North America This section includes general information about health hazards as reported by the World Health Organization and the U.S. Centers for Disease Control and Prevention. In addition to the United States, the region includes Bermuda, Canada, Greenland, and St. Pierre and Miquelon. The area extends from the Arctic to the subtropical cays of the southern United States. The incidence of communicable diseases is such that they are unlikely to prove a hazard for international travelers greater than that found in their own country. There are health risks but, in general, the precautions required are minimal. Certain diseases occasionally occur, such as plague, rabies in wildlife including bats, Rocky Mountain spotted fever, tularemia, and arthropod-borne encephalitis. Recently, rodent-borne hantavirus has been identified, predominantly in the western part of the United States. Lyme disease is endemic in the northeastern, mid-Atlantic, and upper midwestern United States. During recent years, the incidence of certain food-borne diseases, e.g., salmonellosis, has increased in some regions. Other hazards include poisonous snakes, poison ivy, and poison oak. In the north, a serious hazard is the very low temperature in the winter.