For Clinicians | World Cup 2026 Pre-Travel Counseling

Three Host Countries, Three Measles Outbreaks

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Edited and approved by Kristen Carpenter, PA-C — Clinical Advisory Board Member

By the time a patient is in your exam room asking about MMR before a Mexico City group stage match, or whether the dengue notice applies to their cruise out of Galveston, they’ve already done the easy googling the answer online. The basic question doesn’t require a visit with you.

What lands on your schedule now is the second-layer question. The one they couldn’t find a good answer to online.

Most of us were having a different conversation with travelers five years ago. Pre-travel counseling mostly isn’t reaching a provider at all. Patients are searching, asking AI, scrolling forums, and going. The ones who do bring it to you are bringing the residual question, the one the internet didn’t resolve cleanly. Often it’s a very specific recommendation they want: do I actually need this booster, what should be in the kit, etc. This article is meant to be the clinician-side reference for the summer 2026 version of that conversation.

What’s actually on the CDC board for summer 2026?

The World Cup is the biggest thing happening this summer around the world. Measles is active in all three World Cup host countries. The US has confirmed 1,952 cases as of late May, already approaching the full-year 2025 total of 2,288 with the entire summer ahead.¹ Canada lost its measles elimination status in November 2025 after twelve months of sustained transmission and has reported 907 new cases since the start of 2026.² Mexico’s Jalisco state, home of World Cup host city Guadalajara, has logged 5,282 confirmed cases through mid-April in the country’s worst outbreak in decades.³ Guadalajara isn’t a measles statistic, it’s a place your patients are booking flights to.

The CDC has issued a Level 1 Global Dengue notice covering more than 100 countries, which is an unusually broad advisory.⁴ Locally acquired dengue is also showing up in southern US cities, with multiple confirmed cases in Los Angeles County over the past two transmission seasons.⁵

A novel hantavirus cluster on the MV Hondius expedition ship in the South Atlantic killed three passengers in May, identified as Andes virus.⁶ The WHO assessed the global risk as low. More on the cruise question below.

And the World Cup itself is the largest funnel event in the history of international travel: 48 teams, 16 host cities across the US, Mexico, and Canada, and FIFA’s projected engagement figure of nearly 6 billion people.⁷ You’re thinking: most of them will be watching from a couch. True. But millions will not.

Quick reference: summer 2026 by destination

A pull-up-in-the-room reference for the most common itineraries your patients are flying.

World Cup host countries (US, Canada, Mexico). Active measles transmission in all three. Verify MMR status, especially for adults born after 1957 with uncertain documentation. Patients vaccinated between 1963 and 1968 may have received the inactivated vaccine and should be revaccinated. Check the CDC measles notice before departure.

Caribbean, Latin America, and the southern US. Dengue is elevated in 2026 across Cuba, Brazil, Colombia, Mexico, and locally in southern California and along the Gulf. Counsel EPA-registered repellent (DEET or picaridin), permethrin on clothing, and air-conditioned or screened sleeping. Tell patients to seek care if a fever spikes within two weeks of return.

Cruise ships. The cruise ship hantavirus story is everywhere this month, and it deserves a one-line answer: your patient’s Caribbean cruise out of Miami is statistically not where this is happening. The MV Hondius cluster was on an Antarctic expedition vessel, geographically remote, and WHO has assessed the global risk as low. The actual cruise ship risk is much more mundane….and much more likely. Norovirus is the leading cause of cruise ship outbreaks, and a separate norovirus event affected hundreds of passengers on a Caribbean cruise this same month. The other reliable ways to lose a cruise day: respiratory virus, traveler’s diarrhea, motion sickness. Counsel aggressive handwashing (alcohol gel works against respiratory viruses but soap and water is what handles norovirus), pack a small kit, and report symptoms early so the cruise medical staff can manage them in the cabin instead of letting them derail the trip.

The 20-minute checklist

Four steps, and it fits inside a short visit.

1. MMR verification. For adults born after 1957, confirm two documented doses or evidence of immunity. Adults born before 1957 are generally considered immune. Patients vaccinated between 1963 and 1968 may have received the inactivated vaccine and should be revaccinated. (Your MA can pull these records in five minutes. It doesn’t need to be your time.)
2. CDC notices for the specific destination. Send patients to the CDC Travelers’ Health page for their destination. The notices update frequently. The page is at wwwnc.cdc.gov/travel/notices.
3. Medical prep, not just medications. The kit conversation is broader than prescriptions. The prescription backbone is one piece. The rest is the simple stuff that keeps a small problem from becoming the thing they remember about the trip. A reasonable kit, paperback-sized, fits in a carry-on:

• Gauze and adhesive bandages in two sizes
• Antibiotic ointment (Neosporin or equivalent)
• Blister care: moleskin and hydrocolloid patches
• Oral rehydration salts or electrolyte packets
• A digital thermometer
• OTC motion sickness medication
• A short course of clinically appropriate prescription medications for predictable conditions like UTI, traveler’s diarrhea, common respiratory infections, and yeast infections. This is what Jase handles, prescribed and packaged ahead of the trip.

The kit exists so your patient doesn’t end up standing in a foreign pharmacy at 9pm with a phone translator trying to figure out which Spanish word means antiseptic.

4. What’s available at a foreign pharmacy, and what isn’t. Pharmacy availability varies more than patients expect. Some countries dispense antibiotics over the counter. Others require a domestic prescription that a US script won’t satisfy. Brand names you trust at home may carry different active ingredients abroad, or different doses. View our recent article on Prescription Medication Abroad.

The OTC trap when you’re abroad

This sounds boring and obvious, but is the highest-leverage thing a clinician can teach a traveling patient.

Over-the-counter in another country does not mean equivalent to over-the-counter at home. Acetaminophen is sold as paracetamol in most of the world; dosing is usually the same, but the name swap leads to accidental double-dosing when patients also take a combination cold medication that contains the same active ingredient. Ibuprofen is available widely, but the dose per tablet varies. Antihistamines sold under familiar US brand names abroad sometimes contain different active ingredients, including older sedating compounds that can interact with travel sedatives or alcohol. Counterfeit medication is a real concern in some regions and includes products with the wrong dose, the wrong drug, or no active ingredient at all.

The rule we counsel: bring what you already use, in the dose you already use. Foreign pharmacies are useful for things you didn’t anticipate, not for things you could have packed.

When the call comes from abroad

Your patient is on day four of a Caribbean cruise with a UTI that started in Cozumel. Or she’s in Florence with a sinus infection she’s been ignoring since Rome. Or he’s on a two-month sabbatical and the antifungal he meant to refill before he left got missed. The portal message comes in. The voicemail comes in. The text from the family member who has your cell. The expectation is that you’ll fix it from your desk.

You can’t.

As Kristen put it to me when we were drafting this together: “I can’t send a script to Europe.”

That’s the first wall. There is no mechanism for routing US prescriptions to foreign pharmacies. And even within the US, looking up an out-of-state pharmacy in eScript takes a while. It’s doable; just a pain that takes up precious time between patients.

The second wall is bigger: anticipating everything that could come up across a two-week trip. The sinus infection that builds on the flight. The GI bug that hits day three. The skin issue from the cruise pool. The allergic reaction to something at a night market. Half a dozen potential prescriptions across as many therapeutic categories, for conditions that may or may not actually present. That work is complex, isn’t part of your fast clinical workflow, and takes hours, not minutes, per patient. Unless you’ve got a really standardized protocol covering all the categories, it’s just easier to refer. It can be done. It probably just doesn’t feel worth your time.

The known versus the unknown is the real divide here. Writing one or two prophylactic scripts for a patient with a recurring issue you already know about (the UTI history, the predictable cold sore) is something most providers can do confidently. The indication is clear, the duration is short, the patient self-identifies. Anticipating everything that might come up on a trip is hard. It should be hard, because it’s very complex.

Appropriate medical preparation

This is the category Jase is building, and pre-travel readiness is one of its clearest applications. Appropriate medical preparation means a short list of well-defined, common, predictable conditions handled clinically before the patient is sick, by people who know what they’re doing, so the patient has what they need before they need it.

It is in no way a replacement for primary care. Complex diagnoses, chronic conditions, ongoing provider relationships belong in your exam room. We work in the contingency space: the UTI on day four of the trip, the traveler’s diarrhea on day six, the strep that announces itself the night before a flight home. The conditions where the clinical decision is predictable and the only failing variable is access.

This is a call to prepare appropriately, not exhaustively.

Who’s doing this work

Jase is a family company of medical doctors, physician assistants, and pharmacists, five years in, with the credentials breadth (board-certified family medicine, disaster medicine, multi-state pharmacy) to make the clinical work defensible.

Charting the grey area in public

Pre-travel counseling is a capacity problem in most primary care practices. The visit is short, the destinations are varied, the CDC board changes faster than most providers can track. If your patients are asking and you don’t have the time to walk them through it, you can refer them to us at Jase.com. We handle the prescription work, the kit, and the patient education ahead of the trip, and we send them back to you with documentation.

We’re going to keep publishing the framework as we use it. The clinical decision trees, the destination-specific notes, the cases where the call is harder than it looks. Public knowledge gets better when clinicians chart the grey area in public instead of letting the internet do it.

The bottom line

Summer travel is supposed to be exciting. It is not supposed to be anxious.

A verified MMR, a short conversation about the destination’s CDC notice, and a small kit on the shelf will handle the vast majority of what makes a trip go sideways. Most of it is fixable in advance, and the fixing happens in your office or ours, not in a foreign emergency room at 11pm.

If your patient is heading to a host city this summer, send them out the door prepared. If you’d rather refer them, send them to us. Either way, the goal is the same: a trip they remember for the right reasons.

Sources

1. CDC, “Measles Cases and Outbreaks,” data as of May 21, 2026: 1,952 confirmed cases in the US year to date. cdc.gov/measles/data-research
2. Gavi VaccinesWork and PAHO: Canada lost measles elimination status November 10, 2025, after sustained transmission. CIDRAP reporting on 907 cases since January 2026.
3. ABC News, US News, Mexico News Daily reporting on the Jalisco outbreak: 5,282 confirmed cases through April 10, 2026, in Mexico’s worst outbreak in decades.
4. CDC Travel Health Notices, Global Dengue Level 1: wwwnc.cdc.gov/travel/notices/level1/dengue-global
5. Los Angeles County Department of Public Health; CDC Emerging Infectious Diseases, May 2026, on autochthonous dengue transmission in southern California.
6. WHO Disease Outbreak News, May 2026; CDC HAN 00528: MV Hondius hantavirus cluster, Andes virus, 7 cases including 3 deaths.
7. FIFA and TheWorldData on the 2026 World Cup: 48 teams, 16 host cities across the US, Mexico, and Canada; FIFA’s projected engagement figure of approximately 6 billion.

For Clinicians | Can You Get Prescription Medication Abroad?

What Your Patients Assume, What’s Actually True, and What to Do Before They Leave

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Edited and approved by Kristen Carpenter, PA-C — Clinical Advisory Board Member

“I can just buy antibiotics in Mexico if I get sick. I’ll be fine.“
“My friend just borrowed fluconazole from a friend she met on her cruise ship. If I get a yeast infection on my cruise next week I’m sure I can do the same.”

Your patients are telling you this. The travel forums tell the other version: the traveler who spent an afternoon in Florence hunting for a pharmacy willing to fill anything, the person who went to three pharmacies in two French cities before finding the right drug under a name they didn’t recognize, the patient who discovered mid-trip that the medication they take daily doesn’t exist under the brand name they know in the country they’re in.

This article isn’t a pre-travel checklist. You probably don’t have those visits……and when you do, the patient is asking for one specific thing (a vaccine, malaria prophylaxis, a scopolamine patch) and isn’t going to sit through a twenty-minute review of generic drug names across seven countries. 

What this actually is: what your patients are walking into once they leave, what you can’t fix from your desk when they call you from there, and where genuinely-prepared looks different from theoretically-prepared.

The foreign pharmacy experience is harder than patients expect

Before we get to prescriptions, there’s a more basic problem: patients often can’t identify what they’re looking for once they arrive.

Drug names change by country. Acetaminophen (Tylenol) is sold as paracetamol in the UK and across much of the world. A patient who walks into a British pharmacy asking for Tylenol may be told it doesn’t exist there, while paracetamol is stacked behind the counter. Imodium for travelers’ diarrhea is kept behind the counter in Switzerland and requires asking. Aspirin is sold only in pharmacies in many European countries, not in grocery stores or convenience shops. NyQuil doesn’t exist in most of the world. The ingredient combinations are different and the brand isn’t sold.

This is before your patient gets to anything prescription-strength.

This is simple: US prescriptions do not transfer abroad. A pharmacist in Italy, Japan, France, or Canada cannot legally fill what your US-licensed colleague wrote. Prescribing authority is local. There is no international equivalency. Beyond that, the picture breaks down by medication type.

Controlled substances carry the highest stakes. Stimulants used to treat ADHD (including Adderall) are illegal in Japan and restricted in a long list of other countries. Benzodiazepines, opioids, and some sedatives including zolpidem require advance documentation in many destinations: certificates from health authorities obtained before departure, sometimes weeks in advance. Consequences range from confiscation to denial of entry. A 2024 survey found 27% of Americans have had medications confiscated during international travel.² The INCB website (incb.org/travellers) is the right resource by destination. This is not something patients can sort out at the airport last-minute.

Chronic and maintenance medications (antihypertensives, thyroid medications, psychiatric medications, diabetes management) generally cannot be refilled abroad without a local physician visit and a new local prescription. For a two-week trip this is usually manageable with planning. For a six-week trip, a month-long cruise, or an open-ended stay, it requires explicit attention before departure: your patient needs more than they think they need, and they need it before they leave.

Acute medications (antibiotics, antivirals, UTI treatment, GI medications) are the tier where appropriate medical preparation does the most work, because these conditions are predictable. A patient who has had three UTIs is going to have a fourth. A patient going to Mexico has roughly one-in-three odds of needing GI treatment. The question isn’t whether these conditions will come up. It’s whether your patient has what they need, or is wasting an entire day in agony trying to find a doctor who speaks English.

The drug naming problem compounds all three tiers. Even when a pharmacist is willing to help, your patient has to know the generic name of what they’re asking for, in the local formulation. Most don’t.

Top countries Americans visit, quick reference

For when a patient mentions their destination.

Mexico: Most visited by Americans, most misunderstood. Antibiotics are technically prescription-only; enforcement is inconsistent. Large chains (Farmacia Guadalajara, Farmacia del Ahorro) are more compliant. Many pharmacies have attached consultorios where a physician sees patients for a small fee and writes a local prescription. Quality is generally safe at major chains; counterfeit risk at unverified sources. Controlled substances: hard stop. Travelers’ diarrhea risk is high. This is the condition to address specifically when Mexico comes up.

Canada: US prescriptions do not transfer. A Canadian physician must re-authorize before any pharmacy can fill. Walk-in clinics are accessible but not free, not automatic, and not fast on a Saturday night when your patient is sick.

European Union: EU prescriptions transfer within the EU; US prescriptions do not. Pharmacists have broader advisory roles than in the US but cannot prescribe. Drug names and formulations differ enough that patients need generic names, not just brands.

United Kingdom: US prescriptions not valid. Emergency supply at pharmacist discretion exists but is not plannable. Paracetamol, not Tylenol. Generic names matter here more than patients expect.

Japan: US prescriptions not honored. Standard antibiotics permissible up to one month. Over two months requires a Yunyu Kakunin-sho, an importation certificate that takes at least two weeks to obtain. Japan bans several medications that are routine in the US: stimulants for ADHD (Adderall, Ritalin), pseudoephedrine (standard Sudafed), and most common decongestant combinations. Japan requires a destination-specific conversation, not a general one.

Caribbean (Dominican Republic, Jamaica): Prescription requirements mirror Latin American standards. Antibiotic access varies by location. Controlled substances require documentation. Quality control at informal pharmacies is inconsistent.

Southeast Asia: Significant variation by country and by pharmacy. Some OTC antibiotic access exists in parts of the region, quality control is uneven, and your patient cannot know in advance what the rules are where they’re going.

A note on cruise ships

Cruises deserve specific mention. Millions of Americans take them annually, they touch multiple countries and pharmacies in a single trip, and the onboard setup creates a particular kind of false security: patients assume the ship has them covered. It doesn’t. Not for anything short of a genuine medical emergency.

The gift shop medicine shelf. Every ship has one. Basic OTC only: Tylenol, ibuprofen, seasickness pills, anti-diarrhea tablets, cold and flu products. One brand per category. Priced at three times or more what the same product costs on land. It is a gift shop with an OTC aisle.

The onboard medical center. Every ship has one of these, staffed by licensed physicians and nurses and equipped for genuine emergencies. It carries some prescription medications, including antibiotics and epinephrine. For a life-threatening situation, it is there. For the UTI on day four, the sinus infection that’s been building since embarkation, or the travelers’ diarrhea that started in Cozumel, it may technically be able to help, but a physician visit runs $100-200 before any medication is added, everything is charged to the room key and paid upfront with insurance reimbursement to follow, and the medical center is not stocked to refill an existing prescription or treat conditions that are merely miserable. Your patient with a UTI history going on a 14-day Caribbean cruise is not covered by the medical center existing.

In port. Pharmacies are accessible in most cruise ports and a reasonable option for OTC needs. The specific guidance to pass along: avoid pharmacies positioned to catch foot traffic off the gangway. Counterfeit and substandard medications are a documented risk in tourist-facing shops near cruise terminals. Direct patients to pharmacies used by locals, ideally ones co-located with a grocery store or supermarket rather than advertising to cruise passengers. The same drug will often be cheaper there too.

The bottom line for your cruise patients: the ship handles major emergencies. It is not a substitute for appropriate medical preparation.

When the call comes from abroad

Your patient is on day four of a Caribbean cruise with a UTI that started in Cozumel. Or she’s in Florence with a sinus infection she’s been ignoring since Rome. Or he’s on a two-month sabbatical and the antifungal he meant to refill before he left got missed. The portal message comes in. The voicemail comes in. The text from the family member who has your cell. The expectation is that you’ll fix it from your desk.

You can’t.

As Kristen put it to me when we were drafting this together: “I can’t send a script to Europe.”

That’s the first wall. There is no mechanism for routing US prescriptions to foreign pharmacies. And even within the US, looking up an out-of-state pharmacy in eScript takes a while. It’s doable; just a pain that takes up precious time between patients.

The second wall is bigger: anticipating everything that could come up across a two-week trip. The sinus infection that builds on the flight. The GI bug that hits day three. The skin issue from the cruise pool. The allergic reaction to something at a night market. Half a dozen potential prescriptions across as many therapeutic categories, for conditions that may or may not actually present. That work is complex, isn’t part of your fast clinical workflow, and takes hours, not minutes, per patient. Unless you’ve got a really standardized protocol covering all the categories, it’s just easier to refer. It can be done. It probably just doesn’t feel worth your time.

The known versus the unknown is the real divide here. Writing one or two prophylactic scripts for a patient with a recurring issue you already know about (the UTI history, the predictable cold sore) is something most providers can do confidently. The indication is clear, the duration is short, the patient self-identifies. Anticipating everything that might come up on a trip is hard. It should be hard, because it’s very complex.

What you actually do before they leave

For the visits that do happen:

• Vaccines. The thing providers do at a travel-flavored visit. Hepatitis A and B for Mexico, Latin America, Southeast Asia. Typhoid for those plus South Asia. Updated Tdap and seasonal flu. Yellow fever where required. Standard childhood vaccines current.
• Destination-specific controlled substance check, if they ask. The patient flying to Japan with a stimulant prescription needs to know about the Yunyu Kakunin-sho before they leave. The patient traveling with a benzodiazepine needs to know certain destinations require documentation. If they ask, INCB is your reference. If they don’t ask, this falls to them.
• Standard chronic medication supply for the length of the trip plus a buffer. Most patients know to request this. The 90-day mail-order route handles most of it.

The other items that show up in pre-travel articles (clinical letters for customs, written prescription copies, country-by-country generic name briefings) are realistically on the patient, not on you. Patients who want these can request them. They are not standard practice, and there is no expectation that you build them into a fifteen-minute slot.

Where a kit does what a prescription pad can’t

The gap here isn’t one of provider effort. It’s one of category.

A prescription handles one condition. Even if you wrote three prophylactic scripts before the trip, you’d still be one acute presentation away from the call you can’t take. And the patient would still be the one finding pharmacies willing to fill US scripts overseas, in a language they probably don’t read.

A kit is structurally different. It’s a defined formulary built for the conditions that show up most often when patients are away from home: GI infection, UTI, sinus infection, skin issues, common allergic reactions. The clinical work happens on the front end. The patient leaves with the medications, the dosing guidance, and the criteria for use, in English, in one box on their nightstand or in their suitcase.

There’s a quieter benefit that surfaces in patient feedback: the OTC layer is bundled in. Patients don’t have to figure out that paracetamol is what they’re looking for, or that NyQuil isn’t sold in most of the world, or that the dosing instructions on the box they found are in a language they have to Google-translate carefully to use safely. They have what they need, labeled in English, with usage guidance from the team that prescribed it.

This is in no way a replacement for the primary care relationship your patient has with you at home. Complex diagnoses, chronic conditions, ongoing management belong in your exam room. Jase works in a narrow, defined category: predictable, self-limiting conditions where the evidence is strong and the treatment path is clear. The category has a name now, and it’s worth using: appropriate medical preparation.

You can refer patients to Jase.com. We’ll keep sharing our clinical frameworks and decision criteria here as we go. Public knowledge in this space gets better when clinicians chart the grey area together, instead of leaving patients to figure it out on the internet.

The bottom line

A 2024 survey found that 27% of Americans have had medications confiscated during international travel. Most of your patients haven’t thought about this once. They’ll think about it when they’re standing at a foreign counter, sick, several time zones from anyone who knows their chart, asking for a drug by the wrong name.

You’re not going to add a twenty-minute international medication review to every visit. Nobody is. But the next time a patient mentions an upcoming trip, one question is worth asking: do you have anything on hand for the conditions that might show up while you’re there?

For most patients, the answer is no. Most people don’t think about medical preparation until they’ve been sick in a foreign city and spent a miserable day learning the hard way. Then they swear they’ll never leave home unprepared again. You can get them there before it comes to that.

Sources

1. 1. CDC Yellow Book: Travelers’ Diarrhea. https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html
   2. Kiplinger / SingleCare: International Travel with Medications — Know Before You Go. https://www.kiplinger.com/personal-finance/travel/international-travel-with-medications-know-before-you-go
   3. CDC Yellow Book: Traveling with Prohibited or Restricted Medications. https://www.cdc.gov/yellow-book/hcp/travelers-with-additional-considerations/traveling-with-prohibited-or-restricted-medications.html
   4. CDC: Traveling Abroad with Medicine. https://wwwnc.cdc.gov/travel/page/travel-abroad-with-medicine