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About
the Yellow Book
Introduction
to Health Information for International Travel 2003-2004
This book is published by the Division of Global Migration and Quarantine,
National Center for Infectious Diseases, Centers for Disease Control and
Prevention (CDC), as a reference for those who advise international travelers
about health risks. It is written primarily for health-care providers,
although it is also used by others who advise travelers, such as travel
agencies, airlines, cruise lines, missionary organizations, and academic
institutions. Those who are not medical professionals may find the Travelers’
Health web page and Fax Information Service to be more user-friendly.
Sources of
Travel Health Information from CDC
- The hard copy of this book provides the complete text with the convenience
of a paperback reference. Because it is updated biennially, it cannot
remain completely current. Relevant websites have been included throughout
the book to aid readers in finding the most up-to-date information.
- The online version, found on the CDC Internet website at http://www.cdc.gov/travel/yb/index.htm,
will be updated more frequently when indicated by important changes
in disease distribution or preventive measures. The online text is searchable
by destination country, disease, vaccination, special needs, and other
topics.
- The CDC Travelers’ Health home page, http://www.cdc.gov/travel,
is updated frequently and contains links to the online Yellow Book,
updates about recent outbreaks, information sheets on diseases, information
about cruise ships (green sheets), and other helpful links. Notices
about disease outbreaks, emerging infections, and changes in vaccine
requirements or medications are posted promptly.
- Regional and disease-specific documents may be requested from the
CDC Fax Information Service at 1-888-CDC-FAXX (1-888-232-3299); the
directory of international travel documents is available by request
from the same number.
Other Sources
of Information for Healthy Travel
- The International Society of Travel Medicine at http://www.istm.org/
- The American Society of Tropical Medicine and Hygiene at http://www.astmh.org/.
Both these websites include directories of travel clinics throughout
the United States.
- The World Health Organization (WHO), web address at http://www.who.int/,
provides general information, as well as disease surveillance data worldwide.
- For travelers visiting countries in the Western Hemisphere, the Pan
American Health Organization (PAHO), a regional office of the WHO, has
a website at http://www.paho.org
that includes country-specific information about many health issues.
- A valuable resource for country information is the U.S. Central Intelligence
Agency’s website at
http://www.cia.gov/cia/publications/index.html
(select “World Factbook”).
Determinants
of Individual Travelers’ Health Needs
In general, the risk of becoming ill during international travel depends
on the regions of the world visited, the types of destinations within
a country, season of travel, individual factors, and diligence in use
of protective measures.
- Travelers to low-income countries are at greater risk than those who
travel to developed areas. In most developed countries (e.g., Canada,
Australia, New Zealand, Japan, and Western Europe), the risk to the
general health of the traveler is no greater than that incurred in the
United States. On the other hand, living conditions, standards of sanitation
and hygiene, immunization coverage, and thus risk of disease vary considerably
throughout the developing world.
- Travelers visiting primarily urban tourist areas have a lower risk
for exposure to contaminated food or water. In contrast, travelers who
explore beyond the usual tourist routes or who spend extended periods
of time in small villages or rural areas are at greater risk for acquiring
infectious diseases because of exposure to potentially contaminated
water and food and close contact with local residents who might not
appear ill but still might harbor diseases to which the traveler is
susceptible. Consequently, additional vaccines, booster doses of childhood
vaccines, or other prophylaxis is recommended for such travelers.
- Host susceptibility factors can play an important role in determining
risk for acquiring illness during international travel. Travelers at
the extremes of age (young children and the elderly), pregnant women,
or immunocompromised (e.g., HIV-infected) persons are particularly vulnerable
to certain infectious diseases.
Pre-Travel Measures
for Healthy Travel
- International travelers should be advised to contact their physicians,
local health departments, or private or public agencies that advise
international travelers at least 6 weeks before departure for current
health information on the countries they plan to visit and to obtain
vaccinations and prophylactic medications as indicated. See Chapter
3, “Specific Recommendations for Vaccinations and Disease Prevention”
for more detailed comments.
- Travelers who may be more susceptible to certain travel-related illnesses
(e.g., immunocompromised or pregnant travelers) are strongly advised
to contact physicians with special expertise in travel medicine at least
6 weeks before departure, especially if their itinerary includes high-risk
destinations.
Introductory
Matter from the Printed Version of the Yellow Book 2003-2004
The front matter from the 2003-2004 printed edition, pages iii-vi, x-xii,
xv-xviii, and xxvi-xxvii, is included here.
Front Matter, page 1
Front Matter, page 2
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