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CDC Health Information for International Travel 2008

Questions and Answers about Travelers' Health

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Website Overview

Q. What is the purpose of this website?


A.The purpose of the CDC Travelers’ Health website is to provide information, based on scientific studies, disease surveillance, and best practices, to assist travelers and their health-care providers in deciding the vaccines, medications, and other measures necessary to prevent illness and injury during international travel.

Q. The website has so much information. Where should I begin?

A. We suggest you begin by selecting the country you plan to visit from the top of the homepage or from the Destinations page. This will take you to a Destination page that contains the travel health information you need for the country you select. 

Q. What are some important sections of the website?

A. Destinations – Travelers should start here. Use this section to locate information about disease risks and health recommendations, including what to know and what to do before the trip, during the trip, and upon return home.

Vaccinations – This section describes routine childhood and adult immunization schedules, recommended vaccines for travel destinations, yellow fever vaccine recommendations and requirements by country, and recommended vaccines for travelers with immunosuppression, including HIV infection.

Travel Medicine Clinics –This section provides links to professional medical organizations with travel clinic directories and links to state health department websites.

Authorized Yellow Fever Vaccination Clinics throughout the U.S. and its territories. Only authorized providers can give this vaccine.

Diseases –- Information from A-Z about common diseases travelers can encounter.

The 2008 Yellow Book – The complete, searchable Health Information for International Travel, CDC’s comprehensive textbook of travel medicine. 

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Travelers' Health Basics

Q. How soon before I travel should I make an appointment with the doctor?

A. Ideally, set up an appointment with a health-care provider 4 to 6 weeks before your trip. Many vaccines take time to become effective, and some vaccines must be given in a series over a period of days or sometimes weeks. If it is less than 4 weeks before you leave, you should still see your doctor. It might not be too late to get your shots or medications and other information about how to protect yourself from illness and injury while traveling.

Q. What items do you suggest I bring on my trip to help me stay healthy or treat illnesses like diarrhea?

A. We suggest you put together a Travelers' Health Kit. You should pack your prescribed medications, including an antibiotic to self-treat moderate to severe diarrhea. In addition, bring an over-the-counter medication to prevent diarrhea, sunscreen, insect repellent, and alcohol-based hand gels containing at least 60% alcohol to wash your hands when soap and clean water are not readily available. See our full list of suggested items in Travelers' Health Kit. A variety of kits is also available commercially.

Q. What should I look for in choosing an insect repellent?

A. The most effective repellents contain DEET (N,N-diethyl-m-toluamide) as an active ingredient. DEET has a long history of effectiveness and safety when used according to directions. A new repellent is now available in the U.S. containing 7% and 15% concentrations of picaridin (KBR 3023) as an active ingredient, which may be used if a DEET-containing repellent is not acceptable to the user. Because the percentage of picaridin is low, this repellent needs more frequent application. For more information about insect repellent use, see Protection against Mosquitoes and Other Arthropods.

Currently, the use of repellents other than DEET is not recommended for protection against mosquitoes that cause malaria, because there is less information available on how effective these repellents are against all types of mosquitoes that can transmit malaria.

Check the U.S. Environmental Protection Agency (EPA) website to learn about insect repellents that have been EPA-approved for efficacy and human safety; see How to Use Insect Repellents Safely.

Q. Is handwashing important during travel?

A. Yes. One of the most important ways to reduce infectious disease transmission during travel is to wash your hands carefully and frequently.

Soap and water will help remove potentially infectious materials from your hands.

If soap and water are not available, and your hands are not visibly dirty, use a waterless, alcohol-based hand gel with at least 60% alcohol. See these websites for information about effective handwashing: Handwashing Tips (PDF document) and Hand Hygiene After a Disaster.

Q. Where can I find information about travel health insurance and medical evacuation?

A . The U.S. Department of State lists travel health insurance and medical evacuation companies on their website, see Medical Information for Americans Traveling Abroad. For additional information, see Seeking Healthcare Abroad.

Q. Where can I find information about airport security and the items I am not allowed to carry onto an airplane?

A. The Transportation Security Administration (TSA) has in-depth information for travelers about security awareness, prohibited items, and travel tips. See Welcome to the TSA’s Travel Assistant.

Q. What are the new requirements for traveling to the Caribbean, Bermuda, Panama, Mexico, and Canada?

A. Beginning January 23, 2007, ALL persons, including U.S. citizens, traveling by air between the United States and Canada, Mexico, Central and South America, the Caribbean, and Bermuda will be required to present a valid passport, Air NEXUS card, or U.S. Coast Guard Merchant Mariner Document, or an Alien Registration Card, Form I-551, if applicable. See the U.S. Department of State site for details.

Q. While I am abroad, is there any way I can be contacted about an emergency that might affect me, or have my next of kin notified about my safety?

A. Several airlines have registration processes that allow travelers to provide their contact information, emergency contact/next-of-kin information, and travel itinerary information in case of an emergency. Please contact your airline for specific information about its emergency contact forms and procedures.

Additionally, the U.S. State Department provides a free travel registration service to U.S. citizens who are traveling or living in another country. Registration allows a traveler to record information about his or her upcoming trip abroad that the Department of State can use to assist in case of an emergency. Americans residing abroad can also get routine information from the nearest U.S. embassy or consulate. For more information, see the U.S. Department of State’s Travel Registration site.

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Q. What are routine vaccinations?

A. "Routine vaccines," as they are often called, are generally given after birth and throughout childhood and adolescence (such as the polio/measles/mumps/rubella [MMR vaccine] and the diphtheria/pertussis/tetanus [DPT] vaccine), see the childhood and adolescent immunization schedule. There is also a routine adult immunization schedule of recommended vaccines to protect adults from common diseases they are at risk for. These vaccines are recommended even if you do not travel. Although childhood diseases, such as measles, rarely occur in the United States, they are still common in many parts of the world. A traveler who is not vaccinated would be at risk for infection. Click on Vaccinations from the home page or on the table of contents that appears on every page.

Q. What is the difference between a required vaccination and a recommended vaccination?

A. The term “required” is used when a country’s government requires a traveler to present formal proof of vaccination in order to enter the country. A “recommended” vaccination is one that is suggested to protect travelers from illnesses present in other parts of the world and to prevent the importation of infectious diseases across international borders.

Under the International Health Regulations, governments of countries may require proof of yellow fever vaccination for individuals entering their country. Some countries require this proof of vaccination for all individuals above a certain age, while others require it for individuals who are traveling from a country where yellow fever is endemic. For information about country-specific yellow fever vaccination requirements, see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, All Countries (yellow pages).

There are also several vaccination requirements for persons traveling to Mecca for the annual Hajj. For more information, please see Saudi Arabia Hajj Requirements.

Q. How do I know if there is risk for yellow fever in the country I will be visiting?

A. Country-specific yellow-fever risk information, along with yellow fever vaccine recommendations, are listed on the destination pages of countries where there is a yellow fever risk.  Additionally, this information can be found in the Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, all Countries (yellow pages) chart. For some countries, there are only certain areas where there is a yellow fever risk; for those countries, more specific information is given in the chart to guide the recommendation for vaccination. There are also maps that show yellow fever risk areas within countries.

Q. Which countries require a yellow fever vaccination?

A. Yellow fever occurs only in sub-Saharan Africa and certain areas of tropical South America (see maps of Yellow Fever Endemic Zones). Transmission can also occur in Panama and Trinidad and Tobago, although cases have not been reported from either of these countries for many years.

Some yellow fever-endemic countries in sub-Saharan Africa require documented proof of yellow fever vaccination for entry. Certain other countries where yellow fever does not occur may require documented proof of yellow fever vaccination to enter if you have been in a yellow fever area 6 days prior to arriving. This may be particularly important if you will be traveling to multiple countries, but it is not usually a concern if you will be “in-transit” through a country—never leaving the airport. For yellow fever vaccination recommendations or requirements by country, see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country (yellow pages).

Q. Will I have to go to a special clinic to get a yellow fever vaccination and proof of vaccination?

A. Yes. Because yellow fever vaccine is regulated by International Health Regulations, only authorized providers can administer the vaccine. Most providers of yellow fever vaccine can also give you your other vaccines for travel. To find an authorized yellow fever vaccination clinic, see our list of providers at Yellow Fever Vaccination Clinics.

Q. How can I order the International Certificate of Vaccination or Prophylaxis?

A. Individual copies of the International Certificate of Vaccination or Prophylaxis (ICVP) are not available for sale. People who receive yellow fever vaccination should get a signed and stamped ICVP from the vaccination center. The certificate is valid for travel beginning 10 days after vaccination and is good for 10 years.

International Certificates of Vaccination or Prophylaxis (ICVP) are available for purchase in quantity from the Government Printing Office bookstore. To order, please visit or call toll-free (866) 512-1800.

The World Health Organization (WHO) in Geneva, Switzerland, also sells a version of the ICVP. To access the WHO bookstore, please visit$codlan=0$codcol=68$codcch=01000. Shipping may take a week or more.

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Q. How do I know if there is risk for malaria in the country I will be visiting?

A. For countries with malaria risk areas, the destination page details risk by country and lists the correct antimalarial drug or drugs for that country. Country-specific information may also be found on the Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country (yellow pages).

Q. How will I know which antimalarial drug is the correct one for me?

A. Many effective antimalarial drugs are available. Your health-care provider will decide the best drug for you based on the country you plan to visit and your health status.

To allow enough time for the drug to become effective and for a pharmacy to prepare any special doses of medicine, especially doses for children and infants, visit your health-care provider 4-6 weeks before travel.

Q. Can children also take malaria pills?

A. Yes. Children of any age can get malaria, and any child traveling to a malaria-risk area should take the appropriate antimalarial drug for the travel destination. Doses are based on the child’s weight. For more details, see Preventing Malaria in Infants and Children.

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Disease Risks/Outbreaks/Natural Disasters

Q. Where do I find information about general disease risks or recent outbreaks in the country I plan to visit?

A. Destination pages contain travel health information you need for each country, including any travel notices related to the area.  Because disease risks are similar for most countries in a region, destination pages describe other diseases found in the region.  It is importnat to remember that the risk for different diseases can very between countries within a region and also within a country. Some countries in a region will have either lower or higher risk for the listed diseases.  You can access destination pages using the dropdown menu on the Travelers’ Health homepage or the list of destinations on the Destinations page.

Country-specific information about yellow fever risk areas and yellow fever vaccine requirements and recommendations, as well as malaria risk and antimalarial drug recommendations, can also be found in the Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, All Countries (yellow pages) chart.

Information about the Geographic Distribution of Potential Health Hazards to Travelers for different regions of the world can be found in Chapter 3 of CDC Health Information for International Travel 2008. See the Table of Contents to select the appropriate region for your travel destination under the section for Chapter 3.

Outbreak notices and other types of travel notices can be found on the home page and at the top of the destination page for the area where the outbreak is occurring.

Q. What are travel notices?

A. Four levels of travel notices are In the News , Outbreak Notice , Travel Health Precaution , & Travel Health Warning . Notices of disease activity at any of these levels are always posted on the right side of the Travelers' Health home page, at the top of the Destination pages of areas in the affected world regions, and on the Travel Notices, Including Outbreaks page.

A travel notice generally describes two things: 1) the levels of risk a traveler to the affected area has of getting the disease, and 2) what preventive measures a traveler should take at each level of risk.

For more details about how CDC defines travel notices and their levels of importance, see the Travel Notices page.

Q. When I was on this website before, there was a travel notice posted, but it is no longer available. What does that mean?

A. When the health situation discussed in a travel notice is resolved, no longer applies, or the recommendations have been incorporated into the general recommendations for the country, a specific travel notice will be removed. It is important to visit the destinations page for the country you plan to visit for general travel health recommendations, even if a travel notice is not posted for that country.

Q. Are there specific concerns a traveler should have after a natural disaster or another environmentally hazardous event?

A. There can be health risks for travelers in areas where a natural or man-made disaster has occurred, including risks from injuries and disease. The CDC Health Information for International Travel 2008 chapter on Natural Disasters and Environmental Hazards provides information about possible health risks in such settings (e.g., flooding, hurricanes, air pollution) and what you can do to decrease those risks.

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Non-Infectious Risks During Travel

Q. Besides diseases, is there anything else I should think about to protect my health?

A. Yes. There is more to travelers’ health than preventing infectious diseases. Click on the following links for more information about these subjects.

Altitude Illness

Animal-Associated Hazards

Deep Vein Thrombosis/Pulmonary Embolism


Motion Sickness


Temperature Extremes and Extreme Heat: A Prevention Guide to Promote Your Personal Health and Safety

Swimming and Recreational Water Safety

Scuba Diving

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Special Groups

Q. What precautions or vaccinations should be considered for children when they travel?

A. Infants and children will be at risk for many of the same diseases and injuries as adults when they travel. In addition, infants and children have special needs that should be taken into account, such as the correct dose of antimalarial pills. Read about general health information for travel with infants and young children in Traveling Safely with Infants and Children and specific vaccination information in Vaccine Recommendations for Infants and Children or take a copy of these chapters to your doctor.

Q. Are pregnant or breastfeeding women at any particular risk when traveling?

A. Pregnant women are advised to consult with their health-care providers before making any travel decisions. In general, the second trimester (18–24 weeks) is the safest time for a healthy pregnant woman to travel. Some vaccines are not recommended during pregnancy, and some medical conditions in a pregnant woman can get worse if she engages in certain activities. Exposure to certain diseases, such as malaria, can endanger a pregnant woman’s health or that of her unborn child. For more detailed information about the pregnant traveler, see Planning for a Healthy Pregnancy and Traveling While Pregnant.

There are many advantages to breastfeeding an infant during travel, although any travel with an infant comes with its challenges. It is easier, and in many instances safer, to nurse than to prepare bottles on the road. For more detailed information about the breast feeding traveler, see Breastfeeding and Travel.

Q. I am a health-care provider. Where can I find specific information about dosages of vaccines and health recommendations for international travelers?  

A. Vaccination Information from Health and International Travel

ACIP Recommendations for specific vaccines

CDC Malaria Branch: Malaria Case Management Hotline - 770-488-7788 (M-F, 8 am-4: 30 pm, EST). For emergency consultation after hours, 770-488-7100 , ask to speak with a CDC Malaria Branch clinician.

Useful Links



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  • Page last updated: December 19, 2007
  • Content source:
    Division of Global Migration and Quarantine
    National Center for Preparedness, Detection, and Control of Infectious Diseases
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