Health
Information for Travelers to East Asia
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China,
Hong Kong S.A.R. (China), Japan, Democratic People's Republic
of Korea (North), Republic of Korea (South), Macao S.A.R.
(China), Mongolia, Taiwan
NOTE:
Please check the Outbreaks
section for updates on these and other countries. |
![Map of East Asia](/peth04/20041027162518im_/http://www.cdc.gov/travel/images/maps/easia.gif) |
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The preventive measures you need to take while traveling in East
Asia depend on the areas you visit and the length of time you stay.
You should observe the precautions listed in this document in most
areas of this region. However, in highly developed areas of Japan,
Hong Kong, South Korea, and Taiwan, you should observe
health precautions similar to those that would apply while traveling
in the United States.
Travelers diarrhea,
the number one illness in travelers, can be caused by viruses, bacteria,
or parasites, which can contaminate food or water. Infections may
cause diarrhea and vomiting (E. coli, Salmonella,
cholera, and parasites),
fever (typhoid fever
and toxoplasmosis), or liver damage (hepatitis). Make sure your
food and drinking water are safe. (See
below.)
Malaria is a serious, but preventable
infection that can be fatal. Prevent this deadly disease by seeing
your health care provider for a prescription
antimalarial drug and by protecting yourself against mosquito
bites (see below). Travelers to some areas
in China, Hong Kong S.A.R. (China), North Korea, and South Korea
may be at risk for malaria. Travelers to malaria-risk areas in China,
North Korea, and South Korea should take an antimalarial drug. The
risk of malaria in Hong Kong S.A.R. is so limited that taking an
antimalarial drug is not recommended. There is no risk of malaria
in Japan, Taiwan, Macao S.A.R. (China), and Mongolia. For additional
information on malaria in East Asia, malaria-risk area and antimalarial
drugs, see Malaria
Information for Travelers to East Asia. See also Preventing
Malaria in the Pregnant Woman (Information for the Public)
and Preventing Malaria in Infants
and Children (Information for the Public).
Dengue, filariasis,
Japanese encephalitis, leishmaniasis,
and plague are diseases
carried by insects that also occur in this region. Protecting yourself
against insect bites (see below)
will help to prevent these diseases.
If you visit the Himalayan Mountains, ascend gradually to allow
time for your body to adjust to the high altitude, which can cause
insomnia, headaches, nausea, and altitude sickness. In addition,
use sunblock rated at least SPF 15, because the risk of sunburn
is greater at high altitudes.
There is no risk for yellow fever in East Asia. A certificate
of yellow
fever vaccination may be required for entry into certain of
these countries if you are coming from countries in South America
or sub-Saharan Africa. For detailed information, see Comprehensive
Yellow Fever Vaccination Requirements. Also, find the nearest
authorized
U.S. yellow fever vaccine center.
CDC recommends
the following vaccines (as appropriate for age):
See your doctor at least 46 weeks before your trip to allow
time for shots to take effect.
- Hepatitis A or immune
globulin (IG), except travelers to Japan.
- Hepatitis B, if you
might be exposed to blood (for example, health-care workers),
have sexual contact with the local population, stay longer than
6 months, or be exposed through medical treatment.
- Japanese encephalitis, only
if you plan to visit rural areas for 4 weeks or more, except under
special circumstances, such as a known outbreak of
Japanese encephalitis.
- Rabies, if you might
be exposed to wild or domestic animals through your work or recreation.
- Typhoid, particularly
if you are visiting developing countries in this region.
- As needed, booster doses for
tetanus-diphtheria and measles.
Hepatitis B vaccine is
now recommended for all infants and for children ages 1112
years who did not receive the series as infants.
All travelers
should take the following precautions, no matter the destination:
- Wash hands often with soap and water.
- Because motor vehicle crashes are a leading cause of injury
among travelers, walk and drive defensively. Avoid travel at night
if possible and always use seat belts.
- Always use latex condoms to reduce the risk of HIV and other
sexually transmitted diseases.
- Dont eat or drink dairy products unless you know they
have been pasteurized.
- Dont share needles with anyone.
- Eat only thoroughly cooked food or fruits and vegetables you
have peeled yourself. Remember: boil it, cook it, peel it,
or forget it.
- Never eat undercooked ground beef and poultry, raw eggs, and
unpasteurized dairy products. Raw shellfish is particularly dangerous
to persons who have liver disease or compromised immune systems.
Travelers
visiting undeveloped areas should take the following precautions:
To stay healthy,
do...
- Drink only bottled or boiled water, or carbonated (bubbly)
drinks in cans or bottles. Avoid tap water, fountain drinks, and
ice cubes. If this is not possible, make water safer by BOTH filtering
through an absolute 1-micron or less filter AND adding
iodine tablets to the filtered water. Absolute 1-micron
filters are found in camping/outdoor supply stores.
- If you visit an area where there is risk for malaria,
take your malaria prevention
medication before, during, and after travel, as directed.
(See your doctor for a prescription.)
- Protect yourself from mosquito bites:
- Pay special attention to mosquito protection between dusk
and dawn. This is when the type of mosquito whose bite transmits
malaria is active.
- Wear long-sleeved shirts, long pants, and hats.
- Use insect repellents that contain DEET
(diethylmethyltoluamide).
- Read and follow the directions and precautions on the product
label.
- Apply insect repellent to exposed skin.
- Do not put repellent on wounds or broken skin.
- Do not breathe in, swallow, or get into the eyes (DEET is
toxic if swallowed). If using a spray product, apply DEET
to your face by spraying your hands and rubbing the product
carefully over the face, avoiding eyes and mouth.
- Unless you are staying in air-conditioned or well-screened
housing, purchase a bed
net impregnated with the insecticide permethrin or deltamethrin.
Or, spray the bed net with one of these insecticides if you
are unable to find a pretreated bed net.
- DEET may be used on adults, children, and infants older
than 2 months of age. Protect infants by using a carrier draped
with mosquito netting with an elastic edge for a tight fit.
- Children under 10 years old should not apply insect repellent
themselves. Do not apply to young children’s hands or
around eyes and mouth.
- For details on how to protect yourself from insects and
how to use repellents, see Protection against
Mosquitoes and Other Arthropods.
- If you are visiting friends and relatives in your home
country in areas where malaria occurs, please read the malaria
prevention recommendations for recent immigrants on the
CDC malaria site.
- To prevent fungal and parasitic infections, keep feet clean
and dry, and do not go barefoot.
To avoid
getting sick...
- Dont eat food purchased from street vendors.
- Dont drink beverages with ice.
- Dont handle animals (especially monkeys, dogs, and cats),
to avoid bites and serious diseases (including
rabies and plague).
(For more information, please see Animal-Associated
Hazards.)
- Dont swim in fresh water (except for well-chlorinated
swimming pools) in certain areas of China (southeast, east, and
Yangtze River valley) to avoid infection with schistosomiasis.
Salt water is usually safer. (For more information, please see
Swimming and Recreational
Water Precautions.)
What you
need to bring with you:
- Long-sleeved shirt, long pants, and a hat to wear while outside
whenever possible, to prevent illnesses carried by insects.
- Insect repellent containing DEET.
- Bed nets impregnated with permethrin. (Can be purchased in camping
or military supply stores. Overseas, permethrin or another insecticide,
deltamethrin, may be purchased to treat bed nets and clothes.)
- Flying-insect spray or mosquito coils to help clear rooms of
mosquitoes. The product should contain a pyrethroid insecticide;
these insecticides quickly kill flying insects, including mosquitoes.
- Over-the-counter antidiarrheal medicine to take if you have
diarrhea.
- Iodine tablets and water filters to purify water if bottled
water is not available. See Dos
above for more detailed information about water filters.
- Sunblock, sunglasses,
hat.
- Prescription medications: make sure you have enough to last
during your trip, as well as a copy of the prescription(s).
After you
return home:
If you have visited a malaria-risk area in East Asia, continue
taking your antimalarial drug for 4 weeks (chloroquine, doxycycline,
or mefloquine) or 7 days (atovaquone/proguanil) after leaving the
risk area.
Malaria is always a serious disease and may be a deadly
illness. If you become ill with a fever or flu-like illness
either while traveling in a malaria-risk area or after you return
home (for up to 1 year), you should seek immediate
medical attention and should tell the physician your travel history.
For more
information:
Ask your doctor or check the CDC web sites for more information
about how to protect yourself against diseases that occur in East
Asia, including the following:
Diseases carried by insects |
Diseases carried in food or water |
Diseases from person-to-person contact |
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