Latvia Travel Health Guide: A World-Record Tick-Borne Disease History, No Malaria, and Riga's First Measles Outbreak Since 2018

Latvia carries no malaria risk anywhere in the country, but it carries one of Europe's most persistent tick-borne encephalitis (TBE) burdens: 186 confirmed cases in 2025, an incidence rate of 9.89 per 100,000, down from a world-record high of up to 53 per 100,000 in the 1990s, according to national surveillance data cited in peer-reviewed literature. Riga also confirmed its first measles outbreak since 2018 in March 2026, traced to a single school and tracked through more than 1,000 contacts. Rabies is controlled but not eliminated, circulating in wildlife such as raccoon dogs and foxes. Our clinical team reviews each traveler's vaccination history and itinerary before recommending a plan. Start your visit on Wandr before you fly.

By The Wandr Team Last updated: September 18, 2026

Quick Facts: Latvia Health at a Glance

• Region: Northern Europe, the middle of the three Baltic states, EU and Schengen member, eurozone. Borders Estonia, Lithuania, Belarus, and Russia. Capital: Riga. Major visitor draws: Riga's UNESCO World Heritage-listed Old Town and Art Nouveau district, the Gauja National Park, and the Baltic Sea beach town of Jurmala.
• CDC/WHO Malaria Risk: None. The WHO European Region, which includes Latvia, was certified malaria-free in 2016.
• Key Health Risks: Tick-borne encephalitis (one of the most persistent burdens in Europe, historically among the world's highest), a March 2026 measles outbreak in Riga, rabies in wildlife (raccoon dogs, foxes, and bats), and traveler's diarrhea from food and water.
• Recommended Vaccines: MMR (measles, mumps, rubella) for any traveler without documented immunity, tick-borne encephalitis vaccine for anyone spending time hiking, camping, or working outdoors between spring and late autumn, a routine tetanus-diphtheria booster if more than 10 years since the last dose, and rabies pre-exposure vaccination for extended stays, occupational risk, or close wildlife contact.
• Recommended Medications: A just-in-case antibiotic for traveler's diarrhea, an antispasmodic for cramping, motion sickness medication for Baltic Sea ferries, and something for general nausea or travel anxiety on long flights.
• US State Department Advisory: Level 1, Exercise Normal Precautions, updated April 1, 2026.
• Travel Insurance Recommended: Yes. Riga has strong medical care, but rural areas and Gauja National Park have more limited facilities, and a tick-borne encephalitis diagnosis or a measles-related quarantine disruption can both turn into unplanned costs quickly.

Overview

Latvia's tourism numbers keep climbing. The country's accommodation establishments received 2.8 million visitor arrivals in 2025, up 4.5% over 2024, with overnight stays reaching 5.0 million, up 6.1% year over year, according to Latvia's Central Statistical Bureau. Non-resident visitors accounted for 1.7 million of those arrivals, a 5.3% annual increase, led by travelers from Lithuania, Estonia, Germany, Finland, and the United Kingdom, with the UK posting the sharpest growth at nearly 20%. Riga alone captured almost 72% of all non-resident arrivals, and most American visitors spend their trip walking the cobblestone streets of Riga's Old Town and Art Nouveau district before a day trip to Jurmala's beaches or Gauja National Park.

The health story here splits in a way that surprises a lot of travelers who assume a small, highly developed Baltic EU country carries minimal risk. There is no malaria anywhere in Latvia. But tick-borne encephalitis, a viral infection spread by infected ticks, has a documented history here unlike almost anywhere else in the world, and a measles outbreak that started at a Riga school in March 2026 broke an eight-year run without local transmission. Layer in a rabies picture that is controlled but not eliminated, and Latvia turns out to need a more specific pre-trip checklist than its reputation as an easy, low-risk Baltic add-on to Estonia or Lithuania might suggest.

Malaria: A Non-Issue Everywhere in the Country

You do not need antimalarial medication for any itinerary in Latvia. The World Health Organization certified its European Region, all 53 member states including Latvia, malaria-free in 2016, and no locally acquired case has been reported in the country since. If your itinerary continues on to a malaria-endemic country afterward, our clinical team can prescribe Malarone (atovaquone-proguanil) as part of your pre-trip visit, but Latvia itself does not require it.

Tick-Borne Encephalitis: A World-Record History, Still One of Europe's Highest Rates

This is the finding that separates Latvia from most of its EU neighbors. Between 1990 and 2000, Latvia recorded the highest tick-borne encephalitis rates documented anywhere in the world, ranging from 8 to 53 confirmed cases per 100,000 population in a given year, according to peer-reviewed surveillance data. Latvia has made real progress since: the country logged 186 confirmed TBE cases in 2025, an incidence rate of 9.89 per 100,000, down from 240 cases (12.67 per 100,000) in 2022. But that 2022 figure alone still ranked among the highest national TBE incidence rates anywhere in Europe, and UK travel health guidance confirms there is "a risk of TBE in all areas of this country," with the northwestern coastal regions carrying a particularly elevated burden and ticks most active from early spring through late autumn.

TBE has no specific antiviral treatment and no medication in Wandr's catalog treats it directly, so the relevant step is prevention, not a prescription. A TBE vaccine series is available and is the single most effective protection for anyone spending meaningful time outdoors in rural, coastal, or forested parts of Latvia between spring and fall. Our clinical team can help you determine whether your itinerary calls for it. Book your vaccine appointment through Wandr.

Practical prevention matters just as much as the vaccine decision. Use an EPA-registered tick repellent (DEET or picaridin) on skin and permethrin-treated clothing if you plan to hike, camp, or spend time in Gauja National Park or the coastal dunes near Jurmala, do a full-body tick check each evening, avoid unpasteurized dairy products (a secondary TBE exposure route across the Baltics), and remove any attached tick promptly with fine-tipped tweezers, pulling straight out.

Riga's First Measles Outbreak Since 2018

This is the fact that should change your pre-trip checklist if you have not confirmed your MMR status recently. Latvia's Disease Prevention and Control Centre (SPKC) confirmed 14 measles cases as of March 20, 2026, seven laboratory-confirmed and seven clinically diagnosed, all epidemiologically linked to a single outbreak source: Riga's Waldorf School. One adult was among the cases; the rest were schoolchildren, with one child hospitalized and the remainder treated as outpatients. This was Latvia's first confirmed measles outbreak since 2018.

Health authorities traced more than 1,000 contacts and assessed the risk of further spread as "high, particularly among unvaccinated individuals," according to SPKC's own statement, while noting the difficulty of identifying every casual contact in public places. Latvia's routine schedule recommends a first MMR dose at 12 to 15 months and a booster at age 7, with state-funded vaccination available through age 25.

Measles spreads through airborne droplets and is among the most contagious diseases known, capable of infecting up to 90% of susceptible people in close contact with an infected person, according to the World Health Organization. If you are traveling to Latvia without documented MMR immunity, or with a child too young for routine vaccination, closing that gap is the highest-value thing you can do before this trip. Book your vaccine appointment through Wandr, and see our MMR vaccine guide for travelers for how to check your immunity status quickly.

Rabies: Controlled, Not Eliminated

Rabies in Latvia is best described as controlled rather than absent. Peer-reviewed research on the Baltic states describes decades of oral vaccination campaigns targeting wildlife, and current UK travel health guidance rates most travelers to Latvia at low risk. The practical caveat is that raccoon dogs and foxes remain the primary wildlife reservoirs in the region, and bats may also carry rabies-like viruses.

In practice, this means most short trips to Riga and the well-trodden tourist circuit carry minimal rabies exposure risk. Avoid handling bats or any wild animal you encounter, and if you are bitten or scratched by any mammal you cannot verify as vaccinated, wash the wound with soap and running water for a full 15 minutes and seek medical care the same day. If your trip involves extended rural time, forestry work, or wildlife-heavy travel through Gauja National Park, ask our clinical team whether a rabies pre-exposure vaccine makes sense before you go. Our rabies vaccine guide covers the current pre-exposure schedule.

Food and Water Safety

Tap water in Riga and other Latvian cities is treated to EU standards and is generally considered safe to drink, similar to the picture we found in Estonia. Standard travel precautions still apply outside major cities: in rural areas or smaller towns, stick to bottled or filtered water if you are uncertain about the local supply.

Latvian cuisine leans on rye bread, potatoes, and smoked fish, most of it cooked and served hot, which works in your favor. As with most of Northern Europe, traveler's diarrhea from food and water is still the single most common reason a visitor to Latvia ends up needing a prescription mid-trip.

What to Pack: Practical Medications

• Traveler's diarrhea: Azithromycin is our first-line prescription antibiotic for traveler's diarrhea; ciprofloxacin is a reasonable alternative when azithromycin is not appropriate. An antispasmodic (dicyclomine) can help with cramping.
• Motion sickness: Baltic Sea ferry crossings, including routes connecting Riga with Stockholm, are a common trigger. Meclizine or a scopolamine patch cover most itineraries.
• General nausea: Ondansetron is useful for nausea from ferry crossings, food, or general travel illness.
• Sleep and anxiety: Hydroxyzine can help with travel anxiety or disrupted sleep on long flights.

Our providers review your health profile and itinerary before prescribing, so you get what actually fits your trip rather than a generic kit.

Vaccines: What to Get Before You Go

• MMR (measles, mumps, rubella): A priority for 2026 given the active outbreak traced to a Riga school. Confirm documented immunity (two prior doses or a positive titer) before you travel, and get vaccinated if you cannot.
• Tick-borne encephalitis: Strongly consider this if your trip includes hiking, camping, or extended time outdoors in rural or coastal Latvia between spring and late autumn.
• Routine tetanus-diphtheria booster: Confirm your status is current, particularly if hiking or cycling is part of your itinerary.
• Rabies pre-exposure vaccine: Discuss this with our clinical team if your trip involves extended rural time, forestry work, or planned wildlife contact.

Vaccines on Wandr work differently from prescriptions: you pick a partner pharmacy location and time, we book the appointment, and the pharmacist administers your travel vaccines on-site. Schedule your vaccine appointments through Wandr before you fly.

Travel Advisory and Practical Safety

The US State Department rates Latvia Level 1, Exercise Normal Precautions, as of an April 1, 2026 update, describing Latvia as "generally a safe destination for travelers." The advisory flags common tourist-targeted crime, purse snatching and pickpocketing in Riga's Old Town and transportation hubs, along with general internet and scam risk, but does not raise the advisory level. This advisory has nothing to do with the tick-borne encephalitis, measles, or rabies information in this guide; they are tracked and updated separately.

Health and Safety Tips

• Confirm your MMR immunity or get vaccinated before you travel, given the active 2026 Riga measles outbreak.
• Use an EPA-registered tick repellent and do a daily tick check if you plan to hike, camp, or spend time in Gauja National Park or coastal dunes.
• Avoid unpasteurized dairy products, particularly from small rural producers.
• Avoid contact with raccoon dogs, foxes, bats, and other wild animals; seek care immediately for any bite or scratch.
• Confirm your routine vaccines are current before you travel.
• Watch your bags in Riga's Old Town and at transportation hubs, where pickpocketing is the most commonly reported tourist crime.
• Carry a copy of your prescriptions and keep medications in their original, labeled packaging.

FAQ

Do I need malaria pills for Latvia? No. Latvia has no malaria risk anywhere in the country, and the World Health Organization certified its entire European Region malaria-free in 2016. If your itinerary continues to a malaria-endemic country afterward, our clinical team can prescribe Malarone for that leg of the trip.

Why does Latvia have such a high tick-borne encephalitis rate? Latvia recorded the world's highest documented TBE rates between 1990 and 2000, up to 53 cases per 100,000 population in a single year. The country logged 186 confirmed cases in 2025 (9.89 per 100,000), a real improvement but still among the higher incidence rates in Europe. The TBE vaccine is the most effective protection for travelers spending time outdoors in rural or coastal areas between spring and late autumn.

Is there really a measles outbreak in Latvia? Yes. Latvia's Disease Prevention and Control Centre confirmed 14 measles cases as of March 20, 2026, all linked to a single outbreak at a Riga school, marking the country's first measles outbreak since 2018. Health authorities traced more than 1,000 contacts and assessed further spread risk as high among unvaccinated individuals.

Do I need an MMR vaccine before visiting Latvia? If you do not have documented immunity to measles, mumps, and rubella, either from two prior vaccine doses or a positive antibody titer, yes. Given the active 2026 outbreak traced to a Riga school, this is the single highest-priority vaccine check for any traveler to Latvia this year, especially families traveling with young children.

Is rabies a real risk in Latvia? Rabies is controlled in Latvia through decades of wildlife vaccination campaigns, and UK travel health guidance rates most travelers at low risk. Raccoon dogs and foxes remain the primary wildlife reservoirs in the region, and bats may also carry rabies-like viruses, so avoid handling wild animals and seek care immediately for any bite or scratch.

Is tap water safe to drink in Riga? Yes. Tap water in Riga and other Latvian cities is treated to EU standards and is generally considered safe to drink. In rural areas or smaller towns, bottled or filtered water is a reasonable precaution if you are uncertain about the local supply.

Why is Latvia's US travel advisory at Level 1? The US State Department rates Latvia Level 1, Exercise Normal Precautions, as of an April 1, 2026 update describing it as "generally a safe destination for travelers," with the main flagged concerns being pickpocketing and purse snatching in Riga's Old Town and transportation hubs, plus general internet scam risk.

Do I need travel insurance for Latvia? We recommend it, especially if your itinerary includes hiking in Gauja National Park or rural travel outside Riga. Medical care in Riga is strong, but facilities are more limited outside the capital, and a tick-borne encephalitis diagnosis or a measles-related exposure disruption can both turn into unplanned costs.

The Bottom Line

Latvia is not a malaria destination, and its reputation as a clean, efficient, low-hassle Baltic EU country is fair in most respects. But it carries a documented tick-borne encephalitis history unlike almost anywhere else in the world, a fresh 2026 measles outbreak traced to a Riga school, and a rabies picture that is controlled but still calls for basic wildlife caution. None of that requires an elaborate medical kit, but it does call for an MMR check given the active outbreak, a TBE vaccine conversation if you are headed outdoors between spring and fall, and standard animal-contact precautions everywhere in the country. Our providers can build the right prevention plan for your specific itinerary. Start your visit on Wandr, or explore our full travel medication lineup and vaccine booking before you fly.

For more on the vaccines at the center of this guide, see our tick-borne encephalitis vaccine guide, MMR vaccine guide, and rabies vaccine guide. Planning a wider Baltic trip? Read our guide to Estonia.

This article is for general educational purposes and is not a substitute for personalized medical advice. Medication and vaccine recommendations depend on your individual health history, itinerary, and length of stay. This guide does not provide visa or immigration determinations; confirm current entry and border requirements with the Embassy of Latvia or the US Department of State before you travel. Get travel insurance with medical evacuation coverage before departure.

Sources

1. World Health Organization. Europe commits to staying malaria-free (2017), referencing the 2016 certification of the WHO European Region. https://www.who.int/news/item/04-09-2017-europe-commits-to-staying-malaria-free
2. TBE Book / tbenews.com. Latvia country chapter: TBE incidence data 2010-2025 and 1990s historical rates. https://tbenews.com/tbe/13-19-7/
3. European Centre for Disease Prevention and Control. Country profile: Latvia. Tick-borne encephalitis (TBE). https://www.ecdc.europa.eu/en/publications-data/country-profile-latvia-tick-borne-encephalitis-tbe
4. TravelHealthPro (NaTHNaC). Latvia country health guidance. https://travelhealthpro.org.uk/country/125/latvia
5. LSM (Latvian Public Broadcasting), eng.lsm.lv. Fourteen measles cases confirmed in Latvia (March 20, 2026). https://eng.lsm.lv/article/society/health/20.03.2026-fourteen-measles-cases-confirmed-in-latvia.a639665/
6. US Department of State. Latvia Travel Advisory, updated April 1, 2026. https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/latvia-travel-advisory.html
7. PLOS Neglected Tropical Diseases. Rabies in the Baltic States: Decoding a Process of Control and Elimination. https://journals.plos.org/plosntds/article?id=10.1371%2Fjournal.pntd.0004432
8. Central Statistical Bureau of Latvia (stat.gov.lv). Tourist accommodation statistics, 2025. https://stat.gov.lv/en/statistics-themes/business-sectors/tourism/press-releases/27588-latvian-hotels-and-other