Where are you headed?
19 places Americans fly to between December and April, each rated twice: how likely a mosquito-borne illness is, and how much the biting will bother you. They are not the same thing.
Cuba
CaribbeanThe region's hot spot: dengue far above normal, chikungunya still circulating, and power cuts that switch off the AC.
Read the briefing →Honduras
Mexico & Central AmericaRoatán is famous for sand flies, and CDC recommends malaria prevention medicine for the Bay Islands too, though few cases are reported there.
Travel-clinic note for some areas Briefing in the worksCosta Rica
Mexico & Central AmericaActive CDC Level 2 notice for chikungunya in the northwest, next to Tamarindo; dengue running above last year.
Travel-clinic note for some areas Read the briefing →Dominican Republic
CaribbeanCDC advises malaria pills for the province that includes Punta Cana, even though reported cases there are very low.
Travel-clinic note for some areas Read the briefing →Panama
Mexico & Central AmericaPanama City is calm; Bocas del Toro and San Blas are inside CDC's malaria-pill areas.
Travel-clinic note for some areas Briefing in the worksGuatemala
Mexico & Central AmericaThe highlands around Antigua and Atitlán are low-bite. Tikal and the Petén lowlands carry CDC malaria advice.
Travel-clinic note for some areas Briefing in the worksBarbados
CaribbeanDengue is back to baseline. The beach "sandflies" are biting midges, worst at dawn, dusk and on calm days.
Read the briefing →Belize
Mexico & Central AmericaMalaria-free since 2023 with endemic dengue. Sand flies on the cayes and in Placencia are the daily nuisance.
Briefing in the worksCancún & Riviera Maya
MexicoQuintana Roo's dengue count kept climbing into September, plus local chikungunya. Dusk at lagoon-side resorts and cenotes is the bite window.
Read the briefing →Colombia
South AmericaCartagena, Medellín and Bogotá need no malaria pills, but an active yellow fever notice covers rural areas.
Travel-clinic note for some areas Briefing in the worksMexico
Mexico & Central AmericaCoastal dengue that dips in the dry winter months; Mexico City's altitude keeps it almost bite-free.
Travel-clinic note for some areas Read the briefing →Puerto Rico
CaribbeanCalmer after the 2024–25 dengue epidemic, but this year's cases still put half of patients in hospital.
Read the briefing →Saint Lucia
CaribbeanDengue fell sharply in 2025 after a 2024 outbreak. Rainforest hikes around Soufrière need the most repellent.
Briefing in the worksU.S. Virgin Islands
CaribbeanA 2024–25 dengue outbreak hit all three islands and has since dropped sharply.
Briefing in the worksJamaica
CaribbeanDengue below epidemic levels since 2024. Negril's sunset sand flies are the bigger complaint.
Read the briefing →The Bahamas
CaribbeanLow disease risk. Out Island beaches in the Exumas and Eleuthera are no-see-um country on calm evenings.
Read the briefing →Turks and Caicos Islands
CaribbeanThe 2023–24 dengue outbreak is over. No-see-ums come out about an hour before sunset at Grace Bay.
Briefing in the worksAruba
CaribbeanDry and windy, so mosquitoes are scarce. Expect the odd ankle bite at dawn or dusk on still days.
Read the briefing →Cayman Islands
CaribbeanNo dengue cases reported in 2026 so far. Salt-marsh mosquito swarms are a fall problem, small in winter.
Briefing in the worksCuraçao
CaribbeanQuiet in 2026 and kept in check by the trade winds; dawn and dusk sand flies on sheltered beaches.
Briefing in the worksOther briefings
Summer and shoulder-season destinations we have already covered in depth.
Thailand
Southeast AsiaDengue is year-round from Bangkok to the islands; malaria pills only for rural forest along the border provinces.
Read the briefing →Greece
EuropeMostly a comfort question: dry Cyclades are light work, green islands bite harder, and the mainland has a late-summer West Nile footnote.
Read the briefing →Ireland
EuropeThe biter in Connemara is the midge, not a mosquito, and there is no mosquito-borne disease.
Read the briefing →Netherlands
EuropeNo disease, just unscreened bedrooms on warm summer nights.
Read the briefing →Malaysia
Southeast AsiaDengue is the year-round city risk; malaria only matters for Borneo's interior.
Read the briefing →Portugal
EuropeA comfort question on the mainland, with the day-biting tiger mosquito spreading town by town; Madeira has the dengue mosquito.
Read the briefing →How we rate a destination
Each score describes a typical winter trip (December–April) to the main tourist areas, as of October 2026. Disease risk follows CDC travel notices, PAHO and national surveillance data. Bite nuisance comes from what biting insects do in practice, informed by traveler reports. Where the CDC recommends malaria pills or a vaccine for part of a country, the briefing says so separately and names the areas.
- Negligible: no relevant local transmission
- Low: sporadic dengue, no current notice
- Moderate: dengue present year-round at normal levels
- Elevated: an active CDC Level 2 notice, clearly above-normal activity in tourist areas, or CDC malaria pills for commonly visited areas
- High: documented outbreaks of several diseases in the main tourist areas
- Hardly any bites
- Occasional
- Noticeable at dawn, dusk or in certain spots
- Annoying: repellent is essential at the beach or in the evening
- Notorious: can spoil beach time
This index summarizes public-health guidance and is not medical advice. For malaria prevention and vaccines, see a travel medicine clinic 4–6 weeks before departure.