Looking the other way: Preventing vector-borne disease among travelers to the United States

Millions of travelers visit the United States every year during warm months when risk of vector-borne disease is highest. The epidemiology and geographic distribution of the principal vector-borne diseases in the United States are reviewed and recommendations for visitors to reduce their risk of disease are described. Travel advice should focus on preventing Lyme disease, anaplasmosis and babesiosis in the northeast and north central States, West Nile virus disease in western plains States, and Rocky Mountain spotted fever and tularemia in the southeast; other diseases and itineraries requiring particular attention are described. All travelers to the United States should be advised to practice personal protection against arthropod bites, including appropriate use of insect repellents, especially when visiting rural and suburban areas during the warm months. (C) 2010 Elsevier Ltd. All rights reserved.