North America

North America including USA and Canada is highly developed and a stable democracy with modern economic.

CRIME: United States of America has a high rate of violent crime due to the liberal weapon laws. People may be armed.

MEDICAL FACILITIES: Good medical care is available. Care can be very expensive, and doctors and hospital expect immedieatly payment

Arthropod borne diseases:

West Nile virus has been detected in 43 states across the US and 5 provinces in Canada, from Saskatchewan to Nova Scotia. In the US the only states where it has not been detected are Alaska, Arizona (several cases imported from elsewhere), Hawaii, Idaho (though detected in a raven in a bordering county in Washington), Nevada, Oregon (human case contracted elsewhere) and Utah
Rocky Mountain spotted fever
Tularemia,
St Louis encephalitis
Lyme disease is endemic in the northeastern United States, Mid-Atlantic, and the upper Midwest and the southwestern provinces of Canada. Occasional cases have been reported from the Pacific Northwest.

Water- and foodborne diseases:

ETEC E. coli has increased in some regions
Salmonellosis, has increased in some regions

Other diseases:

none

Vaccination recommendation:

A booster for tetanus/diphtheria - if not covered which indicates not vaccinated within the last 10 years.

In the United States, proof of immunization against diphtheria, measles, poliomyelitis, and rubella is now universally required for entry into school. In addition, the school entry requirements of most states include immunization against tetanus (49 states), pertussis (44 states), mumps (46 states), and hepatitis B (26 states). Haemophilus influenzae type b (Hib) vaccine is not required for school entry but is required in 49 states for attendance in day care facilities.

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