TR AVELING IN THE UNITED STATE S The overall health risks of traveling in the United States are low. There are no vaccination requirements for visitors to the U.S. The high standard of living, high level of sanitation, high vaccination rate and well-organized public health systems contribute to the overall safety of traveling here. Foodborne diseases may occur, but the risk is low. Fresh fruit and vegetables are safe despite rare contamination outbreaks, mostly of salmonella. Seafood poisoning is possible, but the risk is also low. Most seafood poisonings result from imported seafood. Periodic red tide events in Atlantic coastal waters may render locally harvested seafood toxic, but a monitoring system effectively prevents contaminated seafood from being sold. Water in the U.S. is generally safe for drinking with the possible exception of well water in some rural areas that may not be treated or adequately controlled. Vector-borne diseases represent a small to moderate risk. Mosquitos are present all over the U.S., but human reservoirs of mosquito-transmitted diseases are small or nonexistent. Ticks are present throughout the country and may transmit a range of diseases. The most significant tickborne disease is Lyme disease, with 96 percent of reported cases in the Northeast and upper Midwest (around the Great Lakes). The risk of infection is limited
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