Information for Travelers

Summer is here, and many people will be packing to travel. No matter where you travel abroad this summer, please don’t let your vacation be spoiled by getting the measles, flu, hepatitis, or any other infection that could have been prevented by using routine or travel-related vaccines.

Why would this summer be any different from other years? Apart from the usual travel-related health risks, there are two international sports events this summer that are expected to increase travel from the US to specific places in Europe and Asia. People from many other countries will also attend these events. The locations of these events in Europe and Asia and the fact that they will be visited by crowds of people from all over the world make it important for travelers to be sure they are up-to-date on all routine and travel-related vaccines.

EURO 2008 Soccer Games

The Union of European Football Associations (UEFA) European Championship is being held in Austria and Switzerland during June 7-29, 2008. Travelers going to Austria or Switzerland for these games should be up-to-date on all routine vaccines, especially measles vaccine. This year, over 2,800 people have been reported as being sick with measles in several European countries, including Austria and Switzerland. If you are traveling to this event, read the travel health information on the CDC Austria and Switzerland destination pages and the news item on the official UEFA EURO 2008 website:Swiss recommend MMR vaccine for visitors. Then talk to your doctor to make sure you are up-to-date with your vaccinations.

2008 Beijing Olympic and Paralympic Games

Did you know that 600,000 foreign visitors and athletes and up to 2.5 million domestic visitors and volunteers are expected to attend the 2008 Beijing Olympic and Paralympic Games? If you’re planning to be one of them, it’s a good idea to become familiar with the health and safety tips on the Travelers’ Health Gold Medal Travel Health Tips for the 2008 Beijing Olympic Games and China destination web pages. These tips provide important information about disease risks in China and how to prevent them.

There is also a risk of acquiring measles in China. During 2008, several US residents have gotten sick with measles as a result of traveling to China or because they were in contact with a visitor from China. Also, many people going to the games will be coming from countries where measles is more common than in the US. If you are traveling to the Olympic or Paralympic Games, CDC recommends that you talk to your doctor to be sure that you are protected against measles and up-to-date on all recommended vaccines, including those recommended routinely and those recommended when traveling.

Summary of Advice for Travelers

If you are traveling to one of these sports events―or anywhere else―this summer, talk to your doctor to make sure you are up-to-date with your vaccinations. If you are traveling with children, be sure that they have been vaccinated, too.

Check the CDC Travelers’ Health recommendations for the country you are visiting by going to the Destinations page and searching for that country from the list or map. 

If you are going to the Olympics or Paralympics, read the information on the Gold Medal Travel Health Tips for the 2008 Beijing Olympic Games and China destination web pages.

Read the travel notices posted on the Travelers’ Health website for the countries where the two sports events will take place.

In the News Notice

• 2008 Measles Update

Outbreak Notices

• Hand, foot, and mouth disease in Asia
• Update: Dengue, Tropical and Subtropical Regions
• Human Infection with Avian Influenza A (H5N1) Virus: Advice for Travelers

After you return home, if you develop a fever, cough, red eyes, runny nose and a red, raised rash that begins on the face and spreads to the arms and legs, you should see your doctor and explain that you have recently traveled.

Additional Information for Health-Care Professionals

There is a heightened concern for disease exposure of travelers to the locations and mass gatherings of the major sporting events this summer and the ongoing risk of measles in these countries.

Measles: A particular concern

Measles outbreaks in Europe and Asia have been documented in the following resources:

European Centre for Disease Prevention and Control (ECDC)

• ECDC warns of an upsurge of measles in Europe: unvaccinated people are at risk (April 10, 2008)
• An ongoing multistate outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and Norway, March-April 2008 (Eurosurveillance, 13(16) Article 4, April 27, 2008)

U.S. Centers for Disease Control and Prevention

• Measles --- United States, January 1--April 25, 2008 (MMWR 57(18);494-498, May 9,2008)
• In the News travel notice: 2008 Measles Update

Pre-travel assessment: Travelers should have evidence of immunity to measles, which includes one of the following:

1. Documented administration of 2 doses of live measles-containing vaccine at least 28 days apart, on or after the first birthday
2. Laboratory evidence of immunity
3. Birth before 1957
4. Documentation of physician-diagnosed measles.

If a traveler does not meet one of the criteria above, measles vaccination should be given.

Pre-travel measles vaccination:

• Children 12 months or older
  • The 2-dose measles (or MMR) vaccine schedule is recommended in the US at age 12-15 months (first dose) and age 4-6 years (second dose). However, for all children traveling or living overseas, the age of measles vaccination should be lowered if needed (see below for guidelines).
• Children 6–11 months of age
  • One dose of single-antigen measles vaccine before travel, if available. If it is not available, a dose of MMR vaccine can be given.
  • Note: measles or MMR vaccines given before 12 months of age should not be counted as part of the series. Children who receive measles or MMR vaccines before age 12 months will need 2 more doses of MMR vaccine, the first of which should be administered at 12–15 months of age (12 months if the child remains in a high-risk area), and the second at least 28 days later.
• Adults
  • Should receive 2 doses of MMR or measles vaccine, separated by at least 28 days.

Refer to the Advisory Committee on Immunization Practices (ACIP) recommendations for measles, mumps, and rubella.

Post-travel consideration: If a patient develops fever, cough, red eyes, runny nose and a red, raised rash that begins on the face and spreads to the arms and legs, a full travel and vaccination history should be obtained and the diagnosis of measles should be considered.
 

Recommended Vaccinations

Health-care professionals should ensure that travelers are up-to-date on the following vaccinations. (Links for each disease connect to the corresponding section in CDC Health Information for International Travel 2008.)

Routine Vaccinations

Influenza
Measles or measles/mumps/rubella (MMR)
Diphtheria/pertussis/tetanus (DPT, dTap)
Poliovirus
Varicella (chickenpox)
Pneumococcal disease (for those in the respective risk groups)

Travel-Related Vaccines

Considered for all travelers to developing countries:
Hepatitis A
Hepatitis B
Typhoid

Considered for travelers who plan to visit certain destinations:
Japanese Encephalitis
Meningococcal
Rabies
Yellow Fever

Also see the Vaccines and Vaccine-Preventable Diseases website for additional vaccine information (National Center for Immunization and Respiratory Diseases website). Armed with this information, health-care professionals can work together with their traveling patients to ensure a safe and healthy summer travel season and prevent the translocation of communicable diseases.