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Cuba
Risk:
Moderate
Health Overview
Cuba is unique among all destinations on this platform in that US citizens face a specific federal legal requirement before any travel discussion: tourist travel to Cuba is prohibited by US law; and OFAC (Treasury Department Office of Foreign Assets Control) regulates all Cuba travel by persons subject to US jurisdiction. US citizens must travel under one of 12 authorized general license categories. Beyond the legal framework; Cuba in 2025-2026 presents three simultaneous active CDC Travel Health Notices — a confirmed chikungunya outbreak; Oropouche virus (specifically named); and dengue — alongside a collapsing electrical grid with nationwide blackouts up to 12 hours daily. No malaria exists; no yellow fever entry requirement; but the healthcare system is severely stressed and medication and supply availability is critically limited throughout the island.
Key Health Risks
High
Three Simultaneous Active Arboviral THNs — Chikungunya; Oropouche; and Dengue
Cuba currently has THREE simultaneous active CDC Travel Health Notices for mosquito-borne and midge-borne viruses: (1) Chikungunya in Cuba Level 1 THN (September 26 2025) — confirmed outbreak; Aedes aegypti mosquito; sudden fever; severe joint pain that can persist weeks to months; no vaccine available for most travelers; DEET all day is the only prevention. (2) Oropouche in the Americas Level 1 THN (September 18 2025) — Cuba specifically named; Oropouche virus spread by biting midges (Culicoides) AND Culex mosquitoes; presents similarly to dengue with fever; headache; myalgia; rash; documented fetal harm risk in pregnancy — Oropouche-specific counseling is required for pregnant travelers or those planning pregnancy. Fine mesh clothing adds protection against midges that can penetrate standard mesh. (3) Global Dengue Level 1 THN (March 23 2026) — Cuba specifically named; year-round risk. All three are simultaneously active. Be sure to consult your Dr. prior to travel to discuss.
High
Electrical Grid Failure and Healthcare Impact
Cuba's electrical grid has been in crisis since October 2024. The September 10 2025 total island-wide power failure was documented by the US Embassy. Havana experiences daily scheduled and unscheduled blackouts of up to 12 hours; provincial areas experience blackouts lasting longer. Clinical implications: hospitals use generators but generator fuel is scarce and rationing has been documented; refrigerated medications (insulin; certain biologics) may not be reliably cold-chained throughout the island; food spoilage from repeated power failures increases foodborne disease risk; internet and cell connectivity fail during blackouts limiting emergency communication. Anyone requiring refrigerated medications must have a specific cold-chain plan.
Moderate
OFAC Legal Restriction and Cash-Only Economy
US law prohibits travel to Cuba for tourist activities — this is not a travel advisory recommendation but a federal legal requirement carrying civil and criminal penalties. OFAC regulates Cuba travel under 12 authorized general license categories: family visits; official US government travel; journalistic activity; professional research and meetings; educational activities; religious activities; public performances/competitions/exhibitions; support for the Cuban people; humanitarian projects; activities of private foundations/research/educational institutes; exportation/importation/transmission of information materials; and certain authorized export transactions. US credit and debit cards universally do not function in Cuba. All expenses must be paid in cash (USD or Euros that can be exchanged for Cuban pesos). Bring the entire trip budget in cash plus an emergency reserve — there is no fallback payment option.
Health Risk Callout
Three simultaneous active CDC Travel Health Notices make Cuba's mosquito situation genuinely complex in 2025-2026. The Oropouche counseling is the item most providers miss — Oropouche is spread by biting midges (Culicoides; tiny flies) as well as mosquitoes; DEET applied to skin helps but the midges are small enough to penetrate some standard fabric meshes. Fine mesh clothing that physically prevents midge penetration adds meaningful protection. Oropouche also has documented fetal harm risk; requiring pregnancy-specific counseling alongside the standard Zika discussion. The electrical grid crisis is the other uniquely Cuba clinical point — anyone with insulin-dependent diabetes or medication requiring cold chain must have an explicit plan; they cannot rely on Cuba's cold chain reliability.
Other Health Risks
Medication and supply scarcity (Cuba's healthcare system suffers from severe medication shortages — bring 30-day supply of ALL prescription medications plus extras; do not rely on obtaining any medication in Cuba); Cash-only economy for US travelers (US credit and debit cards do not function — bring sufficient USD or Euros for entire trip plus emergency reserve); Foodborne disease (blackout-related food spoilage increases risk throughout the country; apply strict hot/cold food safety assessment; bottled water essential); Deteriorating sanitation infrastructure | 2026 UPDATE: Chikungunya: Large 2025-2026 outbreak; combined chikungunya+dengue reportedly reached ~42,000 cases with 33+ deaths; chikungunya continued into early 2026. Disease remains active even though the specific CDC THN page now reads 'Removed'. (https://outbreaknewstoday.substack.com/p/chikungunya-continues-in-cuba-in, 2026) ; Dengue: Ongoing surge alongside chikungunya per BMJ/Cuban epidemiology reporting. (https://www.bmj.com/content/391/bmj.r2688, 2026) ; Oropouche: Cuban epidemiologist warns Oropouche remains an ongoing threat alongside chikungunya and dengue. (https://www.cubaheadlines.com/articles/314334, 2026)
Regional Information
Regional Risk Callout
Cuba's risk profile has a primary urban-rural divide compounded by the island-wide electrical grid crisis. Havana: most tourist infrastructure; US Embassy; the country's best healthcare access (Clínica Cira García for foreigners); but daily blackouts up to 12 hours with resultant food spoilage; elevator failures; and documented hospital generator fuel shortages. Varadero: Cuba's primary beach resort zone; resort enclave infrastructure is somewhat more stable but the same island-wide chikungunya; Oropouche; and dengue risk applies everywhere. Eastern provinces (Santiago de Cuba; Holguín; Baracoa): longer blackouts than Havana; even more limited healthcare; further from US Embassy assistance. Interior towns (Trinidad; Viñales; Cienfuegos): popular authorized itinerary destinations; standard Cuba health risk profile.
Regional Healthcare Callout
Healthcare in Cuba is severely limited by medication shortages; infrastructure deterioration; and the ongoing electrical grid crisis. Clínica Cira García in Havana is the primary facility for foreign travelers but faces supply constraints. Outside Havana: hospitals in Santiago; Trinidad; Varadero; and Holguín have minimal capabilities. US Embassy Havana has limited ability to assist citizens — embassy employees must follow special government notification procedures to travel outside Havana; which can delay emergency response. All US travelers to Cuba need travel insurance with air evacuation coverage — evacuation to Miami (45 minutes by air) is the standard for conditions beyond Cuban capability.
Vaccine and Malaria Prevention
💉 Entry Vaccine Required
None — Cuba has no entry vaccine requirements for US travelers arriving directly from the United States.
🛡️ Recommended Vaccines
CDC recommends Routine vaccines up to date (MMR; Tdap; influenza; COVID-19); Hepatitis A (recommended — water and food safety concerns given infrastructure deterioration); Hepatitis B; Typhoid (recommended given food safety uncertainty from repeated blackout-related spoilage events). Be sure to consult your Dr. prior to travel to discuss.
🦟 Malaria Information
No malaria risk.
None
Physician Note
Dr. Robert
Emergency Medicine · 25+ Years · 40+ Countries
Cuba is one of those consultations where the legal framework conversation must precede the vaccine conversation. US law prohibits tourist travel to Cuba — OFAC regulates this through 12 authorized categories; Religious activities is one of the authorized categories so faith-based travelers have a legal pathway; but documentation of the specific activities matters. On the infectious disease side; Cuba currently has three simultaneous active CDC Travel Health Notices: the chikungunya outbreak confirmed in September 2025; the Oropouche designation from the Americas THN with Cuba specifically named; and the March 2026 dengue THN.
That is a genuinely complex mosquito scenario. The Oropouche counseling is worth explicit time — it is spread by biting midges (Culicoides) as well as mosquitoes; standard DEET alone provides less midge protection than fine mesh clothing; and Oropouche now has documented fetal harm data that requires pregnancy-specific counseling alongside Zika. The electrical grid crisis is the other uniquely Cuba clinical point: anyone who requires refrigerated medication should know that cold chain reliability cannot be assumed anywhere on the island during the current grid situation.
Be sure to consult your Dr. prior to travel to discuss.
Pre-Departure Checklist
8+ Weeks
- Confirm Cuba travel falls under one of 12 OFAC authorized general license categories (tourist travel is illegal — see 31 CFR 515.560
- Violations carry civil and criminal penalties)
- Hepatitis A
- Typhoid
- Routine vaccine review (MMR
- Tdap
- Influenza
- COVID-19).
2–4 Weeks
- Register with STEP
- Travel insurance with air medical evacuation (Clínica Cira García Havana to Miami plan)
- Bring 30-day supply of ALL prescription medications plus extras (medications unavailable in Cuba)
- Cold chain plan for any refrigerated medications (grid failures mean Cuba cold chain is unreliable)
- Exchange sufficient USD or Euros for cash for entire trip plus emergency reserve (US credit/debit cards universally do not function in Cuba)
- DEET 20%+ and permethrin-treated clothing (three simultaneous active THNs — chikungunya
- Oropouche
- Dengue)
- Fine mesh clothing for Oropouche midge protection
- Water purification tablets as bottled water backup
- Portable battery bank for blackout contingency.
Day Of
- US Embassy Havana +53-7-839-4100
- Emergency 104 (ambulance)
- 106 (police)
- Clínica Cira García +53-7-204-2811
- DEET before leaving accommodation for any outdoor activity
- Bottled water only — never tap water
- Be prepared for power blackouts lasting up to 12 hours including during any medical facility visit
- Document all travel activities clearly for OFAC compliance. Be sure to consult your Dr. prior to travel to discuss.
Trip Type Guidance
Mission/Religious Activities: Religious activities is one of the 12 OFAC-authorized general license categories — confirm all specific planned activities clearly qualify under this category and maintain documentation; bring sufficient cash (US cards do not work); full mosquito protection for three concurrent active THNs (DEET all day; fine mesh clothing for Oropouche midges); complete medication supply; confirm cold chain plan for any refrigerated medications.
Beach
- Varadero and other authorized-itinerary beach destinations carry the same island-wide chikungunya
- Oropouche
- And dengue risk — DEET is non-negotiable at the beach
- Bottled water throughout
- OFAC license required.
Business
- Certain commercial activities authorized under OFAC license
- US credit/debit cards do not function
- Plan cash logistics carefully
- Full mosquito prevention for three concurrent active THNs.
Notes
Special Evacuation Notes
Medical evacuation insurance is essential for Cuba. Clínica Cira García is the evacuation point within Havana. Air evacuation to Miami or another US city is the standard for conditions beyond Cuban capability — Cuba to Miami is approximately 45 minutes. US Embassy travel outside Havana faces political restrictions that may delay emergency response. Bring the complete supply of all prescription medications before departure — obtaining any medication in Cuba is not reliably possible. Bring sufficient cash for entire trip and emergencies — US cards do not work.
Safety Notes
Cuba Level 2 for crime and unreliable electrical power. Petty crime (pickpocketing; purse snatching; car break-ins) is common in tourist areas. Violent crime including armed robbery and homicide is rising per the State Dept advisory with economic deterioration. Carry minimal visible cash; use hotel safes for passports and extra currency; maintain situational awareness in markets and tourist areas. Demonstrations and political protests can draw violent government response — avoid entirely. Do not photograph military facilities; police; or demonstrations. Key blackout preparedness: have a portable battery bank for phone and lighting; extra food and water in room; plan for navigating in complete darkness.
partner recommendation
Medical Evacuation & Assistance
A medical crisis far from home can cost $50,000+ to evacuate. Global Rescue — the partner we personally trust — provides worldwide evacuation and round-the-clock medical assistance.
Good For
Beach
Mission
Business