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• Traveler's diarrhea

Gastrointestinal tract

Your digestive tract stretches from your mouth to your anus. It includes the organs necessary to digest food, absorb nutrients and process waste.

Traveler's diarrhea is a digestive tract disorder that commonly causes loose stools and stomach cramps. It's caused by eating contaminated food or drinking contaminated water. Fortunately, traveler's diarrhea usually isn't serious in most people — it's just unpleasant.

When you visit a place where the climate or sanitary practices are different from yours at home, you have an increased risk of developing traveler's diarrhea.

To reduce your risk of traveler's diarrhea, be careful about what you eat and drink while traveling. If you do develop traveler's diarrhea, chances are it will go away without treatment. However, it's a good idea to have doctor-approved medicines with you when you travel to high-risk areas. This way, you'll be prepared in case diarrhea gets severe or won't go away.

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Traveler's diarrhea may begin suddenly during your trip or shortly after you return home. Most people improve within 1 to 2 days without treatment and recover completely within a week. However, you can have multiple episodes of traveler's diarrhea during one trip.

The most common symptoms of traveler's diarrhea are:

• Suddenly passing three or more looser watery stools a day.
• An urgent need to pass stool.
• Stomach cramps.

Sometimes, people experience moderate to severe dehydration, ongoing vomiting, a high fever, bloody stools, or severe pain in the belly or rectum. If you or your child experiences any of these symptoms or if the diarrhea lasts longer than a few days, it's time to see a healthcare professional.

When to see a doctor

Traveler's diarrhea usually goes away on its own within several days. Symptoms may last longer and be more severe if it's caused by certain bacteria or parasites. In such cases, you may need prescription medicines to help you get better.

If you're an adult, see your doctor if:

• Your diarrhea lasts beyond two days.
• You become dehydrated.
• You have severe stomach or rectal pain.
• You have bloody or black stools.
• You have a fever above 102 F (39 C).

While traveling internationally, a local embassy or consulate may be able to help you find a well-regarded medical professional who speaks your language.

Be especially cautious with children because traveler's diarrhea can cause severe dehydration in a short time. Call a doctor if your child is sick and has any of the following symptoms:

• Ongoing vomiting.
• A fever of 102 F (39 C) or more.
• Bloody stools or severe diarrhea.
• Dry mouth or crying without tears.
• Signs of being unusually sleepy, drowsy or unresponsive.
• Decreased volume of urine, including fewer wet diapers in infants.

It's possible that traveler's diarrhea may stem from the stress of traveling or a change in diet. But usually infectious agents — such as bacteria, viruses or parasites — are to blame. You typically develop traveler's diarrhea after ingesting food or water contaminated with organisms from feces.

So why aren't natives of high-risk countries affected in the same way? Often their bodies have become used to the bacteria and have developed immunity to them.

Risk factors

Each year millions of international travelers experience traveler's diarrhea. High-risk destinations for traveler's diarrhea include areas of:

• Central America.
• South America.
• South Asia and Southeast Asia.

Traveling to Eastern Europe, South Africa, Central and East Asia, the Middle East, and a few Caribbean islands also poses some risk. However, your risk of traveler's diarrhea is generally low in Northern and Western Europe, Japan, Canada, Singapore, Australia, New Zealand, and the United States.

Your chances of getting traveler's diarrhea are mostly determined by your destination. But certain groups of people have a greater risk of developing the condition. These include:

• Young adults. The condition is slightly more common in young adult tourists. Though the reasons why aren't clear, it's possible that young adults lack acquired immunity. They may also be more adventurous than older people in their travels and dietary choices, or they may be less careful about avoiding contaminated foods.
• People with weakened immune systems. A weakened immune system due to an underlying illness or immune-suppressing medicines such as corticosteroids increases risk of infections.
• People with diabetes, inflammatory bowel disease, or severe kidney, liver or heart disease. These conditions can leave you more prone to infection or increase your risk of a more-severe infection.
• People who take acid blockers or antacids. Acid in the stomach tends to destroy organisms, so a reduction in stomach acid may leave more opportunity for bacterial survival.
• People who travel during certain seasons. The risk of traveler's diarrhea varies by season in certain parts of the world. For example, risk is highest in South Asia during the hot months just before the monsoons.

Complications

Because you lose vital fluids, salts and minerals during a bout with traveler's diarrhea, you may become dehydrated, especially during the summer months. Dehydration is especially dangerous for children, older adults and people with weakened immune systems.

Dehydration caused by diarrhea can cause serious complications, including organ damage, shock or coma. Symptoms of dehydration include a very dry mouth, intense thirst, little or no urination, dizziness, or extreme weakness.

Watch what you eat

The general rule of thumb when traveling to another country is this: Boil it, cook it, peel it or forget it. But it's still possible to get sick even if you follow these rules.

Other tips that may help decrease your risk of getting sick include:

• Don't consume food from street vendors.
• Don't consume unpasteurized milk and dairy products, including ice cream.
• Don't eat raw or undercooked meat, fish and shellfish.
• Don't eat moist food at room temperature, such as sauces and buffet offerings.
• Eat foods that are well cooked and served hot.
• Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and avocados. Stay away from salads and from fruits you can't peel, such as grapes and berries.
• Be aware that alcohol in a drink won't keep you safe from contaminated water or ice.

Don't drink the water

When visiting high-risk areas, keep the following tips in mind:

• Don't drink unsterilized water — from tap, well or stream. If you need to consume local water, boil it for three minutes. Let the water cool naturally and store it in a clean covered container.
• Don't use locally made ice cubes or drink mixed fruit juices made with tap water.
• Beware of sliced fruit that may have been washed in contaminated water.
• Use bottled or boiled water to mix baby formula.
• Order hot beverages, such as coffee or tea, and make sure they're steaming hot.
• Feel free to drink canned or bottled drinks in their original containers — including water, carbonated beverages, beer or wine — as long as you break the seals on the containers yourself. Wipe off any can or bottle before drinking or pouring.
• Use bottled water to brush your teeth.
• Don't swim in water that may be contaminated.
• Keep your mouth closed while showering.

If it's not possible to buy bottled water or boil your water, bring some means to purify water. Consider a water-filter pump with a microstrainer filter that can filter out small microorganisms.

You also can chemically disinfect water with iodine or chlorine. Iodine tends to be more effective, but is best reserved for short trips, as too much iodine can be harmful to your system. You can purchase water-disinfecting tablets containing chlorine, iodine tablets or crystals, or other disinfecting agents at camping stores and pharmacies. Be sure to follow the directions on the package.

Follow additional tips

Here are other ways to reduce your risk of traveler's diarrhea:

• Make sure dishes and utensils are clean and dry before using them.
• Wash your hands often and always before eating. If washing isn't possible, use an alcohol-based hand sanitizer with at least 60% alcohol to clean your hands before eating.
• Seek out food items that require little handling in preparation.
• Keep children from putting things — including their dirty hands — in their mouths. If possible, keep infants from crawling on dirty floors.
• Tie a colored ribbon around the bathroom faucet to remind you not to drink — or brush your teeth with — tap water.

Other preventive measures

Public health experts generally don't recommend taking antibiotics to prevent traveler's diarrhea, because doing so can contribute to the development of antibiotic-resistant bacteria.

Antibiotics provide no protection against viruses and parasites, but they can give travelers a false sense of security about the risks of consuming local foods and beverages. They also can cause unpleasant side effects, such as skin rashes, skin reactions to the sun and vaginal yeast infections.

As a preventive measure, some doctors suggest taking bismuth subsalicylate, which has been shown to decrease the likelihood of diarrhea. However, don't take this medicine for longer than three weeks, and don't take it at all if you're pregnant or allergic to aspirin. Talk to your doctor before taking bismuth subsalicylate if you're taking certain medicines, such as anticoagulants.

Common harmless side effects of bismuth subsalicylate include a black-colored tongue and dark stools. In some cases, it can cause constipation, nausea and, rarely, ringing in your ears, called tinnitus.

• Feldman M, et al., eds. Infectious enteritis and proctocolitis. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 25, 2021.
• LaRocque R, et al. Travelers' diarrhea: Microbiology, epidemiology, and prevention. https://www.uptodate.com/contents/search. Accessed May 26, 2021.
• Ferri FF. Traveler diarrhea. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed April 28, 2023.
• Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. Accessed April 27, 2023.
• Travelers' diarrhea. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/yellowbook/2020/preparing-international-travelers/travelers-diarrhea. Accessed April 28, 2023.
• LaRocque R, et al. Travelers' diarrhea: Clinical manifestations, diagnosis, and treatment. https://www.uptodate.com/contents/search. Accessed May 26, 2021.
• Khanna S (expert opinion). Mayo Clinic. May 29, 2021.
• Elsevier Point of Care. Clinical Overview: Traveler's diarrhea. https://www.clinicalkey.com. Accessed Oct. 17, 2024.

News from Mayo Clinic

• Mayo Clinic Minute: Preventing traveler's diarrhea July 19, 2024, 04:30 p.m. CDT
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CDC cautions travelers to Mexico about Rocky Mountain spotted fever

The Centers for Disease Control and Prevention is warning people who are traveling to the Baja California region of Mexico to watch out for ticks that could spread Rocky Mountain spotted fever.

The travel advisory, issued Friday , comes after a person from San Diego died from the disease. The person had traveled to Baja California before becoming sick, according to San Diego County public health officials . No other information is known about the patient. The last time someone died in San Diego from the tick-borne disease was in 2014, officials said.

In its notice posted online, the CDC said it has received reports of Rocky Mountain spotted fever in travelers to the U.S. from Baja California, though it was unclear how many people have been sickened. The travel notice did not recommend that Americans avoid traveling to Mexico or reconsider plans to travel to the area.

While several types of ticks can spread Rocky Mountain spotted fever in different parts of the country, the brown dog tick is responsible for the illness in the southwestern U.S. and in Mexico and is found there year-round. Dogs often carry the infected ticks.

Other types of ticks around the nation may also be active during the winter because of warming global temperatures. Ticks can also spread Lyme disease and alpha-gal syndrome , which causes an allergy to red meat.

Symptoms of Rocky Mountain spotted fever include:

• Severe headache
• Muscle pain
• Nausea or vomiting
• Swelling around the eyes or on the back of hands
• Small, flat, reddish spots may pop up on the arms and legs before spreading to the trunk. The rash is not known to be itchy.

It is not spread from person to person.

Quick treatment is critical. The CDC said that the disease can kill within five days after the tick bite unless it’s treated with antibiotics.

Health officials in San Diego recommend using insect repellent and checking for ticks, including pets, after outdoor activities.

"If a person develops a rash or fever after being bitten, they should see a doctor, tell them about the tick bite, when they were bitten, and where they think it happened," the officials wrote online.

Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

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Mexico Travel Advisory

Travel advisory september 6, 2024, mexico - see state summaries.

Reissued after periodic review with updates for Chiapas, and Durango.

Country Summary:  Violent crime – such as homicide, kidnapping, carjacking, and robbery – is widespread and common in Mexico. The U.S. government has limited ability to provide emergency services to U.S. citizens in many areas of Mexico, as travel by U.S. government employees to certain areas is prohibited or restricted. In many states, local emergency services are limited outside the state capital or major cities.

U.S. citizens are advised to adhere to restrictions on U.S. government employee travel. State-specific restrictions are included in the individual state advisories below. U.S. government employees may not travel between cities after dark, may not hail taxis on the street, and must rely on dispatched vehicles, including app-based services like Uber, and regulated taxi stands. U.S. government employees should avoid traveling alone, especially in remote areas. U.S. government employees may not drive from the U.S.-Mexico border to or from the interior of Mexico, except daytime travel within Baja California and between Nogales and Hermosillo on Mexican Federal Highway 15D, between Nuevo Laredo and Monterrey on Highway 85D and between Ciudad Juarez and interior cities as noted in the Chihuahua section. Read the  country information page  for additional information on travel to Mexico.

Do Not Travel To:

• Colima state  due to  crime  and  kidnapping .
• Guerrero state  due to  crime .
• Michoacan state  due to  crime .
• Sinaloa state due to  crime .
• Tamaulipas state  due to  crime  and  kidnapping.
• Zacatecas  state due to  crime  and  kidnapping .

Reconsider Travel To:

• Baja California  state due to  crime  and  kidnapping .
• Chiapas state  due to  crime .
• Chihuahua state  due to  crime  and  kidnapping .
• Guanajuato state  due to  crime .
• Jalisco state  due to  crime  and  kidnapping .
• Morelos state  due to  crime  and  kidnapping .
• Sonora state  due to  crime  and  kidnapping .

Exercise Increased Caution When Traveling To:

• Aguascalientes  state due to  crime .
• Baja California Sur state  due to  crime .
• Coahuila state  due to  crime .
• Durango state  due to  crime .
• Hidalgo state  due to  crime .
• Mexico City  due to  crime .
• Mexico State  due to  crime and kidnapping .
• Nayarit state  due to  crime .
• Nuevo Leon  state due to  crime .
• Oaxaca state  due to  crime .
• Puebla state  due to  crime  and  kidnapping .
• Queretaro state  due to  crime .
• Quintana Roo state  due to  crime .
• San Luis Potosi state  due to  crime and kidnapping .
• Tabasco state  due to  crime .
• Tlaxcala state due to  crime .
• Veracruz state  due to  crime .

Exercise Normal Precautions When Traveling To:

• Campeche state
• Yucatan state

Visit our website for  Travel to High-Risk Areas .

If you decide to travel to Mexico:

• Keep traveling companions and family back home informed of your travel plans. If separating from your travel group, send a friend your GPS location. If taking a taxi alone, take a photo of the taxi number and/or license plate and text it to a friend.
• Use toll roads when possible and avoid driving alone or at night. In many states, police presence and emergency services are extremely limited outside the state capital or major cities.
• Exercise increased caution when visiting local bars, nightclubs, and casinos.
• Do not display signs of wealth, such as wearing expensive watches or jewelry.
• Be extra vigilant when visiting banks or ATMs.
• Enroll in the  Smart Traveler Enrollment Program (STEP)  to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on  Facebook  and  X/Twitter .
• Follow the U.S. Embassy on Facebook and X/Twitter .
• Review the  Country Security Report  for Mexico.
• Mariners planning travel to Mexico should check for U.S. maritime  advisories  and  alerts , which include instructions on reporting suspicious activities and attacks to Mexican naval authorities.
• Prepare a contingency plan for emergency situations. Review the  Traveler’s Checklist .
• Visit the CDC page for the latest travel health information related to your travel. 

Aguascalientes state – Exercise Increased Caution

Exercise increased caution due to crime.

Criminal activity and violence may occur throughout the state.

There are no restrictions on travel for U.S. government employees in Aguascalientes state.

Baja California state – Reconsider Travel

Reconsider travel due to crime and kidnapping.

Transnational criminal organizations compete in the border area to establish narco-trafficking and human smuggling routes. Violent crime and gang activity are common. Travelers should remain on main highways and avoid remote locations. Of particular concern is the high number of homicides in the non-tourist areas of Tijuana. Most homicides appeared to be targeted; however, criminal organization assassinations and territorial disputes can result in bystanders being injured or killed. U.S. citizens and LPRs have been victims of kidnapping.

U.S. government employees must adhere to the noted restrictions:

• Mexicali Valley:  U.S. government employees should avoid the Mexicali Valley due to the heightened possibility of violence between rival cartel factions.  The boundaries of the restricted area are: to the east, the Baja California/Arizona and Baja California/Sonora borders; to the south, from La Ventana (on Highway 5) due east to the Colorado River; to the west, Highway 5; and to the north, Boulevard Lazaro Cardenas/Highway 92/Highway 1 to Carretera Aeropuerto, from the intersection of Highway 1 and Carretera Aeropuerto due north to the Baja California/California border, and from that point eastward along the Baja California/California border.
• Travelers may use Highways 2 and 2D to transit between Mexicali, Los Algodones, and San Luis Rio Colorado during daylight hours. Travelers may also use Highways 1 and 8 to transit to and from the Mexicali Airport during daylight hours.  Travel on Highway 5 is permissible during daylight hours.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas There are no other travel restrictions for U.S. government employees in Baja California state. These include high-traffic tourism areas of border and coastal communities, such as  Tijuana ,  Ensenada , and  Rosarito .

Baja California Sur state – Exercise Increased Caution

There are no restrictions on travel for U.S. government employees in Baja California Sur state.

Campeche state – Exercise Normal Precautions

Exercise normal precautions.

There are no restrictions on travel for U.S. government employees in Campeche state.

Chiapas state – Reconsider Travel

Reconsider travel due to crime.

U.S. government employees may not travel to the municipality of Ocozocoautla and to the following restricted areas in the southeastern region. All areas within the boundaries, including highway and roads unless specifically exempted, are restricted. East-Northeast Boundary: the eastern boundary follows the Mexican-Guatemalan border from the southern point on the Pacific coast, along the border, to the northern end point east of Netzahualcóyotl. Northern Boundary: from Netzahualcóyotl in a straight line southwest towards the northern limit of Ocosingo. Western Boundary: from Ocosingo in a straight-line south to El Ocote, from El Ocote in a straight-line west to San Francisco Pujiltic, from San Franciso Pujiltic southwest to just north of Mapastepec. South-Southwest Boundary: Highway 200 from Mapastepec to Tapachula. All towns along this highway are not restricted. The area to the north of highway 200 defines the southern boundary of the restricted area. From Tapachula, the restricted area boundary is north and east of the city limits and then extends southeast to the Pacific coast at Tres Hermanos San Isidro.

 U.S. government employees may travel to Tapachula within the city limits and on Highway 225, from Port Chiapas to Tapachula, including the Tapachula Airport.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas

Chihuahua state – Reconsider Travel

Violent crime and gang activity are common. Most homicides are targeted assassinations against members of criminal organizations. Battles for territory between criminal groups have resulted in violent crime in areas frequented by U.S. citizens and U.S. government employees, including restaurants and malls during daylight hours. Bystanders have been injured or killed in shooting incidents. U.S. citizens and LPRs have been victims of kidnapping.

U.S. government employee travel is limited to the following areas with the noted restrictions:

• Ciudad Juarez:  U.S. government employees may travel to the area of Ciudad Juarez bounded to the east by Bulevar Independencia; to the south by De los Montes Urales/Avenida Manuel J Clouthier/Carretera de Juárez; to the west by Via Juan Gabriel/Avenida de los Insurgentes/Calle Miguel Ahumada/Francisco Javier Mina/Melchor Ocampo; and to the north by the U.S.-Mexico border.  Direct travel to the Ciudad Juarez airport (officially called the Abraham González International Airport) and the factories located along Bulevar Independencia and Las Torres is permitted.  Travel to San Jerónimo is permitted only through the United States via the Santa Teresa U.S. Port of Entry; travel via Anapra is prohibited.

U.S. government employees may only travel from Ciudad Juarez to the city of Chihuahua during daylight hours via Federal Highway 45, with stops permitted only at the Guardia Nacional División Caminos station, the Umbral del Milenio overlook area, the border inspection station at KM 35, and the shops and restaurants on Federal Highway 45 in the city of Ahumada.

• U.S. government employees may travel between Ciudad Juarez and Ascension via Highway 2.
• Nuevo Casas Grandes Area (including Nuevo Casas Grandes, Casas Grandes, Mata Ortiz, Colonia Juárez, Colonia LeBaron, Paquimé and San Buenaventura):  U.S. government employees may travel to the Nuevo Casas Grandes area during daylight hours via Mexico Federal Highway 2, and subsequently Federal Highway 10, to Nuevo Casas Grandes.  Employees are permitted to stay overnight in the cities of Nuevo Casas Grandes and Casas Grandes only.
• City of Chihuahua:  U.S. government employees may travel at any time to the area of the city of Chihuahua bounded to the north by Avenida Transformación; to the east by Avenida Tecnológico/Manuel Gómez Morín/Highway 16/Blvd.José Fuentes Mares; to the west by the city boundary; and to the south by Periférico Francisco R. Almada.
• U.S. government employees may travel on Highways 45, 16, and 45D through the city of Chihuahua and to the Chihuahua airport (officially called the General Roberto Fierro Villalobos International Airport). 
• U.S. government employees may travel to Santa Eulalia to the east of the city of Chihuahua, as well as to Juan Aldama via Highway 16 to the northeast.
• U.S. government employees may travel south of the city of Chihuahua on Highway 45 to the southern boundary of Parral, including each town directly connected to Highway 45, including Lázaro Cárdenas, Pedro Meoqui, Santa Cruz de Rosales, Delicias, Camargo, Ciudad Jiménez, and Parral itself.
• U.S. government employees may only travel on official business from the city of Chihuahua on Highway 16 to Ciudad Cuauhtémoc bounded by Highway 21 to the north and east, Highway 5 to the west, and Bulevar Jorge Castillo Cabrera to the south. 
• Ojinaga:  U.S. government employees must travel to Ojinaga via U.S. Highway 67 and enter through the U.S. Port of Entry in Presidio, Texas.
• Palomas:  U.S. government employees may travel to Palomas via U.S. highways through the U.S. Port of Entry in Columbus, New Mexico, or via Highway 2 in Mexico.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas U.S. government employees may not travel to other areas of Chihuahua, including  Copper Canyon .

Coahuila state – Exercise Increased Caution

Violent crime and gang activity occur in parts of Coahuila state. 

U.S. government employees must adhere to the following travel restrictions:

• Zaragoza, Morelos, Allende, Nava, Jimenez, Villa Union, Guerrero, and Hidalgo municipalities : U.S. government employees may not travel to these municipalities.
• Piedras Negras and Ciudad Acuña:  U.S. government employees must travel directly from the United States and observe a curfew from midnight to 6:00 a.m. in both cities.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas There are no other restrictions on travel for U.S. government employees in Coahuila state.

Colima state – Do Not Travel

Do not travel due to crime and kidnapping.  

Violent crime and gang activity are widespread. Most homicides are targeted assassinations against members of criminal organizations. Shooting incidents between criminal groups have injured or killed bystanders. U.S. citizens and LPRs have been victims of kidnapping.  

Travel for U.S. government employees is limited to the following areas with noted restrictions: 

• Manzanillo:   U.S. government employee travel is limited to the tourist and port areas of Manzanillo.  
• Employees traveling to Manzanillo from Guadalajara must use Federal Toll Road 54D during daylight hours.  

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas U.S. government employees may not travel to other areas of Colima state. 

Durango state – Exercise Increased Caution

Violent crime and gang activity are common in parts of Durango state.

• West and south of Federal Highway 45:  U.S. government employees may not travel to this region of Durango state.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas There are no other restrictions on travel for U.S. government employees in Durango state.

Guanajuato state – Reconsider Travel

Gang violence, often associated with the theft of petroleum and natural gas from the state oil company and other suppliers, occurs in Guanajuato, primarily in the south and central areas of the state. Of particular concern is the high number of murders in the southern region of the state associated with cartel-related violence. U.S. citizens and LPRs have been victims of kidnapping.

• Areas south of Federal Highway 45D:  U.S. government employees may not travel to the area south of and including Federal Highway 45D, Celaya, Salamanca, and Irapuato.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas There are no other restrictions on travel for U.S. government employees in Guanajuato state, which includes tourist areas in:  San Miguel de Allende ,  Guanajuato City , and  surrounding areas.

Guerrero state – Do Not Travel

Do not travel due to crime.

Crime and violence are widespread. Armed groups operate independently of the government in many areas of Guerrero. Members of these groups frequently maintain roadblocks and may use violence towards travelers. U.S. citizens and LPRs have been victims of kidnapping in previous years.

U.S. government employees may not travel to any area in the state of Guerrero, including to tourist areas in  Acapulco ,  Zihuatanejo , Taxco , and  Ixtapa .

Hidalgo state – Exercise Increased Caution

There are no restrictions on travel for U.S. government employees in Hidalgo state.

Jalisco state – Reconsider Travel

Violent crime and gang activity are common in parts of Jalisco state. In Guadalajara, territorial battles between criminal groups take place in tourist areas. Shooting incidents between criminal groups have injured or killed innocent bystanders. U.S. citizens and LPRs have been victims of kidnapping.

• Jalisco-Michoacan border and Federal Highway 110:  U.S. government employees may not travel to the area between Federal Highway 110 and the Jalisco-Michoacan border, nor travel on Federal Highway 110 between Tuxpan, Jalisco, and the Michoacan border.
• Federal Highway 80:  U.S. government employees may not travel on Federal Highway 80 south of Cocula.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas There are no other restrictions on travel for U.S government employees in Jalisco state which includes tourist areas in:  Guadalajara Metropolitan Area ,  Puerto Vallarta (including neighboring Riviera Nayarit) ,  Chapala , and  Ajijic .

Mexico City (Ciudad de Mexico) – Exercise Increased Caution

Both violent and non-violent crime occur throughout Mexico City. Use additional caution, particularly at night, outside of the frequented tourist areas where police and security patrol more routinely. Petty crime occurs frequently in both tourist and non-tourist areas.

There are no restrictions on travel for U.S. government employees in Mexico City.

Mexico State (Estado de Mexico) – Exercise Increased Caution

Exercise increased caution due to crime and kidnapping.

Both violent and non-violent crime occur throughout Mexico State. Use additional caution in areas outside of the frequented tourist areas, although petty crime occurs frequently in tourist areas as well. U.S. citizens and LPRs have been victims of kidnapping. There are no restrictions on travel for U.S. government employees in Mexico State.

Michoacan state – Do Not Travel

Do not travel due to crime and kidnapping.

Crime and violence are widespread in Michoacan state. Travel for U.S. government employees is limited to the following areas with the noted restrictions:

• Federal Highway 15D:   U.S. government employees may travel on Federal Highway 15D to transit the state between Mexico City and Guadalajara.
• Morelia:  U.S. government employees may travel by air and by land using Federal Highways 43 or 48D from Federal Highway 15D.
• Lazaro Cardenas:  U.S. government employees must travel by air only and limit activities to the city center or port areas.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas U.S. government employees may not travel to other areas of the state of Michoacan, including the portions of the  Monarch Butterfly Reserve  located in Michoacan.

Morelos state – Reconsider Travel

Reconsider travel due to crime and kidnapping.

Violent crime and gang activity are common in parts of Morelos state. U.S. citizens and LPRs have been victims of kidnapping.

There are no restrictions on travel for U.S. government employees in Morelos state.

Nayarit state – Exercise Increased Caution

Criminal activity and violence may occur throughout Nayarit state.

There are no restrictions on travel for U.S government employees in Nayarit state.

Nuevo Leon state – Exercise Increased Caution

Criminal activity and violence may occur throughout the state. There are no restrictions on travel for U.S. government employees in Nuevo Leon state.

Oaxaca state – Exercise Increased Caution

Criminal activity and violence occur throughout the state.

U.S. travelers are reminded that U.S. government employees must adhere to the following travel restrictions:

• Isthmus region:  U.S. government employees may not travel to the area of Oaxaca bounded by Federal Highway 185D to the west, Federal Highway 190 to the north, and the Oaxaca-Chiapas border to the east.  This includes the cities of Juchitan de Zaragoza, Salina Cruz, and San Blas Atempa.  
• Federal Highway 200 northwest of Pinotepa:  U.S. government employees may not use Federal Highway 200 between Pinotepa and the Oaxaca-Guerrero border.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas There are no restrictions on travel for U.S. government employees to other parts of Oaxaca state, which include tourist areas in:  Oaxaca City ,  Monte Alban ,  Puerto Escondido,  and  Huatulco .

Puebla state – Exercise Increased Caution

Exercise increased caution due to crime and kidnapping.

Criminal activity and violence may occur throughout the state. U.S. citizens and LPRs have been victims of kidnapping.

There are no restrictions on travel for U.S. government employees in Puebla state.

Queretaro state – Exercise Increased Caution

There are no restrictions on travel for U.S. government employees in Queretaro state.

Quintana Roo state – Exercise Increased Caution

Criminal activity and violence may occur in any location, at any time, including in popular tourist destinations. While not directed at tourists, shootings between rival gangs have injured and killed innocent bystanders, including U.S. citizens. Violent crime, including homicides and assaults, has increased in Tulum.

There are no restrictions on travel for U.S. government employees in Quintana Roo state. Exercise increased caution after dark in Cancun, Playa del Carmen, and Tulum and remain in well-lit pedestrian streets and tourist zones.

San Luis Potosi state – Exercise Increased Caution

There are no restrictions on travel for U.S. government employees in San Luis Potosi state.

Sinaloa state – Do Not Travel

Violent crime is widespread. Criminal organizations are based in and operating in Sinaloa.

Travel for U.S. government employees is limited to the following areas with the noted restrictions:

• Mazatlan:  U.S. government employees may travel to Mazatlan by air or sea only, are limited to the Zona Dorada and historic town center, and must travel via direct routes between these destinations and the airport and sea terminal.
• Los Mochis and Topolobampo:  U.S. government employees may travel to Los Mochis and Topolobampo by air or sea only, are restricted to the city and the port, and must travel via direct routes between these destinations and the airport.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas U.S. government employees may not travel to other areas of Sinaloa state.

Sonora state – Reconsider Travel

Sonora is a key location used by the international drug trade and human trafficking networks. Violent crime is widespread. U.S. citizens and LPRs have been victims of kidnapping. Travelers should maintain a heightened level of awareness of their surroundings in all their travels in Sonora.  Security incidents may occur in any area of Sonora.

• Travel between Hermosillo and Nogales:  U.S. government employees may travel between the U.S. Ports of Entry in Nogales and Hermosillo during daylight hours via Federal Highway 15 only. U.S. government employees may not use ANY taxi services, public buses, nor ride-share applications due to a lack of secure vetting and/or dispatching procedures. Travelers should exercise caution and avoid unnecessary stops as security incidents, including sporadic, armed carjackings, and shootings have been reported along this highway during daylight hours. Travelers should have a full tank of gas and inform friends or family members of their planned travel.
• Nogales:  U.S. government employees may not travel in the triangular area north of Avenida Tecnologico, west of Bulevar Luis Donaldo Colosio (Periferico), and east of Federal Highway 15D (Corredor Fiscal) and the residential areas to the east of Calle Plutarco Elias. U.S. government employees may not use any taxi services, public buses, nor ride-share applications in Nogales.
• Puerto Peñasco:  U.S. government employees may travel between Puerto Peñasco and the Lukeville-Sonoyta U.S. Port of Entry during daylight hours via Federal Highway 8 only. They may not travel on any other route to Puerto Peñasco. U.S. government employees may not use ANY taxi services, public buses, nor ride-share applications in Puerto Peñasco. due to a lack of secure vetting and/or dispatching procedures and the danger of kidnapping and other violent crimes.
• Triangular region near Mariposa U.S. Port of Entry:  U.S. government employees may not travel into or through the triangular region west of the Mariposa U.S. Port of Entry, east of Sonoyta, and north of Altar municipality.
• San Luis Rio Colorado, Cananea, and Agua Prieta : U.S. government employees may travel directly from the nearest U.S. Port of Entry to San Luis Rio Colorado, Cananea (via Douglas Port of Entry), and Agua Prieta, but may not go beyond the city limits. Travel is limited to daylight hours only. Travel between Nogales and Cananea via Imuris is not permitted. U.S. government employees may not use ANY taxi services, public buses, nor ride-share applications in these cities due to a lack of secure vetting and/or dispatching procedures and the danger of kidnapping and other violent crimes.
• Eastern and southern Sonora (including San Carlos Nuevo Guaymas and Alamos):  U.S. government employees may not travel to areas of Sonora east of Federal Highway 17, the road between Moctezuma and Sahuaripa, and State Highway 20 between Sahuaripa and the intersection with Federal Highway 16. U.S. government employees may travel to San Carlos Nuevo Guaymas and Alamos; travel to Alamos is only permitted by air and within city limits.  U.S. government employees may not travel to areas of Sonora south of Federal Highway 16 and east of Federal Highway 15 (south of Hermosillo), as well as all points south of Guaymas, including Empalme, Guaymas, Obregon, and Navojoa.  U.S. government employees may not use ANY taxi services, public buses, nor ride-share applications in these areas due to a lack of secure vetting and/or dispatching procedures and the danger of kidnapping and other violent crimes.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas U.S. government employees may travel to other parts of Sonora state in compliance with the above restrictions, including tourist areas in: Hermosillo , Bahia de Kino , and Puerto Penasco .

Tabasco state – Exercise Increased Caution

There are no restrictions on travel for U.S. government employees in Tabasco state.

Tamaulipas state – Do Not Travel

Organized crime activity – including gun battles, murder, armed robbery, carjacking, kidnapping, forced disappearances, extortion, and sexual assault – is common along the northern border and in Ciudad Victoria. Criminal groups target public and private passenger buses, as well as private automobiles traveling through Tamaulipas, often taking passengers and demanding ransom payments.

Heavily armed members of criminal groups often patrol areas of the state and operate with impunity particularly along the border region from Reynosa to Nuevo Laredo. In these areas, local law enforcement has limited capacity to respond to incidents of crime. Law enforcement capacity is greater in the tri-city area of Tampico, Ciudad Madero, and Altamira, which has a lower rate of violent criminal activity compared to the rest of the state. U.S. citizens and LPRs have been victims of kidnapping. U.S. citizens and LPRs have been victims of kidnapping.

• Matamoros and Nuevo Laredo:  U.S. government employees may only travel within a limited radius around and between the U.S. Consulates in Nuevo Laredo and Matamoros, their homes, the respective U.S. Ports of Entry, and limited downtown sites, subject to an overnight curfew.
• Overland travel in Tamaulipas:  U.S. government employees may not travel between cities in Tamaulipas using interior Mexican highways. Travel between Nuevo Laredo and Monterrey is limited to Federal Highway 85D during daylight hours with prior authorization.

To view a map of the restricted areas, visit https://mx.usembassy.gov/maps-of-restricted-areas U.S. government employees may not travel to other parts of Tamaulipas state.

Tlaxcala state – Exercise Increased Caution

There are no restrictions on travel for U.S. government employees in Tlaxcala state.

Veracruz state – Exercise Increased Caution

Violent crime and gang activity occur with increasing frequency in Veracruz, particularly in the center and south near Cordoba and Coatzacoalcos. While most gang-related violence is targeted, violence perpetrated by criminal organizations can affect bystanders. Impromptu roadblocks requiring payment to pass are common. There are no restrictions on travel for U.S. government employees in Veracruz state.

Yucatan state – Exercise Normal Precautions

There are no restrictions on travel for U.S. government employees in Yucatan state, which include tourist areas in:  Chichen Itza ,  Merida ,  Uxmal , and  Valladolid .

Zacatecas state – Do Not Travel

Violent crime, extortion, and gang activity are widespread in Zacatecas state. U.S. citizens and LPRs have been victims of kidnapping.

• Zacatecas City : U.S. government employee travel is limited to Zacatecas City proper, and employees may not travel overland to Zacatecas City.
• U.S. government employees may not travel to other areas of Zacatecas state.

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Watch CBS News

CDC warns travelers to Mexico's Baja California of exposure to deadly Rocky Mountain spotted fever

By Simrin Singh

December 8, 2023 / 10:09 PM EST / CBS News

The U.S. Centers for Disease Control and Prevention is warning travelers to Baja California, Mexico, about Rocky Mountain spotted fever, a potentially fatal bacterial disease that spreads through the bite of an infected brown dog tick, which can be carried by pets. 

The warning comes after a San Diego, California, resident who traveled to Baja California died last month after contracting the disease, San Diego County Public Health Services reported . 

In addition to Baja California, RMSF has been found in the Mexican states of Sonora, Chihuahua, Coahuila and Nuevo León.

In the level 1 travel advisory issued Friday, the CDC urged travelers who develop symptoms of RMSF during travel, or within two weeks of returning to the U.S., to seek medical attention.

Symptoms of RMSF include fever, headache, and rash, which can develop two to four days after the onset of symptoms, according to the CDC. 

The disease can progress quickly in infected patients and can become deadly if not treated early with the antibiotic doxycycline. Children under 10 years of age are five times more likely to die from RMSF, the CDC said.

San Diego County public health officials said the last time someone from San Diego died from RMSF was in 2014.

• Centers for Disease Control and Prevention
• CDC Guidelines
• Travel Warning

Simrin Singh is a social media producer and trending content writer for CBS News.

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