CDC Yellow Book 2020

Health Information for International Travel

Centers for Disease Control and Prevention (CDC), Editor in Chief: Gary W. Brunette, and Jeffrey B. Nemhauser

U.S. government's biennial guide to international travel, featuring easy-to-access health information for both travelers and the health professionals who care for them
Recommendations for pre-travel vaccinations and preventative care, plus health guidelines for specific destinations and types of travel
Updated to reflect current outbreaks: yellow fever in South America (including guidelines in light of current vaccine shortage); Ebola in DRC; and ongoing concerns around Zika in pregnant women
Special sections for tailored to military members, their spouses, and families; travelers to mass gatherings; and humanitarian workers and missionaries
Advice for travelers with specific health needs, including those who are pregnant and those with chronic illness
Color illustrations and photographs enrich and simplify subject matter and aid navigability
The most trusted authority in travel medicine, and essential reading for healthcare providers, the travel industry, multinational business, missionary and volunteer organizations, and those embarking on vacation abroad

New to this Edition:

Updated information on new and emerging travel-related illnesses, including Zika, Ebola, and sarcocystosis
Recommendations for practicing travel health remotely, via telemedicine
Legal issues facing clinicians who provide travel health care
The One Health approach to managing zoonoses
Road and traffic-safety advice for travelers
Rapid diagnostic tests for infectious diseases
Guidelines for treating infectious diseases in the face of increasing antimicrobial resistance

CDC Yellow Book 2020

Health Information for International Travel

Centers for Disease Control and Prevention (CDC), Editor in Chief: Gary W. Brunette, and Jeffrey B. Nemhauser

Description

The definitive reference for travel medicine, updated for 2020!

"A beloved travel must-have for the intrepid wanderer." -Publishers Weekly

"A truly excellent and comprehensive resource." -Journal of Hospital Infection

The CDC Yellow Book offers everything travelers and healthcare providers need to know for safe and healthy travel abroad. This 2020 edition includes:

· Country-specific risk guidelines for yellow fever and malaria, including expert recommendations and 26 detailed, country-level maps
· Detailed maps showing distribution of travel-related illnesses, including dengue, Japanese encephalitis, meningococcal meningitis, and schistosomiasis
· Guidelines for self-treating common travel conditions, including altitude illness, jet lag, motion sickness, and travelers' diarrhea
· Expert guidance on food and drink precautions to avoid illness, plus water-disinfection techniques for travel to remote destinations
· Specialized guidelines for non-leisure travelers, study abroad, work-related travel, and travel to mass gatherings
· Advice on medical tourism, complementary and integrative health approaches, and counterfeit drugs
· Updated guidance for pre-travel consultations
· Advice for obtaining healthcare abroad, including guidance on different types of travel insurance
· Health insights around 15 popular tourist destinations and itineraries
· Recommendations for traveling with infants and children
· Advising travelers with specific needs, including those with chronic medical conditions or weakened immune systems, health care workers, humanitarian aid workers, long-term travelers and expatriates, and last-minute travelers
· Considerations for newly arrived adoptees, immigrants, and refugees

Long the most trusted book of its kind, the CDC Yellow Book is an essential resource in an ever-changing field — and an ever-changing world.

CDC Yellow Book 2020

Health Information for International Travel

Centers for Disease Control and Prevention (CDC), Editor in Chief: Gary W. Brunette, and Jeffrey B. Nemhauser

1 Introduction
Introduction to Travel Health & the CDC Yellow Book
Travel Epidemiology
Perspectives: WHY GUIDELINES DIFFER
Air Travel Trends
2 Preparing International Travelers
The Pretravel Consultation
Perspectives: TRAVELERS' PERCEPTION OF RISK
Last-Minute Travelers
Complementary & Integrative Health Approaches
Prioritizing Care for the Resource-Limited Traveler
Telemedicine
Perspectives: LEGAL ISSUES FOR CLINICIANS
Vaccination & Immunoprophylaxis: General Recommendations
Interactions among Travel Vaccines & Drugs
Yellow Fever & Malaria Information, by Country
Food & Water Precautions
Water Disinfection
Food Poisoning from Marine Toxins
Travelers' Diarrhea
Perspectives: ANTIBIOTICS IN TRAVELERS' DIARRHEA-BALANCING THE RISKS & BENEFITS
3 Environmental Hazards & Other Noninfectious Health Risks

Injury & Trauma
Mental Health
Safety & Security Overseas
Mosquitoes, Ticks & Other Arthropods
Sun Exposure
Extremes of Temperature
Air Quality & Ionizing Radiation
Animal Bites & Stings (Zoonotic Exposures)
Scuba Diving: Decompression Illness & Other Dive-Related Injuries
Perspectives: ZOONOSES: THE ONE HEALTH APPROACH
High-Altitude Travel & Altitude Illness
4 Travel-Related Infectious Diseases
Amebiasis
Angiostrongyliasis, Neurologic
Anthrax
B virus
Bartonella Infections
Brucellosis
Campylobacteriosis
Chikungunya
Cholera
Coccidioidomycosis
Cryptosporidiosis
Cutaneous Larva Migrans
Cyclosporiasis
Cysticercosis
Dengue
Diphtheria
Echinococcosis
Escherichia coli, Diarrheagenic
Fascioliasis
Filariasis, Lymphatic
Flukes, Lung
Giardiasis
Hand, Foot& Mouth Disease
Helicobacter pylori
Helminths, Soil-Transmitted
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Histoplasmosis
HIV Infection
Influenza
Japanese Encephalitis
Legionellosis (Legionnaires' Disease & Pontiac Fever)
Leishmaniasis, Cutaneous
Leishmaniasis, Visceral
Leptospirosis
Lyme Disease
Malaria
Measles (Rubeola)
Melioidosis
Meningococcal Disease
Middle East Respiratory Syndrome (MERS)
Mumps
Norovirus
Onchocerciasis (River Blindness)
Pertussis
Pinworm (Enterobiasis, Oxyuriasis, Threadworm)
Plague (Bubonic, Pneumonic, Septicemic)
Pneumococcal Disease
Poliomyelitis
Q Fever
Rabies
Perspectives: ALTERNATIVE APPROACHES TO RABIES IMMUNIZATION
Rickettsial (Spotted & Typhus Fevers) & Related Infections, including Anaplasmosis & Ehrlichiosis
Rubella
Salmonellosis (Nontyphoidal)
Sarcocystosis
Scabies
Schistosomiasis
Shigellosis
Smallpox & Other Orthopoxvirus-Associated Infections
Strongyloidiasis
Taeniasis
Tetanus
Tickborne Encephalitis
Toxoplasmosis
Trypanosomiasis, African (Sleeping Sickness)
Trypanosomiasis, American (Chagas Disease)
Tuberculosis
Perspectives: SCREENING TRAVELERS FOR TUBERCULOSIS INFECTION
Typhoid & Paratyphoid Fever
Varicella (Chickenpox)
Viral Hemorrhagic Fevers
Yellow Fever
Yersiniosis
Zika Virus
5 Travelers with Additional Considerations
Immunocompromised Travelers
Travelers with Disabilities
Travelers with Chronic Illnesses
6 Health Care Abroad
Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance
Perspectives: PHARMACEUTICAL QUALITY & FALSIFIED DRUGS
Travel Health Kits
7 Family Travel
Pregnant Travelers
Travel & Breastfeeding
Traveling Safely with Infants & Children
Vaccine Recommendations for Infants & Children
International Adoption
8 Travel by Air, Land & Sea
Air Travel
Deep Vein Thrombosis & Pulmonary Embolism
Jet Lag
Road & Traffic Safety
Cruise Ship Travel
Motion Sickness
9 Work & Other Reasons for Travel
Business Travel
Aircrews
Health Care Workers, including Public Health Researchers & Medical Laboratorians
Humanitarian Aid Workers
US Military Deployments
Long-Term Travelers & Expatriates
Study Abroad & Other International Student Travel
Visiting Friends & Relatives: VFR Travel
Mass Gatherings
Adventure Travel
Sex & Travel
10 Select Destinations
Rationale for Select Destinations
Africa & the Middle East
East Africa: Safaris
Saudi Arabia: Hajj/Umrah Pilgrimage
South Africa
Tanzania: Kilimanjaro
The Americas & the Caribbean
Brazil
Cuba
Dominican Republic
Haiti
Mexico
Peru: Cusco, Machu Picchu & Other Regions
Asia
Burma (Myanmar)
China
India
Nepal
Thailand
11 Posttravel Evaluation
General Approach to the Returned Traveler
Screening Asymptomatic Returned Travelers
Posttravel Evaluation: Fever
Rapid Diagnostic Tests for Infectious Diseases
Sexually Transmitted Infections
Skin & Soft Tissue Infections
Respiratory Infections
Persistent Diarrhea in Returned Travelers
Newly Arrived Immigrants & Refugees
12 Appendices
Appendix A: Promoting Quality in the Practice of Travel Medicine
Appendix B: Travel Vaccine Summary Table
Appendix C: Death during Travel
Appendix D: Airplanes & Cruise Ships: Illness & Death Reporting & Public Health Interventions
Appendix E: Taking Animals & Animal Products across International Borders
Index
Photography Credits

CDC Yellow Book 2020

Health Information for International Travel

Centers for Disease Control and Prevention (CDC), Editor in Chief: Gary W. Brunette, and Jeffrey B. Nemhauser

Author Information

Centers for Disease Control and Prevention (CDC), Editor in Chief: Gary W. Brunette, Chief, Traveler's Health Branch, Centers for Disease Control and Prevention, and Editor in Chief: Jeffrey B. Nemhauser, Senior Medical Officer and Clinical Team Lead, Traveler's Health Branch, Centers for Disease Control and Prevention

About the Editors in Chief: Gary W. Brunette, MD, MS, is Chief of the Travelers' Health Branch, Centers for Disease Control and Prevention. Jeffrey B. Nemhauser, MD, is Senior Medical Officer and Clinical Team Lead of the Travelers' Health Branch, Centers for Disease Control and Prevention. About the Centers for Disease Control and Prevention: The Centers for Disease Control and Prevention (CDC) is a United States federal agency under the Department of Health and Human Services headquartered in Atlanta, Georgia.

Contributors:

Editors in Chief
Gary W. Brunette, MD, MS
Jeffrey B. Nemhauser, MD

Chief Medical Editor
Phyllis E. Kozarsky, MD

Medical Editors
Kristina M. Angelo, DO, MPH&TM
Nicole J. Cohen, MD, MS
Douglas H. Esposito, MD, MPH
Stephen M. Ostroff, MD
Edward T. Ryan, MD
David R. Shlim, MD
Richard W. Steketee, MD, MPH
Michelle Weinberg, MD, MPH
Mary Elizabeth Wilson, MD

Managing Editor
Jenique Meekins

Technical Editor
Ronnie Henry

CDC Yellow Book 2020

Health Information for International Travel

Centers for Disease Control and Prevention (CDC), Editor in Chief: Gary W. Brunette, and Jeffrey B. Nemhauser

Reviews and Awards

"This is a very well-written book that provides a great explanation of the core principles of travel medicine. This edition includes updated recommendations on some of the vaccines, such as the yellow fever vaccine. An understanding of the concepts in this book serves the needs of clinicians who aim to conquer the outbreaks of infectious diseases associated with travel. (Weighted Numerical Score: 100 - 5 Stars!)" - Manasa Velagapudi, Doodys