Travel Health Notices
Stay aware of current health issues in Japan in order to advise your patients on additional steps they may need to take to protect themselves.
Warning Level 3, Avoid Nonessential Travel
- Global COVID-19 Pandemic Notice April 20, 2020 Widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring globally. CDC recommends that travelers avoid all nonessential international travel.
- COVID-19 and Cruise Ship Travel April 20, 2020 CDC recommends that travelers defer all cruise travel worldwide.
Alert Level 2, Practice Enhanced Precautions
- Rubella in Japan April 20, 2020 There is an outbreak of rubella in Japan. Travelers to Japan should make sure they are vaccinated against rubella with the MMR (measles, mumps, and rubella) vaccine before travel.
The following diseases are possible risks your patients may face when traveling in Japan. This list is based on our best available surveillance data and risk assessment information at the time of posting. It is not a complete list of diseases that may be present in a destination. Risks may vary within different areas of a destination.
Airborne & Droplet
|H5N1 Avian Influenza||
Counsel your patients on actions they can take on their trip to stay healthy and safe.
Counsel travelers to take standard precautions against bug bites, including use of an appropriate insect repellent.
More Information on Insect Repellents
DEET (concentration of 20% or more) is the only insect repellent shown to be effective against ticks. However, several EPA-registered active ingredients provide reasonably long-lasting protection against mosquitoes:
- DEET (chemical name: N,N-diethyl-m-toluamide or N,N-diethyl-3-methyl-benzamide): Concentrations above 50% show no additional protective benefit.
- Picaridin (KBR 3023 [Bayrepel] and icaridin outside the United States; chemical name: 2-(2-hydroxyethyl)-1-piperidinecarboxylic acid 1-methylpropyl ester): Must be reapplied more often than DEET.
- Oil of lemon eucalyptus (OLE) or PMD (chemical name: para-menthane-3,8-diol), the synthesized version of OLE. “Pure” oil of lemon eucalyptus (essential oil) is not the same product; it has not undergone similar testing for safety and efficacy, is not registered with EPA as an insect repellent, and is not covered by this recommendation.
- IR3535 (chemical name: 3-[N-butyl-N-acetyl]-aminopropionic acid, ethyl ester).
Products with <10% active ingredient may offer only limited protection (1–2 hours).
Encourage patients to use repellents and reapply only as instructed. If sunscreen is also needed, they should apply sunscreen first and repellent second. Encourage them to follow package directions for using repellent on children and avoid applying to their hands, eyes, and mouth.
For more detailed information, visit the Yellow Book: Protection against Mosquitoes, Ticks, & Other Insects & Arthropods
- Using Insect Repellents Safely (EPA)
- Insect Repellent Use and Safety (CDC)
- National Pesticide Information Center
Advise travelers to exercise caution during outdoor activities. Important tips include dressing appropriately for the climate (such as loose, lightweight clothing in hot climates and warm layers in cold climates), staying hydrated, avoiding overexposure to the sun, and practicing safe swimming habits.
Encourage travelers to learn basic first aid and CPR before travel, especially if they will be traveling to remote areas where medical assistance may not be accessible. Help them assemble a travel health kit.
Counsel travelers to be cautious around all animals.
- Travelers could be at risk for injuries from domestic animals such as dogs or cats, even in industrialized countries.
- The best course of action is to avoid touching, petting, handling, or feeding animals, including pets.
- Arthropods such as spiders and scorpions can pose a stinging risk, and travelers should exercise care in environments where these creatures are likely to be present.
- Stress the urgency of treating suspected and probable rabies infection by:
- Washing the wound immediately with soap and clean water.
- Seeking medical attention as soon as possible.
People who are ill should not travel. Urge travelers to practice hand hygiene and sneeze into a tissue or their sleeve.Hide
Counsel travelers on the risks of diseases associated with the exchange of saliva, blood, vomit, semen, urine, and feces.
- Use a latex condom correctly every time they engage in sex (vaginal, anal, and oral-genital).
- Not inject drugs.
- Limit alcohol consumption.
- Not have tattoos, piercings, or other procedures that use needles (acupuncture) unless the needles are packaged new or sterilized.
- Ensure that medical and dental equipment is sterile or disinfected if seeking care.
Additional Resources:HIV & AIDS (YB)
Hepatitis B (YB)
Hepatitis C (YB)
Medical Tourism (YB) Hide
Travelers should plan for how to obtain health care during their trip, should the need arise.
Discuss supplemental travel health insurance and medical evacuation insurance, and consider helping the traveler obtain an extra month of prescriptions for any needed medications.
Extended Stay/Study Abroad
People spending prolonged periods abroad are at increased risk of illness and injury that requires local medical care. Emphasize the need for these travelers to buy travel health and medical evacuation insurance.Hide
Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.
Most recommendations for safe transportation are basic and could be considered common sense. However, travelers often do not think about the importance of being aware and careful when walking, riding, driving, or flying. Counsel travelers to think about transportation options before they arrive, especially if they will be driving in Japan.
Some basic reminders to review with your patients:
- Choose safe vehicles and avoid motorbikes when possible.
- Wear a seatbelt or a helmet at all times.
- Do not drive after drinking alcohol or ride with someone who has been drinking.
- If they will be driving, remind them to get any driving permits and insurance they may need. It is recommended to get an International Driving Permit (IDP).
- Avoid using local, unscheduled aircraft, and fly on larger planes (more than 30 seats) when possible.
Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, Auto Insurance, and other resources.
Remind your patients that traffic flows on the left side of the road in Japan. Encourage them to pay close attention to the flow of traffic, especially when crossing the street.
Extended Stay/Study Abroad
Patients who will be living or studying abroad may be considering purchasing a bicycle, vehicle, or motorbike. Counsel them to make sure they have the appropriate permits and insurance.
Remind students that crashes involving in-country travel are a major cause of injury to people studying abroad, so they need to be diligent about finding and using safe modes of travel. (Refer to guidance on traveler pages of the website.)Hide
Travelers should be reminded on how to protect their personal safety during travel, regardless of their destination.
The US Department of State has an extensive website with safety information for international travelers, travel alerts and warnings, and country-specific information. Travelers should be directed to the Department of State resources for information and tips on safe travel.
Stay abreast of current events, particularly those that could pose a safety or health problem for travelers. You can also receive updates on new travel alerts and warnings from the US Department of State by subscribing to their RSS feeds.
Extended Stay/Study Abroad
Students are at risk for heavy drinking. Counsel students on alcohol and drug safety abroad. Emphasize the need to understand and abide by local drug and alcohol laws.
Guide patients to the Students Abroad website from the US Department of State, which has excellent information and resources specifically for study-abroad travel.Hide
Healthy Travel Packing List
Remind your patients to pack health and safety items. Use the Healthy Travel Packing List for Japan for a list of health-related items they should consider packing.
Advising Returning Travelers
Although some illnesses may begin during travel, others may occur weeks, months, or even years after return. A history of travel, particularly within the previous 6 months, should be part of the routine medical history for every ill patient. A newly returned, ill international traveler should be preferentially evaluated by a physician versed in travel-related illness.
Here are two professional medical organizations that provide directories of travel clinics throughout the United States:
- American Society of Tropical Medicine and Hygiene (ASTMH)
- International Society of Travel Medicine (ISTM)
For more information on advising patients after international travel, see Yellow Book Chapter 5: Post-Travel Evaluation.
Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.