Travel Health Guide: Italy — West Nile Virus, Sicilian Dengue, Summer Heat, Etna and Campi Flegrei, and What Most American Travelers Underestimate

American travelers do not prepare for Italy the way they prepare for Kenya or Peru, and that mismatch is exactly what gets people into trouble. In my urgent care practice I see the same returning-tourist diagnoses every summer: heat exhaustion from a midday Colosseum tour, scooter road rash from the Amalfi Coast, a tick bite from a Dolomites hike, and the occasional febrile traveler back from a Po Valley wedding who turns out to have West Nile virus. Italy in 2026 is not a tropical-disease destination, but it is no longer the low-risk Mediterranean stop it used to be. Below is what roughly 5 million Americans visiting Italy each year actually need to plan for.

Most healthy American travelers to Italy do not need exotic vaccines or malaria pills. You do need to be current on routine immunizations (especially MMR, since Italy reported 1,055 measles cases in 2024 and 532 in 2025 per ISS surveillance), hepatitis A (universally recommended by the CDC for Italy), influenza, and Tdap. Beyond the needle list, the dominant 2026 risks are mosquito-borne: 740 confirmed West Nile virus cases including 68 deaths across 75 Italian provinces in 2025, 384 autochthonous chikungunya cases concentrated in Emilia-Romagna and Veneto, and an unprecedented 199-case autochthonous dengue outbreak in Marche in late 2024. Layer on summer heat (Italy logged the highest heat-related death toll in Europe in 2024 at roughly 19,000), active Mount Etna and Campi Flegrei seismicity, tick-borne encephalitis in the northeast, and Vespa or scooter trauma on coastal roads. Pack DEET 30%, electrolytes, an antibiotic for traveler's diarrhea, and proof of MMR immunity.

Quick Facts

• Region: Southern Europe (Mediterranean), EU and Schengen Area member
• CDC Risk Level: Level 1 (Practice Usual Precautions) plus active "Measles in the Globe" Level 1 Travel Health Notice
• Key Health Risks: Measles, West Nile virus, autochthonous dengue and chikungunya, heat illness, tick-borne encephalitis (northeast), volcanic and seismic events (Sicily, Campania), road trauma, marine envenomations
• Recommended Vaccines: MMR, hepatitis A, Tdap, polio, varicella, influenza; selective hepatitis B, tick-borne encephalitis, rabies; chikungunya for select itineraries
• Antimalarials Needed: No, Italy is malaria-free
• Yellow Fever Required: No (only required if arriving from a yellow fever risk country)
• Travel Insurance Recommended: Yes, especially for older travelers, scooter and ATV itineraries, hikers, and divers

Why Italy Surprises American Travelers

Italy looks like a destination you can prepare for with a credit card and a passport. For a decade that was mostly true. What changed is the mosquito map. Climate-driven expansion of Aedes albopictus and Culex pipiens has shifted Italy from "occasional outbreak" to "annual transmission" for West Nile virus, and pushed dengue and chikungunya into northern and central regions that had never seen autochthonous cases. On top of that, the 2024 European heat dome killed more people in Italy than in any other European country, Mount Etna entered an extended eruption cycle that has closed Catania airport multiple times since August 2024, and the Campi Flegrei caldera near Naples is producing the largest earthquakes the area has seen in 40 years. Italy is still safe. It is just a more complicated trip than your parents took.

The good news: you can prevent most of what would land you in an Italian emergency department with a small kit, a few well-timed vaccines, and a plan for shade and water between noon and 4 p.m.

Vaccines for Italy

Measles, mumps, and rubella (MMR), non-negotiable in 2026

The CDC's "Measles in the Globe" Level 1 Travel Health Notice is active for international travel, including to Italy. According to Italy's Istituto Superiore di Sanità (ISS), Italy reported 1,055 measles cases in 2024, 532 in 2025, and another 84 in January 2026 alone, with sustained transmission of genotype B3 in and around Milan. Two doses of MMR at least 28 days apart are required for adequate evidence of immunity for travelers 12 months and older. Adults born in 1957 or later who cannot document two doses should get caught up before travel. Internal link: MMR vaccine for travelers.

Hepatitis A, universally recommended

The CDC universally recommends hepatitis A for travelers to Italy because food and water exposure (especially shellfish in coastal southern Italy and Sicily) carries enough risk to justify protection. A single pre-departure dose of inactivated hepatitis A vaccine produces protective antibodies in roughly 95% of adults within 2 to 4 weeks. If you have never had the series, get one dose now and the second dose 6 to 18 months later. Internal link: Hepatitis A vaccine for travelers.

Tdap, polio, varicella, influenza

These four routine vaccines remain on the recommended list for Italy in 2026. Tdap protects against tetanus from cuts, scrapes, animal exposures, and the road rash that scooter riders pick up on Amalfi Coast guardrails. The CDC also recommends a once-in-a-lifetime adult polio booster for international travelers given continued WHO Public Health Emergency of International Concern designation for poliovirus. Influenza vaccination is recommended year-round for travelers because flu peaks in Italy's October-to-April winter and can still circulate in summer Mediterranean cruise crowds. Internal links: Tdap vaccine for travelers, polio vaccine for travelers, influenza vaccine for travelers.

Hepatitis B, selective

Selective for travelers with potential blood or body fluid exposure (medical or dental procedures while abroad, sexual activity with new partners, tattoos, piercings) and for long-stay travelers. The 2-dose Heplisav-B accelerated schedule (0 and 1 month) gets you about 95% protection in 5 weeks. Internal link: Hepatitis B vaccine for travelers.

Tick-borne encephalitis (TBE), northeast Italy only

TBE virus circulates in the forested and mountainous regions of Friuli Venezia Giulia, Veneto, and Trentino-Alto Adige. Italian surveillance recorded 63 TBE cases in 2025, concentrated in those three regions, with Friuli Venezia Giulia and Trento offering free vaccination to local residents. If your itinerary includes summer hiking or trekking in the Dolomites, Alto Adige, Friuli, or the Julian Alps, the 3-dose TBE vaccine (with accelerated schedules available) is worth discussing with a travel clinician. Most cruise, city, and southern-Italy itineraries do not need it.

Rabies, selective

Italy is canine-rabies-free in the conventional sense, but bat rabies and the occasional imported case of fox rabies do occur. Pre-exposure rabies vaccine is selective for cavers, wildlife biologists, long-stay travelers in rural areas, and unaccompanied minors. Internal link: Rabies vaccine for travelers.

Chikungunya, selective in 2026

The 2024 to 2025 surge in autochthonous chikungunya in Italy (384 cases in 2025 alone, mostly Emilia-Romagna and Veneto) means the question now comes up in clinic. The newer FDA-approved chikungunya vaccines (Ixchiq and Vimkunya) are reasonable to consider for older adults, immunocompromised travelers, or anyone with a prolonged stay in northern Italy during July-to-October transmission season. Internal link: Chikungunya vaccine for travelers.

What you do NOT need for Italy

No malaria pills. No yellow fever vaccine unless you are arriving from a yellow fever risk country and need to present a yellow card at Italian customs. No Japanese encephalitis. No typhoid for routine tourist itineraries (CDC does not list Italy as a typhoid risk destination).

Save the round-trip to a travel clinic. Wandr's clinicians review your trip and book your routine and travel vaccines at a partner pharmacy near you, with appointments often available within 24 to 48 hours. Book your travel vaccines through Wandr

Mosquito-Borne Disease, the New Italy

Italy is no longer a "European destination with no mosquito problem." That framing is a decade out of date.

West Nile virus, the 2025 epidemic

WNV is the dominant mosquito-borne risk in Italy. The Italian National Institute of Health (ISS) reported 740 confirmed human West Nile virus infections and 68 deaths from January to early October 2025, with circulation documented across 75 provinces in 17 regions. Veneto reported 91 cases (33 neuroinvasive). Lombardy reported 53 neuroinvasive cases and 9 deaths. Lazio, including the Rome metropolitan area, led national case counts during the August peak. There is no human WNV vaccine. Prevention is mosquito avoidance.

Most WNV infections are asymptomatic. Roughly 1 in 5 infected people develop a febrile illness (fever, headache, body aches, sometimes rash and lymphadenopathy). About 1 in 150 develop neuroinvasive disease (meningitis, encephalitis, acute flaccid paralysis), with disproportionate risk in adults over 60 and the immunocompromised. The dominant vector is Culex pipiens, which bites from dusk to dawn.

Autochthonous dengue, what Marche taught us

In late 2024 Italy recorded its largest-ever autochthonous dengue outbreak: 199 confirmed cases of DENV-2 in Fano (Marche province), 44 cases of DENV-1 in Cavezzo (Emilia-Romagna), 12 in Lombardy, and scattered cases in Veneto, Abruzzo, and Tuscany. Total national 2024 dengue notifications hit 657 confirmed cases (457 travel-associated, 200 autochthonous), which is more than the prior decade combined. The vector is Aedes albopictus (Asian tiger mosquito), which bites aggressively during the day. Italy is no longer "no dengue risk." Internal link: Dengue fever in travelers: a physician's complete guide.

Autochthonous chikungunya, the 2025 northern surge

In July and August 2025, Italian and ECDC surveillance documented 384 chikungunya cases concentrated in two main outbreaks: 318 cases in Modena province (Carpi and surrounding sites) in Emilia-Romagna, and 61 cases in Verona province, Veneto. Smaller clusters appeared in Bologna, Piacenza, Rimini, and Tuscany. As with dengue, the vector is Aedes albopictus. Chikungunya produces fever and joint pain that can last weeks to months, particularly in older travelers.

Mosquito prevention in Italy, what actually works

The same playbook that protects you in Costa Rica or Vietnam protects you in Po Valley northern Italy in 2026:

• DEET 30% to 50% on exposed skin (or picaridin 20% as a non-DEET alternative). Reapply per label.
• Permethrin-treated clothing for hiking, agritourism stays, and Po Valley itineraries.
• Air conditioning or window screens where you sleep. Many Italian rural rentals do not have screens.
• Long sleeves and pants at dusk and dawn (Culex/WNV season) and during the day in northern Italy summer (Aedes/dengue/chikungunya season).
• Standing-water audit at agritourism stays: empty buckets, plant saucers, and birdbaths within 50 feet of where you sleep.

Heat Illness and Air Quality

Italy was the deadliest country in Europe during the summer 2024 heat dome, with more than 19,000 heat-related deaths according to a 2025 Barcelona Institute for Global Health (ISGlobal) analysis published in Nature Medicine. Rome and Palermo registered above 41°C (106°F). Summer 2025 hit Milan and Rome hard again, with nearly 500 attributable deaths in those two cities alone by mid-July.

If you are traveling between June and September:

• Shift sightseeing to 7 to 10 a.m. and 6 to 9 p.m. Plan museums, basilicas, and shaded gardens for midday.
• Hydrate proactively. Carry 500 to 1,000 mL of water per hour outdoors. Add an electrolyte packet (Liquid I.V., LMNT, or pharmacy ORS) if you are sweating heavily.
• Watch for warning signs. Dizziness, nausea, cramping, throbbing headache, and confusion are heat illness, not jet lag.
• Know the cooling protocol. Move indoors or into shade, remove excess clothing, cool with water and a fan, and seek care if mental status changes or core body temperature crosses 104°F (40°C). That is heat stroke and a true emergency.

Wildfire smoke is a secondary concern in Sicily, Sardinia, and Calabria in late summer. If you have asthma or COPD, bring rescue and controller inhalers in your carry-on and pack N95 masks.

Volcanic and Seismic Risk

Mount Etna, Sicily

Mount Etna entered an extended eruption cycle in 2024 to 2025. On August 14, 2024 an eruption sent ash 9.5 km into the atmosphere and closed Catania-Fontanarossa International Airport the next day. A second eruption began February 11, 2025 with a 3 km lava flow. The June 2, 2025 eruption sent an ash plume to roughly 21,000 feet, triggered a red aviation alert, and disrupted summit access. A new eruption beginning December 24, 2025 continued lava production into 2026.

Travel to Sicily remains safe during Etna activity. Practical considerations: build flight buffer days into your itinerary in case Catania closes; check Istituto Nazionale di Geofisica e Vulcanologia (INGV) status before booking summit tours; pack an N95 if you have respiratory disease and a fine-particle eyewash if you wear contacts; and follow guide instructions on the mountain.

Campi Flegrei, Naples

The Campi Flegrei caldera west of Naples is in the most active phase of bradyseismic uplift in four decades. INGV recorded approximately 2,500 earthquakes in a single month in 2024. Two notable seismic events struck in 2025: a magnitude 4.4 quake on May 13 and a magnitude 4.6 quake on June 30, large enough to crack walls and prompt structural assessments. Cumulative uplift at Rione Terra, Pozzuoli reached approximately 148 cm, with about 29.5 cm of that occurring since January 2024.

If your itinerary includes Pozzuoli, Bacoli, Solfatara, or Pompeii/Herculaneum, register your trip with the U.S. State Department's Smart Traveler Enrollment Program (STEP), know your hotel's evacuation route, and check Dipartimento della Protezione Civile alerts. The risk is not lava in the next 14 days. The risk is being inside a 1960s masonry building when a 4-plus magnitude quake hits.

Vesuvius and Stromboli

Vesuvius is in a long quiescent phase but is closely monitored. Stromboli has continuous low-level strombolian activity that drives boat tours from the Aeolian Islands. Both are tourist-safe with normal precautions.

Tick-Borne Disease in Northeast Italy

If you are hiking the Dolomites, Alto Adige, Friuli Venezia Giulia, or the Julian Alps from April to October, ticks are the underrated risk. Italy recorded 63 confirmed tick-borne encephalitis (TBE) cases in 2025, with the heaviest burden in Trento (18 cases in 2022), Friuli Venezia Giulia, and Veneto (37 cases in 2022). TBE produces a biphasic illness: flu-like symptoms for a week, a symptom-free interval, then neurological symptoms (meningitis, encephalitis, myelitis) in about a third of symptomatic cases. There is no specific treatment beyond supportive care, so the vaccine is the only meaningful prevention if you will be heavily exposed.

Lyme borreliosis is also present in the same Alpine northeast. Italian surveillance documented 1,260 clinically confirmed Lyme cases over the past decade, concentrated in Friuli Venezia Giulia and Trentino-Alto Adige.

Practical tick prevention:

• Tuck pants into socks and treat hiking clothes with permethrin
• Daily full-body tick check, including scalp, groin, behind knees, behind ears
• Remove ticks within 24 hours with fine-tipped tweezers, straight pull
• Photograph the tick in case you need to identify the species later
• Seek care for any expanding red rash, fever, or facial palsy in the 30 days after a known or possible tick bite

Traveler's Diarrhea and Food/Water Safety

Italian tap water is safe nationwide. Public water in Sicily and Sardinia is chlorinated and monitored to EU standards, though many southern residents prefer bottled water for taste. The real traveler's diarrhea drivers in Italy are restaurant food handling errors and raw or undercooked shellfish in coastal southern Italy, not the water supply.

The Italy traveler's diarrhea kit:

• Azithromycin 500 mg, three tablets (one daily for 1 to 3 days) as first-line antibiotic. Campylobacter fluoroquinolone resistance in southern Europe is high enough that I no longer use ciprofloxacin first-line. Internal link: Cipro vs azithromycin for traveler's diarrhea.
• Loperamide (Imodium) 2 mg tablets for symptom control if no fever or bloody stool
• Oral rehydration salts (DripDrop, Liquid I.V., or pharmacy ORS) to replace electrolytes
• Ondansetron 4 mg dissolving tablets for nausea or vomiting

Hepatitis A vaccine is your primary defense against the food and water exposures that matter most in southern Italy. If you have not had it, this is the trip to fix that. Internal link: Traveler's diarrhea complete guide.

Road and Recreation Safety

Vespas, scooters, and the Amalfi Coast

The road from Sorrento to Salerno was designed before mass tourism. It is narrow, twisty, frequently blocked by tour buses, and rented by tourists who often have never operated a scooter. Italian emergency departments along the Amalfi Coast see scooter trauma from American tourists every summer week. The pattern is the same: rented Vespa, no helmet liability training, sliding out on a blind right-hand curve, or being clipped by an oncoming car on the wrong side.

If you have never ridden a 125cc scooter in heavy traffic, the Amalfi Coast is not the place to learn. Capri and Rome are no easier. The two safer alternatives are an organized driver-led Vespa tour or a private car-with-driver service. Travel insurance with adventure-sport coverage is worth confirming if you do plan to ride.

Italian driving and ZTL fines

If you rent a car: Italian Limited Traffic Zones (ZTL) in historic city centers are camera-enforced. Driving into a Florence, Bologna, Milan, or Rome ZTL without a permit will produce a 100-to-200-euro fine per pass, often delivered to your home address 6 to 12 months later. Park outside city walls and use public transit, taxis, or rideshare for old-town visits.

Marine Hazards

• Pelagia noctiluca (mauve stinger) jellyfish: most common painful sting in Italian waters; rinse with seawater (not fresh), remove tentacles with tweezers, apply hot water (40 to 45°C / 104 to 113°F) for 20 to 45 minutes
• Weeverfish: buried in Adriatic and Tyrrhenian shallows; hot-water immersion for the stung foot for 30 to 90 minutes is the standard first-aid
• Sea urchins (Paracentrotus lividus): Sardinia, Sicily, southern Tyrrhenian; soak the affected area in hot vinegar to dissolve spines, then seek care if a spine fragment remains

Region-by-Region Risk

Rome and Lazio

Heat illness (June-September), West Nile virus (Lazio led 2025 case counts), measles transmission, pickpocketing-related injury, ZTL fines. Pack DEET, electrolytes, MMR documentation.

Venice and Veneto

West Nile virus (33 neuroinvasive cases in 2025), autochthonous chikungunya (61 cases in Verona province in 2025), tick-borne encephalitis in nearby Friuli, summer heat. The Lagoon-and-canal mosquito ecology makes Venice itself an active transmission setting in July-October.

Florence and Tuscany

Heat illness in central Tuscan summers, sporadic autochthonous dengue (Tuscany reported one case in the 2024 outbreak), ZTL enforcement, hill-town stair-fall injuries.

Milan and Lombardy

Active measles transmission (sustained B3 genotype in and around Milan in 2024-25), 53 WNV neuroinvasive cases in 2025 and 9 deaths, 2024 autochthonous dengue cluster of 12 cases. Confirm two MMR doses before this trip.

Amalfi Coast and Campania

Scooter trauma is the dominant injury pattern. Campi Flegrei seismicity if your itinerary includes Naples, Pozzuoli, Bacoli, or the Phlegraean Fields. Heat illness on coastal stair systems. Avoid renting a scooter unless you ride regularly at home.

Sicily

Mount Etna activity (Catania flight buffer days), record summer heat (Palermo and Catania), one of the 2025 chikungunya case clusters, hepatitis A risk from coastal shellfish, water-system reliability in some inland towns. The CDC's hepatitis A recommendation matters most here.

Sardinia

Beach and hiking destination with sea urchin and jellyfish exposure, heat-related injury on the granite Costa Smeralda trails, and one of the cleanest tap-water systems in Italy.

Cinque Terre and Liguria

Coastal hiking on the Sentiero Azzurro generates the most ankle, knee, and lower-extremity injuries I see in returning travelers. The terrain is steeper than the photos suggest. Hiking boots, not sneakers.

Dolomites and Alto Adige

Tick-borne encephalitis and Lyme disease are the dominant risks May to October. TBE vaccine if you will hike more than a few days. Altitude is generally below the classical acute mountain sickness threshold but Marmolada and other 3,000+ m summits warrant the same hydration and pacing as a Peruvian sierra trip.

Puglia, Basilicata, Calabria

Heat illness, sun exposure, dust and wildfire smoke in late summer, scattered marine hazards. The food-handling pattern that drives traveler's diarrhea is most consistent with hepatitis A risk here, so the vaccine matters.

Bringing US Medications into Italy

Italy is part of the EU and the Schengen Area. Personal medication for personal use is generally allowed without a separate import permit if you carry:

• The medication in its original prescription bottle
• A copy of the original prescription
• A clinician letter for any controlled substance (Adderall, Vyvanse, controlled benzodiazepines, opioids)

Italian customs is stricter on amphetamine-class stimulants than US travelers expect. If you take Adderall, Vyvanse, Concerta, or Ritalin, bring the original prescription and a clinician letter, and keep the supply limited to your trip duration. Italian law treats some ADHD stimulants as controlled in the schedule equivalent to morphine, and large quantities can be confiscated even with a prescription.

When to Plan Your Italy Travel Health Care

The minimum lead time most travelers actually need is 2 to 4 weeks:

• 6+ weeks out: TBE vaccine (3 doses with accelerated schedules available), rabies pre-exposure (3 doses), hepatitis B with the standard schedule
• 2 to 4 weeks out: Hepatitis A single dose, MMR catch-up if needed, Tdap if you are 10 years out, chikungunya vaccine (Ixchiq or Vimkunya needs about 14 days for immunity)
• 1 week out: Influenza (in season), pre-trip prescription review for antibiotics, anti-nausea, and electrolytes
• Anytime: Travel insurance, scooter-rental adventure coverage decision, medication letter

Wandr's pre-trip health check is built for exactly this timeline. Our clinicians review your itinerary, recommend the vaccines and prescriptions that actually match your risk profile, and call prescriptions in to your local pharmacy. For vaccines, we book your appointment at a partner pharmacy near you. No round-trip to a travel clinic.

Italy in fewer than 4 weeks? Wandr's pre-trip health check is free, takes about 10 minutes, and gets you a physician-reviewed plan within a business day. Start your free pre-trip health check

Italy Travel Insurance

Public Italian healthcare is high quality but not free for foreign travelers. Expect to pay out of pocket for emergency department visits and short hospital stays, with reimbursement claims back home. Travel medical insurance with $50,000 to $100,000 in coverage is a reasonable floor; medical evacuation coverage of $250,000 to $500,000 matters if you will be in the Dolomites, Sicily during volcanic activity, or anywhere remote enough to require a helicopter transfer. Internal link: Do I need travel insurance?

Italy Travel Health Kit

• DEET 30% or picaridin 20% insect repellent
• Permethrin-treated hiking clothing (Po Valley, Dolomites, agritourism)
• Sunscreen SPF 30+ (mineral preferred), reapplied every 90 minutes
• Wide-brim hat, polarized sunglasses
• Refillable 1-liter water bottle and electrolyte packets
• Hand sanitizer
• Azithromycin 500 mg, 3 tablets (clinician-prescribed)
• Loperamide 2 mg, 12 tablets
• Ondansetron 4 mg ODT, 6 tablets (clinician-prescribed)
• Acetaminophen 500 mg and ibuprofen 200 mg
• Antihistamine (cetirizine 10 mg)
• Topical hydrocortisone 1%
• Adhesive bandages, blister care (Compeed), gauze pads, medical tape
• Tweezers (tick removal)
• Thermometer
• Asthma rescue inhaler if applicable
• N95 mask if traveling near active Etna or to Pozzuoli/Naples
• Medication letter and original prescription bottles for any controlled substances

FAQ

Do I need vaccines for Italy?

Yes. The CDC recommends MMR (especially in 2026 given active measles transmission), hepatitis A, Tdap, polio, varicella, and influenza for all travelers to Italy. Tick-borne encephalitis, hepatitis B, rabies, and chikungunya are selective based on your itinerary and risk factors.

Is tap water safe to drink in Italy?

Yes. Italian tap water meets EU drinking-water standards nationwide, including in Sicily, Sardinia, and Puglia where many residents prefer bottled water for taste. The traveler's diarrhea risk in Italy comes from restaurant food handling and raw shellfish, not the tap.

Do I need malaria pills for Italy?

No. Italy has been malaria-free since the 1970s and no Italian region carries malaria transmission risk in 2026.

Should I worry about West Nile virus in Italy?

You should plan for it but not cancel your trip. Italy reported 740 confirmed West Nile virus infections and 68 deaths in 2025 across 75 provinces, with Veneto, Lombardy, and Lazio leading case counts. Most infections are asymptomatic. The prevention strategy is mosquito avoidance (DEET, long sleeves at dusk, screens) since there is no human WNV vaccine.

Is it safe to visit Sicily during Mount Etna eruptions?

Generally yes. Etna has been in an extended eruption cycle since 2024, with multiple events that closed Catania airport temporarily but did not threaten populated areas. Build flight buffer days into your itinerary, check Istituto Nazionale di Geofisica e Vulcanologia (INGV) status before booking summit tours, and follow guide instructions.

Can I take my US prescription medications to Italy?

Most prescription medications are allowed with the original bottle and prescription. Controlled substances (Adderall, Vyvanse, opioids, certain benzodiazepines) require a clinician letter, and Italian customs is stricter on stimulants than US travelers expect. Bring only what you need for the trip.

Should I get a chikungunya vaccine for Italy?

Selective. Italy reported 384 autochthonous chikungunya cases in 2025, concentrated in Emilia-Romagna and Veneto from July to October. Ixchiq or Vimkunya is reasonable to consider for adults over 60, immunocompromised travelers, or anyone with a multi-week northern Italy itinerary in late summer.

What is the biggest health risk for American tourists in Italy?

For most travelers, summer heat illness and road or scooter trauma cause more emergency department visits than any infectious disease. Among infectious diseases, West Nile virus and measles are the two leading causes of serious illness in returning American travelers from Italy in 2025-2026.

Sources

1. CDC Travelers' Health: Italy, including Holy See and Vatican City. https://wwwnc.cdc.gov/travel/destinations/traveler/none/italy
2. CDC Travel Health Notice: Measles in the Globe (Level 1). https://wwwnc.cdc.gov/travel/notices/level1/measles-globe
3. Istituto Superiore di Sanità (ISS) — West Nile virus weekly surveillance, 2025. https://www.epicentro.iss.it/westnile/
4. Bellini R, et al. "Predictable growth, expanded risk: West Nile virus in Italy, 2025." International Journal of Infectious Diseases, 2025.
5. ECDC — Clusters of autochthonous chikungunya cases in Italy, 2025 rapid risk assessment. https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-clusters-autochthonous-chikungunya-cases-italy
6. Riccardo F, et al. "Autochthonous dengue outbreak in Marche Region, Central Italy, August to October 2024." Eurosurveillance. https://pmc.ncbi.nlm.nih.gov/articles/PMC11583309/
7. Filia A, et al. "Surge in Measles Cases in Italy from August 2023 to January 2025." Vaccines, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12298667/
8. ISGlobal / Barcelona Institute for Global Health — heat-related deaths in Europe summer 2024 analysis, Nature Medicine, 2025.
9. Istituto Nazionale di Geofisica e Vulcanologia (INGV) — Mount Etna activity bulletins, 2024-2026. https://www.ct.ingv.it/
10. Dipartimento della Protezione Civile — Campi Flegrei bradyseism updates, 2024-2026. https://rischi.protezionecivile.gov.it/en/volcanic/volcanoes-italy/phlegraen-fields/
11. CDC Yellow Book — Tick-borne encephalitis areas at risk. https://www.cdc.gov/tick-borne-encephalitis/data-maps/index.html
12. ECDC — Tick-borne encephalitis annual epidemiological reports, 2022-2025.

Medical Disclaimer

This article is for educational purposes only and does not constitute personalized medical advice. Travel health recommendations vary based on your individual medical history, current medications, planned activities, and specific itinerary. Always consult a licensed clinician before starting any medication or vaccine. In a medical emergency in Italy, call 112 (the unified European emergency number).