The Mid-Atlantic, like the rest of the USA, has a high level of hygiene, so infectious diseases are not a significant problem. There are no required vaccines, and tap water is safe to drink.

Bring any medications you may need in their original containers, clearly labeled. Having a signed, dated letter from your physician that describes all of your medical conditions and medications (including generic names) is also a good idea.

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Before You Go

Recommended Vaccinations

At the time of writing, there were no recommended vaccinations (aside from the standard tetanus and polio vaccinations) for travelers of most countries visiting the USA and particularly its Mid-Atlantic states.

Health Insurance

The United States offers possibly the finest health care in the world – the problem is that it can be prohibitively expensive. It’s essential to purchase travel health insurance if your home policy doesn’t cover you for medical expenses abroad. Check the Insurance section of the Lonely Planet website ( for more information.

Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.

In Mid-Atlantic USA

Availability & Cost of Health Care

If you have a medical emergency, go to the emergency room of the nearest hospital.

If the problem isn’t urgent, call a nearby hospital and ask for a referral to a local physician; this is usually cheaper than a trip to the emergency room.

Stand-alone, for-profit, urgent-care centers provide good service, but can be the most expensive option.

Pharmacies are abundantly supplied. However, some medications that are available over the counter in other countries require a prescription in the US.

If you don’t have insurance to cover the cost of prescriptions, they can be shockingly expensive.

Infectious Diseases

Most infectious diseases are acquired by mosquito or tick bites or through environmental exposure. The Centers for Disease Control and Prevention ( has further details.

Alpha-gal Syndrome An uncommon but increasingly diagnosed – and very severe – meat allergy that results from Lone Star tick bites. Occurring in Virginia and southeastern states, and may be spreading.

Giardiasis Intestinal infection. Avoid drinking directly from lakes, ponds, streams and rivers.

Lyme Disease Occurs mostly in the Northeast. Transmitted by deer ticks in late spring and summer. Perform a tick check after you’ve been outdoors.West Nile Virus Mosquito-transmitted in late summer and early fall. Prevent by keeping covered (wear long sleeves, long pants, hats and shoes rather than sandals) and apply a good insect repellent, preferably one containing DEET, to exposed skin and clothing.

Zika Of gravest concern to pregnant women, this mosquito-borne virus can cause microcephaly (when the brain does not develop fully) in utero. Miami made the news in 2016 for having the first outbreak of its kind in the US, with over 250 locally acquired cases reported in southern Florida. Although the disease was considered eradicated there in early 2017, epidemiologists warn that Zika could rebound with the arrival of warmer temperatures and heavier rainfall.

Environmental Hazards

Cold exposure This can be a problem, especially in the mountains. Keep all body surfaces covered, including the head and neck. Watch out for the ‘Umbles’ – stumbles, mumbles, fumbles and grumbles – which are signs of impending hypothermia.

Heat exhaustion Dehydration is the main contributor. Symptoms include feeling weak, headache, nausea and sweaty skin. Lay the victim flat with their legs raised, apply cool, wet cloths to the skin, and rehydrate.

Tap Water

Tap water is safe to drink everywhere in the Mid-Atlantic, except in some state or national parks where it is expressly indicated that tap water is not potable.