Travel and Vacation Information & Articles

Handwashing is one of the most important practices in preventing illness from infections while traveling. Travelers should wash their hands often with soap and water or an alcohol-based hand rub to remove potentially infectious materials from the skin and help prevent disease transmission.

New risks to international travelers may arise that are not detailed in this book. These new risks may result from unanticipated outbreaks of infectious diseases in an international travel destination or emerging infectious diseases.

Emerging infectious diseases are diseases of infectious origin the incidence of which in humans has increased within the past two decades or threatens to increase in the near future. Many factors or combinations of factors can contribute to disease emergence and outbreaks. New infectious diseases can emerge from genetic changes in existing organisms; known diseases can spread to new geographic areas and populations; and previously unknown diseases can appear in humans living or working in changing ecologic conditions that increase their exposure to insect vectors, animal reservoirs, or environmental sources of novel pathogens. A good example is the emergence of the severe acute respiratory syndrome (SARS). SARS is a viral respiratory illness caused by a coronavirus (SARS-CoV). SARS was recognized as a global threat in March 2003, after first appearing in Southern China in November 2002. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia. Although the 2003 global outbreak was contained, person-to-person transmission of SARS-CoV may recur. Although there is no evidence that direct contact with civets or other wild animals from live-food markets has led to cases of SARS, viruses very similar to SARS-CoV have been found in these animals. In addition, some persons working with these animals have evidence of infection with SARS-CoV or a very similar virus.

Reemergence can occur because of the development of antimicrobial resistance in existing infections (e.g., gonorrhea, malaria, and pneumococcal disease) or breakdowns in public health measures for previously controlled infections (e.g., cholera, tuberculosis, and pertussis).

Travelers should be aware of the occurrence of any disease outbreaks in their international destinations. Current travel notices on diseases of international concern are posted on the Travelers' Health home page on the CDC website at www.cdc.gov/travel/.

CDC issues different types of notices for international travelers. As of May 20, 2004, these definitions were refined to make the announcements more easily understood by travelers, health-care providers, and the general public. Each type of notice describes the level of risk for the traveler and recommended preventive measures. Guidance is posted on the CDC Travelers' Health website as outbreaks occur, in four levels:

• In The News, the lowest level of notice, will provide information about sporadic cases of disease or an occurrence of a disease of public health significance affecting a traveler or travel destination. The risk for an individual traveler does not differ from the usual risk in that area.


• Outbreak Notice provides information about a disease outbreak in a limited geographic area or setting. The risk to travelers is defined and limited, and the notice will remind travelers about standard or enhanced travel recommendations, such as vaccination.


• Travel Health Precaution provides specific information to travelers about a disease outbreak of greater scope and over a larger geographic area so they can take measures to reduce the risk of infection. The precaution also provides guidance to travelers about what to do if they become ill while in the area. CDC does not recommend against travel to a specific area but may recommend limiting exposure to a defined setting, such as poultry farms or health-care settings.


• Travel Health Warning recommends against nonessential travel to an area because a disease of public health concern is expanding outside the areas or populations that were initially affected. The purpose of a travel warning is to reduce the volume of traffic to affected areas, thus limiting the risk of spreading the disease to unaffected areas.