Review the following health and outbreak updates before traveling to ensure a healthy and safe trip.
Keeping up-to-date with routine vaccinations and visiting your doctor at least six weeks
prior to your trip are highly recommended for safe travel. For information about recent disease
outbreaks around the world, see these outbreak updates below.
| Date |
Health Concern |
Affected Regions |
| November 10, 2011 |
Cholera |
Haiti |
| November 1, 2011 |
Rabies |
Bali, Indonesia |
| October 15, 2011 |
Polio |
Global |
| October 1, 2011 |
Dengue Fever |
Global |
| November 2, 2010 |
Q Fever |
Netherlands |
| September 9, 2010 |
2010 Measles Update |
Global |
| September 8, 2010 |
Hand, Foot, and Mouth Disease |
Asia |
Cholera - November 10, 2011
Regions Affected: Haiti, Dominican Republic
Cholera is a potentially fatal bacterial infection that causes severe diarrhea and dehydration. The disease is most often spread through the ingestion
of contaminated food or drinking water. Water may be contaminated by the feces of an infected person or by untreated sewage. Food is often contaminated
by water containing cholera bacteria or because it was handled by a person ill with cholera.
The majority of cases have been reported in the Haiti Artibonite Departmente, approximately 50 miles north of Port-au-Prince, although the outbreak has
spread to all areas of the country. Affected hospitals are strained by the large number of people who are ill. In the Dominican Republic, the provinces
with the highest number of cases in 2011 are San Juan, Santo Domingo, and the National District.
This outbreak is of particular concern given the current conditions in Haiti, including poor water and sanitation, a strained public health infrastructure,
and large numbers of people displaced by the January earthquake and more recent flooding.
Recommendations
Most travelers are not at high risk for getting cholera, but people who are traveling to Haiti should still take their own supplies to help
prevent the disease and to treat it. Items to pack include:
-
A prescription antibiotic to take in case of diarrhea
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Water purification tablets
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Oral rehydration salts
Although no cholera vaccine is available in the United States, travelers can prevent cholera by following these 5 basic steps:
- Drink bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.
- Use safe water to brush your teeth, wash and prepare food, and make ice.
- Clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse.
- Wash your hands often with soap and safe water.
- Use latrines or bury your feces; do not defecate in any body of water.
- Cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables.
- Avoid raw foods other than fruits and vegetables you have peeled yourself.
- Clean up safely—in the kitchen and in places where the family bathes and washes clothes.
If not drinking or using bottled water to cook, be sure water is safe to drink and use:
- Boil it or treat it with water purification tablets, a chlorine product, or household bleach.
- Bring your water to a complete boil for at least 1 minute.
- To treat your water, use water purification tablets, if you brought some with you from the United States, or one of the locally available treatment products, and follow the instructions.
- If a chlorine treatment product is not available, you can treat your water with household bleach. Add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking.
Before departing for Haiti, talk to your doctor about getting a prescription for an antibiotic. If you get sick with diarrhea while
you are in Haiti, you can take the antibiotic, as prescribed. Also, remember to drink fluids and use oral rehydration salts (ORS) to prevent dehydration.
For more information about the current cholera situation in Haiti, visit the
CDC's Cholera Website.
Rabies - November 1, 2011
Regions Affected: Bali, Indonesia
A threat to both human and animal health, rabies is a rapidly progressing, deadly disease. It is almost always spread by
an animal bite but can also be spread when a rabid animal's saliva gets directly into the eyes, nose, mouth, or broken skin.
The primary sources of human infection worldwide are dogs and certain wildlife species, such as foxes, raccoons, mongooses, and bats.
As of November 1, 2011, more than 100 people have died from rabies in Bali since the outbreak began. Human and animal rabies cases
have been confirmed near popular tourist destinations on the southern tip of Bali and throughout the island.
The following activities may put travelers to Bali at higher risk for rabies:
- Working closely with animals of unknown rabies exposure or vaccination history.
- Spending a lot of time in a rural area or participating in outdoor activities such as bicycling, camping, or hiking. These activities increase the risk for coming in contact with animals.
- Touching or playing with animals.
- Adopting animals with the intention of bringing them home to the United States.
Recommendations
Travelers should follow the steps below to protect themselves from mosquito bites:
-
If your activities in Bali will bring you into contact with animals such as dogs, cats, bats, or other carnivores, you should consider pre-exposure rabies vaccination.
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Even if you receive pre-exposure vaccination, you will still need immediate medical treatment if you are bitten or scratched by an animal.
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Avoid touching all animals, including wild animals and pets. Pets in other countries may not have been vaccinated against rabies.
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Supervise children closely, especially around dogs, cats, and wildlife such as monkeys. This is important since children are more likely to be bitten by animals, may not report the bite, and may have more severe injuries from animal bites.
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If you are traveling with your pet, supervise your pet closely and do not allow it to play with local animals, especially strays.
If you are bitten by a wild animal, take the following steps:
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Wash the wound well with soap and water.
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See a doctor right away, even if you don't feel sick or your wound is not serious. To prevent rabies, you may need to start a series of vaccinations immediately.
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To get vaccinated, be prepared to travel back to the United States or to another area. (Adequate vaccination for exposure to rabies is not available in all parts of the world.)
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After you return home, tell your doctor or state health department that you were bitten or scratched during travel.
For more information about rabies and travel, visit the
CDC's Rabies Homepage.
Polio - October 15, 2011
Regions Affected: China, Tajikistan, Russia, Turkmenistan, Kazakhstan, Uzbekistan, Kyrgyzstan
Polio is a disease that is most often spread through contact with the feces of an infected person. Poliovirus can also be
spread through oral fluids, contaminated items, water, and uncooked food. The disease mainly affects children less than 5
years old, but unvaccinated people of any age are at risk. Signs and symptoms of the illness may include paralysis of limbs
and respiratory muscles. Cases of polio have since been reported in China in October 2011, the country's first cases in more
than 10 years.
Recommendations
Travelers should take the following steps to protect themselves from polio:
-
Talk to your doctor to find out if you are up to date with your polio vaccination and whether you need a booster dose before traveling.
-
Even if you were vaccinated as a child or have been sick with polio before, you may need a booster shot to make sure that you are protected. If you are traveling with children, be sure that they have been appropriately vaccinated, too.
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Eat foods that are fully cooked and served hot.
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Eat and drink dairy products that have been pasteurized, and eat only fruits and vegetables that you can wash with safe water and peel yourself.
-
Drink only bottled or boiled water or beverages that have been bottled and sealed (carbonated drinks or sports drinks). Avoid tap water, fountain drinks, and ice.
-
Wash hands often with soap and water. If soap and water are not available, you can use an alcohol-based hand gel.
-
Travelers who have received the complete series with either IPV or oral polio vaccine (OPV) as a child without an adult booster dose (either OPV or IPV) should receive another dose of IPV before departure.
For more information about polio and traveling to destinations with current outbreaks, visit the
CDC's Polio Homepage.
Dengue Fever - October 1, 2011
Regions Affected: Marshall Islands, Africa, Indian Ocean Islands, Malaysia, Vietnam, Philippines, Singapore, Thailand, Australia, Argentina, Bolivia, Brazil, Colombia, Paraguay, Peru, Saudi Arabia, Brazil, Bolivia, the Bahamas, and Aruba.
Dengue fever is the most common cause of fever in travelers returning from the Caribbean, Central America, and South
Central Asia. This disease is caused by four similar viruses (DENV-1, -2, -3, and -4) and is spread through the bites
of infected mosquitoes.
Usually dengue fever causes a mild illness, but it can be severe and lead to dengue hemorrhagic fever, which can be
fatal if not treated. People who have previously been infected with dengue fever are more at risk of getting severe
dengue. No vaccine is available to prevent dengue, and there is no specific medicine to cure illness caused by dengue.
Travelers can reduce their risk of infection with dengue fever by protecting themselves from mosquito bites. The mosquitoes
that spread dengue usually bite at dusk and dawn but may bite at any time during the day, especially indoors, in shady
areas, or when the weather is cloudy.
Recommendations
Travelers should follow the steps below to protect themselves from mosquito bites:
-
Where possible, stay in hotels or resorts that are well screened or air conditioned and that take measures such as spraying with insecticide to reduce the mosquito population.
-
When outdoors or in a building that is not well screened, use insect repellent on uncovered skin. If sunscreen is needed, apply before applying insect repellent.
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Look for a repellent that contains one of the following active ingredients: DEET, picaridin, Oil of Lemon Eucalyptus/PMD, or IR3535.
-
Wear loose, long-sleeved shirts and long pants when outdoors.
-
For greater protection, clothing may also be sprayed with a repellent containing permethrin or another EPA-registered repellent. (Remember: don't use permethrin on skin.)
For more information about dengue fever and travel, visit the
CDC's Dengue Website.
Q Fever - November 2, 2010
Regions Affected: Netherlands
Reports from the Netherlands National Institute for Public Health confirm an increase in the average number of
cases resulting from the long standing outbreak of Q fever sweeping the country. Since January 1, 2010, 482 human
cases have been reported, including 7 deaths. The majority of these cases have been reported in the following
provinces: Noord (North) Brabant, Gelderland, Limburg, and Utrecht. Q fever has not been limited to these provinces
as cases have been reported throughout The Netherlands.
Recommendations
Q fever is usually passed from infected farm animals to humans. The risk of becoming infected with Q fever is low,
but people traveling to the Netherlands should take the following precautions:
-
Avoid farms in the affected areas. If you cannot avoid visiting farms, avoid going near areas where animals are
kept, such as barns and pens, and avoid direct contact with animals. Breathing in soil and dust contaminated by
animals can make you sick.
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Eat only milk and dairy products that have been pasteurized.
-
Wash your hands often with soap and water, especially if you have been near animals. If soap and water are not
available, use an alcohol-based hand gel with at least 60% alcohol.
-
Pay attention to your health after your trip. People can become sick with Q fever 2–5 weeks after being exposed to
the disease. If you feel sick, go to the doctor and tell him or her that you have traveled to The Netherlands.
Measles Update - September 9, 2010
Regions Affected: Global
An estimated 10 million cases and 164,000 deaths from measles occur worldwide each year. As the leading cause of
vaccine-preventable deaths among young children, measles outbreaks are common in many areas, including Europe. The
risk for exposure to measles is high for many U.S. travelers and U.S. citizens living in other countries.
Recommendations
With measles proven to be a risk in both developed and under-developed countries worldwide, those traveling outside
of the U.S should take the following precautions:
-
Ensure that you and your family are up to date on routine measles immunizations, regardless of the
travel destination. In addition, expatriates should make sure they are vaccinated against measles,
especially in areas where outbreaks are reported.
-
Keep a copy of your immunization records with you as you travel.
Hand, Foot, and Mouth Disease - September 8, 2010
Regions Affected: Asia
Since January 1, 2010, various regions of Asia have seen an increasing number of hand, foot, and mouth disease
(HFMD) cases reported. Travelers to all countries in Asia should take precautions to help reduce their risk of
contracting HFMD.
From January 1, 2010 to May 13, 2010, the China Ministry of Health reported more than 77,000 cases and 40 deaths.
At this time, HFMD outbreaks are expected to continue through the coming months.
Recommendations
This disease is very contagious and is spread through contact with the body fluids of an infected person. Those
traveling to all regions of Asia should take the following precautions in order to prevent infection:
-
Wash your hands often with soap and water, especially before you eat, after you cough or sneeze, and after you
use the bathroom. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol).
Consider packing alcohol-based hand gel in your luggage to ensure you have it when needed.
-
Do not share eating utensils, such as forks, spoons, and cups.
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Avoid close contact with persons with HFMD.
Adults should help child travelers to follow these recommendations. Infants, children, and adolescents are
more susceptible to HFMD.