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Yellow Book

CDC Health Information for International Travel 2008

Chapter 5
Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country

Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country

Country Yellow Fever Malaria
Requirements1 CDC recommendations2,4 Area of risk Chloroquine resistance Recommended prophylaxis
Afghanistan If traveling from an endemic zone None Risk April-December in all areas at altitudes below 2,000m (<6,561ft) Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Albania If traveling from an endemic zone and >1 year of age None None Not Applicable Not Applicable
Algeria If traveling from an endemic zone and >1 year of age None Risk is limited to one small focus in Sahara region in Ihrir (Illizi Department). Risk is very limited; therefore, prophylaxis is not recommended. None None
Samoa, American          
Andorra Not Required None None Not Applicable Not Applicable
Angola Required upon arrival from all countries For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Anguilla (U.K.)

If traveling from an endemic zone and >1 year of age

None

None

Not Applicable

Not Applicable

Antarctica Not Required None None Not Applicable Not Applicable
Antigua and Barbuda

If traveling from an endemic zone and >1 year of age

None

None

Not Applicable

Not Applicable

Argentina

Not Required

For all travelers >9 months of age going to the northern and northeastern forested areas, including Iguaçu Falls and all parts of Misiones Province, as well as all areas bordering Paraguay and Brazil. These areas include: all departments of Misiones and Formosa Provinces; Department of Bermejo in Chaco Province; Departments of Berón de Astrada, Capital, General Alvear, General Paz, Ituzaingó, Itatí, Paso de los Libres, San Cosme, San Miguel, San Martín and Santo Tomé in Corrientes Province; Departments of Valle Grande, Ledesma, Santa Bárbara and San Pedro in Jujuy Province; and Departments of General José de San Martín, Oran, Rivadavia and Anta in Salta Province (see Updated yellow fever risk map for Argentina). Updated April 17, 2008 Rural areas of Salta and Jujuy province (along border with Bolivia) and Misiones and Corrientes province (along border with Paraguay).

None

Chloroquine

Armenia

Not Required

None

Risk limited to the Ararat Valley in the Ararat and Artashat region; greatest risk in Masis district.

None

Chloroquine
Aruba If traveling from an endemic zone and >6 months of age3. None None Not Applicable Not Applicable
Australia; Including Cocos (Keeling) Islands

All persons >1 year of age who, within 6 days of arrival in Australia, have been in or have passed through an endemic zone

None

None

Not Applicable

Not Applicable

Austria

Not Required

None

None

Not Applicable

Not Applicable

Azerbaijan

Not Required

None

Rural lowlands near Kura and Arax rivers in the provinces of Agcabadi, Barda, Beylaqan, Bilasuvar, Calilabad, Fuzuli, Imisli, Kurdamir, Nakhichivan, Sabirabad, Saatli and Zardab typically between July and October.

None

Chloroquine

Azores (Portugal)

If traveling from an endemic zone and >1 year of age

None

None

Not Applicable

Not Applicable

Bahamas, The

If traveling from an endemic zone and >1 year of age

None

Island of Great Exuma only. There is currently no known risk of malaria on other islands in The Bahamas.

None

Chloroquine

Bahrain

Not Required

None

None

Not Applicable

Not Applicable

Bangladesh

If traveling from an endemic zone. Any person (including infants)3 arriving by air or sea without a certificate within 6 days of departure from or transit through an infected area will be quarantined up to 6 days.

Required also for travelers arriving from or transiting:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea Bissau, Kenya, Liberia, Malawi, Mali, Mauritania, Niger, Nigeria, Rwanda, São Tomé and Principe, Senegal, Sierra Leone, Somalia, Sudan (south of 15° N), Tanzania, Togo, Uganda, and Zambia.

Americas: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guatemala,
Guyana, Honduras, Nicaragua, Panama, Peru, Suriname, and Venezuela.

Caribbean: Trinidad and Tobago.

None

All, except no risk in city of Dhaka

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Barbados If coming from an endemic zone and >1 of age

None

None

Not Applicable

Not Applicable

Belarus

Not Required

None

None

Not Applicable

Not Applicable

Belgium

Not Required

None

None

Not Applicable

Not Applicable

Belize If traveling from an endemic zone and >1 year of age None All, except no risk in Belize City None Chloroquine
Benin Required upon arrival from all countries if traveler is > 1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Bermuda (U.K.)

Not Required

None

None

Not Applicable

Not Applicable

Bhutan

If traveling from an endemic zone

None

Risk in rural areas below 1,700 m (<5,577 ft) of the 5 southern belt districts of: Chirang, Samchi, Samdrup Jongkhar, Sarpang, and Shemgang

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Bolivia Required for all travelers >1 year of age. Medical waivers must be translated into Spanish and accompany the International Certificate of Vaccination or Prophylaxis (ICVP). Travelers who do not have a valid ICVP will still be allowed to enter Bolivia if they agree to sign an affidavit exempting the Bolivian state from any liability in the event the traveler gets sick with yellow fever within the Bolivian territory. This last option may cause delays at the point of entry. For all travelers >9 months of age traveling to areas east of the Andes Mountains (see Map 4-16). Does not include the cities of La Paz or Sucre. Risk in areas below 2,500 m (<8,202 ft) in the following departments:
Beni, Chuquisaca, Cochabamba, La Paz, Pando, Santa Cruz, and Tarija. No risk in city of La Paz.
Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Bosnia and Herzegovina

Not Required

None

None

Not Applicable

Not Applicable

Botswana

If traveling from an endemic zone and >1 year of age

None

Risk north of 22°S in the northern provinces of Central, Chobe, Ghanzi, Ngamiland, and including safaris to the Okavango Delta area. No risk in the city of Gaborone.

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Brazil Not required For all travelers ≥9 months of age going to the following areas at risk for yellow fever transmission, including the ENTIRE states of Acre, Amapá, Amazones, Distrito Federal (including the capital city of Brasília),  Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, Tocantins, and designated areas of the following states: northwest and west Bahia, central and west Paraná, southwest Piauí, northwest and west central Rio Grande do Sul, far west Santa Catarina, and north and west São Paulo. (See updated Yellow Fever vaccination recommendations map (PDF).) Vaccination is also recommended for travelers visiting Iguassu Falls. Vaccination is NOT recommended for travel to the following coastal cities: Rio de Janeiro, São Paulo, Salvador, Recife, and Fortaleza. States of Acre, Rondônia, Amapá, Amazonas, Roraima, and Tocantins. Parts of states of Maranhaõ (western part), Mato Grosso (northern part), and Pará (except Belem City). There is also transmission in urban areas, including large cities such as Porto Velho, Boa Vista, Macapa, Manaus, Santarem, and Maraba, where transmission occurs on the periphery of these cities.

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

British Indian Ocean Territory; Includes Diego Garcia (U.K.)

Not Required

None

None

Not Required

Not Required

Brunei

If traveling from an endemic zone and >1 year of age

None

None

Not Applicable

Not Applicable

Bulgaria

Not Required

None

None

Not Applicable

Not Applicable

Burkina Faso Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Burma (Myanmar)

If traveling from an endemic zone.

Required also for nationals and residents of Burma (Myanmar) departing for an endemic zone

None

Risk in rural areas throughout the country at altitudes below 1000 m (<3,281 ft). No risk in cities of Rangoon (Yangon) and Mandalay

Confirmed

Only atovaquone/ proguanil or doxycycline in the provinces of Shan, Kayah, Kachin, Kayin, and Tanintharyi. All other areas atovaquone/ proguanil, doxycycline, or mefloquine (see Map 4-9).
Burundi Required upon arrival from all countries For all travelers >9 months of age All

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Cambodia If traveling from an endemic zone

None

Risk throughout the country, including risk in the temple complex at Angkor Wat. No risk in Phnom Penh and around Lake Tonle Sap.

Confirmed

Only atovaquone/ proguanil or doxycycline in the provinces of Preah Vihear, Siemreap, Oddar, Meanchey, Banteay Meanchey, Battambang, Pailin, Koh Kong, and Pursat bordering Thailand. All other areas atovaquone/ proguanil, doxycycline, or mefloquine. (see Map 4-9)

Cameroon Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Canada

Not required

None

None

Not applicable

Not applicable

Canary Islands (Spain)

Not required

None

None

Not applicable

Not applicable

Cape Verde

If traveling from an endemic zone and >1 year of age.

None

Risk limited to Saõ Tiago Island.

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Cayman Islands (U.K.)

Not required

None

None

Not applicable

Not applicable

Central African Republic Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Chad Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age. All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Chile

Not required

None

None

Not applicable

Not applicable

China

If traveling from an endemic zone

None

Travelers to cities and popular tourist areas, including Yangtze River cruises, are not at risk and do not need to take chemoprophylaxis. Rural areas only of the following provinces: Hainan, Yunnan, Fuijan, Guangdong, Guangxi, Guizhou, Sichuan, Tibet (in the Zangbo River valley only), Anhui, Hubei, Hunan, Jiangsu, Jiangxi, and Shandong. In provinces with risk, transmission exists in rural communities below 1,500 m only during warm weather: north of latitude 33°N, July-November; between latitude 25°N and 33°N, May-December. South of latitude 25°N, transmission occurs year-round.

Confirmed in the provinces of Hainin and Yunnan. Other provinces do not have chloroquine-resistant malaria.

Only atovaquone/ proguanil or doxycycline along China-Burma border in the western part of Yunnan province; Atovaquone/ proguanil, doxycycline or mefloquine in Hainan and the other parts of Yunnan province (see Map 4-9); Chloroquine in all other areas.

Christmas Island (Australia) All travelers >1 year of age, who within the past 6 days have traveled or passed through an endemic area, as listed by WHO. None None Not applicable Not applicable
Cocos (Keeling) Islands

All persons >1 year of age who, within 6 days of arrival in Australia, have been in or have passed through an endemic zone

None

None

Not Applicable

Not Applicable

Colombia Not required For all travelers >9 months of age. Travelers whose itinerary is limited to the cities of Bogotá, Cali, or Medellín are at lower risk and may consider foregoing vaccination. Risk in all rural areas at altitudes below 800 m (<2,624 ft). No risk in Bogotá and vicinity. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Comoros Not required None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Congo Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Cook Islands (New Zeland) Not required None None Not applicable Not applicable
Costa Rica

If traveling from the endemic zones listed below:

Africa: Angola, Benin, Burkina Faso, Cameroon, Democratic Republic of Congo, Gabon, Gambia, Ghana, Guinea, Liberia, Nigeria, Sierra Leone, and Sudan.

Americas: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Peru, and Venezuela.
(Updated September 24, 2007)

None Risk in Alajuela, Limón, Guanacaste, and Heredia provinces. No risk in Limón city (Puerto Limón). None Chloroquine
Côte d'Ivoire (Ivory Coast) Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Croatia Not required None None Not applicable Not applicable
Cuba Not required None None Not applicable Not applicable
Cyprus Not required None None Not applicable Not applicable
Czech Republic Not required None None Not applicable Not applicable
Democratic Republic of the Congo Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Denmark Not required None None Not applicable Not applicable
Djibouti If traveling from an endemic zone and >1 year of age None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Dominica If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Dominican Republic Not required None Rural, with highest risk in provinces bordering Haiti. In addition, risk in all areas of La Altagracia Province, including resort areas. None Chloroquine
Easter Island (Chile) Required for travelers coming from an endemic zone None None Not applicable Not applicable
Ecuador, including the Galápagos Islands

If traveling from an endemic zone and >1 year of age

For all travelers >9 months of age who are traveling to the following provinces in the Amazon Basin: Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos, and Zamora-Chinchipe, and all other areas in the eastern part of the Andes Mountains, NOT including the cities of Quito and Guayaquil or the Galápagos Islands (see Updated yellow fever risk map for Ecuador). Updated May 5, 2008

Risk in all areas at altitudes below 1,500 m (<4,921 ft). No risk in the cities of Guayaquil and Quito, the central highland tourist areas, and the Galápagos Islands.

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Egypt If traveling from an endemic zone and >1 year of age. Air passengers in transit but coming from these countries or areas without a certificate will be detained in the precincts of the airport until they resume their journey. All travelers arriving from Sudan are required to have a vaccination certificate or a location certificate issued by a Sudanese official center, stating that they have not been in Sudan south of 15° N within the previous 6 days.

 

Required also for travelers arriving from or transiting:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, São Tomé and Principe, Senegal, Sierra Leone, Somalia, Sudan (south of 15° N), Tanzania, Togo, Uganda, and Zambia.

Americas: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, and Venezuela.

Caribbean: Trinidad and Tobago.

None Very limited risk in El Faiyûm area only. No risk in tourist areas, including Nile River cruises. Risk is very limited; therefore, prophylaxis is not recommended. None None
El Salvador If traveling from an endemic zone and >6 months of age3 None Rural areas of Santa Ana, Ahuachapán, and La Unión departments. No risk in the city of San Salvador. None Chloroquine
Equatorial Guinea If traveling from an endemic zone For all travelers >9 months of age. All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Eritrea If traveling from an endemic zone None All areas at altitudes below 2,200 m (<7,218 ft). No risk in Asmara. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Estonia Not required None None Not applicable Not applicable
Ethiopia If traveling from an endemic zone and >1 year of age For all travelers >9 months of age. All areas at altitudes below 2,000 m (<6,561 ft). No risk in Addis Ababa. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Falkland Islands (U.K.) Not required None None Not applicable Not applicable
Faroe Islands (Denmark) Not required None None Not applicable Not applicable
Fiji If traveling from an endemic zone and >1 year of age, and within 10 days of having stayed overnight or longer in an endemic zone. None None Not applicable Not applicable
Finland Not required None None Not applicable Not applicable
France Not required None None Not applicable Not applicable
French Guiana Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age Risk in all areas except no risk on Devil’s Island (Ile du Diable) and the other coastal islands. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
French Polynesia, includes the island groups of Society Islands (Tahiti, Moorea, and Bora-Bora); Marquesas Islands (Hiva Oa and Ua Huka); and Austral Islands (Tubuai and Rurutu) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Gabon Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Gambia, The If traveling from an endemic zone and >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Georgia Not required None Risk in southeastern part of the country near Azerbaijan border and Kura River and risk in the districts of Gardabanis, Marneulis, and Sighnaghis in the Kakheti and Kveno Kartli regions. No risk in Tbilisi. None Chloroquine
Germany Not required None None Not applicable Not applicable
Ghana Required upon arrival from all countries For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Gibraltar (U.K.) Not required None None Not applicable Not applicable
Greece Not required None None Not applicable Not applicable
Greenland (Denmark) Not required None None Not applicable Not applicable
Grenada If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Guadeloupe, including St. Barthelemy and Saint Martin (France) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Guam (U.S.) Not required None None Not applicable Not applicable
Guatemala If traveling from an endemic zone and >1 year of age None Rural areas only at altitudes below 1,500 m (<4,921 ft). No risk in Guatemala City, Antigua or Lake Atitlán. None Chloroquine
Guinea If traveling from an endemic zone and >1 year of age. For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Guinea-Bissau If traveling from an endemic zone and >1 year of age.

Required also for travelers arriving from:

Africa: Angola, Benin, Burkina Faso, Burundi, Cape Verde, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Djibouti, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Kenya, Liberia, Madagascar, Mali, Mauritania, Mozambique, Niger, Nigeria, Rwanda, São Tomé and Principe, Senegal, Sierra Leone, Somalia, Tanzania, Togo, Uganda, and Zambia.

Americas: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, and Venezuela.

For all travelers >9 months of age. All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Guyana

If traveling from an endemic zone.

Required also for travelers arriving from:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Gabon, Gambia, Ghana, Guinea, Guinea- Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, São Tomé and Principe, Senegal, Sierra Leone, Somalia, Tanzania, Togo, and Uganda

 

Americas: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guatemala, Honduras, Nicaragua, Panama, Peru, Suriname, and Venezuela

For all travelers >9 months of age. Risk in all rural areas below 900 m (<2,953 ft) Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Haiti If traveling from an endemic zone None All None Chloroquine
Honduras If traveling from an endemic zone None Risk throughout the country at altitudes below 1000 m (<3,281 ft) and in Roatán and other Bay Island. Risk exists in the outskirts of Tegucigalpa and San Pedro Sula. None Chloroquine
Hong Kong SAR (China) Not required None None Not applicable Not applicable
Hungary Not required None None Not applicable Not applicable
Iceland Not required None None Not applicable Not applicable
India

If traveling from an endemic zone.

Required also for travelers arriving from or transiting:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea- Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, São Tomé and Principe, Senegal, Sierra Leone, Somalia, Sudan, Togo, Uganda, Tanzania, and Zambia

Americas: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, and Venezuela

Caribbean: Trinidad and Tobago

Any person (except infants ≤6 months) arriving without a certificate within 6 days of departure from or transit through an endemic area will be isolated for up to 6 days.3

None Risk in all areas throughout country except no risk in areas above 2,000 m (>6,561 ft) in Himachal Pradesh, Jammu, Kashmir, and Sikkim. Risk also exists in urban areas below 2000 m, including Delhi and Mumbai (Bombay). Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Indonesia If traveling from an endemic zone None Risk in rural Sumatra, Sulawesi, Kalimantan and Nusa Tenggara Barat. No risk in urban areas.Risk in all areas of eastern Indonesia (provinces of Papua Indonesia, Irian Jaya Barat, Nusa Tenggara Timur, Maluku, and Maluku Utara).

No risk in Jakarta, resort areas of Bali and the island of Java, except for the Menoreh Hills in central Java.

Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Iran If traveling from an endemic zone None Risk in rural areas of Sistan- Baluchestan, the southern tropical part of Kerman, and Hormozgan province. Risk in Ardebil and East Azerbijan provinces north of the Zagros mountains during March through November. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Iraq If traveling from an endemic zone None Risk in Basrah province and in areas at altitudes below 1,500 m (<4,921 ft) in provices of Duhok, Erbil, Ninawa, Sulaimaninya, and Ta’mim. No risk in Baghdad, Tikrit, and Ramadi. None Chloroquine
Ireland Not required None None Not applicable Not applicable
Israel Not required None None Not applicable Not applicable
Italy Not required None None Not applicable Not applicable
Jamaica

If traveling from an endemic zone and >1 year of age

None

Very limited risk in Kingston; therefore prophylaxis is not recommended.

None

None

Japan Not required None None Not applicable Not applicable
Jordan If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Kazakhstan If traveling from an endemic zone None None Not applicable Not applicable
Kenya If traveling from an endemic zone and >1 year of age For all travelers >9 months of age. The cities of Nairobi and Mombasa have lower risk of transmission than rural areas. Risk in all areas (including game parks) at altitudes below 2,500 m (<8,202 ft). No risk in Nairobi. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Kiribati (formerly Gilbert Islands), includes Tarawa, Tabuaeran (Fanning Island), and Banaba (Ocean Island) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Kosovo Not required None None Not applicable Not applicable
Kuwait Not required None None Not applicable Not applicable
Kyrgyzstan Not required None Risk in some southern and western parts of the country, mainly in the provinces of Batken, Osh, and Jalal-Abad in the areas bordering Tajikistan and Uzbekistan. Risk also in the capital city Bishkek. None Chloroquine
Laos If traveling from an endemic zone None All, except no risk in the city of Vientiane. Confirmed Only atovaquone/ proguanil or doxycycline in the provinces of Bokèo and Louang Namtha along the Laos- Burma border and along the Laos- Thailand border in the province of Saravane and Champassack. All other areas atovaquone/ proguanil, doxycycline, or mefloquine (See Map 4-9).
Latvia Not required None None Not applicable Not applicable
Lebanon If traveling from an endemic zone None None Not applicable Not applicable
Lesotho If traveling from an endemic zone None None Not applicable Not applicable
Liberia Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Libya If traveling from an endemic zone None None Not applicable Not applicable
Liechtenstein Not required None None Not applicable Not applicable
Lithuania Not required None None Not applicable Not applicable
Luxembourg Not required None None Not applicable Not applicable
Macau SAR (China) Not required None None Not applicable Not applicable
Macedonia Not required None None Not applicable Not applicable
Madagascar If traveling from an endemic zone None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Madeira Islands (Portugal) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Malawi If traveling from an endemic zone None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Malaysia If traveling from an endemic zone and >1 year of age. A certificate is also required from travelers who have transited an endemic area within the preceding 6 days. None Risk in rural areas, particularly in the forested, hilly, and underdeveloped interior areas. No risk in urban and coastal areas. Note: No risk in Republic of Singapore. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Maldives If traveling from an endemic zone None None Not applicable Not applicable
Mali Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Malta

If traveling from an endemic zone and >9 months of age.

Children <9 months of age arriving from an endemic zone may be subject to isolation or surveillance.

None None Not applicable Not applicable
Marshall Islands Not required None None Not applicable Not applicable
Martinique (France) Not required None None Not applicable Not applicable
Mauritania Required upon arrival from all countries if traveler is >1 year of age. Exception: Not required for travelers from a non-endemic zone who stay <2 weeks For all travelers >9 months of age All, except no risk in Dakhlet- Nouadhibou and Tiris-Zemmour region. Probable Atovaquone/ proguanil, doxycycline, or mefloquine
Mauritius If traveling from an endemic zone None Rural only. No risk on Rodrigues Island. None Chloroquine
Mayotte (French territorial collectivity) Not required None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Mexico Not required None Risk is limited to areas infrequently visited by travelers including small foci along the Guatemala and Belize borders in the states of Chiapas, Quintana Roo, and Tabasco; rural areas in the states of Nayarit, Oaxaca, Sinaloa; and in an area between 24°N and 28°N latitude, and 106°W and 110°W longitude, which lies in parts of Sonora, Chihuahua, and Durango. No malaria risk exists along the United States-Mexico border. No malaria risk exists in the major resorts along the Pacific and Gulf coasts.

Risk is very limited; therefore, prophylaxis is not recommended for most travelers to Mexico. Travelers should use personal protection measures such as insect repellents for malaria prevention. Chemoprophylaxis is recommended for the rare traveler going to the risk areas.

None Chloroquine
Micronesia, Federated States of; Includes Yap Islands, Pohnpei, Chuuk, and Kosrae Not required None None Not applicable Not applicable
Moldova Not required None None Not applicable Not applicable
Monaco Not required None None Not applicable Not applicable
Mongolia Not required None None Not applicable Not applicable
Montenegro Not required None None Not applicable Not applicable
Montserrat (U.K.) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Morocco Not required None Risk in rural areas of Chefchaouen province. No risk in Tangier, Rabat, Casablanca, Marrakech, and Fès. Risk is very limited; therefore, prophylaxis is not recommended. None None
Mozambique If traveling from an endemic zone and >1 year of age  None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Namibia If traveling from an endemic zone and >1 year of age. Required also for travelers on unscheduled flights who have transited an infected area. Children <1 year of age may be subject to surveillance. None Risk in the provinces of Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, Otjozondjupa, and the Caprivi Strip. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Nauru If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Nepal If traveling from an endemic zone None Risk in rural areas at altitudes below 1,200 m (<3,937 ft) in the Tarai and Hill districts bordering India and in the areas of the inner Tarai valley areas of Udaypur Sindhupalchowk, Makwanpur, Chitwan, and Dang. No risk in Kathmandu or on typical Himalayan treks. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Netherlands Antilles (Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten) If traveling from an endemic zone and >6 months of age3 None None Not applicable Not applicable
Netherlands Not required None None Not applicable Not applicable
New Caledonia (France)

If traveling from an endemic zone and >1 year of age.

Note: In the event of an epidemic threat to the territory, a specific vaccination certificate may be required.

None None Not applicable Not applicable
New Zealand Not required None None Not applicable Not applicable
Nicaragua If traveling from an endemic zone and >1 year of age None Risk in rural areas and in outskirts of Managua. None Chloroquine
Niger Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Nigeria If traveling from an endemic zone and >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Niue (New Zealand) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Norfolk Island (Australia) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Korea, North Not required None Limited malaria risk in some southern areas. None Chloroquine
Northern Mariana Islands (U.S.), includes Saipan, Tinian, and Rota Island Not required None None Not applicable Not applicable
Norway Not required None None Not applicable Not applicable
Oman If traveling from an endemic zone None Limited risk in remote areas of Musandam Province. Risk is very limited; therefore, prophylaxis is not recommended. Confirmed None
Pakistan If traveling from an endemic zone. Not required for infants <6 months of age if the mother’s certificate shows she was vaccinated before the child’s birth.3 None Risk in all areas (including all cities) at altitudes below 2,000 m (<6,562 ft). Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Palau If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Panama If traveling from an endemic zone For all travelers >9 months of age traveling to the provinces of Darien, Kunayala (San Blas) and Panama (see Map 4-16), excluding the Canal Zone, Panama City and the San Blas Islands. Risk exists in rural areas of Bocas Del Toro, Darién, San Blas provinces and San Blas Islands. No risk in Panama City or in the former Canal Zone. Confirmed in Darién and San Blas provinces, including San Blas islands. Chloroquine in Bocas Del Toro. Atovaquone/ proguanil; doxycycline; or mefloquine in Darién and San Blas.
Papua New Guinea If traveling from an endemic zone and >1 year of age None Risk throughout at altitudes below 1,800 m (<5,906 ft). Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Paraguay

If traveling from an endemic zone

For all travelers >9 months of age traveling to all areas of Paraguay.

Risk in the departments of Alto Paraná, Caaguazú, and Canendiyú.

None

Chloroquine

Peru Not required For all travelers >9 months of age traveling to the areas east of the Andes Mountains (see Map 4-16). Travelers who are limiting travel to the cities of Cuzco and Machu Picchu do not need vaccination. Peru recommends vaccination for those who intend to visit any jungle areas of the country <2,300 m (<7,546 ft.). Risk in all departments below 2000 m (6,561 ft) except no risk in Arequipa, Moquegua, Puno, and Tacna. Risk in Puerto Maldonado. Travelers who will visit only in Lima and its vicinity, coastal areas south of Lima, or the highland tourist areas (Cuzco, Machu Picchu, and Lake Titicaca) are not at risk and need no prophylaxis. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Philippines If traveling from an endemic zone and >1 year of age None Risk exists in areas below 600 m (<1,969 ft), except no risk in Bohol Island, Borocay Island, Catanduanes Island, and Cebu Island. No risk is considered to exist in Manila or other urban areas. Confirmed for P. falciparum Atovaquone/ proguanil, doxycycline, or mefloquine
Pitcairn Islands (U.K.) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Poland Not required None None Not applicable Not applicable
Portugal Required only for travelers >1 year of age arriving from an endemic zone and destined for the Azores and Madeira. However, no certificate is required for travelers in transit at Funchal, Santa Maria, and Porto Santo. None None Not applicable Not applicable
Puerto Rico (U.S.) Not required None None Not applicable Not applicable
Qatar Not required None None Not applicable Not applicable
Réunion (France) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Romania Not required None None Not applicable Not applicable
Russia Not required None None Not applicable Not applicable
Rwanda Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Saint Helena (U.K.) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Saint Kitts (Saint Christopher) and Nevis (U.K.) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Saint Lucia If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Saint Pierre and Miquelon (France) Not required None None Not applicable Not applicable
Saint Vincent and the Grenadines If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Samoa (formerly Western Somoa) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
San Marino Not required None None Not applicable Not applicable
São Tomé and Príncipe Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Saudi Arabia If traveling from an endemic zone None Risk in Al Bahah, Al Madinah, Asir (excluding the highaltitude areas above 2,000 m), Jizan, Makkah, Najran, and Tabuk province. No risk in urban areas of Jeddah, Mecca, Medina, and Ta’if. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Senegal If traveling from an endemic zone For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Serbia Not required None None Not applicable Not applicable
Seychelles If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Sierra Leone Required upon arrival from all countries For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Singapore If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Slovakia Not required None None Not applicable Not applicable
Slovenia Not required None None Not applicable Not applicable
Solomon Islands If traveling from an endemic zone None Risk in all areas except for the southern province of Rennell and Bellona, the eastern province of Temotu, and the outer islands of Tikopia, Anuta, and Fatutaka. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Somalia If traveling from an endemic zone For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
South Africa If traveling from an endemic zone and >1 year of age None Risk exists in the low-altitude areas of the Mpumalanga Province, Northern Province (Limpopo), and northeastern Kwa- Zulu-Natal as far south as the Tugela River. Risk in Kruger National Park. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
South Georgia & South Sandwich Islands Not required None None Not applicable Not applicable
Korea, South Not required None Risk limited to demilitarized zone (DMZ) and to rural areas in the northern parts of Kyonggi and Kangwon provinces. None Chloroquine
South Sandwich Islands Not required None None Not applicable Not applicable
Spain Not required None None Not applicable Not applicable
Sri Lanka If traveling from an endemic zone and >1 year of age None Risk in all areas, except no risk in the districts of Colombo, Galle, Kalutara, and Nuwara Eliya. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Sudan If traveling from an endemic zone and >1 year of age. May be required for travelers leaving Sudan. For all travelers >9 months of age All Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Suriname If traveling from an endemic zone For all travelers >9 months of age. Risk in all areas, except no risk in Paramaribo and coastal districts of Nickerie, Coronie, Saramacca, Wanica, Commewijne, and Marowijne north of latitude 5°N. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Swaziland If traveling from an endemic zone None Risk in the northern and eastern lowland areas bordering Mozambique in the Lubombo district, particularly around the villages/towns of Big Bend, Mhlume, Simunye, and Tshaneni. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Sweden Not required None None Not applicable Not applicable
Switzerland Not required None None Not applicable Not applicable
Syria If traveling from an endemic zone None Risk along the northern border in El Hassaka province. None Chloroquine
Taiwan Not required. (Updated February 6, 2008) None None Not applicable Not applicable
Tajikistan Not required None Risk in all areas below 2,500 m (<8,202 ft) particularly along the southern border in Khatlon Oblast; central (Dushanbe), western (Gorno- Badakhshan), and northern (Leninabad) areas. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Tanzania If traveling from an endemic zone and >1 year of age (Updated July 29, 2008) For all travelers >9 months of age. The city of Dar es Salaam has a lower risk of transmission than rural areas All areas at altitudes below 1,800 m (<5,906 ft).

Confirmed

Atovaquone/ proguanil, doxycycline, or mefloquine

Thailand If traveling from an endemic zone and >1 year of age None Risk in rural areas that border Cambodia, Laos, and Myanmar (Burma). Very limited risk in Phang Nga and Phuket therefore prophylaxis is not recommended for these two areas. No risk in cities and in major tourist resorts. No risk in Bangkok, Chiang Mai, Chiang Rai, Pattaya, Koh Samui, and Koh Phangan. (Updated September 19, 2007) Confirmed Atovaquone/ proguanil or doxycycline. (see Map 4-9).
Timor-Leste (East Timor) Required for travelers coming from an endemic zone None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Togo Required upon arrival from all countries if traveler is >1 year of age For all travelers >9 months of age All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Tokelau (New Zealand) Not required None None Not applicable Not applicable
Tonga If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Trinidad and Tobago If traveling from an endemic zone and >1 year of age For all travelers >9 months of age. None Not applicable Not applicable
Tunisia If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Turkey Not required None Risk in the provinces of Adana, Adryaman, Batman, Bingol, Bitlis, Diyarbakar, Elazig, Gaziantep, Hakkari, Hatay, Icel, Kahraman Maras, Kilis, Mardin, Mus, Osmaniyeh, , Sanliurfa, Siirt, Sirnak, and Van. No risk on the Incirlik U.S. Air Force base and on typical cruise itineraries. None Chloroquine
Turkmenistan Not required None Risk in southeast Mary Region and in the flood plains between the Murgab and Tedzhen Rivers. None Chloroquine
Turks and Caicos Islands (U.K.) If traveling from an endemic zone and >1 year of age None None Not applicable Not applicable
Tuvalu Not required None None Not applicable Not applicable
Uganda If traveling from an endemic zone and >1 year of age For all travelers >9 months of age. All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Ukraine Not required None None Not applicable Not applicable
United Arab Emirates Not required None None Not applicable Not applicable
United Kingdom (with Channel Islands and Isle of Man) Not required None None Not applicable Not applicable
United States Not required None None Not applicable Not applicable
Uruguay If traveling from an endemic zone None None Not applicable Not applicable
Uzbekistan Not required None Sporadic cases reported in Uzunskiy, Sariassiskiy, and Shurchinskiy districts (Surkhanda-Rinskaya Region). None Chloroquine
Vanuatu Not required None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Venezuela Not required For all travelers >9 months of age traveling to Venezuela, except the northern coastal area (see Map 4-16). The cities of Caracas and Valencia are not in the endemic zone. Risk exists in rural areas of the following states: Apure, Amazonas, Barinas, Bolivar, Sucre, Tachira, and Delta Amacuro. Risk in Angel Falls. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Vietnam If traveling from an endemic zone and >1 year of age None Rural only, except no risk in the Red River delta and the coastal plain north of the Nha Trang. No risk in Hanoi, Ho Chi Minh City (Saigon), Da Nang, Nha Trang, Qui Nhon, and Haiphong. Confirmed Only atovaquone/ proguanil or doxycycline in the southern part of the country in the provinces of Tay Ninh, Song Be, Lam Dong, Ninh Thuan, Khanh Hoa, Dac Lac, Gia Lai, and Kon Tum. All other areas atovaquone/ proguanil, doxycycline, or mefloquine (see Map 4-9).
Virgin Islands, British Not required None None Not applicable Not applicable
Virgin Islands, U.S. Not required None None Not applicable Not applicable
Wake Island, U.S. Not required None None Not applicable Not applicable
Western Sahara Not required None Risk is very limited; therefore, prophylaxis is not recommended. None None
Yemen If traveling from an endemic zone and >1 year of age None All areas at altitudes below 2,000 m (<6,561 ft). No risk in Sana’a. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Zambia Not required None All Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine
Zimbabwe If traveling from an endemic zone and >1 year of age None All, except no risk in cities of Harare and Bulawayo. Confirmed Atovaquone/ proguanil, doxycycline, or mefloquine

1Yellow fever vaccine entry requirements are necessary for travelers to comply with in order to enter the country. In general, these are in place to prevent importation and transmission of yellow fever virus. Countries requiring yellow fever vaccination for entry adhere to the regulations put forth by WHO as stated in the International Health Regulations. Some countries require vaccination for travelers coming from an endemic zone. “Traveling from an endemic zone” is defi ned as transit through an endemic zone in the previous 6 days. Country requirements are subject to change at any time; therefore, CDC encourages travelers to check with the appropriate embassy or consulate prior to departure.

2The information in the section on yellow fever vaccine recommendations is advice given by CDC to prevent yellow fever infections among travelers.

3Please note, the U.S. Advisory Committee on Immunization Practices recommends avoiding vaccination of infants.

4Recommendations are subject to change at any time if disease conditions change; therefore, CDC encourages travelers to check for relevant travel notices on the website wwwn.cdc.gov/travel prior to departure.

Note: Country requirements are subject to change at any time; therefore, CDC encourages travelers to check with the appropriate embassy or consulate prior to departure.

  • Page last updated: February 15, 2008
  • Content source:
    Division of Global Migration and Quarantine
    National Center for Preparedness, Detection, and Control of Infectious Diseases
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