This notice provides general advice from the Centers for Disease Control and Prevention (CDC) to international travelers about preparedness for a natural or manmade disaster that could potentially contribute to injury or disease transmission during travel. Recommendations are included for measures to reduce any related health risk.
Before Travel
- Visit the U.S. Department of State website (http://travel.state.gov/) to learn about conditions abroad that may affect your safety and security in the area you will be visiting. Consider postponing nonessential travel if conditions are unsafe.
- Register with the State Department’s travel registration website (https://travelregistration.state.gov/ibrs/), so the U.S. Embassy or Consulate in the country you will be visiting is aware of your whereabouts in case it is necessary for a consular officer to contact you in an emergency. This registration is especially important if you plan to stay abroad for longer than 1 month or will be visiting a country that has an unstable political climate or is undergoing a natural disaster, such as an earthquake or hurricane.
- Visit CDC's Travelers' Health website at http://wwwn.cdc.gov/travel to educate yourself and others who may be traveling with you about any disease risks and CDC health recommendations for travel in areas you plan to visit. CDC issues four levels of notices about disease activity abroad: 1) In the News, 2) Outbreak, 3) Travel Health Precaution, and 4) Travel Health Warning (the only notice that recommends against nonessential travel).
- Be sure you are up to date with all your routine vaccinations (i.e., measles, mumps, rubella, tetanus, diphtheria, polio), and see your doctor or health-care provider, ideally 4-6 weeks before travel, to get any additional vaccinations, medications, or information you may need.
- Prepare and bring with you in your* baggage a travel health kit that includes any medications you may be taking, including a back-up supply; an antidiarrheal medication; alcohol-based hand gel (containing at least 60% alcohol); an antibiotic for self-treatment of most causes of acute bacterial illness; a thermometer; and insect repellent containing DEET.
- Familiarize yourself with basic first aid so you can self-treat minor injuries should they occur.
- Identify in-country health-care resources in advance of your trip. The U.S. Department of State has a List of Doctors/Hospitals Abroad. The U.S. embassy or consulate of your travel destination may also be able to assist in locating these resources. Several private travel medicine organizations provide assistance in locating medical care abroad, see Seeking Health Care Abroad in Health Information for International Travel .
- Check your health insurance plan or get additional insurance that covers medical evacuation in case you become sick or injured. Information about medical evacuation services is provided on the U.S. Department of State web page, Medical Information for Americans Traveling Abroad, at http://travel.state.gov/travel/tips/health/health_1185.html.
- Check the Transportation Security Administration website (http://www.tsa.gov/index.shtm) about updates on permitted and prohibited items, including medications that you are allowed to carry onto an airplane.
- Make extra copies of your passport and travel documents that you can leave with a family member or friend, as well as details of your travel plans and how to contact you. Also, make arrangements to check in with your employer, a trusted colleague or family or friends at regular intervals.
- Place extra copies of your passport and travel documents in separate parts of your baggage, in case you lose the original documents.
During Travel
To reduce your risk of illness
- Eat only food that has been fully cooked or fruits and vegetables that you yourself have washed and peeled.
- Drink only bottled or boiled water or carbonated (bubbly) drinks from sources you trust. Do not drink tap water or fountain drinks, or add ice cubes to beverages.
- Do not touch animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). In areas with avian influenza (bird flu), avoid poultry farms, bird markets, and other places where live poultry is raised or kept.
- Wash your hands often with soap and water. If soap and water are not available and your hands are not visibly dirty, use alcohol-based hand gel (containing at least 60% alcohol) to clean your hands.
- If visiting an area where you might get malaria, use insect repellent and a mosquito net for sleeping and make sure to take your malaria prevention medication before, during, and after your trip, as directed.
For your safety
- Do not drink and drive; wear your safety belt and place children in age-appropriate restraints in the back seat; follow the local customs and laws regarding pedestrian safety and vehicle speed; use helmets on bikes, motorcycles, and motor bikes. Be aware of the cultural impact of being involved in, or causing an accident that includes injury to indigenous populations. In unfamiliar or foreign environments, utilize a local driver.
- Be aware of your surroundings and travel with a companion where possible. If traveling alone, tell someone you trust about your whereabouts each day.
- Always carry your passport and travel documents with you (in a water-tight packet).
- Bring a flashlight with extra batteries in case there is loss of electricity in your surroundings.
If a disaster occurs while you are traveling
- Follow the instructions of emergency responders.
- Notify family, friends, a trusted colleague or your employer as soon as possible after involvement in a disaster to advise them of your status.
- If you are injured or sick, see a doctor or get medical care. A U.S. consular officer can assist you in locating medical services and informing your family or friends.
- Clean any wound or rash immediately with soap and clean water to reduce risk of an infection.
- If you are bitten or scratched by any animal, clean the wound well with large amounts of soap and water and a povidone-iodine solution, if available, and get medical attention right away.
- See a doctor or get medical care if you develop diarrhea plus a high fever or bloody diarrhea.
- Replace lost body fluids that can occur with diarrhea by drinking clean water or use oral rehydration solutions for severe diarrhea.
- If you are visiting a malaria risk area and become sick with a fever or flu-like illness, get immediate medical attention.
- If you are seriously ill, evacuation may be necessary to other parts of a country or outside the country to receive adequate medical care.
- Be aware of the dangers from carbon monoxide that can be produced by portable generators, fires, and other emissions (http://www.cdc.gov/co/default.htm).
In areas with flooding, wind damage, or structural damage
- Avoid any downed power lines, particularly those in water. Avoid wading in standing water, which may contain glass or metal fragments.
- If available, wear sturdy footwear to protect your feet from widespread debris in these areas.
- Avoid swiftly flowing water. If you enter swiftly flowing water, you risk drowning, regardless of your ability to swim. Swiftly moving shallow water can be deadly, and shallow standing water can be dangerous, especially for small children. Cars or other vehicles do not provide adequate protection from flood waters. Cars can be swept away or may break down in moving water.
- In areas affected by an earthquake, if an aftershock is occurring,
- Evacuate outside immediately.
- Drop, cover and hold on! Minimize movements.
- If you are struck or trapped by rubble, internal injuries may not be evident, but can be serious or life-threatening. In such cases, call for immediate medical care or first aid assistance.
- Stop a bleeding injury by applying direct pressure to the wound.
- If you are trapped, try to attract attention to your location by using a whistle or making noise. If dust is around you, shout as a last resort, since this can cause you to inhale large amounts of dust.
After Travel
On return from areas affected by a disaster, if you are not feeling well or have been injured, get medical attention, including psychological support and counseling, if necessary.
- It is especially important for you to get health care if you have a fever, rash, cough or difficulty breathing, or any other unusual symptoms.
If you are returning from areas with malaria and become sick with a fever or flu-like illness (for up to 1 year), get immediate medical attention and be sure to tell the doctor or health-care provider your travel history.
For more information:
Natural Disasters and Environmental Hazards in Health Information for International Travel
Health Recommendations for Relief Workers Responding to a Disaster:
http://wwwn.cdc.gov/travel/contentReliefWorkers.aspx
CDC’s Emergency Preparedness and Response website: http://www.bt.cdc.gov/
*Check the Transportation Security Administration website (http://www.tsa.gov/index.shtm) about carry-on baggage permitted items, including medications.
