United States of America
Travel Destination – USA
The United States is a diverse and dynamic destination, offering everything from world-class cities and iconic national parks to vast coastlines and varied climates. Travellers can explore vibrant urban centres such as New York and Los Angeles, experience natural wonders like the Grand Canyon and Yellowstone National Park, or enjoy beach destinations along the Atlantic and Pacific coasts. The USA also boasts rich cultural diversity, shaped by a wide range of communities, landscapes, and regional traditions.
To ensure a safe and enjoyable journey to the United States, appropriate travel health planning is important. While the USA has a highly developed healthcare system, access to medical care and associated costs can vary significantly depending on location, insurance coverage, and the nature of treatment required. Preparing in advance with the right health advice, vaccinations where appropriate, and travel insurance can help travellers stay well and confident throughout their trip.
Health Risks
Pre-travel preparation
Before travelling to the United States, booking an appointment with a travel doctor is strongly recommended. A travel health consultation allows your doctor to review your vaccination history, ensure routine immunisations are up to date, and advise on any destination- or activity-specific vaccines that may be appropriate. Your doctor can also prescribe medications you may need for your trip.
Your travel doctor will provide personalised advice based on your itinerary, whether you are visiting major cities, exploring national parks, travelling between states, or taking part in outdoor or adventure activities. Ideally, schedule your appointment six to eight weeks before departure to allow time for any required vaccinations. However, if your trip is approaching soon, a last-minute consultation can still provide valuable health advice and ensure essential protection before travel.
Insect avoidance
In certain regions of the United States, insects such as mosquitoes and ticks can transmit a range of diseases, including West Nile virus, lyme disease and babesiosis. The risk varies by location, season, and outdoor exposure, but preventing insect bites remains an important health measure for travellers spending time outdoors.
To reduce the risk of bites, wear long-sleeved shirts, long trousers, and closed footwear when outdoors, especially in wooded, grassy, or wet areas. Apply insect repellent containing DEET, picaridin, or oil of lemon eucalyptus to exposed skin. Take extra precautions when camping or hiking. Treating clothing with permethrin can provide an additional layer of protection, particularly against ticks.
Food and water hygiene
Food safety standards in the United States are generally high, but travellers should still take sensible precautions to reduce the risk of gastrointestinal illness, particularly when eating unfamiliar foods or dining in informal settings.
Practise good hand hygiene by washing hands with soap and water before eating, or using an alcohol-based hand sanitiser when handwashing facilities are unavailable. Choose food that is freshly prepared and served hot, and take care with buffet-style or outdoor food where temperature control may be limited.
Rabies prevention
Rabies in the United States is primarily carried by wild mammals. Common carriers include bats, raccoons, skunks, and foxes. Dogs which have not been vaccinated can also carry the disease. Travellers should avoid contact with all wild animals, as well as unfamiliar domestic animals, even if they appear healthy.
A travel doctor can advise whether pre-exposure rabies vaccination is recommended, particularly for travellers who may be involved in outdoor activities, work with animals, explore caves, or spend time in remote areas where access to medical care may be limited.
Any bite, scratch, or contact with saliva from a potentially infected animal requires immediate medical assessment. Rabies is almost always fatal once symptoms develop, making prompt treatment essential.
Our Travel Doctors
Our fully qualified doctors have an interest in travel medicine and immunisations. And they know travel. Their expert advice will be tailored for you, your travel companions and your trip.
Which shots do I need for the USA?
Measles
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Measles is a highly contagious viral illness that continues to cause outbreaks internationally, including in the United States. Travellers are at increased risk of exposure in crowded settings such as airports, public transport, schools, and large events. In Australia, measles transmission is low due to high vaccination coverage; however, overseas exposure remains a key source of infection. All travellers should ensure they are fully vaccinated against measles. Those born during or since 1966 need to have received two documented doses of measles-containing vaccine before travel.
Influenza
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Influenza circulates year-round in the United States, with seasonal peaks that differ from those in Australia. Travellers can be exposed to influenza through close contact in enclosed or crowded environments, particularly during air travel. Annual influenza vaccination is recommended for all travellers aged six months and older, especially those at higher risk of complications, including older adults, pregnant women and those with certain chronic medical conditions.
COVID-19
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COVID-19 continues to circulate globally, including in the United States, with ongoing transmission and periodic surges. International travel increases the risk of exposure due to close contact with others in airports, aircraft, and crowded indoor settings. Travellers are advised to be up to date with COVID-19 vaccination, including recommended booster doses, in line with Australian public health guidance. This includes six-monthly boosters for those aged 75 and over and annual boosters for those aged 65 to 74. Those with underlying health problems may also need booster doses after their initial vaccination. A travel doctor can advise if this is the case for you.
Routine vaccinations
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In addition to routine immunisations, some travellers to the United States may require booster doses or additional vaccines depending on their age, medical history, occupation, and travel activities. A travel health consultation can help determine whether protection against tetanus, diphtheria, and pertussis is up to date, as well as assess the need for vaccines such as hepatitis A, hepatitis B, meningococcal disease, or rabies for those at increased risk. Vaccination recommendations may vary for travellers spending extended periods overseas, visiting remote areas, or engaging in higher-risk activities.
United States
Other health risks in the USA
Gastroenteritis
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Gastroenteritis, often referred to as travellers’ diarrhoea, is less common in the United States than in many other international destinations, due to high food and water safety standards. However, it can still occur, most often from contaminated food or close contact with others. Symptoms such as diarrhoea, nausea, vomiting, and abdominal cramps may develop within 24–72 hours. Maintaining good hydration is the most important treatment, and most cases resolve within a few days. Medical advice should be sought if symptoms are severe, persistent, or unusual. Good hand hygiene and sensible food choices help reduce the risk.
Rabies
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Rabies in the United States is present in wildlife, with bats, raccoons, skunks, and foxes being the most common carriers. Domestic dogs are rarely affected, but travellers should still avoid contact with all wild animals and unfamiliar domestic animals, even if they appear healthy.
A travel doctor can advise whether pre-exposure rabies vaccination is recommended, particularly for travellers working with animals or spending time in remote areas where access to medical care may be limited. Any bite, scratch, or contact with saliva from a potentially infected animal requires immediate medical assessment, as rabies is almost always fatal once symptoms develop.
Lyme disease
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Lyme disease is present in the United States and is transmitted by the bite of infected ticks, particularly in the northeastern, mid-Atlantic, and upper midwestern states. Travellers are at higher risk when spending time in wooded or grassy areas, especially during warmer months. Early symptoms may include fever, fatigue, headache, and a characteristic expanding skin rash, although this rash is not always present. Preventing tick bites by using insect repellent, wearing long clothing, and performing regular tick checks is important, as early diagnosis and treatment significantly reduce the risk of complications.
Dengue and chikungunya
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Dengue and chikungunya are viral infections transmitted by mosquitoes. While rare, local transmission occasionally occurs in parts of the United States, particularly in southern states such as Florida, Texas, and Hawaii. Symptoms can include fever, headache, muscle and joint pain, and fatigue, with chikungunya often causing prolonged joint pain. There are no specific treatments for either infection, making mosquito bite prevention - including the use of insect repellent and protective clothing - a useful health measure for travellers.
Non-infectious conditions
Crime and unrest
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Petty crime such as pickpocketing, bag snatching, and theft can occur in the United States, particularly in large cities and busy tourist areas. Travellers should remain alert in crowded places, keep valuables secure, and be mindful of their surroundings, especially when using public transport or attending large events. Occasional demonstrations may occur and can disrupt travel plans, so it is advisable to avoid protests and follow local authorities’ advice.
Travellers should check Smartraveller for the latest safety advice and updates before and during their trip.
Altitude sickness
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Altitude sickness can occur in the United States for travellers visiting high-altitude destinations such as Colorado, Utah, Wyoming, California, and mountainous national parks, where elevations may exceed 2,400 metres. Acute mountain sickness (AMS) affects around 25% of people who ascend rapidly without adequate acclimatisation. Common symptoms include headache, dizziness, fatigue, nausea, vomiting, and loss of appetite. Symptoms often improve within 12–48 hours if further ascent is paused and time is allowed for acclimatisation.
In more severe cases, altitude illness can progress to high altitude cerebral oedema (HACE), which affects the brain and may cause confusion, disorientation, and altered behaviour, or high altitude pulmonary oedema (HAPE), which affects the lungs and leads to breathlessness, cough, and respiratory distress. These serious conditions are more likely at elevations above 4,300 metres, such as in parts of the Rocky Mountains or the Sierra Nevada, and require immediate descent and urgent medical care, as they can be life-threatening if untreated.
To reduce the risk of altitude illness in the USA, travellers should plan a gradual ascent and avoid rapid elevation gains, particularly when driving or hiking to high-altitude destinations. A travel doctor may advise on preventive or treatment medications when appropriate. Travellers should be familiar with the early warning signs of altitude sickness, avoid sleeping at higher elevations if symptoms are present, and descend if symptoms worsen despite rest. For trekking or climbing at high altitude, travelling with experienced guides is strongly recommended.
Deep vein thrombosis
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Long-haul flights to the United States and extended periods of travel, including road trips, can increase the risk of deep vein thrombosis (DVT). DVT occurs when reduced movement slows blood flow, allowing blood clots to form in deep veins, most commonly in the legs.
To reduce risk, travellers should move around regularly during long flights or drives, perform leg exercises while seated, and stay well hydrated. Travellers with additional risk factors for DVT may benefit from wearing below-knee compression stockings and seeking personalised advice from a travel doctor before departure.