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Adventure Land Travel
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RESERVATIONS
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Outbreaks
Information on outbreaks of concern to
international travelers.
Diseases
Information about specific diseases that can
affect travelers.
Vaccinations
CDC’s vaccination recommendations for
travelers of all ages.
Safe Food and Water
How to avoid illness from food or
water.
Traveling with Children
What to do before taking children to other
countries.
Special Needs Travelers
Health Information for travelers with special
needs such as disabilities, pregnancy and breast-feeding, and HIV.
Cruise Ships and Air Travel
Health information on specific cruise ships.
Includes inspection scores ("green sheets") by
CDC’s Vessel Sanitation Program (VSP).
Health Reference Materials
Includes useful health resources such as the
CDC book Health Information for International Travel (the
"Yellow Book"), the "Blue Sheet," and links to
other related sites.
For CDC information on diseases of a specific location, check the Destinations section and the biweekly Summary of Health Information for International Travel (the “Blue Sheet”).
For more CDC information on diseases and other health topics, see the Health Topics A to Z page.
Health risks and precautions: general considerations
People in their home environment live in a
state of equilibrium with the locally occurring strains of
microorganisms and with the altitude and climatic conditions of
the region. However, this is an unstable equilibrium that can be
upset even in the home environment by factors such as the arrival
of an unfamiliar microorganism, seasonal changes in climate and
unusually stressful situations. The many physical and
environmental changes encountered during international travel may
upset this equilibrium to an even greater extent: sudden exposure
to significant changes in altitude, humidity, microbial flora,
sunlight and temperature, exacerbated by stress and fatigue, may
result in ill-health and an inability to achieve the purpose of
the journey. The health risks associated with international
travel are influenced by characteristics of the traveler
(including age, sex and health status) and by characteristics of
the travel (including destination, purpose and duration).
Forward planning, appropriate preventive measures and careful
precautions can substantially reduce the risks of adverse health
consequences. Although the medical profession and the travel
industry can provide a great deal of help and advice, it is the
traveler's responsibility to ask for information, to understand
the risks involved, and to take the necessary precautions for the
journey.
Travel - Health related risks
Key factors in determining the health risks to which travelers may be exposed are:
Medical consultation before travel
Travelers intending to visit a destination in a
developing country should consult a travel medicine clinic or
medical practitioner before the journey. This consultation should
preferably take place 4–6 weeks before the journey,
particularly if vaccination(s) may be required. However,
last-minute travelers can also benefit from a medical
consultation, even as late as the day before travel. This
consultation will determine the need for any vaccinations and/or
antimalarial medication, as well as any other medical items that
the traveler may require. A basic medical kit will be prescribed
or provided, supplemented as appropriate to meet individual
needs.
A dental check-up is advisable before travel to developing
countries or prolonged travel to remote areas. This is
particularly important for people with chronic or recurrent
dental problems.
Assessment of health risks associated with travel
Medical advisers base their recommendations,
including those for vaccinations and other medication, on an
assessment of risk for the individual traveler, which takes into
account the likelihood of catching a disease and how serious this
might be for the traveler concerned. Key elements of this risk
assessment are the destination, duration and purpose of the
visit, as well as the conditions of accommodation and the health
status of the traveler.
For each disease being considered, an assessment is also made
of:
— availability of prophylaxis, possible side-effects and
suitability for the traveler concerned;
— any associated public health risks (e.g. the risk of
infecting others).
Collecting the information required to make a risk assessment
involves detailed questioning of the traveler. A checklist or
protocol is useful to ensure that all relevant information is
obtained and recorded. The traveler should be provided with a
personal record of the vaccinations given (patient-retained
record) as vaccinations are often administered at different
centers.
Medical kit and toilet items
Sufficient medical supplies should be carried
to meet all foreseeable needs for the duration of the trip.
A medical kit should be carried for all destinations where there
may be significant health risks, particularly those in developing
countries, and/or where the local availability of specific
medications is not certain. This kit will include basic medicines
to treat common ailments, first-aid articles, and any special
medical items that may be needed by the individual traveler.
Certain categories of prescription medicine should be carried
together with a medical attestation, signed by a physician,
certifying that the traveler requires the medication for personal
use. Some countries require not only a physician but also the
national health administration to sign this certificate.
All medicines should be carried in the hand luggage to minimize
any risk of loss during the journey. A duplicate supply carried
in the checked luggage is a safety precaution in case of loss or
theft.
Toilet items should also be carried in sufficient quantity for
the entire visit unless their availability at the travel
destination is assured. These will include items for dental care,
eye care including contact lenses, skin care and personal
hygiene.
Additional health items according to destination and individual needs:
other items to meet foreseeable needs, according to the destination and duration of the visit
Health and Age
Infants and young children have special needs
with regard to vaccinations and antimalarial precautions. They
are particularly sensitive to ultraviolet radiation and become
dehydrated more easily than adults in the event of inadequate
fluid intake or loss of fluid due to diarrhea. A child can be
overcome by dehydration within a few hours. Air travel may cause
discomfort to infants ears due to changes in cabin air pressure
and is contraindicated for infants less than 7 days old. Infants
and young children are more sensitive to sudden changes in
altitude. They are also more susceptible to many infectious
diseases.
Advanced age is not necessarily a contraindication for travel if
the general health status is good. Elderly people should seek
medical advice before planning long-distance travel.
Pregnancy
Travel is not generally contraindicated during
pregnancy until close to the expected date of delivery, provided
that the pregnancy is uncomplicated and the woman's health is
good. Airlines impose some travel restrictions in late pregnancy
and the neonatal period.
There are some restrictions on vaccination during pregnancy:
Pregnant women risk serious complications if they contract
malaria. Travel to malaria-endemic areas should be avoided during
pregnancy if at all possible. Specific recommendations for the
use of antimalarial drugs during pregnancy are given in.
Medication of any type should be taken during pregnancy only in
accordance with medical advice.
Travel to high altitudes or to remote areas is not advisable
during pregnancy.
Disability
Physical disability is not usually a contraindication for travel if the general health status is good. Airlines have regulations on the conditions for travel for disabled passengers who need to be accompanied. Information should be obtained from the airline in advance.
Pre-existing illness
People suffering from chronic illnesses should seek medical advice before planning a journey. Conditions that increase health risks during travel include:
