ministry of Health (MOH) has been reporting data on the locations of Chikungunya patients for the past three years.
As of March 11, 2025, the MOH reported that most of the 40,000 Chikungunya cases reported this year were found in Sao Paulo (5,714) and Minus Gerias (5,120).
Last year, there were about 265,000 Chikungunya cases and 231 related fatalities in Brazil, located in similar states.
The Chikungunya virus is transmitted to people through the bite of an infected mosquito of the Aedes spp., which are found at beaches and in mountains below seven thousand feet in elevation.
While the U.S. CDC has not issued a Travel Health Advisory regarding Brazil's ongoing Chikungunya outbreak, it writes, 'There has been evidence of chikungunya virus transmission in Brazil within the last five years.'
Chikungunya vaccination may be considered for seniors, especially those with underlying medical conditions, who may spend at least two weeks (cumulative time) in indoor or outdoor areas where mosquitoes are present in Brazil, or visitors planning to stay in Brazil for a cumulative period of six months or more.
Before departing for Brazil, most travel clinics and pharmacies in the United States offer the U.S. FDA-approved chikungunya vaccine. Valneva SE's IXCHIQ® vaccine has been found safe and effective in various studies.
While the Kingdom of Morocco is not listed in the U.S. CDC's recent Global Measles Health Advisory, it has been experiencing a significant measles outbreak since late 2023.
According to media reports citing official sources, about 3,600 measles cases and five deaths have been reported in 2025. Since Morocco's outbreak began, there have been about 20,000 cases.
Amine Tahraoui, the Ministry of Health, says the reasons for the increase in measles cases are unknown.
On February 6, 2025, the Minister reviewed the disease status in Morocco and the strategy adopted to combat it. He stated that his department has implemented a multi-faceted plan to curb the spread of measles.
He specified that this plan includes extending the national vaccination campaign and catching up on missed vaccinations, which has enabled the verification of the vaccination status of more than 8.88 million children.
The Moroccan Ministry of Health also extended the vaccination campaign until March 28, 2025, to ensure everyone (37 million residents) can access essential vaccines.
The CDC recommends that all international travelers visiting Morocco be fully vaccinated against measles with the measles, mumps, and rubella (MMR) vaccine, including an early dose for infants.
In addition to the MMR, the CDC recommends various routine and travel vaccines before visiting Morocco in 2025. These vaccines are generally offered in the United States at travel clinics and pharmacies.
The Ministry of Health for the State of São Paulo recently confirmed its first patient infected with Mpox Clade 1b. The infection was confirmed in early March 2025 in an adult woman in the Metropolitan Region of São Paulo.
According to the media statement of March 10, 2025, she is expected to be discharged next week.
The patient had not traveled to outbreak areas in Africa but had contact with individuals from the Democratic Republic of Congo, where the virus is endemic.
"No secondary cases have been identified as yet. The municipal surveillance team is keeping track of possible contacts," the Ministry's Edjalma Borg statement reads.
Mpox has been considered endemic in Africa since the 1970s.
In May 2022, Mpox Clade 2 cases were detected in numerous countries, including the United States. Since July 2024, cases of Clade 1b have been identified in several countries, such as England.
According to various studies, Mpox vaccinations help prevent severe disease.
With the U.S. CDC reissuing a Global Measles Travel Advisory for 57 countries in February 2025, public health leaders are concerned that unvaccinated travelers may bring this highly infectious disease into Texas schools.
Following the city’s first confirmed measles cases since 2018, Houston Public Health issued an alert in February 2025, encouraging everyone to ensure their protection, and launched vaccination campaigns.
A real-time example of this risk is the Houston Livestock Show and Rodeo, which welcomes tens of thousands of out-of-town visitors to Texas daily. This family-friendly event enhances the lives of young people each March, but it could become a disease hot spot for unvaccinated children.
Houston Public Media recently reported that a few private schools in the Houston area are among the Texas institutions with the lowest measles vaccination rates, according to data compiled by the Texas Department of State Health Services (DSHS).
Immunization data from more than 1,600 surveyed public and private schools in Texas shows that 50% or fewer kindergarteners in some private schools in Harris and Montgomery counties were vaccinated for measles during the 2023-24 school year.
As of March 7, 2025, Houston Public Media found that about 36% of kindergarteners at the Acton Leadership Academy of Magnolia were vaccinated for measles in 2023-24.
Acton Leadership Academy of Creekside, located in Spring, also had a 50% measles vaccination rate in its kindergarten class.
Positive data exists across the state: About 92% of kindergarteners at 1,680 surveyed Texas public and private schools were immunized for measles during the 2023-24 school year.
However, in Texas, vaccination exemptions are approved for two reasons: if a physician states the vaccine could pose a health risk to the student, or if the student’s parents have a religious or personal belief that opposes getting vaccinated.
As of March 11, 2025, DSHS and the CDC encourage most people to get two doses of the MMR vaccine, which are generally available at health clinics and pharmacies throughout Texas.
Located on Brazil's northern coast, Marajó Island has been reporting yellow fever outbreaks for two decades. Recently, a severe outbreak has been confirmed.
As of March 7, 2025, Brazil's Ministry of Health confirmed 37 cases and five related deaths from the mosquito-transmitted yellow fever disease in the Belém area of Pará this year.
This area has about 500,000 residents and welcomes thousands of eco-friendly tourists annually.
Yellow fever is an acute infectious febrile disease that can be prevented with a vaccine. It progresses rapidly and has variable severity, and in its most severe forms, it can be fatal.
Locally acquired YF cases are seldom reported in the United States, but travel-related cases were reported in 2024.
Vaccination has been the primary prevention strategy in Brazil since 2014. Currently, yellow fever (YF) vaccination coverage is 72.6%.
YF vaccines are free of charge to the entire population. Since April 2017, Brazil has adopted a single-dose regimen throughout life, following the World Health Organization's (WHO) recommendations.
The Ministry of Health sent 442,400 doses to Pará in 2025 alone to reinforce YF immunization.
The WHO, U.S. CDC, and Brazil have issued vaccination requirements to enter various countries in the Region of the Americas. YF vaccination services are offered at certified travel clinics and pharmacies in the U.S.
