Current incidence of the disease at a glance, recommendations and mandatory vaccination by country August 18, 2025
Chikungunya
China
Since mid-July of this year, there has been an outbreak in Guangdong Province (SE) with approximately 5,155 local cases to date. It was triggered by imported infections. It is important to ensure good protection against daytime mosquitoes, and vaccination may be advisable.
Dengue
Cook Islands
At the end of May of this year, authorities confirmed an outbreak on the island of Rarotonga with 73 cases to date. It is important to ensure good protection against daytime mosquitoes, and vaccination is recommended.
Chikungunya
France
Since mid-June, health authorities have confirmed 50 local infections. The regions affected are Provence-Alpes-Côte d’Azur, Occitanie, Auvergne-Rhône-Alpes, Grand Est, Nouvelle-Aquitaine, and the south of Corsica. The first local cases were reported in France in 2010. Protect yourself against the predominantly daytime-active mosquitoes.
Dengue
Italy
Since mid-July of this year, three local infections have been confirmed in the municipality of Budrio (Bologna Province, Emilia-Romagna Region). Last year, more than 200 local cases were reported, particularly in the north and northeast of the country. It is important to ensure good protection against daytime-active mosquitoes, and vaccination may be recommended if you are staying in affected areas.
Dengue
Cuba
According to press reports, the number of cases in the province of Pinar del Río (West) rose significantly in June of this year. Nationwide, 3,945 infections have been confirmed this year. It is important to ensure good protection against daytime-active mosquitoes, and vaccination is recommended.
Chikungunya
Mauritius
The first local infection since 2009 was confirmed in mid-March of this year. Since then, the number of local cases has risen to around 1,535. The last major outbreak occurred in 2005/2006. It’s important to ensure good mosquito protection, and vaccination may also be advisable.
Intestinal infections
Egypt
Risk of diarrheal diseases nationwide. In recent years, there have been repeated cases of infections with enterohemorrhagic Escherichia coli (EHEC) among returning travelers, especially from Hurghada. Hepatitis A is also very common. Raw salads and undercooked foods should be avoided. Tap water should not be drunk. Observe food hygiene and vaccinations.
Safety Notice
Egypt
Travel to the northern Sinai Peninsula, the Egyptian-Israeli border region (except Taba), and remote areas of the Sahara is advised. Unaccompanied, individual excursions and overland travel in the southern Sinai Peninsula are discouraged (www.auswaertiges-amt.de).
Dengue
Australia
Since the beginning of this year, approximately 1,265 infections have been reported, most of them in the states of Western Australia, New South Wales, Victoria, and Queensland. Last year, approximately 2,370 cases were reported nationwide. The states of Western Australia, New South Wales, and Victoria were once again particularly affected. It is important to ensure excellent protection against daytime mosquitoes; vaccination may be advisable if necessary.
Pertussis
Australia
By the end of July of this year, approximately 17,450 cases had been reported. Last year, approximately 57,145 cases were reported nationwide, most of them in the states of Queensland and New South Wales. One baby died. This is the highest number of cases since 1991. In 2023, a total of approximately 2,440 cases were recorded nationwide. Before traveling abroad, standard vaccinations should always be checked and updated if necessary.
Ross River Fever
Australia
Since the beginning of this year, approximately 1,610 cases have been reported. The state of Queensland is once again particularly affected. Approximately 3,340 cases were reported nationwide last year. Be sure to use mosquito protection.
Chikungunya
Brazil
Since the beginning of this year, approximately 193,480 suspected cases have been reported nationwide. 101 people have died. The state of Mato Grosso is the worst affected. Last year, approximately 422,615 suspected cases and 213 deaths were reported nationwide. Health authorities reported the first local infections in mid-2014. Since then, the infection has spread nationwide. It is important to use good mosquito protection, and vaccination may be advisable.
Dengue
Brazil
There is a high risk of dengue throughout the country. Since the beginning of this year, approximately 3,110,500 suspected cases have been reported nationwide. 1,479 people have died. The state of São Paulo is particularly affected, where authorities have declared a medical emergency. Last year, approximately 10,232,875 suspected cases and 6,103 confirmed deaths were registered nationwide. Compared to the previous year, the number of cases has more than tripled. It is important to ensure good protection against daytime mosquitoes, and vaccination is recommended.
Yellow Fever
Brazil
In February of this year, a teenager from the municipality of Breves (Pará State) died. Since the beginning of March, 46 infections and 7 deaths have been confirmed in Pará State. In São Paulo State, 60 infections have already been confirmed this year. At least 34 people have died. In Minas Gerais State, 5 people have died and 7 others have become ill. In Tocantins State, a worker from Peru died in mid-February. The Ministry of Health has warned tourists of an increase in the number of cases and advised them to get vaccinated. Last year, 8 human infections were confirmed nationwide. There were 4 deaths. Vaccination is recommended for stays in Brazil.
Oropouche Fever
Brazil
Since the beginning of this year, approximately 11,855 infections have been reported. One person has died. Most cases were recorded in the state of Espirito Santo (SW). Last year, the number of confirmed infections nationwide rose to approximately 13,780, with four deaths. In 2023, 832 cases were confirmed nationwide, most of them from the state of Amazonas (NW). The virus is transmitted by midges and predominantly nocturnal mosquitoes. The disease leads to an acute febrile syndrome including joint and limb pain and vomiting. Use mosquito repellent.
Intestinal Infections
Dominican Republic
Risk of diarrhea nationwide. The Dominican Republic is one of the holiday destinations with the highest number of cases of traveler’s diarrhea. Cholera infections can also occur occasionally. Observe hygiene and consider vaccination.
Dengue
Dominican Republic
Since the beginning of this year, approximately 1,110 suspected cases have been registered. Last year, approximately 10,250 cases were registered. 12 people died. In 2023, approximately 27,970 suspected cases were registered. 62 people died. Very good protection against daytime mosquitoes is recommended, and vaccination is also recommended.
Entry Requirements
Dominican Republic
The Dominican government has completely sealed the border with Haiti since September 15, 2023, until further notice. Travel by land, air, or sea between the two countries is currently not possible (www.auswaertiges-amt.de).
Chikungunya
India
In the first three months, approximately 30,880 suspected cases and 1,741 confirmed infections were registered nationwide. The state of Maharashtra is the worst affected. Last year, approximately 240,180 suspected cases were reported nationwide, and 17,930 infections were confirmed. Protect yourself against daytime-active vector mosquitoes (Aedes species), and vaccination may be advisable.
Intestinal Infections
India
Risk of diarrheal diseases nationwide. Cholera is to be expected regionally. Typhoid, paratyphoid, and the orally transmitted forms of hepatitis are endemic throughout India. Anthrax, both in its cutaneous and intestinal form, is frequently found among locals. Ensure proper hygiene and vaccination.
Dengue
India
By the end of May of this year, the Delhi metropolitan area reported the highest number of cases in the last five years. In the first half of this year, approximately 25,100 cases were reported nationwide, and 25 people died. Last year, approximately 233,520 cases were registered. Around 300 people died. The states of Kerala, Karnataka, and Tamil Nadu were particularly affected. In 2023, approximately 289,235 cases and 485 deaths were reported. Very good protection against daytime mosquitoes is recommended, and vaccination is also recommended.
Japanese Encephalitis
India
Since the beginning of this year, approximately 225 cases and nine deaths have been reported nationwide. At the end of November 2024, the first infection since 2011 was reported in the west of the capital, New Delhi. Last year, approximately 1,465 cases of Japanese Encephalitis (JE) were registered nationwide. 105 people died. The highest number of infections was again recorded in the state of Assam (NE). In 2023, 1,097 cases and 56 deaths were officially reported nationwide. Administer exposure prophylaxis and possibly vaccinate!
Malaria
India
Since January of this year, approximately 97,995 cases and 5 deaths have been recorded nationwide. Most infections again originate from the states of Odisha, Chhattisgarh, and Jharkhand. Last year, approximately 257,385 cases were reported nationwide. 62 people have died. It is always advisable to use excellent mosquito repellent, carry emergency medication, and, depending on the outbreak, consider chemoprophylaxis.
Nipah Virus
India
Since the beginning of May, 5 infections have been confirmed in the state of Kerala (S). Two people have died. The districts of Malappuram and Palakkad are affected. The virus is present in the saliva and urine of infected bats. Transmission to humans occurs through the consumption of contaminated food, such as raw date juice; person-to-person transmission is also possible. The disease presents with flu-like symptoms, including high fever, muscle aches, and a general feeling of illness. Observe food hygiene.
Safety Notice
India
Travel to Jammu and Kashmir, Punjab, and the Indian territories bordering Pakistan west of the former National Highway N 15, including the cities of Jaisalmer, Bikaner, and Ganganagar, is cautioned. Travel to Manipur is currently strongly discouraged. Demonstrations and large gatherings should be avoided at all costs, instructions from security forces should be followed, and current media reports should be followed during any stay (www.auswaertiges-amt.de).
Rabies
India
India is one of the countries in the world with the highest number of cases in animals and humans. In the state of Kerala (S), the number of bites by stray dogs has more than doubled since 2017, and the number of rabies-related deaths has roughly tripled. At least 8 deaths and 2 cases of rabies have been recorded this year. The main vector is the (stray) dog. Major cities are also affected. In case of suspicious animal contact, seek immediate medical attention and ensure the use of modern tissue culture vaccines. Preventive vaccination is recommended for all travelers.
Intestinal Infections
Indonesia
Risk of diarrheal diseases nationwide. Cholera outbreaks are sporadically reported in West Papua, and typhoid fever is to be expected. Continue to observe hygiene and vaccination against typhoid fever.
Dengue
Indonesia
By the end of July this year, approximately 79,850 infections and 359 deaths had been reported. By mid-October last year, approximately 203,921 infections had been confirmed nationwide. 1,210 people have died. It is important to ensure very good protection against daytime mosquitoes, and vaccination is recommended.
Entry Requirements
Indonesia
Due to the increasing number of monkeypox cases worldwide, the authorities have adjusted entry requirements. As of August 29, 2024, travelers must complete the electronic health questionnaire at the Ministry of Health (https://sshp.kemkes.go.id/) before entering Indonesia (departure). This will generate a QR code that must be presented upon check-in and entry.
Polio
Indonesia
Last year, seven infections with vaccine-derived poliovirus type 2 (cVDPV2) were reported. In 2023, a total of six infections were confirmed on the islands of Sumatra and Java. A child was already infected on the island of Sumatra in November 2022. This is the first case of polio detected in the country since 2019. The emergence of VDPV makes the country a country with a potential risk of international spread of the pathogen. As a result, all persons (locals and tourists) who have stayed in the country for more than four weeks should be able to show proof of polio vaccination upon departure. The vaccination must be administered between four weeks and one year before departure and documented in an internationally valid vaccination certificate.
Safety Notice
Indonesia
Non-essential travel to five of the six provinces of the Indonesian part of the island of New Guinea (Papua, West Papua, Pegunungan Papua, Central Papua, and South Papua) is discouraged. Some volcanoes in various parts of Indonesia have shown increased activity recently. The Indonesian government’s overview page provides information on the danger levels and current activities of the 127 volcanoes. It is generally recommended to avoid the respective danger zones as far as possible and to inquire about the current danger levels in advance. Large crowds should be avoided and the instructions of the security forces followed. Furthermore, current media reports should be followed during any stay (www.auswaertiges-amt.de).
Ticks
Austria
During the warmer months, there is a risk of tick-borne diseases, including TBE nationwide, which can lead to encephalitis. Take precautions against tick bites. If you are staying in an infected area, vaccination may be recommended after an individual risk assessment.
Safety Notice
South Africa
The South African National Park Service is making every effort to ensure the safety of tourists in and around Kruger National Park and has set up the following helpline for travelers to Mpumalanga Province: +27-(0)6630 0 0991. When traveling to Addo Elephant Park from Port Elizabeth (Gqeberha), it is recommended to avoid using the R335 via Motherwell and instead use the N2 via Colchester. Demonstrations and large gatherings should be avoided at all times, instructions from security forces should be followed, and current media reports should be followed during your stay (www.auswaertiges-amt.de).
Rabies
South Africa
This year, 3 people have died in Limpopo Province and 2 in the Eastern Cape Province, and there was one death in KwaZulu-Natal Province. Last year, 8 deaths were recorded nationwide. In 2023, 12 human cases were confirmed, compared to 13 in 2022. The provinces of Limpopo, KwaZulu-Natal, and the Eastern Cape were particularly affected. A sharp increase in rabid dog cases has been observed nationwide since 2022. Rabies occurs in animals nationwide, affecting jackals, mongooses, cows, unvaccinated dogs, and cats, among others. In 2024, infections were confirmed for the first time in a South African fur seal (Arctocephalus pusillus) in Cape Town. The most common source of infection for humans is dog bites. Immediately seek medical attention in the event of contact with such animals. Preventive vaccination is recommended for those with a foreseeable risk and a longer stay.
Intestinal Infections
Tanzania
Risk of diarrheal diseases nationwide. Localized cholera outbreaks occur regularly. Since September 2023, there have been outbreaks in 23 regions. Maintain careful hygiene and consider vaccination if necessary.
Entry Requirements
Tanzania
Effective October 1, 2024, all visitors to Zanzibar (except residents with Tanzanian residency permits) must purchase mandatory entry insurance from the Zanzibar Insurance Corporation (ZIC) for the duration of their stay (up to 92 days). This insurance can only be purchased through ZIC. Other international travel insurance policies are not accepted. Policies can be purchased starting September 1, 2024. The current cost is USD 44 per person. Further information is available on the Visit Zanzibar website (https://visitzanzibar.go.tz/). Entry may be denied if proof of proper insurance is not provided.
Vaccination Requirements for Entry
Tanzania
The WHO considers the risk of yellow fever infection in Tanzania to be low, and vaccination is not generally recommended. According to the official entry vaccination regulations (ITH 2020), a yellow fever vaccination is required for persons older than 1 year upon entry from endemic areas. Experience has shown that regulations change frequently, and information from various authorities differs. The regulations are sometimes interpreted and applied differently at some airports (Kilimanjaro Airport in Arusha) or by individual border officials. Contrary to official information, a yellow fever vaccination is often required upon entry to Zanzibar. An official statement from the Zanzibar Ministry of Health is published on the website of the Federal Foreign Office.
Security Notice
Tanzania
Non-essential travel to the southern part of the Mtwara region (immediate border region with Mozambique), as well as to the islands and the coastal region south of Kisiju, is discouraged (www.auswaertiges-amt.de).
Intestinal Infections
Thailand
Risk of diarrheal diseases nationwide; small cholera outbreaks are also to be expected locally. Observe good hygiene.
Dengue
Thailand
Since the beginning of this year, approximately 24,370 infections and 22 deaths have been reported. Last year, approximately 102,930 cases and 175 deaths were recorded. In 2023, approximately 159,220 infections and 179 deaths were reported. The provinces of Trat, Nan, Chanthaburi, Rayong, and Mae Hong Son, as well as the capital Bangkok, were particularly affected. It is important to ensure good protection against daytime mosquitoes, and vaccination is recommended.
Melioidosis
Thailand
By the end of July this year, approximately 2,040 infections and 92 deaths had been reported nationwide. The northeast of the country is particularly affected. Percutaneous transmission through small skin wounds can lead to severe illness and sepsis, especially in the elderly and those with weakened immune systems. Observe wound hygiene and avoid contamination of damaged skin with soil and surface water.
Measles
USA
Since the beginning of this year, approximately 760 infections and two deaths have been confirmed in the state of Texas, and approximately 95 in the neighboring state of New Mexico. One adult has died. A total of approximately 1,335 cases have been reported from 40 states. In 2024, 285 cases were recorded nationwide. Before traveling abroad, standard vaccinations should always be checked and updated if necessary.
Pertussis
USA
Last year, approximately 35,000 cases were reported nationwide, the highest number of cases since 2013. Ten people have died. This year, approximately 16,290 infections have been confirmed as of mid-July. Two children each have died in the states of Kentucky and Louisiana. Before traveling abroad, standard vaccinations should always be checked and updated if necessary.
Sun Protection
USA
Since the beginning of 2021, the sale of so-called reef-toxic sunscreens, including products containing oxybenzone (BP3) and octinoxate, has been banned in the state of Hawaii. These substances are suspected of having harmful effects on corals and other marine life.
Avian Flu
USA
In January of this year, a child in San Francisco, California, was confirmed to be infected with influenza A(H5N1). The source of the infection is currently unknown. In mid-February, a woman in Wyoming became ill for the first time. Last year, 70 human cases were reported. Most of the illnesses presented with mild symptoms, such as conjunctivitis and mild flu-like symptoms. Those affected had contact with infected dairy cattle. Contact with poultry or infected wild birds resulted in one death in the state of Louisiana, a patient over 65 years of age. In the US, the outbreak began in birds in 2022, and since then, approximately 1,710 poultry farms (commercial and private) in 50 states have been affected. In 2024, influenza A(H5N1) was first confirmed in dairy cows, affecting approximately 1,075 herds in 17 states.
Intestinal Infections
Vietnam
Risk of diarrheal diseases nationwide; cholera is also endemic. Observe food and drinking water hygiene.
Dengue
Vietnam
According to press reports, the number of cases in Ho Chi Minh City has more than doubled this year. 6 people have died. Since the beginning of this year, approximately 32,000 infections and 5 deaths have been reported nationwide. Last year, approximately 138,345 cases and 26 deaths were recorded nationwide. Very good protection against daytime mosquitoes is important, and vaccination is recommended.
Import Regulations
Vietnam
From January 1, 2025, the import, possession, and use of all electronic cigarettes (including vaporizers, tobacco heaters, etc.) and associated equipment will be prohibited. Fines of up to 3 billion VND (approximately 115,000 euros) or up to 15 years’ imprisonment are possible (www.auswaertiges-amt.de).
Rabies
Vietnam
By the beginning of July, approximately 30 infections had been registered nationwide. Last year, more than 80 deaths were reported nationwide. The provinces of Binh Thuan, Dak Lak, Nghe An, and Gia Lai were particularly affected. In 2023, a total of 82 people died from rabies infection. In case of suspected animal contact, medical attention should be sought immediately. Preventive vaccination is strongly recommended, especially in cases of foreseeable risk and for longer stays. Consultation with a doctor experienced in travel medicine should be sought well in advance of travel.
Avian Flu
Vietnam
In March of last year, an infection with influenza A(H9N2) was reported for the first time in Vietnam. In April of this year, an 8-year-old girl from Tay Ninh Province contracted meningitis. This was the first infection with influenza A(H5N1) this year. After a gap of more than eight years, a 5-year-old girl became ill with an influenza H5 virus in October 2022. She had eaten meat from infected chickens and ducks. In 2024, an 18-year-old man became ill, and a 21-year-old student died. Between 2003 and 2014, a total of 128 people nationwide contracted influenza A(H5N1), resulting in 65 deaths. Corresponding animal contact was documented for all affected individuals. Since 2014, numerous outbreaks have been recorded in domestic poultry nationwide, with more than 129,000 birds culled. At the end of May 2023, an outbreak occurred in Quang Ngai Province, affecting approximately 1,700 infected ducks. Poultry vaccination is widespread in the country. Since 2014, repeated outbreaks of influenza A(H5N6) have been reported in poultry farms. Since the beginning of 2021, three outbreaks have been reported in two provinces. There have been no human cases to date.